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Anticipatory Anxiety as a Function of Panic Attacks and Panic-Related Self-Efficacy: An Ambulatory Assessment Study in Panic Disorder

Published online by Cambridge University Press:  29 February 2012

Sylvia Helbig-Lang ,
Thomas Lang ,
Franz Petermann  and
Jürgen Hoyer
Sylvia Helbig-Lang*
Affiliation:
University of Bremen, Germany
Thomas Lang
Affiliation:
Christoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany
Franz Petermann
Affiliation:
University of Bremen, Germany
Jürgen Hoyer
Affiliation:
Technical University Dresden, Germany
*
Reprint requests to Sylvia Helbig-Lang, University of Hamburg, Department for Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany. E-mail: Sylvia.Helbig-Lang@uni-hamburg.de
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Abstract

Background: Panic attacks and anticipatory anxiety are considered to be inter-correlated, yet distinctive, features of panic disorder, both contributing to its onset and maintenance as well as to the associated impairment. Given the difficulty to yield ecologically valid data on these fluctuating symptoms the natural course of anticipatory anxiety and its correlates have seldom been addressed with adequate methods. Aims: The current study aimed at further exploring the natural variance of anticipatory anxiety and its interdependence with panic-related variables. In addition, impact of anxiety sensitivity, and perceived ability to cope with panic on the relation between panic attacks and subsequent anxiety was inspected. Method: Based on an Ecological Momentary Assessment approach, 21 patients with panic disorder rated study variables continuously over one week; 549 question sets were completed. Results: Anticipatory anxiety followed a diurnal pattern and was associated with situational and internal variables typically linked to panic experiences. Preceding panic attacks intensified anticipatory anxiety and associated negative emotional states; however, perceived ability to cope attenuated these effects. Conclusion: Based on natural observation data, results largely support the importance of cognitive appraisals for anticipatory anxiety, and its interplay with panic attacks as it has been suggested by cognitive theory and recent findings in extinction learning research.

Keywords

Panic disordercognitive appraisalsecological momentary assessmentanticipatory anxiety
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 5 , October 2012 , pp. 590 - 604
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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