scholarly journals Decreased defensive reactivity to interoceptive threat after successful exposure-based psychotherapy in patients with panic disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christoph Benke ◽  
Manuela G. Alius ◽  
Alfons O. Hamm ◽  
Christiane A. Pané-Farré
Keyword(s):  
Panic Disorder ◽  
Primary Diagnosis ◽  
Symptom Improvement ◽  
Defensive Response ◽  
Wait List ◽  
Eyeblink Response ◽  
Waiting Period ◽  
Startle Eyeblink ◽  
Defensive Responses ◽  
Clinically Significant

AbstractPanic disorder (PD) is characterized by a dysfunctional defensive responding to panic-related body symptoms that is assumed to contribute to the persistence of panic symptomatology. The present study aimed at examining whether this dysfunctional defensive reactivity to panic-related body symptoms would no longer be present following successful cognitive behavior therapy (CBT) but would persist when patients show insufficient symptom improvement. Therefore, in the present study, effects of CBT on reported symptoms and defensive response mobilization during interoceptive challenge were investigated using hyperventilation as a respiratory symptom provocation procedure. Changes in defensive mobilization to body symptoms in the course of CBT were investigated in patients with a primary diagnosis of PD with or without agoraphobia by applying a highly standardized hyperventilation task prior to and after a manual-based CBT (n = 38) or a waiting period (wait-list controls: n = 20). Defensive activation was indexed by the potentiation of the amygdala-dependent startle eyeblink response. All patients showed a pronounced defensive response mobilization to body symptoms at baseline. After treatment, no startle reflex potentiation was found in those patients who showed a clinically significant improvement. However, wait-list controls and treatment non-responders continued to show increased defensive responses to actually innocuous body symptoms after the treatment/waiting period. The present results indicate that the elimination of defensive reactivity to actually innocuous body symptoms might be a neurobiological correlate and indicator of successful CBT in patients with PD, which may help to monitor and optimize CBT outcomes.

Effect of Comorbid Post-Traumatic Stress Disorder and Panic Disorder on Defensive Responding

2018 ◽  
Vol 32 (2) ◽  
pp. 43-52 ◽  
Author(s):  
Andrea C. Katz ◽  
Anna Weinberg ◽  
Stephanie M. Gorka ◽  
Randy P. Auerbach ◽  
Stewart A. Shankman
Keyword(s):  
Panic Disorder ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Eyeblink Response ◽  
Healthy Individuals ◽  
Post Traumatic Stress ◽  
Startle Eyeblink ◽  
Post Traumatic ◽  
Defensive Responding

Abstract. Although panic disorder (PD) and post-traumatic stress disorder (PTSD) are characterized by heightened sensitivity to threat, no study to date has examined the effect of comorbid PD and PTSD on defensive responding. The present study probed startle eyeblink response to an acoustic probe in three groups of participants recruited from the community: (1) healthy individuals (n = 63), (2) individuals with PD without PTSD (n = 62), and (3) individuals with comorbid PD and PTSD (n = 24). Results indicated that PD individuals without PTSD exhibited greater sensitivity to threat relative to controls, and comorbid individuals displayed attenuated sensitivity to threat relative to PD individuals without PTSD (both ps < .05). The results are discussed in the context of the anxiety disorder spectrum, which postulates that anxiety disorders exist on a continuum spanning from specific/simple fear to broad distress, with defensive responding decreasing as distress increases.

Panic Self-Efficacy Mediates Panic Disorder Symptom Improvement

2013 ◽  
Author(s):  
H. N. Fentz ◽  
A. Hoffart ◽  
M. B. Jensen ◽  
M. Arendt ◽  
M. S. O'Toole
Keyword(s):  
Panic Disorder ◽  
Self Efficacy ◽  
Symptom Improvement ◽  
Disorder Symptom

Empathy Does Not Amplify Vicarious Threat Learning

2019 ◽  
Author(s):  
Alexander Lane Williams ◽  
Christopher C Conway
Keyword(s):  
Individual Differences ◽  
Skin Conductance ◽  
Defensive Response ◽  
Conditioned Stimuli ◽  
Defensive Reaction ◽  
Direct Exposure ◽  
Conditioned Responses ◽  
Clinically Significant ◽  
Stimulus Materials ◽  
Dispositional Empathy

