Specificity of Peritraumatic Fear in Predicting Anxious Reactivity to a Biological Challenge among Traumatic Event-Exposed Adolescents

Theory implicates peritraumatic fear-based interoceptive conditioning in the development of panic spectrum problems subsequent to traumatic event exposure. Relatively little empirical work has directly investigated this hypothesis. The current study tested the hypothesis that level of peritraumatic fear would predict anxious reactivity to a well-established 3-min voluntary hyperventilation procedure administered to 63 adolescents who had experienced a DSM-IV-TR-defined traumatic event. This relation was examined after controlling for variance accounted for by posttraumatic stress symptoms, sex, age, anxiety sensitivity, general symptoms of psychopathology, and both peritraumatic helplessness and disgust. As predicted, peritraumatic fear was related to anxious reactivity to hyperventilation-elicited bodily arousal. Specificity tests suggested this relation was specific to peritraumatic fear. Prospective research is now needed to better elucidate the relation between peritraumatic fear and subsequent development of anxious reactivity to bodily arousal and panic spectrum problems.

[1]  H. Wittchen,et al.  DSM-IV panic attacks and panic disorder in a community sample of adolescents and young adults: how specific are panic attacks? , 1998, Journal of psychiatric research.

[2]  C. A. Morgan,et al.  Dr. Southwick and Colleagues Reply , 1997 .

[3]  E. Peskind,et al.  Behavioral and neuroendocrine responses to sodium lactate infusion in subjects with posttraumatic stress disorder. , 1997, The American journal of psychiatry.

[4]  M. Rutter,et al.  Beyond longitudinal data: causes, consequences, changes, and continuity. , 1994, Journal of Consulting and Clinical Psychology.

[5]  R. Bootzin,et al.  Theoretical Issues in Behavior Therapy , 1985 .

[6]  M. Zvolensky,et al.  An examination of worry in relation to anxious responding to voluntary hyperventilation among adolescents. , 2006, Behaviour research and therapy.

[7]  B. Rothbaum,et al.  Behavioral/cognitive conceptualizations of post-traumatic stress disorder , 1989 .

[8]  W. Silverman,et al.  Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. , 2001, Journal of the American Academy of Child and Adolescent Psychiatry.

[9]  C. A. Morgan,et al.  Noradrenergic and serotonergic function in posttraumatic stress disorder. , 1997, Archives of general psychiatry.

[10]  J. Ruscio,et al.  The latent structure of posttraumatic stress disorder: a taxometric investigation of reactions to extreme stress. , 2002, Journal of abnormal psychology.

[11]  Laura E. Reardon,et al.  Pubertal Status and Emotional Reactivity to a Voluntary Hyperventilation Challenge Predicting Panic Symptoms and Somatic Complaints , 2007, Behavior modification.

[12]  R. Bryant,et al.  The role of panic attacks in acute stress disorder in children. , 2007, Journal of traumatic stress.

[13]  P. Resick,et al.  Panic following trauma: the etiology of acute posttraumatic arousal. , 2004, Journal of anxiety disorders.

[14]  T. Achenbach.  Manual for the child behavior checklist/4-18 and 1991 profile , 1991 .

[15]  B. Garssen,et al.  Symptom reporting during voluntary hyperventilation and mental load: implications for diagnosing hyperventilation syndrome. , 1990, Journal of psychosomatic research.

[16]  D. Padgett,et al.  Gender differences in young adolescents' exposure to violence and rates of PTSD symptomatology. , 2000, The American journal of orthopsychiatry.

[17]  Jr. Russell Noyes,et al.  Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic , 1990 .

[18]  H. Resnick,et al.  Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. , 2003, Journal of consulting and clinical psychology.

[19]  S. Mineka,et al.  A modern learning theory perspective on the etiology of panic disorder. , 2001, Psychological review.

[20]  B. Olatunji,et al.  An Empirical Test of the Association Between Disgust and Sexual Assault , 2010 .

[21]  R. Rapee.  Psychological factors influencing the affective response to biological challenge procedures in panic disorder , 1995 .

[22]  D. Kaloupek,et al.  Consistency of Retrospective Reporting About Exposure to Traumatic Events , 2003, Journal of traumatic stress.

[23]  C. A. Morgan,et al.  Abnormal noradrenergic function in posttraumatic stress disorder. , 1993, Archives of general psychiatry.

[24]  J. Margraf,et al.  Exposure to internal and external stimuli: Reactions in children of patients with panic disorder or animal phobia☆ , 1996 .

[25]  Paul Gilbert,et al.  Shame : interpersonal behavior, psychopathology, and culture , 1998 .

[26]  Ashley G. Melson,et al.  Child and adolescent measures for diagnosis and screening. , 2008 .

[27]  M. Feldner,et al.  An examination of the relation between traumatic event exposure and panic-relevant biological challenge responding among adolescents. , 2011, Behavior therapy.

[28]  D. Fergusson,et al.  Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood , 2004, Psychological Medicine.

[29]  J. McCracken,et al.  Concurrent Validity of the Anxiety Disorders Section of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions , 2002, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[30]  The Role of Criterion A2 in the DSM-IV Diagnosis of Posttraumatic Stress Disorder , 2010, Biological Psychiatry.

[31]  Chris Hayward,et al.  A critical review of the empirical literature on the relation between anxiety and puberty. , 2009, Clinical psychology review.

[32]  J. E. Calamari,et al.  Panic attack symptomatology and anxiety sensitivity in adolescents , 1996 .

[33]  M. Zvolensky,et al.  A review of psychological factors/processes affecting anxious responding during voluntary hyperventilation and inhalations of carbon dioxide-enriched air. , 2001, Clinical psychology review.

