The influence of an illusion of control on panic attacks induced via inhalation of 5.5% carbon dioxide-enriched air
W. C. Sanderson, R. M. Rapee and D. H. Barlow
Center for Stress and Anxiety Disorders, State University of New York, Albany.
The current study tested the notion that a sense of control can mitigate
anxiety and panic attacks caused by the inhalation of 5.5% carbon dioxide
(CO2)-enriched air. Twenty patients with panic disorder inhaled a mixture
of 5.5% CO2-enriched air for 15 minutes. All patients were instructed that
illumination of a light directly in front of them would signal that they
could decrease the amount of CO2 that they were receiving, if desired, by
turning a dial attached to their chair. For ten patients, the light was
illuminated during the entire administration of CO2. For the remaining ten
patients, the light was never illuminated. In fact, all patients
experienced the full CO2 mixture, and the dial was ineffective. When
compared with patients who believed they had control, patients who believed
they could not control the CO2 administration (1) reported a greater number
of DSM-III-revised panic attack symptoms, (2) rated the symptoms as more
intense, (3) reported greater subjective anxiety, (4) reported a greater
number of catastrophic cognitions, (5) reported a greater resemblance of
the overall inhalation experience to a naturally occurring panic attack,
and (6) were significantly more likely to report panic attacks. These data
illustrate the contribution of psychologic factors to laboratory induction
of panic attacks through inhalation of 5.5% CO2-enriched air.
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Pine et al.
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Physiological Changes During Carbon Dioxide Inhalation in Patients With Panic Disorder, Major Depression, and Premenstrual Dysphoric Disorder: Evidence for a Central Fear Mechanism
Gorman et al.
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Effect of acute tryptophan depletion on CO2-induced anxiety in patients with panic disorder and normal volunteers
MILLER et al.
Br. J. Psychiatry 2000;176:182-188.
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Panic Disorder Subtypes: Differential Responses to CO2 Challenge
Biber and Alkln
Am. J. Psychiatry 1999;156:739-744.
ABSTRACT
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Instructional Set and Physiological Response to CO2 Inhalation
Welkowitz et al.
Am. J. Psychiatry 1999;156:745-748.
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Ventilatory Physiology of Children and Adolescents With Anxiety Disorders
Pine et al.
Arch Gen Psychiatry 1998;55:123-129.
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Respiratory Psychophysiology of Panic Disorder: Three Respiratory Challenges in 98 Subjects
Papp et al.
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Beyond sterile debate
Telch
J Psychopharmacol 1991;5:296-298.