Skip to main content
SpringerLink
Log in

Specificity of Peritraumatic Fear in Predicting Anxious Reactivity to a Biological Challenge among Traumatic Event-Exposed Adolescents

  • Original Article
  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

Theory implicates peritraumatic fear-based interoceptive conditioning in the development of panic spectrum problems subsequent to traumatic event exposure. Relatively little empirical work has directly investigated this hypothesis. The current study tested the hypothesis that level of peritraumatic fear would predict anxious reactivity to a well-established 3-min voluntary hyperventilation procedure administered to 63 adolescents who had experienced a DSM-IV-TR-defined traumatic event. This relation was examined after controlling for variance accounted for by posttraumatic stress symptoms, sex, age, anxiety sensitivity, general symptoms of psychopathology, and both peritraumatic helplessness and disgust. As predicted, peritraumatic fear was related to anxious reactivity to hyperventilation-elicited bodily arousal. Specificity tests suggested this relation was specific to peritraumatic fear. Prospective research is now needed to better elucidate the relation between peritraumatic fear and subsequent development of anxious reactivity to bodily arousal and panic spectrum problems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th Edn-Text Revision). Washington, DC: Author.

    Google Scholar 

  • Andrews, B. (1998). Methodological and definitional issues in shame research. In P. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 39–54). New York: Oxford University Press.

    Google Scholar 

  • Barlow, D. H. (2002). Anxiety and its disorders (Second Edition): The nature and treatment of anxiety and panic. New York: Guilford.

    Google Scholar 

  • Bouton, M., Mineka, S., & Barlow, D. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108, 4–32. doi:10.1037/0033-295X.108.1.4.

    Article  PubMed  CAS  Google Scholar 

  • Brewin, C. R., Andrews, B., & Rose, S. (2000). Fear, helplessness, and horror in posttraumatic stress disorder: Investigating DSM-IV Criterion A2 in victims of violent crime. Journal of Traumatic Stress, 13, 499–509. doi:10.1023/A:1007741526169.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. doi:10.1037/0033-2909.112.1.155.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, J., & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Copeland, W. E., Keeler, G., Angold, A., & Costello, J. (2007). Traumatic events and posttraumatic stress disorder in childhood. Archives of General Psychiatry, 64, 577–584. doi:10.1001/archpsyc.64.5.577.

    Article  PubMed  Google Scholar 

  • Falsetti, S. A., Resnick, H. S., Dansky, B. S., Lydiard, R. B., & Kilpatrick, D. G. (1995). The relationship of stress to panic disorder: cause or effect? In C. M. Mazure (Ed.), Does stress cause psychiatric illness? (pp. 111–147). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Feldner, M. T., Babson, K. A., & Zvolensky, M. J. (2007). Smoking, traumatic event exposure and posttraumatic stress: A critical review of the empirical literature. Clinical Psychology Review, 27, 14–45. doi:10.1016/j.cpr.2006.08.004.

    Article  PubMed  Google Scholar 

  • Feldner, M. T., Frala, J., Badour, C., Leen-Feldner, E. W., & Olatunji, B. O. (2010). An empirical test of the association between disgust and sexual assault. International Journal of Cognitive Therapy, 3, 11–22. doi:10.1521/ijct.2010.3.1.11.

    Article  Google Scholar 

  • Feldner, M. T., Vujanovic, A. A., Gibson, L. E., & Zvolensky, M. J. (2008). Posttraumatic stress disorder and anxious and fearful reactivity to bodily arousal: A test of the mediating role of nicotine withdrawal severity among daily smokers in 12-hour nicotine deprivation. Experimental and Clinical Psychopharmacology, 16, 144–155. doi:10.1037/1064-1297.16.2.144.

    Article  PubMed  Google Scholar 

  • Foa, E. B., Johnson, K., Feeny, N., & Treadwell, K. (2001). The child PTSD symptom scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30, 376–384. doi:10.1207/S15374424JCCP3003_9.

    Article  PubMed  CAS  Google Scholar 

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35. doi:10.1016/S0005-7967(96)00069-1.

    Article  PubMed  CAS  Google Scholar 

  • Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Behavior Therapy, 20, 155–176. doi:10.1016/S0005-7894(89)80067-X.

