Journal of Behavioral Medicine

, Volume 11, Issue 3, pp 303–310 | Cite as

Rebreathing to cope with hyperventilation: Experimental tests of the paper bag method

  • Marcel A. van den Hout
  • Chris Boek
  • G. Margo van der Molen
  • A. Jansen
  • E. Griez
Article

Abstract

To explore if and how the common rebreathing (paper bag) approach to hyperventilation works, two experiments were carried out. In the first experiment, 12 normal volunteers, aware of the common physiological rebreathing rationale, were twice asked to overbreath intensely and then either to rebreath or to restart normal ventilation. Alveolar CO2 increased more quickly and physical symptoms disappeared earlier in the rebreathing condition. The second experiment had a similar design; however, this time the subjects were led to believe that, after both hyperventilation provocation tests, they were rebreathing in a semiclosed tube system. On one of the occasions, the tube system was, in fact, open. The CO2 restoration again differed in the two conditions. In this second experiment, the moment of symptom disappearance was not significantly earlier in the rebreathing condition. The combined results of the studies suggest that expectation and suggestion play a role in the effects of rebreathing approaches on hyperventilation.

Key words

hyperventilation panic cognition rebreathing 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cohen, M. E., and White, P. Q. (1951). Life situation, emotions and neurocirculatory asthenia (anxiety neurosis, neurostenia, effort syndrome).Psychosom. Med. 13: 335–357.Google Scholar
  2. Garssen, B. (1986).Psychofysiologie van de ademhaling en het hyperventilatiesyndroom, Doctoral dissertation, Utrecht University, Utrecht, The Netherlands.Google Scholar
  3. Garssen, B., van Veenendaal, W., and Bloemink, R. (1983). Agoraphobia and the hyperventilation syndrome.Behav. Res. Ther. 21: 643–649.Google Scholar
  4. Griez, E., Pols, H., and van den Hout, M. A. (1987). Acid base balance in real life panic.J. Affect. Disorders 12: 263–266.Google Scholar
  5. Gorman, J. M., Askanazi, J., Liebowitz, M. R., Fyer, A. J., Stein, J., Kinney, J. M., and Klein, D. F. (1984). Response to hyperventilation in a group of patients with panic disorder.Am. J. Psychiat. 141: 857–861.Google Scholar
  6. Ley, R. (1985). Agoraphobia, the panic attack and the hyperventilation syndrome.Behav. Res. Ther. 23: 79–81.Google Scholar
  7. Lum, L. C. (1981). Hyperventilation and anxiety state.J. Roy. Soc. Med. 1: 1–4.Google Scholar
  8. Salkovskis, P. M., Jones, D. R. O., and Clark, D. M. (1986a). Respiratory control in the treatment of panic attacks: Replication and extension with concurrent measurement of behaviour and pCO2.Br. J. Psychiat. 148: 526–534.Google Scholar
  9. Salkovskis, P. M., Warwich, H. M. C., Clark, D. M., and Wessels, D. J. (1986b). A demonstration of acute hyperventilation during naturally occurring panic attacks.Behav. Res. Ther. 24: 91–94.Google Scholar
  10. van den Hout, M. A., and Griez, E. (1985). Peripheral panic symptoms occur during changes in alveolar carbon dioxide.Comp. Psychiat. 26: 381–387.Google Scholar
  11. Woods, S. W., Charney, D. S., Loke, J., Goodman, W. K., Redmond, D. E., and Henninger, G. R. (1986). Carbon dioxide sensitivity in panic anxiety.Arch. Gen. Psychiat. 43: 900–909.Google Scholar

Copyright information

© Plenum Publishing Corporation 1988

Authors and Affiliations

  • Marcel A. van den Hout
    • 1
  • Chris Boek
    • 1
  • G. Margo van der Molen
    • 1
  • A. Jansen
    • 2
  • E. Griez
    • 3
  1. 1.Department of Medical Psychology/Experimental PsychopathologyLimburg UniversityMD MaastrichtThe Netherlands
  2. 2.Department of Human Biology/Experimental PsychopathologyLimburg UniversityMD MaastrichtThe Netherlands
  3. 3.Department of Clinical Psychiatry/Experimental PsychopathologyLimburg UniversityMD MaastrichtThe Netherlands

Personalised recommendations