The role of "interoceptive" fear conditioning in the development of panic disorder.
More than 20% of the general population experience a panic attack at least once in their lives; however, only a minority goes on to develop panic disorder (PD). Conditioning mechanisms have been proposed to explain this evolution in persons who are susceptible to developing panic disorder upon a "traumatic" panic attack. According to preparedness theory, some cues are more likely to condition than others, namely, those referring to internal, bodily signals of danger. The aim of the present study was to test this theory in a differential conditioning paradigm, making use of scripts referring to different internal, bodily sensations as conditioned stimulus (CS) and inhalation of 35% CO(2) as unconditioned stimulus (UCS). Thirty-three healthy volunteers were assigned to three scripts conditions: "suffocation," "neutral," or "urgency." During acquisition, one of two versions of a particular script was always followed by an inhalation of 35% CO(2) (CS+) and the other by room air (CS-). Acquisition was followed by a test phase, where only inhalations of room air were administered. In line with our hypothesis, only participants in the suffocation condition exhibited a selective conditioning effect. They were more fearful and showed a significantly higher increase in tidal volume than participants in the two control conditions. Results are discussed with relation to interoceptive conditioning, preparedness, and the possible role of tidal volume in PD.
Academic Anxiety Center, School for Mental Health and Neuroscience, Maastricht University, PO 88, 6200 AB Maastricht, The Netherlands. klaradecort@skynet.be
Klara
K
De Cort
Eric
E
Griez
Marjolein
M
Büchler
Koen
K
Schruers
D000280:Administration, Inhalation; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000008:administration & dosage; D003214:Conditioning, Classical / Q000502:physiology*; D003463:Cues; D004311:Double-Blind Method; D005239:Fear / Q000502:physiology* / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000209:etiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D013990:Tidal Volume / Q000502:physiology
D002245:Carbon Dioxide