Freezing reaction in panic disorder patients associated with anticipatory anxiety.
Open accessAbstract
BACKGROUND: Anticipatory anxiety can be described as a conditioned response with a defensive posture of freezing and autonomic activation. The purpose of this study was to assess the postural control analysis and autonomic activation in panic disorder (PD) patients presented with visual stimuli. METHODS: PD patients (n=29) and healthy controls (n=27) stood on a force platform while viewing a series of anxiogenic, mutilation, and neutral pictures. Skin conductance responses and the displacements of the center of pressure were measured. RESULTS: Overall, the PD patients demonstrated significantly reduced body sway, increased mean power frequency, and increased skin conductance compared to control group throughout the experiment (P<.05). PD patients also showed a negative correlation between anticipatory anxiety and mean sway area throughout the experiment. However, there was no significant difference in body sway velocity compared to healthy controls while viewing the anxiogenic block of pictures or the neutral block. CONCLUSIONS: Our data shows that PD patients experiencing anticipatory anxiety may present with lower mobility, consistent with the freezing behavior of the defense cascade. The data also shows that PD patients do not have a postural instability when confronted with specific anxiogenic context. The importance of this study is that it objectively demonstrates freezing-like behavior in PD patients.
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Cites
Neural organization of the defensive behavior system responsible for fear
Fanselow, M. S. (1994) · Psychonomic Bulletin & Review · doi:10.3758/bf03210947 · Cited by 1,000 · see citing works
The influence of postural threat on the control of upright stance
Carpenter, M. G., Frank, J. S., Silcher, C. P., & Peysar, G. (2001) · Experimental Brain Research · doi:10.1007/s002210100681 · Cited by 472 · see citing works
Neurological bases for balance–anxiety links
Balaban, C. D., & Thayer, J. F. (2001) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(00)00042-6 · Cited by 439 · see citing works
Defensive behaviors of laboratory and wild Rattus norvegicus..
Blanchard, R. J., Flannelly, K. J., & Blanchard, D. C. (1986) · Journal of comparative psychology · doi:10.1037/0735-7036.100.2.101 · Cited by 405 · see citing works
A freezing‐like posture to pictures of mutilation
Azevedo, T. M., Volchan, E., Imbiriba, L. A., Rodrigues, E. C., Oliveira, J. M., Oliveira, L. F., Lutterbach, L. G., & Vargas, C. D. (2005) · Psychophysiology · doi:10.1111/j.1469-8986.2005.00287.x · Cited by 320 · see citing works
Self-citationFeature selection of stabilometric parameters based on principal component analysis.
Rocchi, L., Chiari, L., & Cappello, A. (2004) · Medical & Biological Engineering & Computing · doi:10.1007/bf02351013 · Cited by 237 · see citing works
International Affective Picture System
Bradley, M. M., & Lang, P. J. (2020) · Springer eBooks · doi:10.1007/978-3-319-24612-3_42 · Cited by 215 · see citing works
The Panic‐Associated Symptom Scale: measuring the severity of panic disorder
Argyle, N., Deltito, J. A., Allerup, P., Maier, W., Albus, M., Nutzinger, D. O., Ayuso, J. L., Bech, P., & Rasmussen, S. (1991) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1991.tb05506.x · Cited by 65 · see citing works
Alprazolam blockade of CO2-provoked panic in patients with panic disorder
Sanderson, W. C., Wetzler, S. E., & Asnis, G. M. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.8.1220 · Cited by 65 · see citing works
Fear and Anxiety: The Benefits of Translational Research
Ruiz, P. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.1.200 · Cited by 36 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- Lang PJ, Bradley MM, Cuthbert BN. Motivated attention: affect, activation and action. In: Lang PJ, Simons RF, Balaban MT, editors. Attention and Orienting: Sensory And Motivational Processes. Mahwah, NJ: Erlbaum; 1997:97-135.
- First MB, Spitzer RL, Gibbon M, Williams JBM. Structured Clinical Interview Diagnostic (SCID) for DSM-IV Axis I Disorders-Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press; 1997.
- Oliveira LF, Schilindwein FS, Dangelo MD, Oliveira CG. Stabilometric system to evaluate postural balance. In: Abstracts of the 1st National Forum of Science and Technology in Health. Rio de Janeiro, Brazil: Brazilian Society of Biomedical Engineering; 1996:107-110.
