title: Anticipatory anxiety as a function of panic attacks and panic-related self-efficacy: an ambulatory assessment study in panic disorder.
abstract: BACKGROUND
  Panic attacks and anticipatory anxiety are considered to be inter-correlated, yet distinctive, features of panic disorder, both contributing to its onset and maintenance as well as to the associated impairment. Given the difficulty to yield ecologically valid data on these fluctuating symptoms the natural course of anticipatory anxiety and its correlates have seldom been addressed with adequate methods.
  
  
  OBJECTIVE
  The current study aimed at further exploring the natural variance of anticipatory anxiety and its interdependence with panic-related variables. In addition, impact of anxiety sensitivity, and perceived ability to cope with panic on the relation between panic attacks and subsequent anxiety was inspected.
  
  
  METHODS
  Based on an Ecological Momentary Assessment approach, 21 patients with panic disorder rated study variables continuously over one week; 549 question sets were completed.
  
  
  RESULTS
  Anticipatory anxiety followed a diurnal pattern and was associated with situational and internal variables typically linked to panic experiences. Preceding panic attacks intensified anticipatory anxiety and associated negative emotional states; however, perceived ability to cope attenuated these effects.
  
  
  CONCLUSIONS
  Based on natural observation data, results largely support the importance of cognitive appraisals for anticipatory anxiety, and its interplay with panic attacks as it has been suggested by cognitive theory and recent findings in extinction learning research.
authors.affiliation: University of Hamburg, Department for Clinical Psychology and Psychotherapy, Germany. Sylvia.Helbig-Lang@uni-hamburg.de
authors.forename: Sylvia
authors.initials: S
authors.lastname: Helbig-Lang
authors.forename: Thomas
authors.initials: T
authors.lastname: Lang
authors.forename: Franz
authors.initials: F
authors.lastname: Petermann
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoyer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D059031:Anticipation, Psychological; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D002940:Circadian Rhythm; D015928:Cognitive Behavioral Therapy; D034201:Computers, Handheld; D003469:Culture; D005260:Female; D006801:Humans; D007206:Individuality; D007389:Internal-External Control; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D020377:Self Efficacy; D012931:Social Environment; D011795:Surveys and Questionnaires; D055815:Young Adult