Clinically significant fears and phobias can be acquired vicariously. Witnessing a demonstrator’s defensive reaction to potentially dangerous objects and situations can instill conditioned threat responses in the observer. The present study concentrates on individual differences in this social learning process. Specifically, we hypothesized that dispositional empathy modulates vicarious threat conditioning. We examined university students’ (N = 150) conditioned threat responding after they observed strangers undergo Pavlovian threat conditioning. There was evidence of a substantial conditioned defensive response (Cohen’s d = 0.66), as indexed by elevated skin conductance reactions during participants’ direct exposure to the vicariously conditioned stimuli. Contrary to expectations, indices of dispositional empathy were weakly related to the size of conditioned responses (median r = .04). Our results confirm that vicarious threat learning can be evaluated experimentally, but they do not support the hypothesis that empathy amplifies this process. The preregistration, stimulus materials, data, and analysis code for this study are available at https://osf.io/h6hm2.

Differential Expression of Cytokeratins 8 and 20 Distinguishes Craniopharyngioma From Rathke Cleft Cyst

2002 ◽  
Vol 126 (10) ◽  
pp. 1174-1178 ◽  
Author(s):  
Wei Xin ◽  
Mark A. Rubin ◽  
Paul E. McKeever
Keyword(s):  
Molecular Weight ◽  
Differential Expression ◽  
Expression Patterns ◽  
Primary Diagnosis ◽  
Pars Intermedia ◽  
Rathke Cleft Cyst ◽  
Cytokeratin Expression ◽  
Pituitary Glands ◽  
Clinically Significant ◽  
Difficult Cases

Abstract Background.—Craniopharyngiomas are epithelial neoplasms usually located in the sellar and suprasellar regions. Distinguishing craniopharyngioma from Rathke cleft cyst is sometimes difficult, and the distinction is clinically significant because Rathke cleft cysts have a better prognosis than craniopharyngiomas. Design.—We retrieved 10 cases with a primary diagnosis of craniopharyngioma and 5 cases with a diagnosis of Rathke cleft cyst for analysis. Five cases of normal pars intermedia of pituitary glands from autopsy served as controls. We evaluated the expression patterns of a broad range of low– to intermediate–molecular weight cytokeratins (CK7, CK8, CK10, CK17, CK18, CK19, and CK20) and high–molecular weight cytokeratins (K903: a combination of CK1, CK5, CK10, and CK14; and CK5/6) in these cases. Results.—Craniopharyngiomas had a cytokeratin expression pattern distinct from that of Rathke cleft cysts and pituitary gland pars intermedia: craniopharyngiomas did not express cytokeratins 8 and 20, whereas Rathke cleft cysts and pars intermedia of pituitary glands both expressed cytokeratins 8 and 20. Conclusion.—The differential expression of cytokeratins distinguishes between craniopharyngioma and Rathke cleft cyst, and this difference could be useful for identifying craniopharyngioma in difficult cases in which only a small biopsy is available. The different cytokeratin profiles of craniopharyngioma and Rathke cleft cyst suggest that these lesions do not come from the same origin, or that they come from a different developmental stage of the pouch epithelium.

scholarly journals REVIEW OF THE CURRENT STATE OF THE PROBLEM OF PRIMARY DETECTION OF MALIGNANT TUMORS OF THE CAVITY

2019 ◽  
Vol 15 (2) ◽  
pp. 50-55
Author(s):  
Наталья Нуриева ◽  
Natal'ya Nurieva ◽  
Александр Гузь ◽  
Aleksandr Guz ◽  
Александр Захаров ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Diagnostic Procedures ◽  
Primary Diagnosis ◽  
Malignant Neoplasms ◽  
Dental Rehabilitation ◽  
Late Treatment ◽  
Clinically Significant

