The Relationship Between Catastrophic Cognitions and the Components of Panic Disorder

1991 ◽  
Vol 5 (3) ◽  
pp. 175-186 ◽  
Author(s):  
Susan Robinson ◽  
Max Birchwood

Cognitive models of panic postulate that panic attacks arise from the catastrophic misinterpretation of somatic symptoms. Hitherto, research has concentrated on the link between cognitions and the somatic sensations experienced during panic attacks; little attention has been directed towards the relationship between cognitions and other critical components of Panic Disorder (e.g., avoidance behavior). Fifty-eight patients presenting with Panic Disorder with Agoraphobia (DSM-III-R) rated their degree of belief in nine “core” catastrophic cognitions and completed self-report measures of the critical symptoms of Panic Disorder. Results demonstrated a link between cognitions of physical catastrophe and somatic symptoms. Additionally, strong links were detected between the cognitions of losing control and “experiential” symptoms, between the cognition of insanity and depressive symptoms, and between the cognition of social embarrassment and avoidance behavior. Implications for the cognitive model and treatment of Panic Disorder are discussed.

2015 ◽  
Vol 29 (2) ◽  
pp. 123-133 ◽  
Author(s):  
Alexander M. Talkovsky ◽  
Peter J. Norton

The cognitive model of panic (Clark, 1988) suggests that panic attacks result from the catastrophic misinterpretation of bodily sensations rather than the sensations themselves. Anxiety sensitivity (AS) is fear of anxious bodily sensations (Reiss, 1991) and has implications in panic development, maintenance, and severity. Although previous work has demonstrated that AS amplifies symptoms in response to provocations, few have analyzed the role of AS in the relationship between panic symptoms and panic disorder severity. The purpose of this investigation was to determine if AS, a cognitive risk for panic, has an indirect effect on the association between self-reported panic symptoms and panic severity, both self-reported and clinician-assessed, among 67 treatment-seeking individuals with a primary diagnosis of panic disorder with or without agoraphobia. Data were analyzed using the bootstrapped conditional process indirect effects model. Results indicated that the overall total mediational effect on Panic Disorder Severity Scale (PDSS) was significant with evidence of partial mediation. The direct effect of Beck Anxiety Inventory (BAI) on PDSS remained significant although there was also a significant indirect effect of BAI via AS. Results showed a similar relationship when Clinician Severity Rating was the outcome. Moderation analyses were not significant. Therefore, AS was a significant partial mediator of the relationship between symptom intensity and panic severity, whether clinician-rated or self-reported. This investigation provides support for the importance of AS in panic, highlighting its importance but suggesting that it is not sufficient to explain panic disorder.


Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.


2010 ◽  
Vol 15 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Mette M. Aanes ◽  
Maurice B. Mittelmark ◽  
Jørn Hetland

This paper investigated whether the lack of social connectedness, as measured by the subjective feeling of loneliness, mediates the well-known relationship between interpersonal stress and psychological distress. Furthermore, a relationship between interpersonal stress and somatic symptoms was hypothesized. The study sample included 3,268 women and 3,220 men in Western Norway. The main findings were that interpersonal stress was significantly related to psychological distress as well as to somatic symptoms, both directly and indirectly via paths mediated by loneliness. The size of the indirect effects varied, suggesting that the importance of loneliness as a possible mediator differs for depressive symptoms, anxiety symptoms, and somatic symptoms. In the case of depressive symptoms, more than 75% of the total effect was mediated through loneliness, while in the case of somatic symptoms just over 40% of the total effect was mediated through loneliness. This study supports the hypotheses that social connectedness mediates a relationship between interpersonal stress and psychological distress. The study also provides the first link between interpersonal stress, as measured by the Bergen Social Relationships Scale, and somatic symptoms, extending earlier research on the relationship between interpersonal stress and psychological distress.


1989 ◽  
Vol 18 (4) ◽  
pp. 325-338 ◽  
Author(s):  
Bruce R. Deforge ◽  
Jeffery Sobal

Depression is one of the most common mental health problems in the elderly, but there is little consensus about the best way to assess depression in the aged. The relationship between the CES-D and the ZUNG self-report depression scales was investigated in seventy-eight elderly people with osteoarthritis (mean age 71). The correlation between the scales was r = .69, with the CES-D classifying 15 percent of the participants as depressed, as compared to 6 percent by the ZUNG. Psychological symptoms had the strongest relationship with overall depression scores on both scales. No sex differences were found on psychological items on either scale, but females reported more somatic symptoms on the ZUNG. People over age seventy-four reported more psychological symptoms than their younger counterparts.


