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

Frontiers in Psychology

Volumn 6, Issue , 2015, Pages

  Pappens, Meike ^a   Vandenbossche, Evelien ^a   Van den Bergh, Omer ^a   Van Diest, Ilse ^a  

^a UNIVERSITY OF LEUVEN   (Belgium)

Author keywords

CS US contingency; dual process theory; fear conditioning; interoceptive fear; panic; respiration

Indexed keywords

EID: 85009327932     PISSN: None     EISSN: 16641078     Source Type: Journal    
DOI: 10.3389/fpsyg.2015.01150     Document Type: Article

References (48)

1. Acheson D. T. Forsyth J. P. Moses E. (2012). Interoceptive fear conditioning and panic disorder: the role of conditioned stimulus–unconditioned stimulus predictability. Behav. Ther. 6 174–189. 10.1016/j.beth.2011.06.001
2. Acheson D. T. Forsyth J. P. Prenoveau J. M. Bouton M. E. (2007). Interoceptive fear conditioning as a learning model of panic disorder: an experimental evaluation using 20% CO2-enriched air in a non- clinical sample. Behav. Res. Ther. 45 2280–2294. 10.1016/j.brat.2007.04.008
3. Beaver J. D. Mogg K. Bradley B. P. (2005). Emotional conditioning to masked stimuli and modulation of visuospatial attention. Emotion 5 67–79.
4. Bechara A. Tranel D. Damasio H. Adolphs R. Rockland C. Damasio A. R. (1995). Double dissociation of conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. Science 269 1115–1118.
5. Blumenthal T. D. Cuthbert B. N. Filion D. L. Hackley S. Lipp O. V. Van Boxtel A. (2005). Committee report: guidelines for human startle eyeblink electromyographic studies. Psychophysiology 42 1–15. 10.1111/j.14698986.2005.00271.x
6. Bouton M. E. Mineka S. Barlow D. H. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychol. Rev. 108 4–32.
7. Briggs A. C. Stretch D. D. Brandon S. (1993). Subtyping of panic disorder by symptom profile. Br. J. Psychiatry 163 201–209. 10.1192/bjp.163.2.201
8. Clark R. E. Squire L. R. (1998). Classical conditioning and brain systems: the role of awareness. Science 280 77–81.
9. De Clerck A. Verschuere B. Crombez G. De Vlieger P. (2006). Psychophysiological analysis (PSPHA): a modular script based program for analyzing psychophysiological data. Behav. Res. Methods 38 504–510. 10.3758/BF03192805
10. De Cort K. Griez E. Büchler M. Schruers K. (2012). The role of “interoceptive” fear conditioning in the development of panic disorder. Behav. Ther. 1 203–215. 10.1016/j.beth.2011.06.005
11. Dworkin B. R. (2000). “Interoception,” in Handbook of Psychophysiology, 2nd Edn, eds Cacioppo J. T. Tassinary L. G. Berntson G. G. (New York: Cambridge University Press), 482–506.
12. Hamm A. O. Vaitl D. (1996). Affective learning: awareness and aversion. Psychophysiology 33 698–710.
13. Hamm A. O. Weike A. I. (2005). The neuropsychology of fear learning and fear regulation. Int. J. Psychophysiol. 57 5–14. 10.1016/j.ijpsycho.2005.01.006
14. Johnson P. L. Federici L. M. Shekhar A. (2014). Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks. Neurosci. Biobehav. Rev. 46 429–454. 10.1016/j.neubiorev.2014.07.027
15. Kessler R. C. Chiu W. T. Jin R. Ruscio A. M. Shear K. Walters E. E. (2006). The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch. Gen. Psychiat. 63 415–424.
16. Kindt M. Soeter M. Vervliet B. (2009). Beyond extinction: erasing human fear responses and preventing the return of fear. Nat. Neurosci. 12 256–258. 10.1038/nn.2271
17. Kircanski K. Phil C. Craske M. G. Epstein A. M. Wittchen H.-U. (2009). Subtypes of panic attacks: a critical review of the empirical literature. Depress. Anxiety 26 878–887. 10.1002/da.20603
18. Klein D. F. (1993). False suffocation alarms, spontaneous panics, and related conditions: an integrative hypothesis. Arch. Gen. Psychiatry 50 306–317. 10.1001/archpsyc.1993.01820160076009
19. Knight D. Nguyen H. Bandettini P. (2003). Expression of conditional fear with and without awareness. Proc. Natl. Acad. Sci. U.S.A. 100 15280–15283.
20. LeDoux J. E. (1996). The Emotional Brain. New York: Simon & Schuster.
21. LeDoux J. E. (2000). Emotion circuits in the brain. Annu. Rev. Neurosci. 23 155–184. 10.1146/annurev.neuro.23.1.155
22. Ley R. (1989). Dyspneic-fear and catastrophic cognitions in hyperventilatory panic attacks. Behav. Res. Ther. 27 549–554. 10.1016/0005-7967(89)90089-2
23. Lovibond P. F. Shanks D. R. (2002). The role of awareness in Pavlovian conditioning: empirical evidence and theoretical implications. J. Exp. Psychol. 1 3–26.
24. McHugh R. K. Smits J. A. Otto M. W. (2009). Empirically supported treatments for panic disorder. Psychiat. Clin. N. Am. 32 593–610. 10.1016/j.psc.2009.05.005
