Abstract
In order to elucidate the impact of psychological factors on panic severity the correlation between baseline anxiety and panic response to cholecystokinin-tetrapeptide (CCK-4), an established model of human anxiety, was investigated in 33 healthy volunteers. Baseline anxiety was assessed with the State-Trait-Anxiety-Inventory (STAI). Trait and state anxiety did not differ between panickers and nonpanickers nor were they correlated with panic severity. In conclusion, psychological factors are not major determinants for the subjective panic response to CCK-4 thus emphasising the importance of neurobiological factors.
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Ackenheil M, Stotz G, Dietz-Bauer R, Vossen A (1999) Mini international neuropsychiatric interview, German version 5.0.0
Aluoja A, Shlik J, Vasar V, Kingisepp PH, Jagomagi K, Vasar E, Bradwejn J (1997) Emotional and cognitive factors connected with response to cholecystokinin tetrapeptide in healthy volunteers. Psychiatry Res 66:59–67
Bitsios P, Szabadi E, Bradshaw CM (2002) Relationship of the ‘fear-inhibited light reflex’ to the level of state/trait anxiety in healthy subjects. Int J Psychophysiol 43:177–184
Bradwejn J, Koszycki D, Shriqui C (1991) Enhanced sensitivity to cholecyskinin tetrapeptide in panic disorder. Clinical and behavioral findings. Arch Gen Psychiatry 48:603–610
Bradwejn J, LeGrand JM, Koszycki D, Bates JH, Bourin M (1998) Effects of cholecystokinin tetrapeptide on respiratory function in healthy volunteers. Am J Psychiatry 155:280–282
Clark DM (1986) A cognitive approach to panic. Behav Res Ther 24:461–470
Eke M, McNally RJ (1996) Anxiety sensitivity, suffocation fear, trait anxiety, and breath-holding duration as predictors of response to carbon dioxide challenge. Behav Res Ther 34:603–607
Endler NS, Kocovski NL (2001) State and trait anxiety revisited. J Anxiety Disord 15:231–245
Eser D, Schule C, Baghai T, Floesser A, Krebs-Brown A, Enunwa M, de la MS, Engel R, Kucher K, Rupprecht R (2007) Evaluation of the CCK-4 model as a challenge paradigm in a population of healthy volunteers within a proof-of-concept study. Psychopharmacology 192(4):479–487
Flint AJ, Koszycki D, Vaccarino FJ, Cadieux A, Boulenger JP, Bradwejn J (1998) Effect of aging on cholecystokinin-induced panic. Am J Psychiatry 155:283–285
Grillon C, Ameli R, Foot M, Davis M (1993) Fear-potentiated startle: relationship to the level of state/trait anxiety in healthy subjects. Biol Psychiatry 33:566–574
Holloway W, McNally RJ (1987) Effects of anxiety sensitivity on the response to hyperventilation. J Abnorm Psychol 96:330–334
Koszycki D, Cox BJ, Bradwejn J (1993) Anxiety sensitivity and response to cholecystokinin tetrapeptide in healthy volunteers. Am J Psychiatry 150:1881–1883
Koszycki D, Zacharko RM, Bradwejn J (1996a) Influence of personality on behavioral response to cholecystokinin-tetrapeptide in patients with panic disorder. Psychiatry Res 62:131–138
Koszycki D, Zacharko RM, Le Melledo JM, Young SN, Bradwejn J (1996b) Effect of acute tryptophan depletion on behavioral, cardiovascular, and hormonal sensitivity to cholecystokinin-tetrapeptide challenge in healthy volunteers. Biol Psychiatry 40:648–655
Koszycki D, Zacharko RM, Le Melledo JM, Bradwejn J (1998) Behavioral, cardiovascular, and neuroendocrine profiles following CCK-4 challenge in healthy volunteers: a comparison of panickers and nonpanickers. Depress Anxiety 8:1–7
Laux L, Glanzmann P, Schaffner P, Spielberg CD (1981) Das State-Trait-Angstinventar. Theoretische grundlagen und handanweisungen. Beltz test GmbH, Weinheim
McNally RJ (1989) Is anxiety sensitivity distinguishable from trait anxiety? Reply to Lilienfeld, Jacob, and Turner (1989). J Abnorm Psychol 98:193–194
McNally RJ (2001) On the scientific status of cognitive appraisal models of anxiety disorder. Behav Res Ther 39:513–521
McNally RJ (2002) Anxiety sensitivity and panic disorder. Biol Psychiatry 52:938–946
Nagai M, Wada M, Sunaga N (2002) Trait anxiety affects the pupillary light reflex in college students. Neurosci Lett 328:68–70
Radu D, Ahlin A, Svanborg P, Lindefors N (2003) Pentagastrin test for anxiety-psychophysiology and personality. Psychopharmacology 166:139–145
Rehfeld JF, Neilson FC (1995) Molecular form and regional distribution of cholecystokinin in the central and peripheral nervous system. In: Bradwejn J, Vasar E (eds) Cholecystokinin and anxiety: from neuron to behaviour. Springer, Austin, pp 33–56
Reiss S (1997) Trait anxiety: it’s not what you think it is. J Anxiety Disord 11:201–214
Reiss S, Peterson RA, Gursky DM, McNally RJ (1986) Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther 24:1–8
Schmidt NB, Zvolensky MJ, Maner JK (2006) Anxiety sensitivity: prospective prediction of panic attacks and axis I pathology. J Psychiatr Res 40:691–699
Shioiri T, Kuwabara H, Abe R, Iijima A, Kojima-Maruyama M, Kitamura H, Bando T, Someya T (2006) Lack of a relationship between the pupillary light reflex response and state/trait anxiety in remitted patients with panic disorder. J Affect Disord 95:159–164
Spielberg CD, Gorsuch RL, Lushene RE (1970) STAI, Manual for the State-Trait-Anxiety-Inventory. Consulting Psychologist Press, Palo Alto, Calif
Starcevic V, Berle D (2006) Cognitive specificity of anxiety disorders: a review of selected key constructs. Depress Anxiety 23:51–61
van Megen HJ, Westenberg HG, den Boer JA, Kahn RS (1996) Cholecystokinin in anxiety. Eur Neuropsychopharmacol 6:263–280
Zwanzger P, Eser D, Aicher S, Schule C, Baghai TC, Padberg F, Ella R, Moller HJ, Rupprecht R (2003) Effects of alprazolam on cholecystokinin-tetrapeptide-induced panic and hypothalamic-pituitary-adrenal-axis activity: a placebo-controlled study. Neuropsychopharmacology 28:979–984
Acknowledgments
We thank Dr. Michaela Enunwa and Dr. Stephan de la Motte, Harrison Clinical Research Institute, Munich, Germany for expert technical assistance in challenge performance.
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Funding/support: this research was part of a proof-of-concept study sponsored by Novartis Pharma AG, Basel, Switzerland.
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Eser, D., Wenninger, S., Baghai, T. et al. Impact of state and trait anxiety on the panic response to CCK-4. J Neural Transm 115, 917–920 (2008). https://doi.org/10.1007/s00702-008-0047-2
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DOI: https://doi.org/10.1007/s00702-008-0047-2