Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-24T08:56:42.387Z Has data issue: false hasContentIssue false
  • English
  • Français

Baseline Heartbeat Perception Accuracy and Short-Term Outcome of Brief Cognitive-Behaviour Therapy for Panic Disorder with Agoraphobia

Published online by Cambridge University Press:  13 December 2013

Vasilios G. Masdrakis ,
Emilia-Maria Legaki ,
Nikolaos Vaidakis ,
Dimitrios Ploumpidis ,
Constantin R. Soldatos ,
Charalambos Papageorgiou ,
George N. Papadimitriou  and
Panagiotis Oulis
Vasilios G. Masdrakis*
Affiliation:
Athens University Medical School, Greece
Emilia-Maria Legaki
Affiliation:
Athens University Medical School, Greece
Nikolaos Vaidakis
Affiliation:
Athens University Medical School, Greece
Dimitrios Ploumpidis
Affiliation:
Athens University Medical School, Greece
Constantin R. Soldatos
Affiliation:
Athens University Medical School, Greece
Charalambos Papageorgiou
Affiliation:
Athens University Medical School, Greece
George N. Papadimitriou
Affiliation:
Athens University Medical School, Greece
Panagiotis Oulis
Affiliation:
Athens University Medical School, Greece
*
Reprint requests to Vasilios G. Masdrakis, Athens University Medical School, 1st Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Avenue, Athens 11528, Greece. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Increased heartbeat perception accuracy (HBP-accuracy) may contribute to the pathogenesis of Panic Disorder (PD) without or with Agoraphobia (PDA). Extant research suggests that HBP-accuracy is a rather stable individual characteristic, moreover predictive of worse long-term outcome in PD/PDA patients. However, it remains still unexplored whether HBP-accuracy adversely affects patients’ short-term outcome after structured cognitive behaviour therapy (CBT) for PD/PDA. Aim: To explore the potential association between HBP-accuracy and the short-term outcome of a structured brief-CBT for the acute treatment of PDA. Method: We assessed baseline HBP-accuracy using the “mental tracking” paradigm in 25 consecutive medication-free, CBT-naive PDA patients. Patients then underwent a structured, protocol-based, 8-session CBT by the same therapist. Outcome measures included the number of panic attacks during the past week, the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory-Alone subscale (MI-alone). Results: No association emerged between baseline HBP-accuracy and posttreatment changes concerning number of panic attacks. Moreover, higher baseline HBP-accuracy was associated with significantly larger reductions in the scores of the ACQ and the MI-alone scales. Conclusion: Our results suggest that in PDA patients undergoing structured brief-CBT for the acute treatment of their symptoms, higher baseline HBP-accuracy is not associated with worse short-term outcome concerning panic attacks. Furthermore, higher baseline HBP-accuracy may be associated with enhanced therapeutic gains in agoraphobic cognitions and behaviours.