    Article  Google Scholar 

  • Fried, R., & Grimaldi, J. (1993). The psychology and physiology of breathing: In behavioral medicine, clinical psychology, and psychiatry. New York: Plenum press.

    Google Scholar 

  • Glaser, J.-P., van Os, J., Portegijs, P. J. M., & Myin-Germeys, I. (2006). Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. Journal of Psychometric Research, 61, 229–236. doi:10.1016/j.jpsychores.2006.04.014.

    Article  Google Scholar 

  • Goodwin, R. D., Fergusson, D. M., & Horwood, L. J. (2005). Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood. Psychological Medicine, 35, 881–890. doi:10.1017/S0033291704003265.

    Article  PubMed  Google Scholar 

  • Gotlib, I. A., Traill, S. K., Montoya, R. L., Joormann, J., & Chang, K. (2005). Attention and memory biases in the offspring of parents with bipolar disorder: Indications from a pilot study. Journal of Child Psychology and Psychiatry, 46, 84–93. doi:10.1111/j.1469-7610.2004.00333.x.

    Article  PubMed  Google Scholar 

  • Hawks, E., Blumenthal, H., Feldner, M. T., Leen-Feldner, E. W., & Jones, R. (in press). An examination of the relation between traumatic event exposure and panic-relevant biological challenge responding among adolescents. Behavior Therapy. doi:10.1016/j.beth.2010.11.002.

  • Haynes, S. N., & Lench, H. C. (2003). Incremental validity of new assessment measures. Psychological Assessment, 15, 456–466.

    Article  PubMed  Google Scholar 

  • Hayward, C., Killen, J. D., Hammer, L. D., Litt, I. F., Wilson, D. M., Simmonds, B., et al. (1992). Pubertal stage and panic attack history in sixth- and seventh-grade girls. American Journal of Psychiatry, 149, 1239–1243.

    PubMed  CAS  Google Scholar 

  • Hayward, C., Killen, J. D., Kraemer, H. C., Blair-Greiner, A., Strachowski, D., Cunning, D., et al. (1997). Assessment and phenomenology of nonclinical panic attacks in adolescent girls. Journal of Anxiety Disorders, 11, 17–32. doi:10.1016/S0887-6185(96)00032-1.

    Article  PubMed  CAS  Google Scholar 

  • Hinton, D. E., Hofmann, S. G., Pitman, R. K., Pollack, M. H., & Barlow, D. H. (2008). The panic attack-posttraumatic stress disorder model: Applicability to orthostatic panic among Cambodian refugees. Cognitive Behaviour Therapy, 37, 101–116. doi:10.1080/16506070801969062.

    Article  PubMed  Google Scholar 

  • Hinton, D. E., So, V., Pollack, M. H., Pitman, R. K., & Orr, S. P. (2004). The psychophysiology of orthostatic panic in Cambodian refugees attending a psychiatric clinic. Journal of Psychopathology and Behavioral Assessment, 26, 1–13. doi:10.1023/B:JOBA.0000007451.85942.42.

    Article  Google Scholar 

  • Hornsveld, H., Garssen, B., Dop, M. F., & van Spiegel, P. (1990). Symptom reporting during voluntary hyperventilation and mental load: Implications for diagnosing hyperventilation syndrome. Journal of Psychosomatic Research, 34, 687–697. doi:10.1016/0022-3999(90)90113-I.

    Article  PubMed  CAS  Google Scholar 

  • Hornsveld, H., Garssen, B., & van Spiegel, P. (1995). Voluntary hyperventilation: The influence of duration and depth on the development of symptoms. Biological Psychology, 40, 299–312. doi:10.1016/0301-0511(95)05120-Y.

    Article  PubMed  CAS  Google Scholar 

  • Hughes, C. W., & Melson, A. G. (2008). Child and adolescent measures for diagnosis and screening. In A. J. Rush, M. B. First, & D. Blacker (Eds.), Handbook of psychiatric measures (2nd ed., pp. 251–308). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Jensen, C. F., Keller, T. W., Peskind, E. R., McFall, M. E., Veith, R. C., Martin, D., et al. (1997). Behavioral and neuroendocrine responses to sodium lactate infusion in subjects with posttraumatic stress disorder. The American Journal of Psychiatry, 154, 266–268.

