Abstract
Panic attacks have recently been given a central role in the classification of anxiety disorders (DSM-IIIR, Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, third edition-revised, APA 1987). The etiology of these anxiety attacks is controversial. One of their most puzzling and fascinating features for clinicians and researchers is that panic attacks often occur in the absence of any perceived situational triggers. This apparent spontaneity has led researchers to search for possible causes of panic attacks “within” the patient.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders. Third edition - revised. APA Press, Washington, DC
Arnow BA, Taylor CB, Agras WS, Teich MJ (1986) Enhancing agoraphobia treatment outcome by changing couple communication patterns. Behav Ther 16: 452–467
Barlow D (1986) A psychological model of panic. In: Shaw BF, Cashman F, Segal ZY, Yallis TM (eds) Anxiety disorder: theory, diagnosis, and treatment. Plenum, New York
Barlow DH, Cohen AS, Waddell Mt, Vermilyea BB, Klosko JS, Blanchard EB, DiNardo PA (1984) Panic and generalized anxiety disorders: Nature and treatment. Behav Ther 15: 431–449
Bass C, Kartsoumis L, Lelliott P (in press) Hyperventilation and its relationship with anxiety and panic. Integrative Psychiatry
Beck AT, Laude R, Bohnert M (1974) Ideational components of anxiety neurosis. Arch Gen Psychiatry 31: 319–325
Beck AT, Emery GD, Greenberg R (1985) Anxiety disorders and phobias: a cognitive perspective. Basic, New York
Bonn JA, Harrison J, Rees W (1973) Lactate infusion in the treatment of “free-floating” anxiety. Therapeutic application. Br J Psychiatry 119: 468–470
Bonn JA, Readhead CPA, Timmons BA (1984) Enhanced adaptive behavioral response in agoraphobic patients pretreated with breathing retraining. Lancet 1984: 665–669
Boulenger JP, Uhde TW, Wolff EA, Post RM (1984) Increased sensitivity to caffeine in patients with panic disorder. Arch Gen Psychiatry 41: 1067–1071
Breggin PR (1964) The psychophysiology of anxiety. J Nery Ment Dis 139: 558–568
Buller R, Maier W, Benkert O (1978) Das Herzangst-Syndrom–ein Subtyp der Panik-Syndroms. In: Nutzinger DO, Pfersmann D, Welan T, Zapotoczky HG (eds) Herzphobie. Enke, Stuttgart, pp 42–49
Burgess IS, Jones LM, Robertson SA, Radcliff WN, Emerson E (1981) The degree of control exerted by phobic and non-phobic verbal stimuli over the recognition behaviour of phobies and non-phobic subjects. Behav Res Ther 19: 233–243
Burns LE, Thorpe GL, Cavallero A, Gosling J (1983) Agoraphobia eight years after behavioral treatment: A follow-up study with interview, questionnaire and behavioral data. World Congress of Behavior Therapy, Washington, DC
Chambless DL, Caputo GC, Bright P, Gallagher R (1984) Assessment of fear of fear in agoraphobics: the Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. J Consult Clin Psychol 52: 1090–1097
Clark DM (1986) A cognitive approach to panic. Behav Res Ther 24: 461–470
Clark DM (1988) A cognitive model of panic attacks. In: Rachman S, Maser J (eds) Panic: psychological perspectives. Erlbaum, Hillsdale
Clark DM, Salkovskis PM, Chalkley AJ (1985) Respiratory control as a treatment for panic attacks. J Behav Ther Exp Psychiatry 16: 23–30
Chamey DS, Heninger GR (1986) Abnormal regulation of noradrenergic function in panic disorders. Arch Gen Psychiatry 43: 1042–1054
Cohen AS, Barlow DH, Blanchard EB (1985) Psychophysiology of relaxation-associated panic attacks. J Abn Psychol 94: 96–101
Ehlers A, Margraf J, Roth WT (1986a) Experimental induction of panic attacks. In: Hand I, Wittchen HU (eds) Panic and phobias: empirical evidence of theoretical models and longterm efficacy of behavioral treatments. Springer, Berlin Heidelberg New York, pp 53–66
Ehlers A, Margraf J, Roth WT, Taylor CB, Maddock RJ, Sheikh J, Kopell ML, McClenahan KL, Gossard D, Blowers GH, Agras WS, Kopell BS (1986b) Lactate infusions and panic attacks: do patients and controls respond differently? Psychiatry Res 17: 295–308
Ehlers A, Margraf J, Roth WT, Taylor CB (1987) Psychophysiology of panic attacks. 27th Annual meeting of the Society for Psychophysiological Research, Amsterdam
Ehlers A, Margraf J, Roth WT, Taylor CB, Birbaumer N (1988a) Anxiety induced by false heart rate feedback in patients with panic. disorder. Behav Res Ther 26: 1–11
Ehlers A, Margraf J, Roth WT (1988b) Interaction of expectancy and stressors in a laboratory model of panic. In: Hellhammer C, Florin I, Weiner H (eds) Neurobiological approaches to human disease. Huber, Toronto, pp 379–384
Ehlers A, Margraf J, Davies S, Roth WT (in press). Selective processing of threat cues in subjects with panic attacks. Cognition and Emotion.
