Vagal control of the heart decreases during increasing imminence of interoceptive threat in patients with panic disorder and agoraphobia

Richter, Jan; Pietzner, Anne; Koenig, Julian; Thayer, Julian F.; Pané-Farré, Christiane A.; Gerlach, Alexander L.; Gloster, Andrew T.; Wittchen, Hans‐Ulrich; Lang, Thomas; Alpers, Georg W.; Helbig-Lang, Sylvia; Deckert, Jürgen; Fydrich, Thomas; Fehm, Lydia; Ströhle, Andreas; Kircher, Tilo; Arolt, Volker; Hamm, Alfons O.

doi:10.1038/s41598-021-86867-y

Cited by 9 publications

(6 citation statements)

References 44 publications

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“…These different emotional states of fear and anxiety might also involve different neural substrates 44 . A heightened sensitivity to unpredictable threats might increase the susceptibility to develop anxiety disorders 42 , 45 – 48 . It remains to be determined whether the threat of scream paradigm could be utilized as a screening device for individuals at risk to develop an anxiety disorder.…”

Section: Discussionmentioning

confidence: 99%

Recognition memory, primacy vs. recency effects, and time perception in the online version of the fear of scream paradigm

Zlomuzica

Kullmann²,

Hesse³

et al. 2022

Sci Rep

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Anxiety disorders are characterized by cognitive dysfunctions which contribute to the patient’s profound disabilities. The threat of shock paradigm represents a validated psychopathological model of anxiety to measure the impact of anxiety on cognitive processes. We have developed an online version of the threat of scream paradigm (ToSP) to investigate the impact of experimental anxiety on recognition memory. Two animated passive walkthrough videos (either under threat of scream or safety conditions) were shown to healthy participants. Recognition memory, primacy vs. recency effects, and subjective estimations of the length of encoding sessions were assessed. Subjective anxiety, stress, and emotional arousal ratings indicated that experimental anxiety could successfully be induced (Safe-Threat) or reversed (Threat-Safe) between the two passive walkthrough sessions. Participants exposed to distress screams showed impaired retrieval of complex information that has been presented in an animated environment. In the threat condition, participants failed to recognize details related to the persons encountered, their spatial locations, as well as information about the temporal order and sequence of encounters. Participant groups, which received a threat announcement prior to the first walkthrough session (Threat-Threat vs. Safety-Safety and Threat-Safety vs. Safety-Threat) showed poorer recognition memory as compared to the groups that received a safety announcement (P = 0.0468 and P = 0.0426, respectively; Mann–Whitney U test, Cohen’s d = 0.5071; effect size r = 0.2458). In conclusion, experimental anxiety induced by the online version of the ToSP leads to compromised recognition memory for complex multi-dimensional information. Our results indicate that cognitive functions of vulnerable populations (with limited mobility) can be evaluated online by means of the ToSP.

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Section: Discussionmentioning

confidence: 99%

Recognition memory, primacy vs. recency effects, and time perception in the online version of the fear of scream paradigm

Zlomuzica

Kullmann²,

Hesse³

et al. 2022

Sci Rep

View full text Add to dashboard Cite

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“…His behavior (rushing home, where it is safe) reinforces his belief that anywhere else is unsafe. Treatment aims to break this negative cycle by addressing the three main components of anxiety: changing self-talk or beliefs, controlling physiological responses, and confronting objects, situations, and places that cause fear [18].…”

Section: Avoidancementioning

confidence: 99%

Psychotherapy of Panic Disorder: Revisiting Past and Present Research and Moving toward Future Directions

Afshari¹

2023

The Psychology of Panic

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Panic disorder is one of the most debilitating mental disorders. Therefore, it is necessary to apply treatments for this problem to eliminate the disability of patients. Both psychotherapy and medication have been shown to reduce the frequency and severity of panic attacks and panic disorder. In this chapter, we first mentioned cognitive-behavioral therapy as the cornerstone of psychotherapy for panic disorder and then, medication as one of the most common treatments for this disorder. Cognitive-behavioral therapy has been found by numerous studies to be the most important psychotherapy for panic attacks and panic disorder. Medication is another effective treatment because some medications can be very helpful in managing the symptoms of a panic attack as well as anxiety and depression. Finally, emotion regulation therapies for the treatment of panic disorder will be introduced and explained for the first time.

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“…Among patients with panic disorder and agoraphobia, a study compared dynamic changes in vagal‐mediated HRV response during an entrapment threat challenge. Patients with the largest heart rate acceleration from recovery to exposure had the greatest reductions in RMSSD, with differences being highest at the start of exposure and gradually declining during exposure, though still significant (Richter et al., 2021). In contrast, patients with a lack of or decrease in heart rate reactivity demonstrated an elevation in RMSSD during exposure relative to recovery.…”

Section: Heart Rate Variability: a Transdiagnostic Endophenotype For ...mentioning

confidence: 99%

Heart rate variability: Evaluating a potential biomarker of anxiety disorders

Tomasi,

Zai,

Pouget

et al. 2023

Psychophysiology

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Establishing quantifiable biological markers associated with anxiety will increase the objectivity of phenotyping and enhance genetic research of anxiety disorders. Heart rate variability (HRV) is a physiological measure reflecting the dynamic relationship between the sympathetic and parasympathetic nervous systems, and is a promising target for further investigation. This review summarizes evidence evaluating HRV as a potential physiological biomarker of anxiety disorders by highlighting literature related to anxiety and HRV combined with investigations of endophenotypes, neuroimaging, treatment response, and genetics. Deficient HRV shows promise as an endophenotype of pathological anxiety and may serve as a noninvasive index of prefrontal cortical control over the amygdala, and potentially aid with treatment outcome prediction. We propose that the genetics of HRV can be used to enhance the understanding of the genetics of pathological anxiety for etiological investigations and treatment prediction. Given the anxiety–HRV link, strategies are offered to advance genetic analytical approaches, including the use of polygenic methods, wearable devices, and pharmacogenetic study designs. Overall, HRV shows promising support as a physiological biomarker of pathological anxiety, potentially in a transdiagnostic manner, with the heart–brain entwinement providing a novel approach to advance anxiety treatment development.

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Vagal control of the heart decreases during increasing imminence of interoceptive threat in patients with panic disorder and agoraphobia

Cited by 9 publications

References 44 publications

Recognition memory, primacy vs. recency effects, and time perception in the online version of the fear of scream paradigm

Recognition memory, primacy vs. recency effects, and time perception in the online version of the fear of scream paradigm

Psychotherapy of Panic Disorder: Revisiting Past and Present Research and Moving toward Future Directions

Heart rate variability: Evaluating a potential biomarker of anxiety disorders

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