The match-mismatch model and panic patients' accuracy in predicting naturally occurring panic attacks

Beurs, Edwin de; Chambless, Dianne L.; Goldstein, Alan

doi:10.1002/da.10073

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Ecological monitoring of PAs corroborates these findings of (retrospective) interview data. Self-monitoring of PAs over a period of 6 weeks confirmed palpitations as the most frequently reported panic symptom (de Beurs et al 2002). Notably, more than 80% of their sample presented with highly unstable symptom patterns, quite like that of panic symptom severity.…”

Section: Beyond General Fight-or-flight: Symptom Clusters and Subtype...mentioning

confidence: 89%

Panic Disorder Comorbidity with Medical Conditions and Treatment Implications

Meuret

Kroll

Ritz

2017

Annu. Rev. Clin. Psychol.

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Panic disorder (PD) is unique among the anxiety disorders in that panic symptoms are primarily of a physical nature. Consequently, comorbidity with medical illness is significant. This review examines the association between PD and medical illness. We identify shared pathophysiological and psychological correlates and illustrate how physiological activation in panic sufferers underlies their symptom experience in the context of the fight-or-flight response and beyond a situation-specific response pattern. We then review evidence for bodily symptom perception accuracy in PD. Prevalence of comorbidity for PD and medical illness is presented, with a focus on respiratory and cardiovascular illness, irritable bowel syndrome, and diabetes, followed by an outline for potential pathways of a bidirectional association. We conclude by illustrating commonalities in mediating mechanistic pathways and moderating risk factors across medical illnesses, and we discuss implications for diagnosis and treatment of both types of conditions.

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Section: Beyond General Fight-or-flight: Symptom Clusters and Subtype...mentioning

confidence: 89%

Panic Disorder Comorbidity with Medical Conditions and Treatment Implications

Meuret

Kroll

Ritz

2017

Annu. Rev. Clin. Psychol.

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“…Of the anxiety disorders, two are of particular interest because the processes that initiate or maintain them may differ, whereas the neural substrates might be quite overlapping and support the generalizability of our proposed model. First, the development of panic disorder has been described by some [71] as a process they termed "fear of fear" developing from interoceptive conditioning. In particular, the matchmismatch model of panic states that panic disorder patients tend to overestimate the probability of panic prior to engaging in a fear-provoking situation [71].…”

Section: Anxiety Phenotypesmentioning

confidence: 99%

“…First, the development of panic disorder has been described by some [71] as a process they termed "fear of fear" developing from interoceptive conditioning. In particular, the matchmismatch model of panic states that panic disorder patients tend to overestimate the probability of panic prior to engaging in a fear-provoking situation [71]. This is part of the general mismatch prediction model, which states that people overestimate how frightened they will be when faced by a fear-provoking situation [72].…”

Section: Anxiety Phenotypesmentioning

confidence: 99%

The role of neuroimaging for the diagnosis and treatment of anxiety disorders

Paulus

2008

Depress. Anxiety

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Neuroimaging comprises a set of tools, which include different types of magnetic resonance imaging such as fMRI, MRS, ASL, and radiotracer imaging such as PET and SPECT. The focus of this review is to address the question whether functional magnetic resonance imaging (fMRI) can contribute to the diagnosis and treatment of anxiety disorders. Key anxiety processes and neural substrates are reviewed. The main findings and shortcomings of fMRI in the context of anxiety are briefly summarized. Finally, the next stages of developing fMRI for diagnosis and treatment are highlighted. The main conclusion of this review is that fMRI could become a clinical tool for the diagnosis and treatment of anxiety disorders but neuroimaging groups will need to better develop its specificity and sensitivity so that fMRI results can be meaningful for an individual patient not just for groups of individuals. fMRI -what is it and what does it measure?Functional magnetic resonance imaging (fMRI) is a technique that enables one to map cognitive, affective, and experiential processes onto brain substrates. However, fMRI is not about increased or decreased activation in a certain part of the brain; rather it is a proxy measure about how complex cognitive, emotional, social and other experiential processes are implemented in different neural systems. For example, it is important to realize that it makes little sense to talk about hyperactivity in the amygdala in individuals with anxiety disorder without referencing the process, which is being measured during the amygdala hyperactivity, i.e. the task that individuals are engaged in while the functional images are obtained. Although the human brain comprises only about 2% of the body mass, it accounts for approximately 20% of its total oxygen consumption [1]. Deoxyhemoglobin has paramagnetic effects in the blood upon the nuclear magnetic resonance transverse relaxation times of nearby water protons in the tissue [2]. The fact that changes in the oxygen level in the blood can affect the fraction of hemoglobin in the deoxygenated state can be utilized as an image contrast and was termed as blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) [3]. Recent BOLD fMRI experiments in the awake Correspondence should be sent to: Martin P Paulus, Professor in Residence,

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“…For instance, various facets of movement could be classified and related to physiological activation during exposure: the order in which fear-relevant contexts are encountered; duration and total distance traveled during exposure; and speed at which feared situations are confronted. Tracking movement patterns might also elucidate how overprediction of anxiety, commonly seen in agoraphobic patients (de Beurs, Chambless, & Goldstein, 2002), affects the manner in which fear-evoking situations are confronted. In summary, documenting movement patterns during exposure could provide useful insights into the mechanisms underlying exposure, which remain hotly debated.…”

Section: Potential Research Usesmentioning

confidence: 99%

Where have they gone? Tracking movement patterns to document the process of situational exposure in agoraphobia.

White¹,

Umpfenbach²,

Alpers³

2014

Professional Psychology: Research and Practice

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Therapists typically have limited information ahout how unaccompanied situational exposure is undertaken. To address this issue, we present a method of assessing movement patterns and concurrent arousal collected during situational exposure. We illustrate how this provides both objective and useful accounts of this important treatment component. In this case suidy. recordings of global positioning system-derived position and heart rate were obtained from a 47-yeai-old female patient suffering from panic disorder with agoraphobia who received treatment through an outpatient clinic. Ambulatory assessment of movement and accompanying physiology (heart rate) during situational exposure is described. Visualizations of positional and physiological data recorded during exposure sessions revealed (a) that the patient actually confronted feared environmental cues, (b) that she experienced elevated physiological arousal, and (c) good therapeutic compliance. These depictions were used to plan subsequent exposure sessions and we discuss how this information provided unique insights into the process of exposure. Assessment of movement patterns using commercially available technology can yield clinically relevant information about treatment progress. We conclude that this method could extend traditional self-report measures of agoraphobic avoidance. Future directions, such as the possibility of using movement information to refuie follow-up assessment, and the limitations of this approach are discussed.Keywords: agoraphobia, ambulatory assessment. GPS, heart rate, movement patterns, panic disorder with agoraphobia It is common knowledge that movement can be accurately tracked with cheap, reliable global positioning system (GPS) devices. To date, however, these tools have neither been integrated ANDREW J. WHITE is a graduate student in the Doctoral Center in Social and Behavioral Science (CDSS) at the University of Mannheim. In 2010, he received a master

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The match-mismatch model and panic patients' accuracy in predicting naturally occurring panic attacks

Cited by 6 publications

References 20 publications

Panic Disorder Comorbidity with Medical Conditions and Treatment Implications

Panic Disorder Comorbidity with Medical Conditions and Treatment Implications

The role of neuroimaging for the diagnosis and treatment of anxiety disorders

Where have they gone? Tracking movement patterns to document the process of situational exposure in agoraphobia.

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