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Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223

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Authors and Corporations: Richter, Jan, Hamm, Alfons O., Pané-Farré, Christiane A., Gerlach, Alexander L., Gloster, Andrew T., Wittchen, Hans-Ulrich, Lang, Thomas, Alpers, Georg W., Helbig-Lang, Sylvia, Deckert, Jürgen, Fydrich, Thomas, Fehm, Lydia, Ströhle, Andreas, Kircher, Tilo, Arolt, Volker
Title Statement: Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
Type of Resource: E-Article
published:
Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden 2012
Series: Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
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700 |a Gloster, Andrew T. 
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700 |a Lang, Thomas 
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245 |a Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder  |n Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223 
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520 3 |a Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder. 
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author Richter, Jan
author2 Hamm, Alfons O., Pané-Farré, Christiane A., Gerlach, Alexander L., Gloster, Andrew T., Wittchen, Hans-Ulrich, Lang, Thomas, Alpers, Georg W., Helbig-Lang, Sylvia, Deckert, Jürgen, Fydrich, Thomas, Fehm, Lydia, Ströhle, Andreas, Kircher, Tilo, Arolt, Volker
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contents Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder.
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series2 Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
source_id 22
spelling Richter, Jan, Hamm, Alfons O., Pané-Farré, Christiane A., Gerlach, Alexander L., Gloster, Andrew T., Wittchen, Hans-Ulrich, Lang, Thomas, Alpers, Georg W., Helbig-Lang, Sylvia, Deckert, Jürgen, Fydrich, Thomas, Fehm, Lydia, Ströhle, Andreas, Kircher, Tilo, Arolt, Volker, Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden 2012 (issued 2013-08-15) (created 2012), Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223, Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder., article, https://nbn-resolving.org/urn:nbn:de:bsz:14-qucosa-120100 Online-Zugriff, Agoraphobie, Angst, Panikattacken, Panikstörung, Schreckreaktion, Agoraphobia, anxiety, fear, panic attacks, panic disorder, startle potentiation
spellingShingle Richter, Jan, Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder, Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder., Agoraphobie, Angst, Panikattacken, Panikstörung, Schreckreaktion, Agoraphobia, anxiety, fear, panic attacks, panic disorder, startle potentiation
title Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder
title_auth Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder
title_full Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
title_fullStr Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
title_full_unstemmed Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
title_list_str Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder, Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
title_part_str Biological Psychiatry, Bd. 72 (2012), Nr. 6, S. 512-520, ISSN: 0006-3223
title_short Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder
title_sort dynamics of defensive reactivity in patients with panic disorder and agoraphobia implications for the etiology of panic disorder
topic Agoraphobie, Angst, Panikattacken, Panikstörung, Schreckreaktion, Agoraphobia, anxiety, fear, panic attacks, panic disorder, startle potentiation
topic_facet Agoraphobie, Angst, Panikattacken, Panikstörung, Schreckreaktion, Agoraphobia, anxiety, fear, panic attacks, panic disorder, startle potentiation
url https://nbn-resolving.org/urn:nbn:de:bsz:14-qucosa-120100
urn urn:nbn:de:bsz:14-qucosa-120100