On Attributing Fictitious Cardiac Responses

Liebhart, E

doi:10.2466/pms.1976.43.1.202

Cited by 4 publications

(4 citation statements)

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“…The positive feedback loop between internal perceptions and physiological activity can accumulate in a panic attack. Similar hypotheses have been formulated to explain hypochondriasis (Barsky, Barnett, & Cleary, 1994; Kellner, 1986; Warwick & Salkovskis, 1990) or cardiac neurosis (Liebhart, 1976; Sachse, 1994), and research has shown that patients with NCCP are differentially sensitive to cardiorespiratory sensations (Aikens, Zvolensky, & Eifert, 2001; White, Craft, & Gervino, 2007). It may be that the experience of panic attacks or limited-symptom panic attacks, not any specific disorder, exacerbates and maintains NCCP.…”

Section: Discussionmentioning

confidence: 91%

Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization.

White¹,

Raffa²,

Jakle³

et al. 2008

Journal of Consulting and Clinical Psychology

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The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) revealed a psychiatrically heterogeneous sample of whom 44% had a current Axis I psychiatric disorder. A total of 41% were diagnosed with a current anxiety disorder, and 13% were diagnosed with a mood disorder. Overall, 75% of patients had an Axis I clinical or subclinical disorder. Lifetime diagnoses of anxiety (55%) and mood disorders (44%) were also prevalent, including major depressive disorder (41%), social phobia (25%), and panic disorder (22%). Patients with an Axis I disorder reported more frequent and more painful chest pain compared with those without an Axis I disorder. Presence of an Axis I disorder was associated with increased life interference and health care utilization. Findings reveal that varied DSM-IV Axis I psychiatric disorders are prevalent among patients with NCCP, and this psychiatric morbidity is associated with a less favorable NCCP presentation. Implications for early identification of psychiatric disorders are discussed.

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Section: Discussionmentioning

confidence: 91%

Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization.

White¹,

Raffa²,

Jakle³

et al. 2008

Journal of Consulting and Clinical Psychology

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show abstract

“…This model and other influential models propose that panic is triggered by bodily sensations that may be misinterpreted and posits an important role (or essential role, in some cases; Clark, 1986) for conscious appraisal of the sensations as dangerous (Schmidt & Woolaway-Bickel, 2006). Similar hypotheses with adaptations have been extended to hypochondriasis (Barsky, Cleary, Sarnie, & Ruskin, 1994; Kellner, 1986; Warwick & Salkovskis, 1990) or cardiac neurosis (Liebhart, 1976). Moreover, in their model of hypochondriasis, Warwick and Salkovskis (1990) indicate that if a patient’s anxiety about a disease elicits autonomic symptoms that coincide with the symptoms of the feared disease, then anxiety will escalate.…”

mentioning

confidence: 73%

Anxiety and hypervigilance to cardiopulmonary sensations in non-cardiac chest pain patients with and without psychiatric disorders

White

Craft

Gervino

2010

Behaviour Research and Therapy

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We investigated body vigilance, cardiac anxiety, and the mediating role of interoceptive fear on pain in patients with non-cardiac chest pain (NCCP; a syndrome of chest pain in the absence of identifiable organic etiology). Patients were more attentive to cardiac-congruent sensations than cardiac-incongruent sensations (e.g., gastrointestinal, cognitive dyscontrol; p's < .001). Patients with a DSM-IV Axis I anxiety or mood disorder were more body vigilant compared to patients who did not have a disorder (p's < .05). Patients with anxiety disorders were particularly vigilant to and fearful of cardiac sensations relative to patients without anxiety disorders. Latent variable path models examined the extent that interoceptive fear mediated the association between body vigilance and cardiac anxiety on chest pain. Within each model, diagnostic status, body vigilance, and cardiac anxiety were exogenous and predicted interoceptive fear that in turn predicted pain. Separate models examined body vigilance and cardiac anxiety, and both models fit the data well. Findings showed partial mediation for the body vigilance factor, and full mediation for the cardiac anxiety factor. Interoceptive fear played a mediating role in both models. The syndrome of NCCP may persist partly due to conscious hypervigilance to and fear of cardiac-congruent body sensations, particularly among anxious patients.

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“…In Valins's (1966) and later work selective heart rate decrease yields little effect. Liebhart (1976) offers and documents an ingenious explanation: people have less defi nite suppositions about the causes of deceleration than about the causes of acceleration. The process involved in the "Valins" effect is probably more complex than suggested above.…”

Section: Va Rious Ca Uses Fo R Arousalmentioning

confidence: 99%