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Dimensional structure of bodily panic attack symptoms and their specific connections to panic cognitions, anxiety sensitivity and claustrophobic fears

Published online by Cambridge University Press:  08 December 2014

I. Drenckhan ,
A. Glöckner-Rist ,
F. Rist ,
J. Richter ,
A. T. Gloster ,
L. Fehm ,
T. Lang ,
G. W. Alpers ,
A. O. Hamm  and
T. Fydrich
...Show all authors
I. Drenckhan*
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Münster, Fliednerstraße 21, Münster, Germany
A. Glöckner-Rist
Affiliation:
Department Survey Design and Methodology, GESIS Leibniz Institute for Social Science, Mannheim, Germany
F. Rist
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Münster, Fliednerstraße 21, Münster, Germany
J. Richter
Affiliation:
Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
A. T. Gloster
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
L. Fehm
Affiliation:
Department of Psychology, Humboldt University of Berlin, Berlin, Germany
T. Lang
Affiliation:
Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany
G. W. Alpers
Affiliation:
Department of Clinical and Biological Psychology, University of Mannheim, Mannheim, Germany
A. O. Hamm
Affiliation:
Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
T. Fydrich
Affiliation:
Department of Psychology, Humboldt University of Berlin, Berlin, Germany
T. Kircher
Affiliation:
Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
V. Arolt
Affiliation:
Department of Psychiatry, University of Münster, Germany
J. Deckert
Affiliation:
Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
A. Ströhle
Affiliation:
Department of Psychiatry and Psychotherapy, Charité-UniversitätsmedizinBerlin, Germany
H.-U. Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
A. L. Gerlach
Affiliation:
Clinical Psychology and Psychotherapy, Institute of Psychology, University of Münster, Fliednerstraße 21, Münster, Germany Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
*
*Address for correspondence: I. Drenckhan, University of Münster, Institute of Psychology, Fliednerstraße 21, 48149 Münster, Germany. (Email: [email protected])
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Abstract

Background.

Previous studies of the dimensional structure of panic attack symptoms have mostly identified a respiratory and a vestibular/mixed somatic dimension. Evidence for additional dimensions such as a cardiac dimension and the allocation of several of the panic attack symptom criteria is less consistent. Clarifying the dimensional structure of the panic attack symptoms should help to specify the relationship of potential risk factors like anxiety sensitivity and fear of suffocation to the experience of panic attacks and the development of panic disorder.

Method.

In an outpatient multicentre study 350 panic patients with agoraphobia rated the intensity of each of the ten DSM-IV bodily symptoms during a typical panic attack. The factor structure of these data was investigated with nonlinear confirmatory factor analysis (CFA). The identified bodily symptom dimensions were related to panic cognitions, anxiety sensitivity and fear of suffocation by means of nonlinear structural equation modelling (SEM).

Results.

CFA indicated a respiratory, a vestibular/mixed somatic and a cardiac dimension of the bodily symptom criteria. These three factors were differentially associated with specific panic cognitions, different anxiety sensitivity facets and suffocation fear.

Conclusions.

Taking into account the dimensional structure of panic attack symptoms may help to increase the specificity of the associations between the experience of panic attack symptoms and various panic related constructs.

Keywords

Anxiety sensitivityclaustrophobic fearpanic attackpanic disordersubtypessymptom dimensions
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 8 , June 2015 , pp. 1675 - 1685
Copyright
Copyright © Cambridge University Press 2014 

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