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Interoceptive fear learning to mild breathlessness as a laboratory model for unexpected panic attacks.

Pappens M, Vandenbossche E, Van den Bergh O, Van Diest I - Front Psychol (2015)

Bottom Line: It has been suggested that fear learning to interoceptive cues would result in unpredictable panic.At the end of acquisition, both groups displayed the same levels of US expectancy and skin conductance in response to the CS, but the experimental group showed a fear potentiated startle eyeblink and a different respiratory response to the CS compared to the control group.Our findings suggest that interoceptive fear learning is not dependent on declarative knowledge of the CS-US relationship.

View Article: PubMed Central - PubMed

Affiliation: Health Psychology, University of Leuven Leuven, Belgium.

ABSTRACT
Fear learning is thought to play an important role in panic disorder. Benign interoceptive sensations can become predictors (conditioned stimuli - CSs) of massive fear when experienced in the context of an initial panic attack (unconditioned stimulus - US). The mere encounter of these CSs on a later moment can induce anxiety and fear, and precipitate a new panic attack. It has been suggested that fear learning to interoceptive cues would result in unpredictable panic. The present study aimed to investigate whether fear learning to an interoceptive CS is possible without declarative knowledge of the CS-US contingency. The CS consisted of mild breathlessness (or: dyspnea), the US was a suffocation experience. During acquisition, the experimental group received six presentations of mild breathlessness immediately followed by suffocation; for the control group both experiences were always separated by an intertrial interval. In the subsequent extinction phase, participants received six unreinforced presentations of the CS. Expectancy of the US was rated continuously and startle eyeblink electromyographic, skin conductance, and respiration were measured. Declarative knowledge of the CS-US relationship was also assessed with a post-experimental questionnaire. At the end of acquisition, both groups displayed the same levels of US expectancy and skin conductance in response to the CS, but the experimental group showed a fear potentiated startle eyeblink and a different respiratory response to the CS compared to the control group. Further analyses on a subgroup of CS-US unaware participants confirmed the presence of startle eyeblink conditioning in the experimental group but not in the control group. Our findings suggest that interoceptive fear learning is not dependent on declarative knowledge of the CS-US relationship. The present interoceptive fear conditioning paradigm may serve as an ecologically valid laboratory model for unexpected panic attacks.

No MeSH data available.


Related in: MedlinePlus

Change in Tidal Volume (VT). Mean changes in VT (in ml) during the CS relative to baseline (CS minus baseline) for the experimental and the control group. Respiratory responses were averaged across three pre-exposure trials (PE), two acquisition trials (A1, A2, A3), and two extinction trials (E1, E2, E3).
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Figure 4: Change in Tidal Volume (VT). Mean changes in VT (in ml) during the CS relative to baseline (CS minus baseline) for the experimental and the control group. Respiratory responses were averaged across three pre-exposure trials (PE), two acquisition trials (A1, A2, A3), and two extinction trials (E1, E2, E3).

Mentions: We observed no differences between the experimental and the control group in VT during pre-exposure: F(1,48) = 0.14, p = 0.71, = 0.003. See Figure 4.


Interoceptive fear learning to mild breathlessness as a laboratory model for unexpected panic attacks.

Pappens M, Vandenbossche E, Van den Bergh O, Van Diest I - Front Psychol (2015)

Change in Tidal Volume (VT). Mean changes in VT (in ml) during the CS relative to baseline (CS minus baseline) for the experimental and the control group. Respiratory responses were averaged across three pre-exposure trials (PE), two acquisition trials (A1, A2, A3), and two extinction trials (E1, E2, E3).
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4527095&req=5

Figure 4: Change in Tidal Volume (VT). Mean changes in VT (in ml) during the CS relative to baseline (CS minus baseline) for the experimental and the control group. Respiratory responses were averaged across three pre-exposure trials (PE), two acquisition trials (A1, A2, A3), and two extinction trials (E1, E2, E3).
Mentions: We observed no differences between the experimental and the control group in VT during pre-exposure: F(1,48) = 0.14, p = 0.71, = 0.003. See Figure 4.

Bottom Line: It has been suggested that fear learning to interoceptive cues would result in unpredictable panic.At the end of acquisition, both groups displayed the same levels of US expectancy and skin conductance in response to the CS, but the experimental group showed a fear potentiated startle eyeblink and a different respiratory response to the CS compared to the control group.Our findings suggest that interoceptive fear learning is not dependent on declarative knowledge of the CS-US relationship.

View Article: PubMed Central - PubMed

Affiliation: Health Psychology, University of Leuven Leuven, Belgium.

ABSTRACT
Fear learning is thought to play an important role in panic disorder. Benign interoceptive sensations can become predictors (conditioned stimuli - CSs) of massive fear when experienced in the context of an initial panic attack (unconditioned stimulus - US). The mere encounter of these CSs on a later moment can induce anxiety and fear, and precipitate a new panic attack. It has been suggested that fear learning to interoceptive cues would result in unpredictable panic. The present study aimed to investigate whether fear learning to an interoceptive CS is possible without declarative knowledge of the CS-US contingency. The CS consisted of mild breathlessness (or: dyspnea), the US was a suffocation experience. During acquisition, the experimental group received six presentations of mild breathlessness immediately followed by suffocation; for the control group both experiences were always separated by an intertrial interval. In the subsequent extinction phase, participants received six unreinforced presentations of the CS. Expectancy of the US was rated continuously and startle eyeblink electromyographic, skin conductance, and respiration were measured. Declarative knowledge of the CS-US relationship was also assessed with a post-experimental questionnaire. At the end of acquisition, both groups displayed the same levels of US expectancy and skin conductance in response to the CS, but the experimental group showed a fear potentiated startle eyeblink and a different respiratory response to the CS compared to the control group. Further analyses on a subgroup of CS-US unaware participants confirmed the presence of startle eyeblink conditioning in the experimental group but not in the control group. Our findings suggest that interoceptive fear learning is not dependent on declarative knowledge of the CS-US relationship. The present interoceptive fear conditioning paradigm may serve as an ecologically valid laboratory model for unexpected panic attacks.

No MeSH data available.


Related in: MedlinePlus