Vickers Kristin, McNally Richard J
Department of Psychology, Harvard University, USA.
Behav Res Ther. 2005 Aug;43(8):1011-8. doi: 10.1016/j.brat.2004.06.019. Epub 2004 Sep 23.
According to suffocation false alarm theory (Arch. Gen. Psychiatry 50 (1993) 31), respiratory symptoms are the symptoms that best distinguish the panic attacks of individuals with panic disorder (PD) from those of individuals without PD. Using National Comorbidity Survey data from those 609 respondents who had lifetime histories of panic attacks or PD, we tested this prediction. Neither respiratory symptom (smothering; dyspnea) strongly differentiated between respondents with PD and those with only panic attacks. Respiratory symptom endorsement was unrelated to PD when the number of other symptoms endorsed was controlled; furthermore, respiratory symptoms had slight effect sizes and were not included in a multivariate context. In contrast, fear of dying had the largest effect size, an association with PD that persisted after control for other symptom endorsement, and a continuing importance in multivariate analyses. Strikingly, panic attack respondents who reported having had only one panic attack were as likely as PD respondents to report respiratory symptoms during panic. These findings, although based on retrospective self-report and thus subject to recall bias, are inconsistent with the hypothesis that respiratory symptoms during panic have diagnostic significance.
根据窒息误报理论（《普通精神病学文献》50 (1993) 31），呼吸症状是最能区分惊恐障碍（PD）患者的惊恐发作与非PD患者的惊恐发作的症状。利用来自609名有终生惊恐发作或PD病史的受访者的全国共病调查数据，我们对这一预测进行了检验。无论是呼吸症状（窒息感；呼吸困难），在PD患者和仅有惊恐发作的患者之间都没有强烈的区分度。当控制其他认可症状的数量时，呼吸症状的认可与PD无关；此外，呼吸症状的效应量较小，且未纳入多变量分析。相比之下，对死亡的恐惧效应量最大，在控制其他症状认可后与PD的关联依然存在，且在多变量分析中持续具有重要意义。引人注目的是，报告仅经历过一次惊恐发作的惊恐发作受访者与PD受访者在惊恐发作时报告呼吸症状的可能性相同。这些发现虽然基于回顾性自我报告，因此存在回忆偏差，但与惊恐发作时的呼吸症状具有诊断意义这一假设不一致。