    PubMed  CAS  Google Scholar 

  • Jensen, C. F., Peskind, E. R., Keller, T. W., McFall, M. E., & Raskind, M. A. (1998). Comparison of sodium lactate-induced panic symptoms between panic disorder and posttraumatic stress disorder. Depression and Anxiety, 7, 122–125. doi:10.1002.

    Article  PubMed  CAS  Google Scholar 

  • Jones, J. C., & Barlow, D. H. (1990). The etiology of PTSD. Clinical Psychology Review, 10, 299–328. doi:10.1016/0272-7358(90)90064-H.

    Article  Google Scholar 

  • Karam, E. G., Andrews, G., Bromet, E., Petukhova, M., Ruscio, A. M., & Kessler, R. C. (2010). The role of criterion A2 in the DSM-IV diagnosis of posttraumatic stress disorder. Biological Psychiatry, 68, 465–473. doi:10.1016/j.biopsych.2010.04.032.

    Article  PubMed  Google Scholar 

  • Kaysen, D., Morris, M., Rizvi, S. L., & Resick, P. A. (2005). Peritraumatic responses and their relationship to perceptions of threat in female crime victims. Violence Against Women, 11, 1515–1535. doi:10.1177/1077801205280931.

    Article  PubMed  Google Scholar 

  • Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence and comorbidity: Results from the national survey of adolescents. Journal of Consulting and Clinical Psychology, 71, 692–700. doi:10.1037.0022-006X.71.4.692.

    Article  PubMed  Google Scholar 

  • Krinsley, K. E., Gallagher, J. G., Weathers, F. W., Kutter, C. J., & Kaloupek, D. G. (2003). Consistency of retrospective reporting about exposure to traumatic events. Journal of Traumatic Stress, 16, 399–409. doi:10.1023/A:1024474204233.

    Article  PubMed  Google Scholar 

  • Lau, J. J., Calamari, J. E., & Waraczynski, M. (1996). Panic attack symptomatology and anxiety sensitivity in adolescents. Journal of Anxiety Disorders, 10, 355–364. doi:10.1016/0887-6185(96)00016-3.

    Article  Google Scholar 

  • Leen-Feldner, E. W., Feldner, M. T., Bernstein, A., McCormick, J. T., & Zvolensky, M. J. (2005). Anxiety sensitivity and anxious responding to bodily sensations: A test among adolescents using a voluntary hyperventilation challenge. Cognitive Therapy and Research, 29, 593–609. doi:10.1007/s10608-005-3510-5.

    Article  Google Scholar 

  • Leen-Feldner, E. W., Feldner, M. T., Tull, M. T., Roemer, L., & Zvolensky, M. J. (2006a). An examination of worry in relation to anxious responding to voluntary hyperventilation among adolescents. Behavior Research and Therapy, 44, 1803–1809. doi:10.1016/j.brat.2005.12.014.

    Article  Google Scholar 

  • Leen-Feldner, E. W., Reardon, L. E., McKee, L. G., Feldner, M. T., Babson, K. A., & Zvolensky, M. J. (2006b). The interactive role of anxiety sensitivity and pubertal status in predicting anxious responding to bodily sensations among adolescents. Journal of Abnormal Child Psychology, 34, 797–810. doi:10.1007/s10802-006-9079-y.

    Article  Google Scholar 

  • Leen-Feldner, E. W., Reardon, L. E., & Zvolensky, M. J. (2007). Pubertal status and emotional reactivity to a voluntary hyperventilation challenge predicting panic symptoms and somatic complaints: A laboratory-based multi-informant test. Behavior Modification, 31, 8–31. doi:10.1177/0145445506295058.

    Article  PubMed  Google Scholar 

  • Leen-Feldner, E. W., Feldner, M. T., Reardon, L. E., Babson, K. A., & Dixon, L. (2008). Anxiety sensitivity and posttraumatic stress among traumatic event-exposed youth. Behavior Research and Therapy, 46, 548–556. doi:10.1016/j.brat.2008.01.014.

    Article  Google Scholar 

  • Macaulay, J. L., & Kleinknecht, R. A. (1989). Panic and panic attacks in adolescents. Journal of Anxiety Disorders, 3, 221–241. doi:10.1016/0887-6185(89)90016-9.

