Ehlers A, Breuer P, Dohn D, Fiegenbaum W
Department of Psychiatry, University of Oxford, U.K.
Behav Res Ther. 1995 Jan;33(1):69-76. doi: 10.1016/0005-7967(94)e0002-z.
Results on cardiac awareness in panic disorder are inconsistent. The present study attempted to clarify whether differences in instructions or the inclusion of patients taking antidepressant medication could account for these inconsistencies. 112 patients with panic disorder with agoraphobia were compared to 40 normal controls on the heartbeat perception task developed by Schandry (1981) [Schandry, R., Psychophysiology, 18, 483-488] using a standard instruction ("count all heartbeats you feel in your body") and a strict instruction ("count only those heartbeats about which you are sure"). Superior heartbeat perception for patients was only found with the standard instruction. Similarly, only with the standard instruction, patients taking medication affecting the cardiovascular system performed worse than patients without medication, as expected based on the relationship between stroke volume and heartbeat perception. The pattern of group differences indicates that agoraphobic patients have a better feeling for how fast their heart is beating than controls although these differences may be due to a tendency to interpret weak sensations as heartbeats. Furthermore, we tested in a subgroup of 40 patients whether cardiac awareness changes with exposure treatment. No changes in heartbeat perception were observed.
惊恐障碍患者心脏觉知方面的研究结果并不一致。本研究试图阐明，指导语的差异或纳入正在服用抗抑郁药物的患者是否能够解释这些不一致的情况。将112例伴有广场恐惧症的惊恐障碍患者与40名正常对照者进行比较，采用Schandry（1981年）[Schandry, R., 《心理生理学》, 18, 483 - 488]开发的心跳感知任务，分别使用标准指导语（“数出你感觉到的身体内所有的心跳”）和严格指导语（“只数出你确定的那些心跳”）。仅在标准指导语下发现患者具有更优的心跳感知能力。同样，也仅在标准指导语下，正如基于每搏输出量与心跳感知之间的关系所预期的那样，服用影响心血管系统药物的患者比未服药患者表现更差。组间差异模式表明，广场恐惧症患者比对照者对自己心跳的速度感觉更敏锐，尽管这些差异可能是由于倾向于将微弱感觉解释为心跳所致。此外，我们在40例患者的亚组中测试了心脏觉知是否会随着暴露治疗而改变。未观察到心跳感知的变化。