2009 ◽  
Vol 137 (11-12) ◽  
pp. 659-663 ◽  
Author(s):  
Milan Latas ◽  
Danilo Obradovic ◽  
Marina Pantic

Introduction. A cognitive model of aetiology of panic disorder assumes that people who experience frequent panic attacks have tendencies to catastrophically interpret normal and benign somatic sensations - as signs of serious illness. This arise the question: is this cognition specific for patients with panic disorder and in what intensity it is present in patients with serious somatic illness and in healthy subjects. Objective. The aim of the study was to ascertain the differences in the frequency and intensity of 'catastrophic' cognitions related to body sensations, and to ascertain the differences in the frequency and intensity of anxiety caused by different body sensations all related to three groups of subjects: a sample of patients with panic disorder, a sample of patients with history of myocardial infarction and a sample of healthy control subjects from general population. Methods. Three samples are observed in the study: A) 53 patients with the diagnosis of panic disorder; B) 25 patients with history of myocardial infarction; and C) 47 healthy controls from general population. The catastrophic cognitions were assessed by the Agoraphobic Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). These questionnaires assess the catastrophic thoughts associated with panic and agoraphobia (ACQ) and the fear of body sensations (BSQ). All study subjects answered questionnaires items, and the scores of the answers were compared among the groups. Results. The results of the study suggest that: 1) There is no statistical difference in the tendency to catastrophically interpret body sensations and therefore to induce anxiety in the samples of healthy general population and patients with history of myocardial infarction; 2) The patients with panic disorder have a statistically significantly more intensive tendency to catastrophically interpret benign somatic symptoms and therefore to induce a high level of anxiety in comparison to the sample of patients with the history of serious somatic illness (myocardial infarction) and the sample of healthy general population. Conclusion. The tendency to catastrophically interpret benign somatic symptoms and therefore to induce a high level of anxiety in patients with panic disorder, confirms the cognitive aetiology model of panic disorder and suggests that it should be the focus of prophylactic and therapeutic management of patients with panic disorder.


2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Reiji Yoshimura ◽  
Naomichi Okamoto ◽  
Yuki Konishi ◽  
Atsuko Ikenouchi

We present a case of panic disorder induced by the coronavirus disease (COVID-19) pandemic in a patient with an organic mood disorder. The patient was a 62-year-old woman with mild mood swings and reduced motivation and volition caused by a traumatic brain injury after a traffic accident. She was maintained on carbamazepine (600 mg/day). When the COVID-19 outbreak occurred in Japan, she developed concerns regarding the illness and complained of multiple episodes of panic attacks. Further, her depressive symptoms worsened. Thus, vortioxetine was added to the ongoing CBZ treatment. Four weeks after initiating vortioxetine treatment, the symptoms of panic disorder and depressive state were ameliorated. The present case suggests that vortioxetine augmentation can improve symptoms of depressive state and panic disorder induced by the COVID-19 pandemic.


1995 ◽  
Vol 29 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Edwin de Beurs ◽  
Alfred Lange ◽  
Pieter Koele ◽  
Richard van Dyck

Thirty-two patients suffering from panic disorder with agoraphobia were treated with repeated hyperventilation provocations and respiratory training, followed by exposure in vivo. The treatment was evaluated with a comprehensive set of outcome measures, including self-report questionnaires, a multitask behavioural avoidance test and continuous monitoring of panic. The treatment was found effective for the majority of patients in diminishing the frequency of panic attacks and agoraphobic avoidance. The clinical relevance of the treatment effect was evidenced by the considerable number of patients that recovered. The effect of the treatment was sustained over a three and six month follow-up period. The prognostic value of a number of variables for treatment outcome was also investigated. Three variables accounted for the majority of the variance in treatment outcome: a higher pretreatment level of agoraphobic complaints, use of psychotropic medication and a longer duration of the disorder were associated with poorer outcome. Other variables, such as the therapeutic relationship and the quality of the marital bond, had no prognostic value.


