Are Catastrophic Misinterpretations of Bodily Sensations Typical for Patients with Panic Disorder? An Experimental Study
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ORIGINAL ARTICLE
Are Catastrophic Misinterpretations of Bodily Sensations Typical for Patients with Panic Disorder? An Experimental Study of Patients with Panic Disorder or Other Anxiety Disorders and Healthy Controls Barnabas Ohst1 · Brunna Tuschen‑Caffier1
© The Author(s) 2020
Abstract Background Research on catastrophic misinterpretations of bodily sensations in patients with a diagnosis of panic disorder has yielded inconsistent findings concerning the question of how typical these misinterpretations are and how this compares with other anxiety disorders. Limitations of assessment strategies concerning catastrophic misinterpretations have been discussed. We assessed catastrophic misinterpretations by activating participants’ fear memory, as has been suggested. Methods Participants in the experimental group (EG) were shown a suspenseful film clip to induce physiological arousal before completing a measure of catastrophic misinterpretation (BSIQ-FR). Skin conductance level (SCL) was used as marker for physiological arousal. Results As expected, the film manipulation led to a significant increase in physiological arousal in the EG compared to the control group (CG) across all disorder groups. ANOVAs did not show significant interactions between factors Group (Panic Disorder, Other Anxiety Disorder, and Healthy Controls) and Condition (EG, CG). However, comparison of means indicated that participants with panic disorder showed more catastrophic misinterpretations of bodily sensations than patients with other anxiety disorders in the EG, but not in the CG. Conclusions The findings indicate that the activation of fear memory via induction of physiological arousal facilitated the measurement of catastrophic misinterpretations, and provide further evidence that catastrophic misinterpretations of bodily sensations are typical for panic disorder. Keywords Panic disorder · Anxiety disorder · Catastrophic misinterpretation · Experimental induction of physiological arousal · Fear memory
Introduction Catastrophic misinterpretations of bodily sensations play a central role in the cognitive model of panic by Clark (1986). They are assumed to be mainly responsible for the emergence of panic during panic attacks, by leading from ambiguous bodily sensations to heightened apprehension and eventually to panic. Catastrophic misinterpretations have been found to occur in patients with panic disorder (e.g., Austin and Richards 2006; Clark et al. 1997; McNally and Foa 1987), patients with other anxiety disorders (e.g., * Barnabas Ohst [email protected]‑freiburg.de 1
Institut für Psychologie, Albert-Ludwigs-Universität Freiburg, 79085 Freiburg, Germany
social anxiety disorder: Austin and Kiropoulos 2008; Clark et al. 1997; Harvey et al. 1993; generalized anxiety disorder: Clark et al. 1997), and even in people without a diagnosed mental disorder (e.g., Clark et al. 1997; McNally and Foa 1987; Richards et al. 2001; for a systematic review and meta-analysis, see Ohst and Tuschen-Caffier 2018). Thus, catastrophi
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