When dyspnea gets worse: Suffocation fear and the dynamics of defensive respiratory responses to increasing interoceptive threat
When dyspnea gets worse: Suffocation fear and the dynamics of defensive respiratory responses to increasing interoceptive threat
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DOI：
10.1111/psyp.12881
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发表时间：
2017-09-01
期刊：
影响因子：
3.7
通讯作者：
Pane-Farre, Christiane A.
中科院分区：
文献类型：
--
作者：
Benke, Christoph;Hamm, Alfons O.;Pane-Farre, Christiane A.
在患有焦虑症和/或呼吸系统疾病的患者中，身体感觉，特别是来自呼吸系统的感觉，可能会增加强度和厌恶性，从而导致防御行为（例如，逃离或恐慌。然而，可能导致症状达到顶峰并转变为防御行动的过程尚未得到很好的理解。本研究旨在评估一个实验范式，以表征防御动员的动态身体感觉增加的强度和厌恶。报告低和高窒息恐惧（SF; N=69）的人暴露于由吸气阻力负荷和需要自主屏气的呼吸阻塞引起的呼吸困难的越来越不愉快的感觉。呼吸反应与焦虑和恐慌症状的主观报告一起进行沿着评估。随着身体阻力的增加，呼吸负荷的出现导致呼吸困难的感觉越来越不愉快。28名参与者至少提前终止了一次暴露。当呼吸困难是严重的，高SF相比，低的人表现出呼吸频率增加，伴随着更强烈的恐慌症状的报告。提前终止暴露之前，焦虑，呼吸频率和口腔压力激增，潮气量减少。我们成功地建立了一个实验范式，以评估防御反应的变化与内感受性威胁的强度增加。目前的数据促进了我们对焦虑和/或呼吸系统疾病患者的行为表达模式的理解，以及身体感觉和焦虑达到高潮而导致恐慌的过程。
In patients with anxiety and/or respiratory diseases, body sensations, particularly from the respiratory system, may increase in intensity and aversiveness and thus lead into defensive action (e.g., escape) or panic. The processes, however, that might contribute to the culmination of symptoms and the switch into defensive action have not been well understood yet. The current study aimed at evaluating an experimental paradigm to characterize the dynamics of defensive mobilization to body sensations increasing in intensity and aversiveness. Persons reporting low and high suffocation fear (SF; N=69) were exposed to increasingly unpleasant feelings of dyspnea induced by inspiratory resistive loads and a breathing occlusion requiring voluntary breath holding. Respiratory responses were assessed along with subjective reports of anxiety and panic symptoms. Presentation of respiratory loads with increasing physical resistance led to increasingly unpleasant feelings of dyspnea. Twenty-eight participants terminated the exposure prematurely at least once. When dyspnea was severe, high compared to low SF persons exhibited an increased respiratory rate that was accompanied by reports of more intense panic symptoms. Premature terminations of exposure were preceded by a surge in anxiety, breathing frequency, and mouth pressure, and a decrease in tidal volume. We successfully established an experimental paradigm to assess changes in defensive responding with increasing intensity of an interoceptive threat. The current data foster our understanding of behavioral expression patterns observed in patients with anxiety and/or respiratory diseases and the processes involved in the culmination of bodily sensations and anxiety into panic.