PHYSIOLOGICAL MARKERS FOR ANXIETY DISORDER--PD AND GAD

焦虑症的生理标志——PD 和 GAD

• 批准号: 2034915
• 负责人: WALTON Thompson ROTH
• 金额: $ 22.07万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-05-15 至 2000-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2034915
• 关键词: anxiety disorders; autonomic nervous system; avoidance behavior; behavior test; behavioral /social science research tag; biomarker; clinical research; human subject; hyperpnea; noise; panic disorder; psychophysiology; respiratory hypoxia; startle reaction; temporal lobe /cortex

DESCRIPTION (Adapted from applicant's abstract): The DSM-IV classification of anxiety disorders postulates a number of distinct diseases presumed to have different biological underpinnings. Although physiological symptoms such as rapid heart beat and breathlessness are important component criteria for both Panic Disorder (PD) with and without agoraphobia, and Generalized Anxiety Disorder (GAD), diagnosis is based on subjective report of physiological disturbance rather than its objective measurement. The clinical phenomenology of PD and GAD suggests different temporal patterns, e.g., abrupt surges of activation in panic attacks versus more sustained activation in phobic situations and in GAD. While primarily characterized by sustained activation, GAD patients may also show short spikes of activation associated with intrusive, worried thoughts. Biologic mechanisms proposed to account for the phenomenology of PD, with and without agoraphobia, include autonomic instability, hyperventilation, suffocation false alarm, and epileptic discharge. Ambulatory monitoring and laboratory tests (relaxation, habituation, breath holding, hyperventilation, concomitants of thought, and classical conditioning) developed specifically to assess these physiological mechanisms will be used in two separate studies. Study 1 will compare 30 GAD patients, 30 PD patients with agoraphobia, and 30 controls. Study 2 will compare 20 PD patients with agoraphobia, 20 PD patients without agoraphobia, and 20 controls. In Study 2, ambulatory monitoring will include a behavioral avoidance test in a shopping mall. Analysis will determine if: 1. PD patients manifest more spontaneous autonomic fluctuations coinciding with dips and/or peaks in end-tidal pCO2 and electroencephalography changes suggesting epileptic discharge, than controls and GAD patients. 2. PD patients respond with more exaggerated psychophysiological reactions to dips and peaks in end-tidal pCO2 produced respiratory maneuvers than GAD patients or controls. 3. GAD patients and PD patients with agoraphobia habituate more slowly to noise bursts than PD patients without agoraphobia or controls. 4. Emotional conditioning to noise bursts is acquired more quickly and is more resistant to extinction in PD patients with agoraphobia than PD patients without agoraphobia or controls. 5. Physiological activation is related to subjective report of anxiety and panic and specific anxiety symptoms.

描述(改编自申请人的摘要)：DSM-IV分类 焦虑症的一系列不同疾病被认为是 有着不同的生物学基础。虽然生理症状 如心跳过快和呼吸困难是重要组成标准 对于有和没有广场恐惧症的惊恐障碍(PD)，以及泛化 焦虑症(GAD)，诊断基于主观报告 生理干扰，而不是它的客观测量。这个 PD和GAD的临床现象学提示不同的时间模式， 例如，恐慌症发作时激活的突然激增与更持续的 在恐惧症和广泛性焦虑症中被激活。虽然主要的特点是 通过持续的激活，广泛性痴呆症患者也可能表现出短的尖峰 与侵扰性的、忧心忡忡的想法相关的激活。生物机制 建议解释帕金森病的现象学，有和没有 广场恐惧症，包括自主神经不稳定、过度换气、窒息 虚惊一场，癫痫样放电。非卧床监测和实验室 测试(放松、习服、屏气、过度换气、 思想的伴随性和经典条件作用)是专门开发的 为了评估这些生理机制，将在两个不同的 学习。研究1将30名广泛性AD患者、30名帕金森病患者与 广场恐惧症和30名对照组。研究2将比较20名帕金森病患者和 20例无广场恐怖症的帕金森病患者和20例对照组。在学习中 2、动态监测将包括行为回避测试 购物中心。分析将确定是否： 1.PD患者表现出更多的自发性自主神经波动 呼气末二氧化碳分压下降和/或峰值和脑电改变 提示癫痫样放电，高于对照组和GAD患者。 2.帕金森病患者的心理生理反应更加夸张 到呼气末二氧化碳分压的下降和峰值比GAD产生的呼吸动作 患者或对照组。 3.患有广场恐怖症的GAD患者和PD患者习惯于 噪声爆发较无广场恐怖症或对照组的帕金森病患者更明显。 4.对噪音爆发的情绪调节获得得更快，而且 患有广场恐怖症的帕金森病患者比帕金森病患者更能抵抗灭绝 没有广场恐惧症或对照组的患者。 5.生理激活与焦虑和焦虑的主观反映有关 恐慌和特定的焦虑症状。