title: Assessment of automatic associations with bodily sensations and agoraphobic situations in panic disorder.
abstract: One of the central assumptions of cognitive models of Panic Disorder (PD) is that automatic panic-related associations are a core feature of PD. However, empirical findings are mixed and inconsistent, rendering it difficult to evaluate the role of panic-related associations adequately, particularly in relation to the relevant theories. The present study aimed to further advance our understanding of automatic associations in PD, and therefore applied a paradigm novel in this context, namely an Extrinsic Affective Simon Task (EAST).
  
  
  
  Participants involved treatment seeking, unmedicated panic patients (n = 45) and healthy controls (n = 38). The EAST was applied prior to treatment. It included the following stimuli as targets: panic-related bodily sensations and agoraphobia-related situations, and as attributes: pleasant versus unpleasant, fear-related words.
  
  
  
  Contrary to our expectations, panic patients did not show stronger negative than positive automatic associations for either panic-related symptoms or agoraphobia-related situations, compared to healthy controls. Moreover, EAST effects did not correlate with panic-related self-report measures.
  
  
  
  Although the present study involved patients who were actively seeking treatment, panic-related associations might not have been activated sufficiently. Hence, a brief activation procedure (e.g., hyperventilation) might have been needed to optimize the assessment condition.
  
  
  
  The present findings do not support contemporary theories of panic-related associations. Therefore, follow-up work is needed to disentangle their functional and operational properties more thoroughly.
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 9-13, 44787 Bochum, Germany. Electronic address: marcella.woud@rub.de.
authors.forename: Marcella L
authors.initials: ML
authors.lastname: Woud
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6526 HR Nijmegen, The Netherlands.
authors.forename: Eni S
authors.initials: ES
authors.lastname: Becker
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 9-13, 44787 Bochum, Germany; Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6526 HR Nijmegen, The Netherlands.
authors.forename: Mike
authors.initials: M
authors.lastname: Rinck
authors.affiliation: Warneford Hospital, Department of Psychiatry, University of Oxford, Warneford Lane, Oxford OX3 7JX, UK.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Harmer
authors.affiliation: Warneford Hospital, Department of Psychiatry, University of Oxford, Warneford Lane, Oxford OX3 7JX, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Reinecke
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000150:complications*; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time / Q000502:physiology; D012677:Sensation / Q000502:physiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Automatic associations; Extrinsic affective simon task (EAST); Information processing bias; Panic disorder