Keywords

Cognitive-behaviour therapyheartbeat perceptioninteroceptionpanic disorder with agoraphobia
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 4 , July 2015 , pp. 426 - 435
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington DC: American Psychiatric Association.Google Scholar
Antony, M. M., Meadows, E. A., Brown, T. A. and Barlow, D. H. (1994). Cardiac awareness before and after cognitive-behavioral treatment for panic disorder. Journal of Anxiety Disorders, 8, 341–350.CrossRefGoogle Scholar
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M. and Westbrook, D. (Eds.) (2004). Oxford Guide to Behavioural Experiments in Cognitive Therapy. New York: Oxford University Press.Google Scholar
Chambless, D. L., Caputo, G. C., Bright, P. and Gallacher, R. (1984). Assessment of fear in agoraphobics: the Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097.CrossRefGoogle ScholarPubMed
Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J. and Williams, C. (1985). The Mobility Inventory for agoraphobia. Behaviour Research and Therapy, 23, 35–44.Google Scholar
Clark, D. M. (1998). Anxiety states: panic and generalized anxiety. In Hawton, K., Salkovskis, P. M., Kirk, J. and Clark, D. M. (Eds.), Cognitive Behaviour Therapy for Psychiatric Problems: a practical guide (pp. 52–96). Oxford: Oxford University Press.Google Scholar
Craske, M. G. and Barlow, D. H. (2007). Mastery of your Anxiety and Panic: therapist guide (4thed.). Oxford: Oxford University Press.Google Scholar
Domschke, K., Stevens, S., Pfleiderer, B. and Gerlach, A. L. (2010). Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings. Clinical Psychology Review, 30, 1–11.Google Scholar
Ehlers, A. (1995). A one-year prospective study of panic attacks: clinical course and factors associated with maintenance. Journal of Abnormal Psychology, 104, 164–172.Google Scholar
Ehlers, A. and Breuer, P. (1992). Increased cardiac awareness in panic disorder. Journal of Abnormal Psychology, 101, 371–382.Google Scholar
Ehlers, A. and Breuer, P. (1996). How good are patients with panic disorder at perceiving their heartbeats? Biological Psychology, 42, 165–182.Google Scholar
Ehlers, A., Breuer, P., Dohn, D. and Fiegenbaum, W. (1995). Heartbeat perception and panic disorder: possible explanation for discrepant findings. Behaviour Research and Therapy, 33, 69–76.Google Scholar
Fairclough, S. H. and Goodwin, L. (2007). The effect of psychological stress and relaxation on interoceptive accuracy: implications for symptom perception. Journal of Psychosomatic Research, 62, 289–295.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. (1998). Structured Clinical Interview for DSM-IV axis I Disorders: patient edition (SCID-I/P, Version 2.0, 8/98 revision. New York: Biometric Research Department, New York State Psychiatric Institute.Google Scholar
Herbert, B. M., Pollatos, O. and Schandry, R. (2007). Interoceptive sensitivity and emotion processing: an EEG study. International Journal of Psychophysiology, 65, 214–227.Google Scholar
Matthias, E., Schandry, R., Duschek, S. and Pollatos, O. (2009). On the relationship between interoceptive awareness and the attentional processing of visual stimuli. International Journal of Psychophysiology, 72, 154–159.Google Scholar
Nunes, J. S. and Marks, I. M. (1975). Feedback of true heart rate during exposure in vivo. Archives of General Psychiatry, 32, 933–936.CrossRefGoogle ScholarPubMed
Otto, M. W., Tolin, D. F., Nations, K. R., Utschig, A. C., Rothbaum, B. O., Hofmann, S. G., et al. (2012). Five sessions and counting: considering ultra-brief treatment for panic disorder. Depression and Anxiety, 29, 465–470.Google Scholar
Raes, A. K. and De Raedt, R. (2011). Interoceptive awareness and unaware fear conditioning: are subliminal conditioning effects influenced by the manipulation of visceral self-perception? Consciousness and Cognition, 20, 1393–1402.CrossRefGoogle ScholarPubMed
Schandry, R. (1981). Heart beat perception and emotional experience. Psychophysiology, 18, 483–488.CrossRefGoogle ScholarPubMed
Sloan, T. and Telch, M. J. (2002). The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation. Behaviour Research and Therapy, 40, 235–251.Google Scholar
Spielberger, C. D., Gorsuch, R. L. and Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, California: Consulting Psychologists Press.Google Scholar
Steketee, G. and Chambless, D. L. (1992). Methodological issues in prediction of treatment outcome. Clinical Psychology Review, 12, 387–400.Google Scholar
Telch, M. J., Valentiner, D. P., Ilai, D., Petruzzi, D. and Hehmsoth, M. (2000). The facilitative effects of heart-rate feedback in the emotional processing of claustrophobic fear. Behaviour Research and Therapy, 38, 373–387.Google Scholar
Telch, M. J., Valentiner, D. P., Ilai, D., Young, P. R., Powers, M. B. and Smits, J. A. (2004). Fear activation and distraction during the emotional processing of claustrophobic fear. Journal of Behavior Therapy and Experimental Psychiatry, 35, 219–232.Google Scholar
Van der Does, A. J. W., Antony, M. M., Ehlers, A. and Barsky, A. J. (2000). Heartbeat perception in panic disorder: a reanalysis. Behaviour Research and Therapy, 38, 47–62.Google Scholar
Van der Does, A. J. W., Van Dyck, R. and Spinhoven, P. (1997). Accurate heartbeat perception in panic disorder: fact and artefact. Journal of Affective Disorders, 43, 121–130.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.