title: Avoidant coping in panic disorder: a yohimbine biological challenge study.
abstract: Few studies have addressed whether the use of avoidance-oriented coping strategies is related to the development of panic in patients with panic disorder(PD). Self-report, clinician-rated, and physiological data were collected from 42 individuals who participated in a yohimbine biological challenge study, performed under double-blind, placebo-controlled conditions. Participants included 20 healthy controls and 22 currently symptomatic patients who met DSM-IV-TR diagnostic criteria for PD. Consistent with prediction, patients with PD who had higher perceived efficacy of avoidance-oriented strategies in reducing anxiety-related thoughts reported increased severity in panic symptoms during the yohimbine challenge condition as compared to the placebo. Further, patients with PD who had more fear of cognitive dyscontrol, cardiovascular symptoms, and publicly observable anxiety also reported increased severity in panic symptoms during the challenge. Healthy controls who had more fear of cardiovascular symptoms similarly reported increased severity in panic symptoms during the challenge. No effects were found for heart rate response to the challenge agent. These results provide support for the role of avoidance-oriented coping strategies and fear of anxiety-related symptoms as risk and maintenance factors in the development of panic symptoms, particularly within a biological challenge model.
authors.affiliation: Mood and Anxiety Disorders Program, National Institute of Mental Health, NIH, DHHS, Bethesda, MD, USA. johannaskaplan@gmail.com
authors.forename: Johanna S
authors.initials: JS
authors.lastname: Kaplan
authors.forename: Diane B
authors.initials: DB
authors.lastname: Arnkoff
authors.forename: Carol R
authors.initials: CR
authors.lastname: Glass
authors.forename: Ruth
authors.initials: R
authors.lastname: Tinsley
authors.forename: Marilla
authors.initials: M
authors.lastname: Geraci
authors.forename: Elisa
authors.initials: E
authors.lastname: Hernandez
authors.forename: David
authors.initials: D
authors.lastname: Luckenbaugh
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Carlson
mesh_terms: D000223:Adaptation, Psychological; D058669:Adrenergic alpha-2 Receptor Antagonists / Q000494:pharmacology*; D000328:Adult; D001921:Brain / Q000503:physiopathology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D016584:Panic Disorder / Q000139:chemically induced / Q000503:physiopathology / Q000523:psychology*; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D015016:Yohimbine / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D058669:Adrenergic alpha-2 Receptor Antagonists; D015016:Yohimbine