2018 ◽  
Vol 46 (4) ◽  
pp. 504-509 ◽  
Author(s):  
Noboru Matsumoto ◽  
Satoshi Mochizuki

Background: The meta-cognitive model of rumination is a theoretical model regarding the relationship between rumination and depression. Although meta-cognitive therapy for rumination was established based on this model, insufficient longitudinal studies addressing this model have been conducted. Moreover, the uncontrollability of rumination, suggested to be driven by negative meta-beliefs about rumination, has not been examined using this meta-cognitive model. Aims: We longitudinally examined the meta-cognitive model and its relationship with uncontrollability of rumination and depressive symptoms. Method: Undergraduate students (n = 117) were asked to complete two measurements (with a 6-month gap between them) of positive and negative meta-beliefs about rumination, causal analysis, understanding, uncontrollability of rumination and depression. Results: Cross-lagged effect modelling revealed that positive meta-beliefs predicted high causal analytic rumination. However, the results did not support the causal analytic and understanding aspects of how rumination predicted negative meta-beliefs. Negative meta-beliefs predicted high depressive symptoms, and depressive symptoms predicted high negative meta-beliefs. Negative meta-beliefs predicted high uncontrollability of rumination, whereas uncontrollability of rumination did not predict depressive symptoms. Conclusions: The results partially supported the meta-cognitive model. The prediction of depressive symptoms on negative meta-beliefs suggests that depression-related cognition might be involved in increasing negative meta-beliefs, rather than the repetitive causal analytic and understanding aspects of rumination. In line with meta-cognitive therapy, negative meta-beliefs could be a target for treating depression.


2012 ◽  
Vol 17 (5) ◽  
pp. 335-340 ◽  
Author(s):  
Whitney Scott ◽  
Michael Sullivan

BACKGROUND: Numerous investigations report that depressive symptoms frequently coexist with persistent pain. However, evidence suggests that symptoms of depression are not an inevitable consequence of pain. Diathesis-stress formulations suggest that psychological factors interact with the stress of pain to heighten the risk of depressive symptoms. Perceptions of injustice have recently emerged as a factor that may interact with the stress of pain to increase depressive symptoms.OBJECTIVES: The purpose of the present study was to examine whether perceived injustice moderates the relationship between pain and depressive symptoms.METHODS: A total of 107 individuals with persistent musculoskeletal pain completed self-report measures of pain severity, depressive symptoms, perceived injustice and catastrophizing.RESULTS: A hierarchical regression analysis revealed that the interaction between pain severity and perceived injustice uniquely contributed an additional 6% of the variance to the prediction of depressive symptoms, beyond the main effects of these variables. Post hoc probing indicated that pain was significantly related to depressive symptoms at high, but not low levels of perceived injustice. This finding remained statistically significant even when controlling for pain catastrophizing.CONCLUSIONS: The results suggest that perceived injustice augments the relationship between pain severity and depressive symptoms. The inclusion of techniques specifically targeting perceptions of injustice may enhance the effectiveness of interventions aimed at reducing symptoms of depression for individuals presenting with strong perceptions of injustice.


2021 ◽  
Vol 12 ◽  
Author(s):  
Liat Korn ◽  
Miriam Billig ◽  
Gil Zukerman

Introduction: We examined how community type, residence attachment, and religiosity contribute to resilience to depressive symptoms, psychosomatic complaints, residential stress, and avoidance behavior among students exposed to terror.Methods: Undergraduate students from Ariel University (N = 1,413; 62.7% females; Mage = 26.5; SD = 6.03) completed a self-report questionnaire on socio-demographics, terror exposure, place attachment, and depressive/psychosomatic symptoms. Participants were divided into three residential groups: “Ariel,” “Small settlement communities in Judea and Samaria” or “Other places in Israel.”Results: Participants from small settlement communities in Judea and Samaria showed significantly fewer depressive symptoms and greater adjustment– less avoidance, psychosomatic symptoms, and residential stress– compared to those living in Ariel or other places in Israel, despite significantly higher exposure to terror.Conclusion: Greater religiosity and residence attachment may protect against depressive symptom development following terror exposure. Secular, temporary residents living in highly terror-exposed areas should be targeted for community strengthening interventions.


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