Department of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS 39406, USA.
Department of Psychology, Florida State University, Tallahassee, FL, USA.
Psychiatry Res. 2019 Mar;273:82-88. doi: 10.1016/j.psychres.2019.01.025. Epub 2019 Jan 7.
Nocturnal panic involves waking suddenly from sleep in a state of panic, with no apparent cause, and affects more than half of patients with panic disorder. The Fear of Loss of Vigilance theory is the only proposed model for nocturnal panic, suggesting nocturnal panickers fear states in which they are unable to react to danger or protect themselves from threats. Prior work using a self-report questionnaire designed to test the theory (i.e., Fear of Loss of Vigilance Questionnaire; FLOVQ) was unsuccessful at differentiating nocturnal from daytime panickers. This study tested the theory using alternative measures to the FLOVQ. We predicted nocturnal panickers would show elevated responses to measures assessing fears of being unable to respond to or protect themselves from threats. A diverse community sample (N = 218) completed self-report measures related to panic attacks, intolerance of uncertainty, responsibility for harm, and anxiety sensitivity dimensions. Nocturnal panickers endorsed greater inhibitory intolerance of uncertainty and responsibility for harm, but not prospective intolerance of uncertainty, or anxiety sensitivity physical or cognitive concerns. This study provides support for the fear of loss of vigilance theory and suggests intolerance of uncertainty and responsibility for harm reduction be targeted in treatment for nocturnal panic attacks.
夜间惊恐发作是指在没有明显原因的情况下，从睡眠中突然惊醒并处于惊恐状态，超过一半的惊恐障碍患者都会经历这种情况。目前唯一提出的夜间惊恐发作模型是警觉丧失恐惧理论，该理论认为夜间惊恐发作的患者担心自己无法对危险做出反应或无法保护自己免受威胁。先前使用旨在检验该理论的自我报告问卷（即警觉丧失恐惧问卷；FLOVQ）的研究未能区分夜间惊恐发作和日间惊恐发作。本研究使用 FLOVQ 的替代测量方法来检验该理论。我们预测夜间惊恐发作患者在评估无法对威胁做出反应或无法保护自己免受威胁的恐惧的测量中会表现出更高的反应。一个多样化的社区样本（N=218）完成了与惊恐发作、不确定性容忍度、伤害责任和焦虑敏感性维度相关的自我报告测量。夜间惊恐发作患者更赞同抑制性不确定性容忍度和伤害责任，但不赞同前瞻性不确定性容忍度或焦虑敏感性的身体或认知担忧。本研究支持警觉丧失恐惧理论，并表明在治疗夜间惊恐发作时应针对不确定性容忍度和伤害责任降低进行治疗。
