Distinctiveness of Perceived Health in Panic Disorder and Relation to Panic Disorder Severity

Abstract

The aims of this study were to investigate to what extent perceived health in panic disorder (PD) is distinct from related constructs and to examine the relationship between perceived health and various domains of PD severity. Seventy-five PD outpatients were administered instruments measuring perceived health, anxiety sensitivity, hypochondriacal fears and beliefs, catastrophic appraisals of the consequences of physical symptoms of anxiety and panic, various aspects of psychopathology, and PD severity. Results of the correlation, partial correlation, and multiple regression analyses suggest the following: (1) among PD patients there is much overlap between negatively perceived health, catastrophic appraisals of the consequences of physical symptoms of anxiety and panic, and hypochondriacal beliefs; (2) negatively perceived health is not significantly related to PD severity nor to any aspect of PD severity, whereas anxiety sensitivity and hypochondriacal beliefs have a significant relationship with the severity of anticipatory anxiety, and in that regard may be more clinically useful than perceived health before the beginning of treatment.

The indirect effect of panic disorder on smoking cognitions via difficulties in emotion regulation

“…Individuals with PD who report greater hypervigilance to bodily sensations, fear of anxious arousal (Schmidt et al, 2003), and worry about health (Starcevic et al, 2009), as compared to those who report fewer concerns, may be more sensitive to nicotine withdrawal symptoms (Jarvik et al, 2000; Shadel et al, 2001). In the context of poorer regulation strategies, and perhaps exacerbation of symptoms, their awareness of their smoking status may increase expectations about negative health consequences (Zvolensky & Bernstein, 2005; Zvolensky & Schmidt, 2003).…”

“…Our finding that ER difficulties explains the relation between PD status in smokers and negative reinforcement and negative personal consequence smoking outcome expectancies extends previously observed relations among smokers high in anxiety sensitivity (Johnson et al, 2012). Individuals with PD who report greater hypervigilance to bodily sensations, fear of anxious arousal (Schmidt et al, 2003), and worry about health (Starcevic et al, 2009), as compared to those who report fewer concerns, may be more sensitive to nicotine withdrawal symptoms (Jarvik et al, 2000; Shadel et al, 2001). In the context of poorer regulation strategies, and perhaps exacerbation of symptoms, their awareness of their smoking status may increase expectations about negative health consequences (Zvolensky & Bernstein, 2005; Zvolensky & Schmidt, 2003).…”

“…Also, in daily smokers, the combination of PD and more intense nicotine withdrawal symptoms, compared to either individuals with PD with less withdrawal symptoms, smokers without PD or nonsmokers with PD, is also associated with greater subjective and physiological reactivity and slower recovery from a biological challenge (Leyro & Zvolensky, 2013, 2014; Zvolensky et al, 2004). Among individuals with PD, there is a significant association between vigilance to bodily sensations and health related concerns (Schmidt, Joiner Jr, Staab, & Williams, 2003; Starcevic et al, 2009), which may in part explain why smokers with PD are more sensitive to nicotine withdrawal symptoms (Jarvik et al, 2000; Shadel, Niaura, Brown, Hutchison, & Abrams, 2001). In smokers with PD, this hypervigilance may increase the expectation that their smoking is negatively affecting health.…”