The extension of the cognitive model of panic disorder

Čuržik, Doris. (2017). The extension of the cognitive model of panic disorder. PhD Thesis. Filozofski fakultet u Zagrebu, Department of Psychology.
(Poslijediplomski doktorski studij psihologije) [mentor Jokić-Begić, Nataša].

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Abstract

Introduction: Panic disorder is an anxiety disorder defined by unexpected and repeated episodes of intense fear, a sense of loss of control and impending doom, followed by intensive physical symptoms. In addition to anxiety sensitivity, or the fear of the threatening consequences of anxiety symptoms, one particular cognitive factor seems to contribute to reinforcing panic symptomatology. This refers to looming cognitive style - a stable and generalized tendency of creating dynamic perceptions and mental scenarios of threat rapidly rising in risk through time and space. On the other hand, it appears necessary to examine in more detail the role of time perception in panic disorder. This construct represents a mechanism presumably dependent on the interaction of attention and arousal, potentially associated with trait measures important for the etiology of panic disorder. Aim and methodology: The aim of this study was to explore the basic assumptions of the expansion the cognitive model of panic disorder, which combines factors of anxiety sensitivity, looming cognitive style, experience of stress and time perception in individuals with panic disorder. The research sample consisted of clinical group participants with panic disorder (N = 30) as well as the participants in the comparison group (N = 30). The research problems were explored via quasi-experimental design that included measures of physiological activity and subjective arousal and time estimates during relaxation, anticipation and stress. Furthermore, we explored the relationship between trait anxiety, anxiety sensitivity and looming cognitive style and measures of physiological and subjective arousal and experience of time against experimental situations and group membership. Results: In comparison to relaxation, individuals with panic disorder tend to react with a more intensive heart rate activity and skin conductance level in response to stressor. Stress is percieved as subjectively more unsettling and arousing experience by panic disorder individuals. Time perception seems to slow down during stress in comparison to relaxation and is relatd to anxiety sensitivity in individuals with panic disorder. Moreover, time spent in the situation of stress is shorter for individuals with this disorder. The perception of subjective change in stress arousal is related to looming cognitive style, as well as psysical and social looming subscales in panic disorder. In the comparison group, this measure of subjective arousal is related only to intensities in measures of physical looming. In general, anxiety sensitivity, trait anxiety and looming cognitive style appear to predict changes in heart rate activity in response to stress. Conclusion: Individuals with panic disorder appear to be somewhat physiologically and subjectively more reactive in response to a stressor. Anxiety sensitivity contributes to the experience of slower time passage during stress in panic disorder. Looming cognitive style contributes to cognitive assessments of more intense stress arousal changes. There are some indications of the possible contribution of cognitive factors to the intensities of physiological stress responses. The results highlight the need to consider the role of distortions in the perception of the dynamics of physiological and subjective stress arousal in the formation, intensification and maintenance of panic disorder.

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