- Sullivan GM, LeDoux JE. Synaptic self: conditioned fear, develop- mental adversity, and the anxious individual. In: Gorman JM, editor. Fear and Anxiety. The Benefits Of Translational Research. Washington, DC: American Psychopathological Association; 2004:1-22.
Cited by
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Roelofs, K. (2017) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2016.0206 · Cited by 616 · see citing works
Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000065 · Cited by 468 · see citing works
The age of anxiety: role of animal models of anxiolytic action in drug discovery
Cryan, J. F., & Sweeney, F. F. (2011) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2011.01362.x · Cited by 313 · see citing works
Facing Freeze: Social Threat Induces Bodily Freeze in Humans
Roelofs, K., Hagenaars, M. A., & Stins, J. (2010) · Psychological Science · doi:10.1177/0956797610384746 · Cited by 288 · see citing works
Updating freeze: Aligning animal and human research
Hagenaars, M. A., Oitzl, M., & Roelofs, K. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2014.07.021 · Cited by 260 · see citing works
Fear bradycardia and activation of the human periaqueductal grey
Hermans, E. J., Henckens, M. J. A. G., Roelofs, K., & Fernández, G. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2012.10.063 · Cited by 151 · see citing works
Fureix, C., & Meagher, R. K. (2015) · Applied Animal Behaviour Science · doi:10.1016/j.applanim.2015.08.036 · Cited by 149 · see citing works
Aversive life events enhance human freezing responses.
Hagenaars, M. A., Stins, J. F., & Roelofs, K. (2012) · Journal of Experimental Psychology General · doi:10.1037/a0024211 · Cited by 128 · see citing works
Meulders, A., & Vlaeyen, J. W. S. (2012) · Pain · doi:10.1016/j.pain.2012.10.025 · Cited by 103 · see citing works
Translating dynamic defense patterns from rodents to people
Blanchard, D. C. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.11.001 · Cited by 94 · see citing works
Warthen, D. M., Wiltgen, B. J., & Provencio, I. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1103214108 · Cited by 58 · see citing works
Freezing of gaze during action preparation under threat imminence
Rösler, L., & Gamer, M. (2019) · Scientific Reports · doi:10.1038/s41598-019-53683-4 · Cited by 50 · see citing works
Motor alterations in depression and anxiety disorders: A systematic review and meta-analysis
Elkjær, E., Mikkelsen, M. B., Michalak, J., Mennin, D. S., & O’Toole, M. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.08.060 · Cited by 48 · see citing works
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Self-citationManagement of anxiety and motor symptoms in Parkinson’s disease
Coakeley, S., Martens, K. A. E., & Almeida, Q. J. (2014) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2014.936388 · Cited by 25 · see citing works
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Schoenberg, P. L. A. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-32-9705-0_3 · Cited by 24 · see citing works
Head movement measurement: An alternative method for posturography studies
Ciria, L. F., Muñoz, M. Á., Gea, J., Peña, N., Miranda, J. G. V., Montoya, P., & Vila, J. (2016) · Gait & Posture · doi:10.1016/j.gaitpost.2016.11.020 · Cited by 23 · see citing works
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Cunha, Â. G. J., Nunes, M. D. P. T., Ramos, R. T., Carvalho‐Pinto, R. M., Boffino, C. C., Martins, F. C., & Tanaka, C. (2012) · Journal of Asthma · doi:10.3109/02770903.2012.750668 · Cited by 23 · see citing works
Niermann, H. C. M., Figner, B., Tyborowska, A., Cillessen, A. H. N., & Karin Roelofs, A. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2018.00097 · Cited by 18 · see citing works
Centralized gaze as an adaptive component of defensive states in humans
Merscher, A., Tovote, P., Pauli, P., & Gamer, M. (2022) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.2022.0405 · Cited by 17 · see citing works
Postural balance in patients with social anxiety disorder
Levitan, M. N., Crippa, J. A., Bruno, L. M., Pastore, D. L., Freire, R. C. R., Arrais, K. C., Hallak, J. E. C., & Nardi, A. E. (2011) · Brazilian Journal of Medical and Biological Research · doi:10.1590/s0100-879x2011007500155 · Cited by 14 · see citing works
