Responses to Interoceptive Exposure in People With Posttraumatic Stress Disorder (PTSD): A Preliminary Analysis of Induced Anxiety Reactions and Trauma Memories and Their Relationship to Anxiety Sensitivity and PTSD Symptom Severity

A growing body of evidence suggests that anxiety sensitivity (AS; fear of arousal‐related sensations) plays a role in posttraumatic stress disorder (PTSD). Consistent with this, evidence indicates that interoceptive exposure (IE), which is a method for reducing AS, reduces PTSD symptoms. Clinical observations from our treatment studies indicate that IE triggers both anxiety and trauma memories in people with PTSD. The primary aim of this study was to describe the anxiety responses to a series of IE exercises and to examine whether or not trauma memories were activated. A secondary aim was to explore the relationships among AS, PTSD symptom severity, and IE responses. Data were collected from 23 people with PTSD who completed measures of PTSD symptoms and AS and a standardized battery of 10 IE exercises. Elevated anxiety and strong arousal responses were frequently elicited by the exercises, and trauma memories were also frequently triggered. AS and IE‐triggered trauma memories significantly predicted IE‐induced peak anxiety. The implications of the findings are discussed in terms of how IE might exert its therapeutic effects in the treatment of PTSD.

[1]  M. Zvolensky,et al.  Anxiety sensitivity taxon and trauma: discriminant associations for posttraumatic stress and panic symptomatology among young adults , 2005, Depression and anxiety.

[2]  J. Wald,et al.  Efficacy of interoceptive exposure therapy combined with trauma-related exposure therapy for posttraumatic stress disorder: a pilot study. , 2007, Journal of anxiety disorders.

[3]  M. Stein,et al.  Anxiety sensitivity and PTSD among female victims of intimate partner violence , 2002, Depression and anxiety.

[4]  J. Abramowitz,et al.  Anxiety sensitivity and its dimensions across the anxiety disorders. , 2006, Journal of anxiety disorders.

[5]  David H. Barlow,et al.  Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder , 2020, The Neurotic Paradox.

[6]  R. Zinbarg,et al.  Anxiety Sensitivity and Panic Attacks , 2007, Behavior modification.

[7]  Charles R. Figley.  Clinician's Guide to PTSD: A Cognitive-Behavioral Approach , 2008 .

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

[9]  M. Zvolensky,et al.  Risk-factor research and prevention programs for anxiety disorders: a translational research framework. , 2006, Behaviour research and therapy.

[10]  Steven Taylor,et al.  Understanding and Treating Panic Disorder: Cognitive-Behavioural Approaches , 2000 .

[11]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[12]  Jessica W Cook,et al.  Anxiety sensitivity and depression: mechanisms for understanding somatic complaints in veterans with posttraumatic stress disorder. , 2006, Journal of traumatic stress.

[13]  S. Taylor,et al.  An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample. , 1998, Journal of anxiety disorders.

[14]  Michael A. Mallott,et al.  Evaluating anxiety sensitivity and other fundamental sensitivities predicting anxiety symptoms and fearful responding to a biological challenge. , 2006, Behaviour research and therapy.

[15]  M. Antony,et al.  Responses to symptom induction exercises in panic disorder. , 2006, Behaviour research and therapy.

[16]  M K Shear,et al.  Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. , 2000, JAMA.

[17]  P. Schnurr,et al.  Anxiety Sensitivity as a Moderator of the Relation Between Trauma Exposure Frequency and Posttraumatic Stress Symptomatology , 2006, Journal of Cognitive Psychotherapy.

[18]  R. McNally,et al.  Anxiety sensitivity and panic disorder , 2002, Biological Psychiatry.

[19]  E. Keogh,et al.  Does Anxiety Sensitivity Predict Post-Traumatic Stress Symptoms Following Childbirth? A Preliminary Report , 2002 .

[20]  J. Albeck.  Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies , 2001 .

[21]  M. Zvolensky,et al.  Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology. , 2006, Journal of psychiatric research.

[22]  N. Schmidt,et al.  Interoceptive assessment and exposure in panic disorder: A descriptive study , 2004 .

[23]  R. Bradley,et al.  A multidimensional meta-analysis of psychotherapy for PTSD. , 2005, The American journal of psychiatry.

[24]  N. Rector,et al.  Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity. , 2007, Behaviour research and therapy.

[25]  Steven Taylor,et al.  COGNITIVE FACTORS IN TRAUMATIC STRESS REACTIONS: PREDICTING PTSD SYMPTOMS FROM ANXIETY SENSITIVITY AND BELIEFS ABOUT HARMFUL EVENTS , 2000, Behavioural and Cognitive Psychotherapy.

[26]  J. Wald,et al.  Interoceptive Exposure Therapy Combined with Trauma‐related Exposure Therapy for Post‐traumatic Stress Disorder: a Case Report , 2005, Cognitive behaviour therapy.

[27]  Steven Taylor,et al.  Anxiety sensitivity. , 2020, Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms..

[28]  M. Craske,et al.  Interoceptive exposure versus breathing retraining within cognitive-behavioural therapy for panic disorder with agoraphobia. , 1997, The British journal of clinical psychology.