Original Article

Archives of Women's Mental Health

, Volume 15, Issue 6, pp 413-422

First online:

The role of menstrual cycle phase and anxiety sensitivity in catastrophic misinterpretation of physical symptoms during a CO2 challenge

  • Yael I. NillniAffiliated withDepartment of Psychology, University of VermontDepartment of Psychiatry and Human Behavior, University of Mississippi Medical Center Email author 
  • , Kelly J. RohanAffiliated withDepartment of Psychology, University of Vermont
  • , Michael J. ZvolenskyAffiliated withDepartment of Psychology, University of Houston

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The current study examined the interactive effects of anxiety sensitivity (AS; fear of anxiety and anxiety-related sensations) and menstrual cycle phase (premenstrual phase vs. follicular phase) on panic-relevant responding (i.e., cognitive and physical panic symptoms, subjective anxiety, and skin conductance level). Women completed a baseline session and underwent a 3-min 10 % CO2-enriched air biological challenge paradigm during her premenstrual and follicular menstrual cycle phases. Participants were 55 women with no current or past history of panic disorder recruited from the general community (M age = 26.18, SD = 8.9) who completed the biological challenge during both the premenstrual and follicular cycle phases. Results revealed that women higher on AS demonstrated increased cognitive panic symptoms in response to the challenge during the premenstrual phase as compared to the follicular phase, and as compared to women lower on AS assessed in either cycle phase. However, the interaction of AS and menstrual cycle phase did not significantly predict physical panic attack symptoms, subjective ratings of anxiety, or skin conductance level in response to the challenge. Results are discussed in the context of premenstrual exacerbations of cognitive, as opposed to physical, panic attack symptoms for high AS women, and the clinical implications of these findings.


Anxiety sensitivity Biological challenge Menstrual cycle Panic disorder Premenstrual phase