Self-citationStoffels, M., Nijs, M., Spinhoven, P., Mesbah, R., & Hagenaars, M. A. (2017) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2017.02.001 · Cited by 12 · see citing works
Panic attack provocation in panic disorder patients with a computer simulation
Freire, R. C. R., Ferreira-Garcia, R., do Cabo, M. C., Martins, R. M., & Nardi, A. E. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.081 · Cited by 10 · see citing works
Self-citationIncident experience predicts freezing-like responses in firefighters
Ly, V., Roijendijk, L., Hazebroek, H., Tonnaer, C., & Hagenaars, M. A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0186648 · Cited by 9 · see citing works
Karimi, A. (2013) · Journal of Spine · doi:10.4172/2165-7939.1000139 · Cited by 7 · see citing works
Effect of Induced Anxiety on Respiratory Resistance Using Virtual Reality Simulation
Bohensky, M., Johnson, A. T., & Vossoughi, J. (2017) · Open Journal of Respiratory Diseases · doi:10.4236/ojrd.2017.72008 · Cited by 6 · see citing works
Amiaz, R., Kimel-Naor, S., Caspi, A., Czerniak, E., Noy, S., Pelc, T., Mintz, M., & Plotnik, M. (2021) · Brain and Behavior · doi:10.1002/brb3.2411 · Cited by 6 · see citing works
Hashemi, M. M., Zhang, W., Kaldewaij, R., Koch, S. B. J., Jonker, R., Figner, B., Klumpers, F., & Karin Roelofs, A. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/554840 · Cited by 5 · see citing works
Hendrie, C. A. (2022) · Human Ethology · doi:10.22330/he/37/002-007 · Cited by 2 · see citing works
Lee, G., & Kim, E.-J. (2016) · The Korean Journal of Clinical Psychology · doi:10.15842/kjcp.2016.35.1.009 · Cited by 3 · see citing works
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Kuan, H.-Y., & Chang, C. (2024) · Journal of physiological investigation. · doi:10.4103/ejpi.ejpi-d-24-00072 · Cited by 3 · see citing works
Levchenko, V. (2015) · Pedagogics psychology medical-biological problems of physical training and sports · doi:10.15561/18189172.2015.0207 · Cited by 3 · see citing works
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Lange, W., & Hagenaars, M. A. (2025) · Clinical Psychology in Europe · doi:10.32872/cpe.15365 · Cited by 2 · see citing works
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Karos, K., Meulders, A., Leyssen, T., & Vlaeyen, J. W. S. (2020) · PeerJ · doi:10.7717/peerj.10094 · Cited by 2 · see citing works
Martin, W. (2014) · Griffith Research Online · doi:10.25904/1912/225 · Cited by 2 · see citing works
Caldirola, D., Carminati, C., Daccò, S., Grassi, M., Perna, G., & Teggi, R. (2023) · Audiology Research · doi:10.3390/audiolres13030027 · Cited by 1 · see citing works
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Mendolia, M. (2015) · Anxiety Stress & Coping · doi:10.1080/10615806.2015.1015423 · Cited by 1 · see citing works
Increased body sway in phobic patients exposed to images of spiders
Linares, I. M. P., Nardi, A. E., Guimarães, F. S., Arrais, K. C., Chagas, M. H. N., Osório, F. D. L., Hallak, J. E. C., Zuardi, A. W., Coimbra, N. C., & Crippa, J. A. S. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-1466 · Cited by 1 · see citing works
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- Authors
- Lopes, F. L., Azevedo, T. M., Imbiriba, L. A., Freire, R. C., Valença, A. M., Caldirola, D., Perna, G., Volchan, E., & Nardi, A. E.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Neurobiology Laboratory, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade Federal Fluminense (BR)
- Vita-Salute San Raffaele University (IT)
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT Translational Medicine, Rio de Janeiro, Brazil
- ORCID
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2009-07-06
- Volume
- 26
- Issue
- 10
- Pages
- 917-921
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2167341520
- Cited by
- 54
- References
- 10
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 7 · 2016: 2 · 2015: 5 · 2014: 4 · 2013: 1 · 2012: 3
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- panic disorder, anticipatory anxiety, freezing behavior, postural control, autonomic activation, skin conductance, center of pressure displacement, postural sway, defensive behavior
- MeSH terms
- Adult, Anxiety Disorders, Arousal, Defense Mechanisms, Postural Balance, Female, Galvanic Skin Response, Heart Rate, Humans, Male, Middle Aged, Panic Disorder, Freezing Reaction, Cataleptic
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