Stewart S H, Taylor S, Jang K L, Cox B J, Watt M C, Fedoroff I C, Borger S C
Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada.
Behav Res Ther. 2001 Apr;39(4):443-56. doi: 10.1016/s0005-7967(00)00023-1.
We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.
我们使用结构方程模型（SEM）来检验以下假设：童年期的工具性学习和替代性学习经历会直接以及通过对焦虑敏感性（AS）的影响间接影响青年期惊恐发作的频率。共有478名大学生参与了一项回顾性评估，内容涉及他们童年期对唤醒反应性感觉（如恶心、心跳加速、呼吸急促、头晕）和唤醒非反应性感觉（即感冒、疼痛和皮疹）的学习经历。结构方程模型显示，唤醒反应性躯体症状的学习史直接影响焦虑敏感性水平和惊恐发作频率；焦虑敏感性直接影响惊恐发作频率；而唤醒非反应性症状的学习史直接影响焦虑敏感性，但不直接影响惊恐发作频率。这些结果与先前关于焦虑敏感性和惊恐发作的学习史起源的回顾性研究结果一致，并首次提供了实证证据，证明焦虑敏感性在解释童年学习经历与青年期惊恐发作之间的关系中具有部分中介作用。文中还讨论了这些结果对理解惊恐障碍病因的意义。
