Respiratory Muscle Tension as Symptom Generator in Individuals With High Anxiety Sensitivity

Ritz, Thomas; Meuret, Alicia E.; Bhaskara, Lavanya; Petersen, Sibylle

doi:10.1097/psy.0b013e31827d1072

Cited by 23 publications

(18 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In line with this, research is increasingly demonstrating the relationship between fear, anxiety and respiratory disruption in animal and human models (Ren, Ding, Funk & Greer, 2012; Ritz, Meuret, Bhaskara & Peterson, 2013; Trueba, et al, 2013; Pate & Davenport, 2012). This is clinically related to the high incidence of anxiety in patients suffering from asthma and COPD (Bhandari et al, 2013; Maurer et al, 2008; Hill, Geist & Goldstein 2008; Ritz et al, 2012).…”

Section: Introductionmentioning

confidence: 87%

“…The specific comparison of the cognitive response to magnitude estimation of loads while breathing against a variety of sustained inspiratory loads has not been investigated, although single-breath, large resistive loads have been shown to induce fear of suffocation (Alius, Pané-Farré, Von Leupoldt, & Hamm, 2013;Pappens, Smets, Vansteenwegen, Van den Bergh, & Van Diest, 2012). In line with this, research is increasingly demonstrating the relationship between fear, anxiety, and respiratory disruption in animal and human models (Pate & Davenport, 2012;Ren, Ding, Funk, & Greer, 2012;Ritz, Meuret, Bhaskara, & Petersen, 2013;Trueba, Rosenfield, Oberdörster, Vogel, & Ritz, 2013). This is clinically related to the high incidence of anxiety in patients suffering from asthma and COPD (Bhandari, Jain, Marolda, & Zuwallack, 2013;Hill, Geist, Goldstein, & Lacasse, 2008;Maurer et al, 2008;Ritz, Meuret, Trueba, Fritzsche, & von Leupoldt, 2012).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Subjective ratings of prolonged inspiratory resistive loaded breathing in males and females

Miller

Davenport

2014

Psychophysiology

View full text Add to dashboard Cite

Dyspnea and fear of suffocation are burdensome to patients with respiratory disease. Inspiratory resistive loads offer an experimental respiratory stimulus to quantify the discriminative domain of respiratory perception. Resistive (R) load magnitude estimation (ME) and subjective ratings were measured over sustained multiple breaths in healthy subjects. There was no significant group difference between the ME for breath 1 and 20 for small R loads, but a significant gender difference for large R loads. Subjective responses of fear, fear of suffocation, displeasure, chest pressure, faintness, dizziness, fear of losing control, trembling, and tingling were significantly greater for females. These results demonstrate that ME of large resistive sustained loads elicits non-significant increases in ME in females, but a significant decrease in ME for males. The maintenance of ME in females co-occurs with increased aversive processing relative to males.

show abstract

Section: Introductionmentioning

confidence: 87%

mentioning

confidence: 99%

Subjective ratings of prolonged inspiratory resistive loaded breathing in males and females

Miller

Davenport

2014

Psychophysiology

View full text Add to dashboard Cite

show abstract

“…We should note that these developments do not rule out the possibility of identifying clinically relevant biomarkers for panic disorder. For example, respiratory muscle tension has been identified as a generator of dyspnea in individuals predisposed to panic disorder ( 132 ), and levels of cortisol have been found to moderate clinical improvement during exposure therapy for individuals with panic disorder ( 133 ).…”

Section: Panic Disorder: the Prototypical Interoceptive Disordermentioning

confidence: 99%

Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?

2016

View full text Add to dashboard Cite

Disrupted interoception is a prominent feature of the diagnostic classification of several psychiatric disorders. However, progress in understanding the interoceptive basis of these disorders has been incremental, and the application of interoception in clinical treatment is currently limited to panic disorder. To examine the degree to which the scientific community has recognized interoception as a construct of interest, we identified and individually screened all articles published in the English language on interoception and associated root terms in Pubmed, Psychinfo, and ISI Web of Knowledge. This search revealed that interoception is a multifaceted process that is being increasingly studied within the fields of psychiatry, psychology, neuroscience, and biomedical science. To illustrate the multifaceted nature of interoception, we provide a focused review of one of the most commonly studied interoceptive channels, the cardiovascular system, and give a detailed comparison of the most popular methods used to study cardiac interoception. We subsequently review evidence of interoceptive dysfunction in panic disorder, depression, somatic symptom disorders, anorexia nervosa, and bulimia nervosa. For each disorder, we suggest how interoceptive predictions constructed by the brain may erroneously bias individuals to express key symptoms and behaviors, and outline questions that are suitable for the development of neuroscience-based mental health interventions. We conclude that interoception represents a viable avenue for clinical and translational research in psychiatry, with a well-established conceptual framework, a neural basis, measurable biomarkers, interdisciplinary appeal, and transdiagnostic targets for understanding and improving mental health outcomes.

show abstract

“…In contrast, persons who fear suffocation exhibited a reduced mouth pressure associated with a decreased volume per breath (Harver & Mahler, 1998;Shipherd, Beck, & Ohtake, 2001). This suggests that high SF persons may have decreased their workload of the respiratory muscles to avoid the unpleasant respiratory sensations associated with a higher muscle tension (Ritz, Meuret, Bhaskara, & Petersen, 2013). Interestingly, this pattern, which may be interpreted as being indicative of a behavioral avoidance strategy, did not alleviate the intensity of bodily sensations.…”

Section: Characterization Of Defensive Mobilization To Increasing Dmentioning

confidence: 99%

When dyspnea gets worse: Suffocation fear and the dynamics of defensive respiratory responses to increasing interoceptive threat

2017

View full text Add to dashboard Cite

In patients with anxiety and/or respiratory diseases, body sensations, particularly from the respiratory system, may increase in intensity and aversiveness and thus lead into defensive action (e.g., escape) or panic. The processes, however, that might contribute to the culmination of symptoms and the switch into defensive action have not been well understood yet. The current study aimed at evaluating an experimental paradigm to characterize the dynamics of defensive mobilization to body sensations increasing in intensity and aversiveness. Persons reporting low and high suffocation fear (SF; N = 69) were exposed to increasingly unpleasant feelings of dyspnea induced by inspiratory resistive loads and a breathing occlusion requiring voluntary breath holding. Respiratory responses were assessed along with subjective reports of anxiety and panic symptoms. Presentation of respiratory loads with increasing physical resistance led to increasingly unpleasant feelings of dyspnea. Twenty-eight participants terminated the exposure prematurely at least once. When dyspnea was severe, high compared to low SF persons exhibited an increased respiratory rate that was accompanied by reports of more intense panic symptoms. Premature terminations of exposure were preceded by a surge in anxiety, breathing frequency, and mouth pressure, and a decrease in tidal volume. We successfully established an experimental paradigm to assess changes in defensive responding with increasing intensity of an interoceptive threat. The current data foster our understanding of behavioral expression patterns observed in patients with anxiety and/or respiratory diseases and the processes involved in the culmination of bodily sensations and anxiety into panic.

show abstract

Respiratory Muscle Tension as Symptom Generator in Individuals With High Anxiety Sensitivity

Cited by 23 publications

References 47 publications

Subjective ratings of prolonged inspiratory resistive loaded breathing in males and females

Subjective ratings of prolonged inspiratory resistive loaded breathing in males and females

Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry?

When dyspnea gets worse: Suffocation fear and the dynamics of defensive respiratory responses to increasing interoceptive threat

Contact Info

Product

Resources

About