a Department of Psychology , Ryerson University , Toronto , Canada.
b Institute for Stress and Wellbeing Research , Ryerson University , Toronto , Ontario , Canada.
Anxiety Stress Coping. 2019 Mar;32(2):216-230. doi: 10.1080/10615806.2019.1570803.
BACKGROUND/RATIONALE: The carbon dioxide (CO) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations.
A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review.
Both the meta-analysis and systematic review found the CO challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling.
Findings highlight the CO challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO challenge and its anticipated effects in healthy and non-clinical control populations are discussed.
背景/原理：二氧化碳（CO）挑战已在实验室环境中被可靠地用作临床人群的惊恐源。然而，其对健康和非临床对照人群的影响程度尚不清楚。本荟萃分析和系统评价的目的是提供这些影响的定量估计。具体来说，目前的论文将评估 CO 挑战在诱发健康和非临床对照人群的主观和生理唤醒方面的相对效果。
荟萃分析共纳入 16 篇文章的 35 个独立样本，系统评价共纳入 37 篇文章的 74 个独立样本。
荟萃分析和系统评价均发现 CO 挑战通过自我报告的焦虑和恐惧引起主观不适增加。通过血压和心率的生理反应在抽样研究中存在异质性，没有观察到研究间的显著变化。调节分析表明，研究结果的差异可能归因于参与者筛选和有创采样。
研究结果强调 CO 挑战作为引起主观不适的有用工具。讨论了 CO 挑战的使用及其在健康和非临床对照人群中的预期效果的影响。