Emmelkamp PMG, Kuipers ACM (1979) Agoraphobia: A follow-up study four years after treatment. Br J Psychiatry 143: 352–355
Epstein S (1972) The nature of anxiety with emphasis on its relationship to expectancy. In: Spielberger CD (ed) Anxiety. Academic, New York
Evans IM (1972) A conditioning model of common neurotic pattern–fear of fear. Psychother Theor Res Pract 9: 238–241
Fenichel O (1945) Psychoanalytic theory of the neuroses. Norton, New York
Fiegenbaum W (1986) Longterm efficacy of exposure therapy in cardiac phobia. In: Hand I, Wittchen HU (eds) Panic and phobias: Empirical evidence of theoretical models and longterm efficacy of behavioral treatments. Springer, Berlin Heidelberg New York, pp 81–89
Foa EB, Kozak MJ (1986) Emotional processing of fear: exposure to corrective information. Psych Bull 99: 20–35
Foa EB, McNally RJ (1986) Sensitivity to feared stimuli in obsessive-compulsives: a dichotic listening analysis. Cogn Ther Res 10: 477–485
Frankl VE (1975) Paradoxical intention and dereflection. Psychotherapy 12: 226–237
Freud S (1895) Über die Berechtigung von der Neurasthenie einen bestimmten Symptomkomplex als “Angstneurose” abzutrennen. In: Freud S (1952) Gesammelte Werke, vol 1. (Standard Edition, vol 3, p 85, Hogarth, London )
Gitlin B, Martin J, Shear MK, Frances A, Ball G, Josephson S (1985) Behavior therapy for panic disorder. J Nery Ment Dis 173: 742–743
Goldstein AJ (1982) Agoraphobia: Treatment successes, treatment failures, and theoretical implications. In: Chambless DL, Goldstein AJ (eds) Agoraphobia: multiple prespectives on theory and treatment. Wiley, New York
Goldstein AJ, Chambless DL (1978) A reanalysis of agoraphobia. Behav Ther 9: 47–59
Griez E, van den Hout MA (1983) Treatment of phobophobia by exposure to CO2-induced anxiety symptoms. J Nery Ment Dis 173: 742–743
Griez E, van den Hout MA (1986) CO2 inhalation in the treatment of panic attacks. Behav Res Ther 24: 145–150
Guttmacher LB, Nelles C (1984) In vivo desensitization of lactate-induced panic: a case study. Behav Ther 15: 369–372
Hand I, Lamontagne Y, Marks I (1974) Group exposure (flooding) in vivo for agoraphobies. Br J Psychiatry 124: 588–602
Hand I, Angenendt J, Fischer M, Wilke C (1986) Exposure in vivo with panic management: Treatment rationale and longterm outcome. In: Hand I, Wittchen HU (eds) Panic and phobias: empirical evidence of theoretica models and longterm efficacy of behavioral treatments. Springer, Berlin Heidelberg New York, pp 104–128
Harbauer-Raum U (1987) Wahrnehmung von Herzschlag and Herzarrhythmien–Eine Labor-Feldstudie an Patienten mit Herzphobie. In: Nutzinger DO, Pfersmann D, Welan T, Zapotoczky Hg (eds) Die Herzphobie, Enke, Stuttgart, pp 84–91
Hibbert GA (1984) Ideational components of anxiety. Br J Psychiatry 144: 618–624
Jacob RG, Rapport MD (1984) Panic disorder: medical and psychological parameters. In: Turner SM (ed) Behavioral theories and treatment of anxiety. Plenum, New York
Jacob RG, Moller MB, Turner SM, Wall C (1985) Otoneurological examination in panic disorder and agoraphobia with panic attacks: a pilot study. Am J Psychiatry 142: 715–720
Katkin ES (1985). Blood, sweat and tears: individual differences in autonomic self-perception. Psychophysiology 22: 125–137
King R, Margraf J, Ehlers A, Maddock R (1986) Panic disorder–overlap with somatization disorder. In: Hand I, Wittchen HU (eds) Panic and phobias: empirical evidence of theoretical models and longterm efficacy of behavioral treatments. Springer, Berlin Heidelberg New York, pp 72–77
Klein DF (1980) Anxiety reconceptualized. Compreh Psychiatry 21: 411–427
Lader MH, Mathews AM (1968) A physiological model of phobic anxiety and desensitization. Behav Res Ther 6: 411–421
Lader MH, Mathews AM (1970) Physiological changes during spontaneous panic attacks. J Psychosom Res 14: 377–382
Lazarus RS, Averill JR (1972) Emotion and cognition: With special reference to anxiety. In: Spielberger CD (ed) Anxiety. Academic, New York
Lelliott PT, Marks IM, Monteiro WO, Tsakiris F, Noshirvani H (1987) Agoraphobia 5 years after imipramine and exposure. Outcome and predictors. J Nery Ment Dis 175: 599–605
Ley R (1985) Agoraphobia, the panic attack and the hyperventilation syndrome. Behav Res Ther 23: 79–81
