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Anxiety induced by cardiac perceptions in patients with panic attacks: a field study
P Pauli1, C Marquardt, L Hartl
1Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany.
Behaviour Research and Therapy
|January 1, 1991
Summary
Individuals with panic disorder experience a vicious cycle where they interpret bodily sensations, like increased heart rate, as catastrophic, leading to more anxiety and heart rate increases. This study confirms this panic attack model.
Area of Science:
- Psychophysiology
- Clinical Psychology
Background:
- Bodily sensations are key triggers for anxiety in panic disorder.
- A psychophysiological model suggests a vicious circle: catastrophic interpretation of heart rate increases anxiety, further raising heart rate.
Purpose of the Study:
- To evaluate the vicious circle model of panic attacks.
- To investigate the relationship between cardiac perceptions, anxiety, and heart rate changes in panic disorder patients.
Main Methods:
- A 24-hour ambulatory electrocardiogram (ECG) was used in a field study.
- Subjects (28 with panic attacks, 20 healthy controls) reported cardiac perceptions and associated anxiety.
- ECG data were analyzed for heart rate changes preceding and following reported perceptions.
Main Results:
- Cardiac perceptions occurred similarly in both groups; only panic disorder patients reported anxiety.
- Heart rate accelerations preceded cardiac perceptions in all subjects.
- Healthy controls showed heart rate deceleration post-perception, while panic disorder patients showed further acceleration.
- Increased heart rate post-perception correlated positively with reported anxiety levels.
Conclusions:
- The findings strongly support the vicious circle model of panic attacks.
- Catastrophic interpretation of bodily sensations significantly impacts heart rate and anxiety in panic disorder.