Spinhoven P, Onstein E J, Sterk P J, Le Haen-Versteijnen D
Department of Psychiatry, State University of Leiden, The Netherlands.
Behav Res Ther. 1992 Sep;30(5):453-61. doi: 10.1016/0005-7967(92)90029-g.
Forty-eight patients with DSM-III-R Panic Disorder underwent a hyperventilation provocation Test (HVPT). Twenty-four patients rated the symptoms induced during the HVPT as similar to those occurring during panic attacks in daily life. Contrary to the classical hyperventilation model of panic, no differences were found in respiratory physiology between recognizers and non-recognizers before and during voluntary hyperventilation. Moreover, recognizers and non-recognizers reported comparable levels of panic and hyperventilation symptoms and state anxiety during panic attacks in daily life. Ten of the recognizers also had a panic attack during the HVPT, independent of any differential CO2 alterations. Compared to non-panickers, panickers obtained higher scores for agoraphobia and depression. On the basis of these results, it is concluded that recognizers or panickers do not show a tendency towards hyperventilation, but that reports of severe panic and hyperventilation symptoms are more closely related to the level of anxiety. These results are more consistent with the cognitive model of panic, which emphasizes the patient's tendency to interpret somatic symptoms catastrophically.
48名患有DSM-III-R惊恐障碍的患者接受了过度通气激发试验(HVPT)。24名患者将HVPT期间诱发的症状评定为与日常生活中惊恐发作时出现的症状相似。与经典的惊恐过度通气模型相反,在自主过度通气之前和期间,识别者和非识别者在呼吸生理学方面未发现差异。此外,识别者和非识别者报告在日常生活中惊恐发作期间的惊恐、过度通气症状和状态焦虑水平相当。10名识别者在HVPT期间也出现了惊恐发作,与任何不同的二氧化碳变化无关。与非惊恐者相比,惊恐者在广场恐惧症和抑郁方面得分更高。基于这些结果,得出的结论是,识别者或惊恐者没有表现出过度通气的倾向,但严重惊恐和过度通气症状的报告与焦虑水平更密切相关。这些结果与惊恐的认知模型更一致,该模型强调患者将躯体症状灾难性地解释的倾向。