Document Detail

Anxiety induced by cardiac perceptions in patients with panic attacks: a field study.
MedLine Citation:
PMID:  2021376     Owner:  NLM     Status:  MEDLINE    
In panic disorder bodily sensations appear to play an important role as a trigger for anxiety. In our psychophysiological model of panic attacks we postulate the following vicious circle: individuals with panic attacks perceive even quite small increases in heart rate and interpret these changes as being catastrophic. This elicits anxiety and a further increase in heart rate. To evaluate this model we conducted a field study of 28 subjects with panic attacks and 20 healthy controls. A 24 hr ambulatory ECG was recorded and the subjects were instructed to report any cardiac perceptions during this period and to rate the anxiety elicited by these perceptions. The incidence of cardiac perceptions was about the same in both groups, but only subjects with panic attacks reported anxiety associated with such perceptions. Analysis of the ECGs revealed that in both groups heart rate accelerations preceded cardiac perceptions. Following cardiac perceptions, the healthy controls showed a heart rate deceleration, whereas the subjects with panic attacks had a further acceleration. This heart rate increase after cardiac perceptions was positively related to the level of anxiety elicited by the perceptions. These results provide clear evidence in support of the vicious circle model of panic attacks.
P Pauli; C Marquardt; L Hartl; D O Nutzinger; R Hölzl; F Strian
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Behaviour research and therapy     Volume:  29     ISSN:  0005-7967     ISO Abbreviation:  Behav Res Ther     Publication Date:  1991  
Date Detail:
Created Date:  1991-05-30     Completed Date:  1991-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372477     Medline TA:  Behav Res Ther     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  137-45     Citation Subset:  IM    
Clinical Department, Max Planck Institute for Psychiatry, Munich, Germany.
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MeSH Terms
Anxiety Disorders / etiology*,  psychology
Awareness / physiology
Feedback / physiology
Heart Rate / physiology*
Models, Psychological

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