Intolerance of uncertainty and responsibility for harm predict nocturnal panic attacks

Area of Science:

• Psychology
• Clinical Psychology
• Sleep Medicine

Background:

• Nocturnal panic attacks are a common symptom in panic disorder, characterized by sudden awakenings with intense fear.
• The Fear of Loss of Vigilance (FLOV) theory posits that nocturnal panic stems from a fear of being unable to detect or respond to threats during sleep.
• Previous attempts to validate the FLOV theory using the Fear of Loss of Vigilance Questionnaire (FLOVQ) were inconclusive.

Purpose of the Study:

• To test the Fear of Loss of Vigilance theory of nocturnal panic using alternative self-report measures.
• To investigate whether nocturnal panickers exhibit heightened fears related to vigilance, threat detection, and self-protection during sleep.

Main Methods:

• A diverse community sample (N=218) completed validated self-report measures.
• Measures assessed panic attack frequency, intolerance of uncertainty (inhibitory and prospective), responsibility for harm, and anxiety sensitivity.
• Participants were categorized as nocturnal panickers or non-nocturnal panickers based on their symptom reports.

Main Results:

• Nocturnal panickers reported significantly higher levels of inhibitory intolerance of uncertainty compared to non-nocturnal panickers.
• Nocturnal panickers also endorsed greater responsibility for harm.
• No significant differences were found in prospective intolerance of uncertainty or anxiety sensitivity dimensions between the groups.

Conclusions:

• The findings provide empirical support for the Fear of Loss of Vigilance theory in explaining nocturnal panic.
• Intolerance of uncertainty and a heightened sense of responsibility for harm appear to be key psychological factors in nocturnal panic.
• Targeting these factors, specifically inhibitory intolerance of uncertainty and responsibility for harm, may be beneficial for treating nocturnal panic attacks.