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The Self-fulfilling Panic Prophecy: Anxiety-Related Control Attributions Uniquely Predict Reactivity to a 7.5 % CO2 Challenge

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Abstract

Theoretical models of panic disorder posit a unique role for external anxiety-related control attributions (i.e., lack of perceived control over the onset and maintenance of one’s anxiety symptoms) in predicting panic reactivity, even beyond well-established cognitive risk factors such as anxiety sensitivity. The present study examined whether anxiety-related control attributions would uniquely predict a range of anxious responses across multiple phases and sessions of a biological stressor. Undergraduate students (N = 317) completed measures of anxiety-related control attributions and anxiety sensitivity prior to undergoing a 7.5 % carbon dioxide (CO2) challenge. A subset of these participants (N = 102) returned 1 week later for a second administration. Self-reported subjective distress, physical panic symptoms, and panic-related threat cognitions were measured at baseline and again during several phases of the challenge procedure. Physiological measures of heart rate, skin conductance, and respiration rate were also recorded throughout the challenge. Consistent with theoretical models, higher external control attributions uniquely predicted greater reactivity on all self-report indices across challenge phases and sessions; findings were more mixed for the physiological indices, with higher external control attributions predicting higher heart rate but lower skin conductance, and no prediction for respiration rate. Implications for theory and treatment of panic pathology are discussed.

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Notes

  1. Note: History of panic attacks and panic symptoms was assessed at baseline (with 35 % of the sample reporting a history of at least one full or limited symptom panic attack on the Panic Disorder Severity Scale, modified for self-report (PDSS-SR; Houck et al. 2002); however, panic history was not included as an exclusionary criterion, given our desire to capture maximum variability in panic-relevant responding within our sample. Notably, the results of this study did not change when panic attack history (coded as a dichotomous “yes/no” variable) was included as a covariate. Full details of these analyses are available from the first author.

  2. The materials reported here are part of a larger, two-session study on predictors of responses to a CO2 challenge. A full list of measures is available from the first author.

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Acknowledgments

This study was funded by a National Institute of Mental Health grant to Dr. Roxann Roberson-Nay (K01MH080953) and a National Institute on Aging grant to Dr. Bethany Teachman (R01AG033033). Preliminary findings from these data were previously presented as posters at the Association for Behavioral and Cognitive Therapies (Gorlin et al. 2012a) and the Anxiety Disorders Association of America (Gorlin et al. 2012b; Beadel et al. 2012). The authors are thankful for the feedback provided by the members of the Teachman Program for Anxiety, Cognition and Treatment lab, and to Jacob York and the other research assistants who helped develop and administer the study.

Conflict of Interest

Eugenia I. Gorlin, Jessica R. Beadel, Roxann Roberson-Nay and Bethany A. Teachman declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (national and institutional). Informed consent was obtained from all individual subjects participating in the study. If any identifying information is contained in the paper the following statement is also necessary—Additional informed consent was obtained from any subjects for whom identifying information appears in this paper.

Animal Rights

No animal studies were carried out by the authors for this article.

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Authors and Affiliations

  1. University of Virginia, P.O. Box 400400, Charlottesville, VA, 22904, USA

    Eugenia I. Gorlin, Jessica R. Beadel & Bethany A. Teachman

  2. Virginia Commonwealth University, Richmond, VA, USA

    Roxann Roberson-Nay

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  1. Eugenia I. Gorlin
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  2. Jessica R. Beadel
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  4. Bethany A. Teachman
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Correspondence to Eugenia I. Gorlin.

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Gorlin, E.I., Beadel, J.R., Roberson-Nay, R. et al. The Self-fulfilling Panic Prophecy: Anxiety-Related Control Attributions Uniquely Predict Reactivity to a 7.5 % CO2 Challenge. Cogn Ther Res 38, 585–599 (2014). https://doi.org/10.1007/s10608-014-9626-8

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