Subject: malignant neoplasms of the oral cavity, primary detectability, appeal to specialists, terms of treatment before hospitalization. Objective: based on a five-year analysis of the medical records of patients with a verified diagnosis of malignant neoplasm of the oral cavity, to identify significant criteria for primary diagnosis, doctors of the first contact, including non-cancer profile. Methodology. Malignant neoplasms occupy one of the leading places among all medical and social problems. This is due to a number of reasons, among which are particularly high rates of morbidity and mortality, late treatment of patients and frequent disability. the Purpose of early detection of malignant tumors of the oral cavity is to increase the effectiveness and radicality of treatment, increase the possibility of dental rehabilitation, reduction of disability. To write this article, we conducted a five-year analysis of the primary detection of malignant tumors of the oral cavity in 76 patients hospitalized for treatment in the head and neck Department of the Chelyabinsk district Oncology center. All patients with histologically confirmed diagnosis. Everyone needs specialized anti-tumor treatment. In addition to standard diagnostic procedures, all patients were surveyed on the issues of primary complaints and appeals to medical specialists. Results. On the example of the received questionnaires as well as the standard medical examinations conducted upon admission to the head and neck Department, the trends of the primary referral of patients to primary contact doctors, the terms of treatment before referral to a specialized oncological institution, the stage of the process and the presence of metastasis of the primary focus during treatment, the presence of aggravating factors are analyzed. Conclusions. The results for the five-year period in patients with primary malignant neoplasm of the oral cavity were evaluated, practical recommendations on clinically significant symptoms of malignant tumors of the oral cavity, orientation on the timing of observation were given.

Sensorimotor Gating and Attitudes Related to Schizotypal Proneness

2001 ◽  
Vol 88 (3_suppl) ◽  
pp. 1035-1045 ◽  
Author(s):  
Almut I. Weike ◽  
Alfons O. Hamm ◽  
Dieter Vaitl
Keyword(s):  
Prepulse Inhibition ◽  
Sensorimotor Gating ◽  
Schizophrenia Spectrum Disorders ◽  
Eyeblink Response ◽  
Startle Eyeblink ◽  
Psychosis Proneness ◽  
Gating Mechanism ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Information Processing Deficits

The magnitude of the startle eyeblink response is diminished when the startle-eliciting probe is shortly preceded by another stimulus. This so called prepulse inhibition is interpreted as an automatic sensorimotor gating mechanism. There is substantial support for prepulse inhibition deficits in subjects suffering from schizophrenia spectrum disorders and in psychosis-prone normals as well. Thus, prepulse inhibition deficits may reflect vulnerability on the hypothesized psychopathological continuum from “normal” to “schizophrenia.” The present experiment investigated the amount of prepulse inhibition in a sample selected for “belief in extraordinary phenomena,” an attitude related to measures of psychosis-proneness. Believers and skeptics were tested in an acoustic prepulse-inhibition paradigm. As expected, presentation of prepulses clearly diminished magnitude of startle response, with greatest inhibition effects gained by lead intervals of 60 and 120 msec. Patterns of response were identical for believers and skeptics, i.e., attitude towards extraordinary phenomena did not seem to be related to functional information-processing deficits as has been observed in psychosis-prone normals.

SELF-FOCUSED ATTENTION: COMMONALITIES ACROSS PSYCHOPATHOLOGIES AND PREDICTORS

2001 ◽  
Vol 29 (2) ◽  
pp. 169-178 ◽  
Author(s):  
Janet Woodruff-Borden ◽  
Andrew J. Brothers ◽  
Sally C. Lister
Keyword(s):  
Problem Solving ◽  
Panic Disorder ◽  
Negative Relationship ◽  
Primary Diagnosis ◽  
Focused Attention ◽  
Affective States ◽  
Significant Relationships ◽  
Causal Direction ◽  
Clinical Syndromes ◽  
The Relationship

Self-focused attention, also thought of a self-absorption, has been linked to a variety of affective states and clinical syndromes, including depression, panic disorder, social anxiety, schizophrenia, and alcoholism. Ingram (1990b) has suggested that self-focus may be a “nonspecific process” that is common across psychopathologies. Studies with nonclinical samples have supported this contention, and the current study assessed whether self-focus was common across various clinically diagnosed groups. A second issue, given this commonality, was to examine the factors across diagnostic conditions to which self-focus was related. One hundred and thirty-eight outpatients were included, and were divided into three groups based on primary diagnosis: “depression”, “panic”, and “other anxiety”. They were assessed with the ADIS-R/IV and completed measures assessing self-focus, affective states, global psychopathology, and problem-solving. Self-focus was common across groups, with minor valence variations. Severity of primary diagnosis predicted total self-focus, with level of depression and trait anxiety predicting negative self-focus. Correlational analyses suggested that self-focused attention is related to general measures of psychopathology and severity, and negatively related to problem-solving. The pattern with negative self-focus was even more pronounced, with significant relationships to all measures of psychopathology, clinician-rated severity, and a negative relationship with problem-solving. Results are discussed in terms of differences between “normal” and problematic self-focus, the causal direction in the relationship between self-focus and negative affect, and the link between self-focus and problem-solving.

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