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Cognitive Aspects of Panic Attacks

Content, Course and Relationship to Laboratory Stressors

Published online by Cambridge University Press:  02 January 2018

D. Zucker*
Affiliation:
Laboratory for the Study of Behavioral Medicine, Psychiatry Department, Stanford University School of Medicine
C. B. Taylor
Affiliation:
Behavioral Medicine Program, Stanford University School of Medicine
M. Brouillard
Affiliation:
Behavioral Medicine Program, Psychiatry Department, Stanford University School of Medicine
A. Ehlers
Affiliation:
Fachbereich Psychologie, Marburg, West Germany
J. Margraf
Affiliation:
Fachbereich Psychologie Marburg, West Germany
M. Telch
Affiliation:
Department of Psychology, University of Texas
W. T. Roth
Affiliation:
Behavioral Medicine Program, Stanford University School of Medicine
W. S. Agras
Affiliation:
Behavioral Medicine Program, Stanford University School of Medicine
*
Behavioral Medicine Program, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA 94305-5490 USA

Abstract

Twenty patients with panic attacks and ten controls were given a standardised interview about thoughts occurring during times of anxiety or panic attacks. The interviewer was blind to the subject's diagnosis. The 20 panic patients underwent a psychophysiological test battery which included a cold pressor test, mental arithmetic task, and 5.5% CO2 inhalation. More patients than controls reported thoughts centred on fears of losing control and shame when anxious. Panic patients rated their thoughts as stronger and clearer than did controls and they had more difficulty excluding them from their minds. A feeling of anxiety preceded anxious thoughts in patients. This suggests that ‘faulty cognitions' are not the initial event in a panic attack, although anxious thoughts may exacerbate or maintain them. Significant correlations were found between the intensity of anxiety-related thoughts in anticipation of mental arithmetic and changes in diastolic blood pressure and heart rate during mental arithmetic.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington DC: APA.Google Scholar
Beck, A. T., Emery, G. D. & Greenberg, R. (1985) Anxiety Disorders and Phobias, a Cognitive Perspective. New York: Basic Books.Google Scholar
Beck, A. T., Laude, R. & Bohnert, M. (1974) Ideational components of anxiety neurosis. Archives of General Psychiatry, 31, 319325.CrossRefGoogle ScholarPubMed
Brouillard, M. (1988) Effects of behavioral, cognitive behavioral, and drug treatments on the catastrophic fears of agoraphobics. Unpublished dissertation, Stanford University.Google Scholar
Clark, D. M. (1986) A cognitive model of panic. Behaviour Research and Therapy, 24, 461470.CrossRefGoogle Scholar
Ehlers, A., Margraf, J. & Roth, W. T. (1988a) Interaction of expectancy effects and stressors in a laboratory model of panic. In Neurobiological Approaches to Human Disease (eds Hellhammer D., Florin I. & Weiner H.). Toronto: Huber.Google Scholar
Ehlers, A., Margraf, J. & Roth, W. T. (1988b) Selective information processing, interoception, and panic attacks. In Treatment of Panic and Phobias (eds Hand I. & Wittchen H. U.). Berlin: Springer.Google Scholar
Goldstein, A. J. & Chambless, D. L. (1978) A reanalysis of agoraphobia. Behavior Therapy, 9, 4759.Google Scholar
Gorman, J., Askanazi, J., Liebowitz, M., et al (1984) Response to hyperventilation in a group of patients with panic disorder. American Journal of Psychiatry, 141, 857861.Google Scholar
Hamilton, M. (1959) The assessment of anxiety state by ratings. British Journal of Medical Psychology, 32, 5055.Google Scholar
Hibbert, G. A. (1984) Ideational components of anxiety. British Journal of Psychiatry, 144, 618624.CrossRefGoogle ScholarPubMed
Horowitz, M. J., Simon, N., Holden, M., et al (1983) The stressful impact of news of risk for premature heart disease. Psychosomatic Medicine, 45, 3240.CrossRefGoogle ScholarPubMed
Lader, M. (1975) The Psychophysiology of Mental Illness. London: Routledge and Kegan Paul.Google Scholar
Ley, R. (1985) Agoraphobia, the panic attack and hyperventilation syndrome. Behaviour Research and Therapy, 23, 7981.CrossRefGoogle ScholarPubMed
Margraf, J., Ehlers, A. & Roth, W. T. (1986) Biological models of panic disorder and agoraphobia: a review. Behaviour Research and Therapy, 24, 553567.Google Scholar
Mathews, A. M., Gelder, M. G. & Johnston, D. W. (1981) Agoraphobia: Nature and Treatment. New York: Guilford Press.Google Scholar
Ottaviani, R. & Beck, S. T. (1987) Cognitive aspects of panic disorders. Journal of Anxiety Disorders, 1, 1528.Google Scholar
Rapee, R. (1985) Distinction between panic disorder and generalized anxiety disorder: clinical presentation. Australian and New Zealand Journal of Psychiatry, 19, 227232.CrossRefGoogle ScholarPubMed
Speilberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1970) State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press.Google Scholar
Spitzer, R. L. & Williams, J. B. (1983) Structured Clinical Interview for DSM-III. New York: New York State Psychiatric Institute.Google Scholar
Telch, M. J. (1984) Stanford Panic Appraisal Inventory. Unpublished scale, Stanford University.Google Scholar
Van den Hout, M. A. (1988) The explanation of experimental panic. In Panic: Psychological Perspectives (eds Rachman S. & Maser J. D.). Hillsdale, N. J.: Lawrence Erlbaum.Google Scholar
Ward, M. M., Mefford, I. N., Parker, D., et al (1983) Epinephrine and norepinephrine responses in continuously collected human plasma to a series of stressors. Psychosomatic Medicine, 45, 471486.CrossRefGoogle ScholarPubMed
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