title: Anxiety sensitivity, the menstrual cycle, and panic disorder: a putative neuroendocrine and psychological interaction.
abstract: The 2:1 female-to-male sex difference in the prevalence of panic disorder (PD) suggests that there is a sex-specific vulnerability involved in the etiology and/or maintenance of this disorder. The purpose of this paper is to present a new conceptual model, which emphasizes the interaction between a cognitive vulnerability for PD, anxiety sensitivity, and the effects of progesterone and its metabolite, allopregnanolone, on behavioral and physiological responses to stress during the premenstrual phase. This interaction is proposed to be a potential sex-specific pathway that may initiate and/or maintain panic and anxiety symptoms in women. This review paper presents preliminary evidence from both the human and animal literatures to support this new model. Specific topics reviewed include: psychopathology related to the menstrual cycle, anxiety sensitivity and its relationship to the menstrual cycle, PMS, and PMDD, anxiety-modulating effects of progesterone and its neuroactive metabolite, allopregnanolone, and how results from the neuroendocrine literature relate to psychopathology or symptoms associated with the menstrual cycle.
authors.affiliation: Department of Psychology, University of Vermont, John Dewey Hall, 2 Colchester Ave., Burlington, VT 05405, USA. ynillni@uvm.edu
authors.forename: Yael I
authors.initials: YI
authors.lastname: Nillni
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Toufexis
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Rohan
mesh_terms: D001007:Anxiety / Q000378:metabolism / Q000523:psychology*; D001921:Brain / Q000378:metabolism; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000378:metabolism / Q000523:psychology*; D008960:Models, Psychological; D009490:Neurosecretory Systems / Q000378:metabolism; D018377:Neurotransmitter Agents / Q000378:metabolism; D016584:Panic Disorder / Q000378:metabolism / Q000523:psychology*; D011293:Premenstrual Syndrome / Q000378:metabolism / Q000523:psychology
chemical_list: D018377:Neurotransmitter Agents