Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
J Anxiety Disord. 2022 Jan;85:102514. doi: 10.1016/j.janxdis.2021.102514. Epub 2021 Dec 9.
Nocturnal panic refers to waking in a state of panic without obvious triggers, experiencing the same symptoms as panic attacks that occur while awake. Interrelationships between daytime and nocturnal panic symptoms have not been examined despite theories suggesting panic symptoms perpetuate one another in a forward feedback loop. The current study compared associations between symptoms in daytime and nocturnal panic using network analysis. Network theory conceptualizes symptoms as causing one another, rather than originating from a latent variable (i.e., a disorder). Given that nocturnal panic originates from sleep stages without cognitive activity, cognitive symptoms were expected to be more central in daytime panic networks than nocturnal panic networks. Prior literature indicates similar nocturnal and daytime panic severity; thus, we expected that panic groups would report equivalent panic symptom severity. An online community sample (N = 215) provided panic symptom history. Panic network structures did not differ, although the daytime panic network produced stronger and more numerous connections between physical and cognitive symptoms. The nocturnal panic group, however, reported more severe cognitive symptoms than the daytime panic group. These results challenge biologically-focused nocturnal panic theories and suggest a more significant role of cognitive symptoms in perpetuating nocturnal panic attacks once the individual awakens.
夜间惊恐是指在没有明显诱因的情况下惊醒，并经历与白天发生的惊恐发作相同的症状。尽管有理论表明惊恐症状会在正向反馈循环中相互延续，但日间和夜间惊恐症状之间的相互关系尚未得到检验。本研究使用网络分析比较了日间和夜间惊恐症状之间的关联。网络理论将症状视为相互引起的，而不是源于潜在变量（即障碍）。由于夜间惊恐源自没有认知活动的睡眠阶段，因此预计在日间惊恐网络中，认知症状比夜间惊恐网络更为核心。先前的文献表明，夜间和日间惊恐严重程度相似；因此，我们预计惊恐组会报告相同的惊恐症状严重程度。在线社区样本（N=215）提供了惊恐症状史。尽管日间惊恐网络中身体和认知症状之间产生了更强、更多的连接，但惊恐网络结构并未有所不同。然而，夜间惊恐组报告的认知症状比日间惊恐组更为严重。这些结果对以生物学为重点的夜间惊恐理论提出了挑战，并表明在个体醒来后，认知症状在延续夜间惊恐发作方面发挥着更为重要的作用。
