Respiratory Therapeutic Procedures in Panic Disorder

恐慌症的呼吸治疗程序

• 批准号: 6924716
• 负责人: WALTON Thompson ROTH
• 金额: $ 26.33万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-19 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6924716
• 关键词: behavioral /social science research tag; biofeedback; clinical research; human subject; human therapy evaluation; hypercapnia; hyperpnea; hypocapnia; interview; medical complication; panic disorder; psychophysiology; questionnaires; respiratory disorder; respiratory hypoxia; respiratory therapy

DESCRIPTION (provided by applicant): Both the hyperventilation and suffocation alarm theories of panic together with recent research findings point towards a central role for respiratory dysregulation in Panic Disorder. Cognitive-behavioral treatment packages for Panic Disorder typically include respiratory training and hyperventilation exposure, but little is known about their physiological effects and specific contribution to outcome. Our preliminary study of home-based pCO2 feedback-assisted respiratory training suggests that teaching patients to raise their pCO2 relieves certain panic symptoms fairly rapidly, but whether it does so by preventing hyperventilation is uncertain. We propose comparing the results of two kinds of breathing training based on opposing theories. In this 3-year project we will recruit 75 Panic Disorder patients and 25 non-anxious controls. Patients will be randomly assigned to one of three groups: raise-pCO2 respiratory training (based on the hyperventilation theory), lower pCO2 respiratory training (based on the suffocation alarm theory), or waiting-list. Patients will be evaluated before, during, and at 1 month and 6 months after a 5-session, 4-week course of therapy. Besides the usual clinical outcome measures, we will gather in-vivo evidence for changes in respiration, both in response to standardized basal activation and hyperventilation tests and at other times during 24-hour monitoring using novel assessment systems. Our hypotheses include the following: 1) The raise-C02 procedure will produce more reduction in the frequency and severity of panic attacks than the lower-C02 procedure or waiting for treatment. If this common assumption is not upheld, and both procedures produce similar improvement, we can infer that they work nonspecifically. 2) The raise-C02 breathing training will lead to higher pC02 levels and the lower-C02 breathing training to lowerpC02 levels during tests and during 24-hour monitoring than before training. If this is not true, we will know that what is learned during the sessions is not transferred to other situations. 3) Clinical improvement in frequency and severity of panic attacks for both breathing training procedures will be better predicted by initial respiratory symptoms and respiratory abnormalities than by cardiac symptoms. If this is true, therapeutic application of breathing training should be restricted to patients with breathing complaints. In addition, we will characterize patients' pre-treatment respiratory dysfunction in ecologically valid settings. The general significance of this proposal lies in its multi-modal evaluation of respiratory training as a procedure for treating certain Panic Disorder symptoms and its extension of in-depth respiratory assessment beyond the laboratory for longer time periods, affording a better understanding of respiratory dysregulation in this disorder.

描述（由申请人提供）：恐慌的过度通气和窒息警报理论以及最近的研究结果都指出了呼吸失调在恐慌障碍中的核心作用。惊恐障碍的认知行为治疗方案通常包括呼吸训练和过度通气暴露，但对其生理效果和对结果的具体贡献知之甚少。我们对基于家庭的pCO2反馈辅助呼吸训练的初步研究表明，教患者提高pCO2相当迅速地缓解某些恐慌症状，但是否通过防止过度换气来实现这一点尚不确定。我们建议比较两种基于对立理论的呼吸训练的结果。在这个为期3年的项目中，我们将招募75名恐慌症患者和25名非焦虑对照组。患者将随机分配到三组中的一组：提高pCO2呼吸训练（基于过度通气理论），降低pCO2