Ley R (1987) Panic disorder: a hyperventilation interpretation. In: Michelson L, Ascher M (eds) Cognitive-behavioral assessments and treatment of anxiety disorders. Guilford, New York
MacLeod C, Mathews A, Tata P (1986) Attentional bias in emotional disorders. J Abn Psychol 95: 15–20
Marchione KE, Michelson L, Greenwald M, Dancu C (1987) Cognitive behavioral treatment of agoraphobia. Behav Res Ther 25: 319–328
Margraf J, Ehlers A (in press) Biological models of panic disorder and agoraphobia: Theory and evidence. In: Roth M, Burrows GD, Noyes R (eds) Handbook of anxiety, Vol. III. Elsevier, Amsterdam
Margraf J, Ehlers A, Roth WT (1986a) Biological models of panic disorder and agoraphobia: a review. Behav Res Ther 24: 553–567
Margraf J, Ehlers A, Roth WT (1986b) Sodium lactate infusions and panic attacks: a review and critique. Psychosom Med 48: 23–51
Margraf J, Ehlers A, Roth WT (1987a) Panic attack associated with perceived heart rate acceleration: a case report. Behav Ther 18: 84–89
Margraf J, Taylor CB, Ehlers A, Roth WT, Agras WS (1987b) Panic attacks in the natural environment. J Nery Ment Dis 175: 558–565
Margraf J, Ehlers A, Roth WT (in press) Expectancy effects and hyperventilation as laboratory stressors. In: Florin I, Weiner H, Hellhammer D (eds) Frontiers of stress research. Huber, Toronto
Marks I (1987) Fears, phobias and rituals. Oxford University Press, New York
Mathews AM, MacLeod C (1985) Selective processing of threat cues in anxiety states. Behav Res Ther 23: 563–569
Mathews AM, MacLeod C (1986) Discrimination of threat cues without awareness in anxiety states. J Abn Psychol 95: 131–138
Mathews AM, Teasdale J, Munby M, Johnston DW, Shaw P (1977) A home-based treatment program for agoraphobia. Behav Ther 8: 915–925
McFarland RA (1975) Heart rate perception and heart rate control. Psychophysiology 12: 402–405
McNally RJ, Foa EB (1987) Cognition and agoraphobia: bias in the interpretation of threat. Cogn Ther Res 11: 567–582
McNally RJ, Lorenz M (1987) Anxiety sensitivity in agoraphobies. J Behav Ther Exp Psychiatry 18: 3–11
McPherson FM, Brougham I, McLaren S (1980) Maintenance of improvement of agoraphobic patients treated with behavioural methods–four year follow-up. Behav Res Ther 18: 150–152
Melzack R, Wall PD (1973) The challenge of pain. Basic, New York
Michelson L, Mavissakalian M, Marchione K (1985) Cognitive and behavioral treatments of agoraphobia: Clinical and behavioral, and psychophysiological outcomes. J Consult Clin Psychol 53: 913–925
Mogg K, Mathews A, Weinman J (1987) Memory bias in clinical anxiety. J Abn Psychol 96: 94–98
Munby M, Johnston DW (1980) Agoraphobia: the long-term follow-up of behavioral treatment. Br J Psychiatry 137: 418–427
Öst LG (1988) Applied relaxation vs progressive relaxation in the treatment of panic disorder. Behav Res Ther
Ottavani R, Beck AT (1987) Cognitive aspects of panic disorder. J Anxiety Disorders 1: 15–28
Porges SW, Raskin DC (1969) Respiratory and heart rate components of attention. J Exp Psychol 81: 497–503
Rachman S, Levitt K, Lopatka C (1987) Panic: the links between cognitions and bodily symptoms–I. Behav Res Ther 25: 411–423
Rapee RM (1985a) A case of panic disorder treated with breathing retraining. J Behav Ther Exp Psychiatry 16: 63–65
Rapee RM (1985b) Distinction between panic disorder and generalised anxiety disorder: clinical presentation. Aust N Z J Psychiatry 19: 227–232
Rapee RM (in press) The psychological treatment of panic attacks: theoretical conceptualization and review of evidence. Clin Psychol Review
Rapee RM, Mattick R, Murrell E (in press) Cognitive mediation in the affective component of spontaneous panic attacks. J Behav Ther Exp Psychiatry
Reiss S, McNally RJ (1985) Expectancy model of fear. In: Reiss S, Bootzin RR (eds) Theoretical issues in behavior therapy. Academic, New York, pp 107–121
Salkovskis PM, Jones DRO, Clark DM (1986) Respiratory control in the treatment of panic attacks: replication and extension with concurrent measurement of behaviour and pCO2. Br J Psychiatry 148: 526–532
Sanderson WC, Rapee RM, Barlow DH (submitted) The influence of an illusion of control on panic attacks via inhalation of 5,5% carbon dioxideenriched air.