25. Melzig C. A. Holtz K. Michalowski J. M. Hamm A. O. (2011). Interoceptive threat leads to defensive mobilization in highly anxiety sensitive persons. Psychophysiology 48 745–754. 10.1111/j.1469-8986.2010.01150
26. Meuret A. E. Rosenfield D. Wilhelm F. H. Zhou E. Conrad A. Ritz T. et al. (2011). Do unexpected panic attacks occur spontaneously? Biol. Psychiatry 70 985–991. 10.1016/j.biopsych.2011.05.027
27. Mitchell C. J. De Houwer J. Lovibond P. F. (2009). The propositional nature of human associative learning. Behav. Brain Sci. 32 183–198.
28. Newell B. R. Shanks D. R. (2014). Unconscious influences on decision making: a critical review. Behav. Brain Sci. 37 1–19. 10.1017/S0140525X12003214
29. Öhman A. Mineka S. (2001). Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. Psychol. Rev. 108 483–522.
30. Öhman A. Soares J. J. (1998). Emotional conditioning to masked stimuli: expectancies for aversive outcomes following nonrecognized fear relevant stimuli. J. Abnorm. Psychol. 127 69–82.
31. Pappens M. Schroijen M. Sütterlin S. Smets E. Van den Bergh O. Thayer J. et al. (2014). Resting heart rate variability predicts safety learning and fear extinction in an interoceptive fear conditioning paradigm. PLoS ONE 9:e105054. 10.1371/journal.pone.0105054
32. Pappens M. Smets E. Vansteenwegen D. Van den Bergh O. Van Diest I. (2012). Learning to fear suffocation: a new paradigm for interoceptive fear conditioning. Psychophysiology 6 821–828.
33. Pappens M. Van den Bergh O. Vansteenwegen D. Ceunen E. De Peuter S. Van Diest I. (2013). Learning to fear obstructed breathing: comparing interoceptive and exteroceptive cues. Biol. Psychol. 92 36–42.
34. Purkis H. M. Lipp O. V. (2001). Does affective learning exist in the absence of contingency awareness? Learn. Motiv. 32 84–99.
35. Raes A. K. Koster E. H. Van Damme S. Fias W. De Raedt R. (2010). Aversive conditioning under conditions of restricted awareness: effects on spatial cueing. Q. J. Exp. Psychol. 1 23.
36. Schroijen M. Pappens M. Schruers K. Van den Bergh O. Vervliet B. Van Diest I. (2015). Generalization of fear to respiratory sensations. Behav. Ther. (in press). 10.1016/j.beth.2015.004
37. Schultz D. H. Helmstetter F. J. (2010). Classical conditioning of autonomic fear responses is independent of contingency awareness. J. Exp. Psychol. Anim. Behav. Process. 36 495–500. 10.1037/a0020263
38. Sebastiani L. Castellani E. D’Alessandro L. (2011). Emotion processing without awareness: features detection or significance evaluation? Int. J. Psychophysiol. 80 150–156. 10.1016/j.ijpsycho.2011.02.019
39. Sevenster D. Beckers T. Kindt M. (2014). Fear conditioning of SCR but not the startle reflex requires conscious discrimination of threat and safety. Front. Behav. Neurosci. 8 32. 10.3389/fnbeh.2014.00032
40. Shulman I. D. Cox B. J. Swinson R. P. Kuch K. Reichman J. T. (1994). Precipitating events, locations and reactions associated with initial unexpected panic attacks. Behav. Res. Ther. 32 17–20.
41. Smith C. Clark R. Manns J. Squire L. (2005). Acquisition of differential delay eyeblink conditioning is independent of awareness. Behav. Neurosci. 119 78–86.
42. Soeter M. Kindt M. (2010). Dissociating response systems: erasing fear from memory. Neurobiol. Learn. Mem. 94 30–41. 10.1016/j.nlm.2010.03.004
43. Spruyt A. Clarysse J. Vansteenwegen D. Baeyens F. Hermans D. (2010). Affect 4.0: A free software package for implementing psychological and psychophysiological experiments. Exp. Psychol. 57 36–45. 10.1027/1618-3169/a000005
44. Tabbert K. Merz C. J. Klucken T. Schweckendiek J. Vaitl D. Wolf O. T. et al. (2011). Influence of contingency awareness on neural, electrodermal and evaluative responses during fear conditioning. Soc. Cogn. Affect. Neurosci. 6 495–506. 10.1093/scan/nsq070
45. Tabbert K. Stark R. Kirsch P. Vaitl D. (2006). Dissociation of neural responses and skin conductance reactions during fear conditioning with and without awareness of stimulus contingencies. Neuroimage 32 761–770. 10.1016/j.neuroimage.2006.03.038
46. Vervliet B. Craske M. G. Hermans D. (2013). Fear extinction and relapse: state of the art. Annu. Rev. Clin. Psychol. 9 215–248. 10.1146/annurev-clinpsy-050212-185542
47. Vickers K. McNally R. J. (2005). Respiratory symptoms and panic in the National Comorbidity Survey: a test of Klein’s suffocation false alarm theory. Behav. Res. Ther. 43 1011–1018.
48. Weike A. I. Schupp H. T. Hamm A. O. (2007). Fear acquisition requires awareness in trace but not delay conditioning. Psychophysiology 44 170–180. 10.1111/j.1469-8986.2006.00469.x