Measuring approach-avoidance behavior in patients with panic disorder using the human elevated plus maze in mixed...

Area of Science:

• Psychology
• Neuroscience
• Clinical Psychology

Background:

• Avoidance behavior is key in panic disorder (PD), but hard to study without specific threats.
• The human Elevated Plus Maze (EPM) in mixed reality offers a way to assess approach-avoidance.
• This paradigm allows ecologically valid measurement under controlled conditions.

Purpose of the Study:

• To investigate approach-avoidance behavior in PD patients versus healthy controls (HC).
• To assess subjective anxiety, physiological responses, and hormonal markers in relation to avoidance.
• To explore the role of trait factors like sensation seeking in avoidance behavior.

Main Methods:

• Twenty PD patients and 20 HC were tested on the human EPM.
• Approach-avoidance behavior, anxiety, tension, and cardiovascular responses were measured.
• Hormonal markers (copeptin, ACTH, cortisol) were analyzed in a subgroup.

Main Results:

• PD patients exhibited higher anticipatory anxiety, tension, and heart rate than HC.
• No significant differences in approach-avoidance behavior were found between PD patients and HC.
• Sensation seeking was the strongest inverse predictor of avoidance and anxiety; higher center anxiety predicted avoidance.

Conclusions:

• The human EPM effectively elicits anxiety responses, proving its translational value.
• Avoidance behavior is more influenced by trait factors (e.g., sensation seeking) than by PD diagnosis.
• Sensation seeking may be a protective trait; antidepressant use might reduce avoidance in PD, suggesting personalized treatment targets.