[34]  M. Zvolensky,et al.  Experimental Psychopathology in Psychological Science , 2001 .

[35]  S. Orr,et al.  The black hole of trauma , 1990, Biological Psychiatry.

[36]  R. Kleinknecht,et al.  Panic and panic attacks in adolescents , 1989 .

[37]  B. Garssen,et al.  Voluntary hyperventilation: the influence of duration and depth on the development of symptoms , 1995, Biological Psychology.

[38]  Debra,et al.  The role of Criterion A 2 in the DSM-IV diagnosis of post-traumatic stress disorder , 2011 .

[39]  I. Litt,et al.  Pubertal stage and panic attack history in sixth- and seventh-grade girls. , 1992, The American journal of psychiatry.

[40]  D. Hinton,et al.  The Psychophysiology of Orthostatic Panic in Cambodian Refugees Attending a Psychiatric Clinic , 2004 .

[41]  Heather C. Lench,et al.  Incremental validity of new clinical assessment measures. , 2003, Psychological assessment.

[42]  R. McNally,et al.  How does anxiety sensitivity vary across the anxiety disorders , 1992 .

[43]  H. Kraemer,et al.  Assessment and phenomenology of nonclinical panic attacks in adolescent girls. , 1997, Journal of anxiety disorders.

[44]  Dean McKay,et al.  Handbook of research methods in abnormal and clinical psychology , 2008 .

[45]  C. Grus.  The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties , 2001 .

[46]  W. Silverman,et al.  The Anxiety Disorders Interview Schedule for Children. , 1988, Journal of the American Academy of Child and Adolescent Psychiatry.

[47]  Carolyn M. Mazure,et al.  Does stress cause psychiatric illness , 1995 .

[48]  Jutta Joormann,et al.  Attention and memory biases in the offspring of parents with bipolar disorder: indications from a pilot study. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[49]  I. Myin-Germeys,et al.  Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. , 2006, Journal of psychosomatic research.

[50]  M. Zvolensky,et al.  Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature. , 2007, Clinical psychology review.

[51]  Jacob Cohen,et al.  A power primer. , 1992, Psychological bulletin.

[52]  L. Sechrest.  Incremental Validity : a Recommendation , 1963 .

[53]  Shireen L. Rizvi,et al.  Peritraumatic Responses and Their Relationship to Perceptions of Threat in Female Crime Victims , 2005, Violence against women.

[54]  E. Peskind,et al.  Comparison of sodium lactate‐induced panic symptoms between panic disorder and posttraumatic stress disorder , 1998, Depression and anxiety.

[55]  Laura E. Reardon,et al.  Anxiety sensitivity and posttraumatic stress among traumatic event-exposed youth. , 2008, Behaviour research and therapy.

[56]  T. Ollendick,et al.  Panic in children and adolescents: a review. , 1994, Journal of child psychology and psychiatry, and allied disciplines.

[57]  C. Brewin,et al.  Fear, Helplessness, and Horror in Posttraumatic Stress Disorder: Investigating DSM-IV Criterion A2 in Victims of Violent Crime , 2000, Journal of traumatic stress.

[58]  D. Barlow,et al.  The etiology of posttraumatic stress disorder. , 1990 .

[59]  D. Hinton,et al.  The Panic Attack–Posttraumatic Stress Disorder Model: Applicability to Orthostatic Panic Among Cambodian Refugees , 2008, Cognitive behaviour therapy.

[60]  Michael B. First,et al.  Handbook of Psychiatric Measures , 2000 .

[61]  M. Kozak,et al.  Emotional processing of fear: exposure to corrective information. , 1986, Psychological bulletin.

[62]  Laura E. Reardon,et al.  The Interactive Role of Anxiety Sensitivity and Pubertal Status in Predicting Anxious Responding to Bodily Sensations among Adolescents , 2006, Journal of abnormal child psychology.

[63]  R. Lydiard,et al.  The relationship of stress to panic disorder: Cause or effect? , 1995 .

[64]  M. Zvolensky,et al.  Posttraumatic stress disorder and anxious and fearful reactivity to bodily arousal: a test of the mediating role of nicotine withdrawal severity among daily smokers in 12-hr nicotine deprivation. , 2008, Experimental and clinical psychopharmacology.

[65]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[66]  John E. Cooper,et al.  Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM-IV-TR) , 2001, British Journal of Psychiatry.

[67]  Adrian Angold,et al.  Traumatic events and posttraumatic stress in childhood. , 2007, Archives of general psychiatry.

[68]  J. Wolpe,et al.  Psychotherapy by reciprocal inhibition , 1958, Conditional reflex.

[69]  V. Yeragani,et al.  A laboratory procedure for the induction of flashbacks. , 1987, The American journal of psychiatry.

[70]  R. Fried,et al.  The psychology and physiology of breathing : in behavioral medicine, clinical psychology, and psychiatry , 1993 .

[71]  M. Zvolensky,et al.  Anxiety Sensitivity and Anxious Responding to Bodily Sensations: A Test among Adolescents Using a Voluntary Hyperventilation Challenge , 2005, Cognitive Therapy and Research.

[72]  C. A. Morgan,et al.  Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm. , 1997, The American journal of psychiatry.

[73]  M. Elliott,et al.  A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. , 2003, JAMA.

[74]  R. Bryant,et al.  Peritraumatic and persistent panic attacks in acute stress disorder. , 2003, Behaviour research and therapy.

[75]  S. Galea,et al.  Panic reactions to terrorist attacks and probable posttraumatic stress disorder in adolescents. , 2006, Journal of traumatic stress.