Cognitive Vulnerability in the Context of Panic: Assessment of Panic-Related Associations and Interpretations in Individ
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ORIGINAL ARTICLE
Cognitive Vulnerability in the Context of Panic: Assessment of Panic‑Related Associations and Interpretations in Individuals with Varying Levels of Anxiety Sensitivity Lisa Zahler1 · Katharina Sommer1 · Andrea Reinecke2 · Frank H. Wilhelm3 · Jürgen Margraf1 · Marcella L. Woud1 Published online: 25 April 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Cognitive models of panic disorder (PD) highlight the role of panic-related associations and interpretations. However, results are mixed and rely on specific measures. This study examined panic-related associations and interpretations using established and new paradigms in individuals varying on anxiety sensitivity (AS). Methods Associations were measured using a priming task and a novel Single Target Implicit Association Test (STIAT); interpretations were assessed using the Interpretation Bias Questionnaire (IBQ) and a novel Scrambled Sentences Task (SST). Symptoms were assessed via a provocation task (Straw Breathing Task, SBT). Results Panic-related interpretations correlated with AS and other PD-related measures. Of the association tasks, only the priming task correlated with one of the other PD-related measures. Panic-related interpretations assessed via the SST, but not priming, STIAT, and IBQ, predicted SBT reactivity. The relationship between AS and SBT reactivity was mediated by panic-related interpretations. Conclusions Our data provide support for panic-related interpretations as an important cognitive mechanism. Keywords Panic disorder · Anxiety sensitivity · Automatic associations · Interpretations · Cognitive-behavior therapy
Introduction Panic disorder (PD) is a prevalent and often disabling anxiety disorder (Barlow et al. 2000; Olesen et al. 2012). Several theories have been developed, postulating strong cognitive components in the pathogenesis of PD (e.g., Clark 1986; Margraf and Ehlers 1989). In brief, these accounts Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10103-6) contains supplementary material, which is available to authorized users. * Marcella L. Woud [email protected] 1
Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstraße 9‑13, 44787 Bochum, Germany
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Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford OX3 7JX, UK
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Division of Clinical Psychology, Psychotherapy, and Health Psychology, Department of Psychology, University of Salzburg, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
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assume that people with PD are hypervigilant to their bodily reactions, and once attention is paid to these reactions, panic-related threat associations (e.g., fear) are immediately triggered. These are then followed by more complex, panicrelated interpretations (e.g., a catastrophizing interpretation). This, in turn, increases anxiety, triggers additional anxiety-related bodily reactions, and ultima
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