Sartory G (1985) Vagal innervation techniques in the treatment of panic attacks. 15th Annual meeting of the European Association for Behaviour therapy, Munich
Schandry R (1981) Heart beat perception and emotional experience. Psychophysiology 18: 483–488
Schandry R (1983) On the relation between the improvement of cardiac perception and the increase of emotional experience. Psychophysiology 20: 468
Shands HC, Schor N (1982) The modern syndrome of phobophobia and its management. In: Dupont RL (ed) Phobia: a comprehensive summary of modern treatments. Brunner and Mazel, New York
Shear MK, Fyer A (1987) Effects of cognitive-behavioral treatments on sodium-lactate response of panic patients. Preliminary findings. Symposium treatments of panic and phobias, Ringberg
Stalmann H, Hartl L, Pauli P, Strian F (1987) Perception of pathological cardiac activity. Psychophysiology 24: 614
Streblow H, Hoffmann J, Kasielke E (1985) Experimentalpsychologische Analyse von Gedächtnisprozessen bei Phobikern. Z Psychol 193: 147–161
Taylor CB, Sheikh J, Agras WS, Roth WT, Margraf J, Ehlers A, Maddock RJ, Gossard D (1986) Ambulatory heart rate changes in patients with panic attacks. Am J Psychiatry 143: 478–482
Taylor CB, King R, Ehlers A, Margraf J, Clark D, Roth WT, Agras WS (in press) Treadmill exercise test and ambulatory monitoring in patients with panic attacks. Am J Cardiol
Teich MJ, Agras WS, Taylor CB, Roth WT, Gallen CC (1985) Combined pharmacological and behavioral treatment for agoraphobia. Behav Res Ther 23: 325–335
Tyrer P, Lee I, Alexander J (1980) Awareness of cardiac function in anxious, phobic and hypochondriacal patients. Psychol Med 10: 171–174
van den Hout MA (1988) The explanation of experimental panic. In: Rachman S, Maser J (eds) Panic: psychological perspectives. Erlbaum, Hillsdale
van den Hout MA, Griez E (1982) Cognitive factors in carbon dioxide therapy. J Psychosom Res 26: 209–214
van den Hout MA, Griez E (1983) Some remarks on the nosology of anxiety states and panic disorder. Acta Psychiat Belg 83: 33–42
van der Molen GM, van den Hout MA, Vroemen J, Lousberg H, Griez E (1986) Cognitive determinants of lactate-induced anxiety. Behav Res The 24: 677–680
Waddell MT, Barlow DH, O’Brien GT (1984) A preliminary investigation of cognitive and relaxation treatment of panic disorder: effects on intense anxiety vs “background” anxiety. Behav Res Ther 22: 393–402
Watts FN, McKenna FP, Sharrock R, Trezise L (1986a) Colour naming of phobia-related words. Br J Psychol 77: 97–108
Watts FN, Trezise L, Sharrock R (1986b) Processing of phobic stimuli. Br J Clin Psychol 25: 253–259
Westphal C (1871) Die Agoraphobie, eine neuropathische Erscheinung. Arch Psychiat Nervenkrankh 3: 138–161
Whitehead WE, Drescher VM, Heriman P, Blackwell B (1977) Relation of heart rate, heart rate control and heart rate perception. Biodfeed Self-Reg 2: 371–392
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Ehlers, A., Margraf, J., Roth, W.T. (1988). Selective Information Processing, Interoception, and Panic Attacks. In: Hand, I., Wittchen, HU. (eds) Panic and Phobias 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-73543-1_12
Download citation
DOI: https://doi.org/10.1007/978-3-642-73543-1_12
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-73545-5
Online ISBN: 978-3-642-73543-1
eBook Packages: Springer Book Archive