    Article  Google Scholar 

  • Nixon, R., & Bryant, R. (2003). Peritraumatic and persistent panic attacks in acute stress disorder. Behaviour Research and Therapy, 41, 1237–1242. doi:10.1016/S0005-7967(03)00150-5.

    Article  PubMed  Google Scholar 

  • Nixon, R., Resick, P., & Griffin, M. (2004). Panic following trauma: The etiology of acute posttraumatic arousal. Journal of Anxiety Disorders, 18, 193–210. doi:10.1016/S0887-6185(02)00290-6.

    Article  PubMed  Google Scholar 

  • Olatunji, B. O., Leen-Feldner, E. W., Feldner, M. T., & Forsyth, J. P. (2007). Experimental psychopathology. In D. McKay (Ed.), Handbook of research methods in abnormal and clinical psychology (pp. 47–60). California: Sage.

    Google Scholar 

  • Ollendick, T. H., Mattis, S. G., & King, N. J. (1994). Panic in children and adolescents: A review. Journal of Child Psychology and Psychiatry, 35, 113–134. doi:10.1111/j.1469-7610.1994.tb01134.x.

    Article  PubMed  CAS  Google Scholar 

  • Pfefferbaum, B., Stuber, J., Galea, S., & Fairbrother, G. (2006). Panic reactions to terrorist attacks and probable posttraumatic stress disorder in adolescents. Journal of Traumatic Stress, 19, 217–228. doi:10.1002/jts.20118.

    Article  PubMed  Google Scholar 

  • Pitman, R. K., & Orr, S. P. (1990). The black hole of trauma. Biological Psychiatry, 27, 469–471.

    Article  PubMed  CAS  Google Scholar 

  • Rainey, J. M., Aleem, A., Ortiz, A., Yeragani, V., Phol, R., & Berchou, R. (1987). A laboratory procedure for the induction of flashbacks. American Journal of Psychiatry, 144, 1317–1319.

    PubMed  Google Scholar 

  • Rapee, R. M. (1995). Psychological factors influencing the affective response to biological challenge procedures in panic disorder. Journal of Anxiety Disorders, 9, 59–74. doi:10.1016/0887-6185(94)00028-9.

    Article  Google Scholar 

  • Reardon, L. E., Leen-Feldner, E. W., & Hayward, C. (2009). A critical review of the empirical literature on the relation between anxiety and puberty. Clinical Psychology Review, 29, 1–23. doi:10.1016/j.cpr.2008.09.005.

    Article  PubMed  Google Scholar 

  • Reed, V., & Hittchen, H.-u. (1998). DSM-IV panic attacks and panic disorder in a community sample of adolescents and young adults: How specific are panic attacks? Journal of Psychiatric Research, 32, 335–345. doi:10.1016/S0022-3956(98)00014-4.

    Article  PubMed  CAS  Google Scholar 

  • Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–121). San Diego, CA: Academic Press.

    Google Scholar 

  • Ruscio, A. M., Ruscio, J., & Keane, T. M. (2002). The latent structure of post-traumatic stress disorder. A taxometric investigation of reactions to extreme stress. Journal of Abnormal Psychology, 111, 290–301.

    Article  PubMed  Google Scholar 

  • Rutter, M. (1994). Beyond longitudinal data: Causes, consequences, changes, and continuity. Journal of Consulting and Clinical Psychology, 62, 928–940.

    Article  PubMed  CAS  Google Scholar 

  • Sechrest, L. (1963). Incremental validity: A recommendation. Educational and Psychological Measurement, 23, 153–158. doi:10.1177/001316446302300113.

    Article  Google Scholar 

  • Silverman, W. K., & Albano, A. M. (1996). The anxiety disorders interview schedule for DSM-IV: Child and parent versions. San Antonio, TX: Physiological Corporation.

    Google Scholar 

  • Silverman, W. K., Fleisig, W., Rabian, B., & Peterson, R. A. (1991). Childhood anxiety sensitivity index. Journal of Clinical Child Psychology, 20, 162–168. doi:10.1207/s15374424jccp2002_7.

