Abstract
The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of “fear of fear” in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.
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REFERENCES
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Asmundson, G. J. G., & Stein, M. B. (1994). Triggering the false alarm in panic disorder patients by using a voluntary breath-holding procedure. American Journal of Psychiatry, 151, 264–266.
Barlow, D. H. (1988). Anxiety and its Disorders. New York: Guilford Press.
Beitman, D. B., Basha, I., Flaker, G., DeRosear, L., Mukerji, V., & Lamberti, J. (1987). Nonfearful panic disorder: Panic attacks without fear. Behaviour Research and Therapy, 25, 487–492.
Clark, D. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.
Cox, B. J. (1996). The nature and assessment of catastrophic thoughts in panic disorder. Behaviour Research and Therapy, 34, 363–374.
Edinburgh, A. E. (1987). Emotional upset after myocardial infarction—How should it be conceptualized and measured? International Journal of Rehabilitation Research, 10, 191–1994.
Eifert, G. H. (1996). More theory-driven and less diagnosis-based behavior therapy. Journal of Behavior Therapy and Experimental Psychiatry, 27, 75–86.
Eifert, G. H. (1992). Cardiophobia: A paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain. Behaviour Research and Therapy, 30, 329–245.
Eifert, G. H., Hodson, S. E., Tracey, D. R., Seville, J. L., & Gunawardane, K. (1996). Cardiac anxiety, illness beliefs, psychological impairment: Comparing healthy heart-anxious patients with cardiac and surgical patients. Journal of Behavioral Medicine, 19, 385–399.
Eifert, G. H., Forsyth, J. P., Zvolensky, M. J., & Lejuez, C. W. (1999a). Moving from the laboratory to the real world and back again: Increasing the relevance of laboratory examinations of anxiety sensitivity. Behavior Therapy, 30, 275–285.
Eifert, G. H., Thompson, R. N., Zvolensky, M. J., Edwards, K., Frazer, N. L., Haddad, J. W., & Davig, J. (1999b). The cardiac anxiety questionnaire: Development and preliminary validity. Behaviour Research and Therapy (in press).
Eke, M., & McNally, R. J. (1996). Anxiety sensitivity, suffocation fear, trait anxiety, and breath-holding duration as predictors of response to carbon dioxide challenge. Behaviour Research and Therapy, 8, 603–677.
Forsyth, J. P., & Eifert, G. H. (1998). Intensity of systemic alarms in content-specific fear conditioning: Comparing 20% versus 13% CO2-enriched air as a UCS. Journal of Abnormal Psychology, 107, 291–304.
Forsyth, J. P., Eifert, G. H., & Canna, M. A. (1999). Evoking analogue subtypes of panic attacks in a nonclinical population using carbon dioxide-enriched air. Behaviour Research and Therapy (in press).
Forsyth, J. P., Eifert, G. H., & Thompson, R. N. (1996). Systemic alarms in fear conditioning II: An experimental methodology using 20% CO2 inhalation as a UCS. Behavior Therapy, 27, 391–415.
Holloway, W., & McNally, R. J. (1987). Effects of anxiety sensitivity on the response to hyperventilation. Journal of Abnormal Psychology, 96, 330–334.
Klein, D. F. (1993). False suffocation alarms, spontaneous panics, and related conditions: An integrative hypothesis. Archives of General Psychiatry, 50, 306–317.
Lejuez, C. W., O'Donell, J., Wirth, O., Zvolensky, M. J., & Eifert, G. H. (1998a). Avoidance of carbon dioxide-enriched air in humans. Journal of the Experimental Analysis of Behavior, 70, 79–86.
Lejuez, C. W., Forsyth, J. P., & Eifert, G. H. (1998b). Devices and methods for administering carbon dioxide-enriched air in experimental and clinical settings. Journal of Behavior Therapy and Experimental Psychiatry, 29, 239–248.
McNally, R. J. (1989). Is anxiety sensitivity distinguishable from trait anxiety? A reply to Lilienfeld, Jacob, and Turner (1989). Journal of Abnormal Psychology, 98, 193–194.
McNally, R. J. (1994). Panic disorder: A critical analysis. New York: Guilford Press.
McNally, R. J. (1999). On the Experimental Induction of Panic. Behavior Therapy, 30, 333–341.
McNally, R. J., & Eke, M. (1996). Anxiety Sensitivity, suffocation fear, and breath-holding duration as predictors of response to carbon dioxide challenge. Journal of Abnormal Psychology, 105, 146–149.
Norton, G. R., Pidlubny, S. R., & Norton, P. J. (1999). The use of nonclinical panickers to test a prediction. Behavior Therapy, 30, 321–332.
Rachman, S., & Taylor, S. (1993). Analyses of claustrophobia. Journal of Anxiety Disorders, 7, 281–291.
Rachman, S., & Taylor, S. (1994). Suffocation Fear Scale, Unpublished questionnaire. Departments of Psychology and Psychiatry, University of British Columbia, Vancouver, Canada.
Rapee, R. M. (1995). Psychological factors influencing the affective response to biological challenge procedures in Panic Disorder. Journal of Anxiety Disorders, 9, 59–74.
Rapee, R., & Medoro, L. (1994). Fear of physical sensations and trait anxiety as mediators of the response to hyperventilation in nonclinical subjects. Journal of Abnormal Psychology, 4, 693–699.
Rapee, R. M., Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Response to hyperventilation and inhalation of 5.5% carbon dioxide-enriched air across the DSM-III-R anxiety disorders. Journal of Abnormal Psychology, 101, 538–552.
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety Sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.
Taylor, S., & Cox, B. J. (1998). Anxiety sensitivity: Multiple dimensions and hierarchic structure. Behaviour Research and Therapy, 36, 37–51.
Taylor, S., & Rachman, S. (1994). Klein's suffocation theory of panic. Archives of General Psychiatry, 51, 505–506.
Van Der Does, A. J. (1997). Voluntary breath-holding: Not a suitable probe of the suffocation alarm in panic disorder. Behaviour Research and Therapy, 35, 779–184.
Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press.
Zvolensky, M. J., Lejuez, C. W., & Eifert, G. H. (1998). The role of control in anxious responding: An experimental test using repeated administrations of 20% CO2-enriched air. Behavior Therapy, 29, 193–209.
Zvolensky, M. J., Eifert, G. H., Lejuez, C. W., & McNeil, D. W. (1999). The effects of offset control over 20% carbon dioxide-enriched air on anxious responding. Journal of Abnormal Psychology, 108, 624–632.
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Eifert, G.H., Zvolensky, M.J., Sorrell, J.T. et al. Predictors of Self-Reported Anxiety and Panic Symptoms: An Evaluation of Anxiety Sensitivity, Suffocation Fear, Heart-Focused Anxiety, and Breath-Holding Duration. Journal of Psychopathology and Behavioral Assessment 21, 293–305 (1999). https://doi.org/10.1023/A:1022116731279
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DOI: https://doi.org/10.1023/A:1022116731279