Effects of threat context and cardiac sensitivity on fear responding to a 35% CO2 challenge: A test of the context-sensitivity panic vulnerability model

Department of Psychology, Laboratory for the Study of Anxiety Disorders, The University of Texas at Austin, 1 University Station, Mail Code A8000, Austin, TX 78712, USA.
Journal of Behavior Therapy and Experimental Psychiatry (Impact Factor: 2.23). 12/2010; 41(4):365-72. DOI: 10.1016/j.jbtep.2010.03.008
Source: PubMed


The present study tested several predictions of a context-sensitivity panic vulnerability model emphasizing the interaction between threat context and threat sensitivities. Participants without a history of panic (N=47) completed both global and domain-specific panic relevant sensitivity measures and were then randomized to undergo a 35% CO2 inhalation challenge in the presence or absence of a cardiac defibrillator (threat context). As predicted by the model, cardiac sensitivity (but not trait anxiety or anxiety sensitivity) potentiated the effects of the presence of the defibrillator on CO2 fear responding. Moreover, as predicted by the model, the observed potentiation effects of cardiac sensitivity on CO2 fear responding were mediated by participants' threat appraisals connected to the presence of the defibrillator. Theoretical and clinical implications are discussed.

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Available from: Michael J Telch, Sep 29, 2014
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    • "This finding is additionally substantiated by the contextsensitivity vulnerability model that emphasizes the interplay of person and contextual factors such as the dispositional sensitivity to fear arousal sensations and an expected arousal induction (Telch et al. 2011). Thus, high AS potentiated the effect of the instructional set (arousal induction) by increasing the perceived threat of the expected arousal induction based on beliefs that arousal sensations signify potential dangerous consequences (McNally 2002; Telch et al. 2010). This notion is similarly supported by higher alertness rating in high-AS persons when an arousal expectation was created. "
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    ABSTRACT: The way in which the tendency to fear somatic arousal sensations (anxiety sensitivity), in interaction with the created expectations regarding arousal induction, might affect defensive responding to a symptom provocation challenge is not yet understood. The present study investigated the effect of anxiety sensitivity on autonomic arousal, startle eyeblink responses, and reported arousal and alertness to expected vs. unexpected caffeine consumption. To create a match/mismatch of expected and experienced arousal, high and low anxiety sensitive participants received caffeine vs. no drug either mixed in coffee (expectation of arousal induction) or in bitter lemon soda (no expectation of arousal induction) on four separate occasions. Autonomic arousal (heart rate, skin conductance level), respiration (end-tidal CO2, minute ventilation), defensive reflex responses (startle eyeblink), and reported arousal and alertness were recorded prior to, immediately and 30 min after beverage ingestion. Caffeine increased ventilation, autonomic arousal, and startle response magnitudes. Both groups showed comparable levels of autonomic and respiratory responses. The startle eyeblink responses were decreased when caffeine-induced arousal occurred unexpectedly, e.g., after administering caffeine in bitter lemon. This effect was more accentuated in high anxiety sensitive persons. Moreover, in high anxiety sensitive persons, the expectation of arousal (coffee consumption) led to higher subjective alertness when administering caffeine and increased arousal even if no drug was consumed. Unexpected symptom provocation leads to increased attention allocation toward feared arousal sensations in high anxiety sensitive persons. This finding broadens our understanding of modulatory mechanisms in defensive responding to bodily symptoms.
    Psychopharmacology 07/2015; 232(18). DOI:10.1007/s00213-015-3996-9 · 3.88 Impact Factor
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    • "Thus, the perception of caffeine-induced arousal sensations might trigger an anxiety response to caffeine particularly when these sensations occur unexpectedly or are stronger than expected. It is known that instructional sets or created expectancies may serve as important moderators for the physiological and subjective responses to interoceptive challenges (MacDonald et al. 2001; Rapee et al. 1986; Telch et al. 2010; van der Molen and van den Hout 1988). In a study by Telch et al. (2011), high-and low-AS participants received single inhalations of room air vs. 35% CO 2 while being instructed that CO 2 will lead to arousal vs. relaxation. "
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    ABSTRACT: This study aimed to test how expectations and anxiety sensitivity influence respiratory and autonomic responses to caffeine. The current study investigated the effects of expected vs. unexpected caffeine ingestion in a group of persons prone to the anxiety-provoking effect of caffeine (high anxiety sensitive persons, that is, persons scoring at least one SD above the mean on the Anxiety Sensitivity Index (Peterson and Reiss 1992)) as compared to low-anxious controls. Autonomic arousal (heart rate, skin conductance level), respiratory responding (expired CO2, minute ventilation), and subjective report were assessed in high and low anxiety sensitive participants immediately after beverage consumption and at absorption peak (30 min post-consumption) in four separate sessions during which either coffee (expectation of caffeine) or bitter lemon soda (no expectation of caffeine) was crossed with 4 mg/kg caffeine vs. no drug. High and low anxiety sensitive persons showed comparable autonomic arousal and symptom reports to caffeine which was modulated by expectation, i.e., greater for coffee. Respiratory responding (CO2 decrease, minute ventilation increase) was more accentuated when caffeine was both expected and administered in the low anxiety sensitive group but more accentuated when caffeine was unexpectedly administered in the high anxiety sensitive group. Autonomic arousal and respiratory effects were observable within a few minutes after caffeine administration and were most pronounced at maximum absorption. The results highlight the modulating role of expectancies in respiratory responding to caffeine in low vs. high anxiety sensitive persons and might have important implications for the better understanding of unexpected panic attacks.
    Psychopharmacology 12/2014; 232(11). DOI:10.1007/s00213-014-3828-3 · 3.88 Impact Factor
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    • "Previous research has demonstrated that sensitivity to threat predicts fearful responding in the context of heightened threat ( Telch et al . , 2010 ) . However , findings from the present study failed to support the context - sensitivity panic vulnerability hypothesis . In contrast to experimental condition , baseline AS specific to physical sensations did not consistently predict fearful responses to the second hyperventilation challenge . Moreover , physical AS failed to predict "
    05/2013; 4(2):208. DOI:10.5127/jep.027512
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