    Article  Google Scholar 

  • Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test–retest reliability of anxiety symptoms and diagnoses with Anxiety Disorders Interview Schedule for DSM-IV: Child and parent versions. Journal of the American Academy Child Adolescent Psychiatry, 40, 937–944. doi:10.1097/00004583-200108000-00016.

    Article  CAS  Google Scholar 

  • Sinclair, E., Salmon, K., & Bryant, R. A. (2007). The role of panic attacks in acute stress disorder in children. Journal of Traumatic Stress, 20, 1069–1073. doi:10.1002/jts.20272.

    Article  PubMed  Google Scholar 

  • Southwick, S. M., Krystal, J. H., Morgan, C. A., Johnson, D., Nagy, L. M., Nicolaou, A., et al. (1993). Abnormal noradrenergic function in posttraumatic stress disorder. Archives of General Psychiatry, 50, 266–274.

    Article  PubMed  CAS  Google Scholar 

  • Southwick, S. M., Krystal, J. H., Bremner, J. D., Nicolaon, A. L., Nagy, L. M., & Charney, D. M. (1997a). Noradrenergic and serotonergic function in posttraumatic stress disorder. Archives of General Psychiatry, 54, 749–758.

    Article  PubMed  CAS  Google Scholar 

  • Southwick, S. M., Morgan, C. A., Nicolaou, A. L., & Charney, D. S. (1997b). Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm. American Journal of Psychiatry, 154, 173–177.

    PubMed  CAS  Google Scholar 

  • Springer, C., & Padgett, D. (2000). Gender differences in young adolescents’ exposure to violence and rates of PTSD symptomatology. American Journal of Orthopsychiatry, 70, 370–379. doi:10.1037/h0087637.

    Article  PubMed  CAS  Google Scholar 

  • Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliott, M. N., et al. (2003). A mental health intervention for schoolchildren exposed to violence. Journal of the American Medical Association, 290, 603–611. doi:10.1001/jama.290.S.603.

    Article  PubMed  Google Scholar 

  • Taylor, S., Koch, W. J., & McNally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6, 249–259. doi:10.1016/0887-6185(92)90037-8.

    Article  Google Scholar 

  • Unnewehr, S., Schneider, S., Margraf, J., Jenkins, M., & Florin, I. (1996). Exposure to internal and external stimuli: Reactions in children of patients with panic disorder and animal phobia. Journal of Anxiety Disorders, 10, 489–508. doi:10.1016/S0887-6185(96)00025-4.

    Article  Google Scholar 

  • Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for the DSM-IV: Child and parent versions. Journal of Clinical Child and Adolescent Psychology, 31, 335–342. doi:10.1207/S15374424JCCP3103_05.

    PubMed  Google Scholar 

  • Zvolensky, M. J., & Eifert, G. H. (2001). A review of psychological factors/processes affecting anxious responding during voluntary hyperventilation and inhalations of carbon-dioxide-enriched air. Clinical Psychology Review, 21, 375–400. doi:10.1016/S0272-7358(99)00053-7.

    Article  PubMed  CAS  Google Scholar 

  • Zvolensky, M. J., Lejuez, C. W., Stuart, G. L., & Curtin, J. J. (2001). Experimental psychopathology in psychological science. Review of General Psychology, 5, 371–381. doi:10.1037//1089-2680.5.4.371.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Arkansas, 216 Memorial Hall, Fayetteville, AR, 72701, USA

    Christal L. Badour, Matthew T. Feldner, Heidemarie Blumenthal, Sarah J. Bujarski, Ellen W. Leen-Feldner & Kimberly A. Babson

  2. University of Washington School of Medicine, Seattle, WA, USA

    Kimberly A. Babson

Authors
  1. Christal L. Badour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew T. Feldner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heidemarie Blumenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah J. Bujarski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ellen W. Leen-Feldner
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kimberly A. Babson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christal L. Badour.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Badour, C.L., Feldner, M.T., Blumenthal, H. et al. Specificity of Peritraumatic Fear in Predicting Anxious Reactivity to a Biological Challenge among Traumatic Event-Exposed Adolescents. Cogn Ther Res 36, 397–406 (2012). https://doi.org/10.1007/s10608-011-9380-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10608-011-9380-0

Keywords

Search

Navigation