Cognition-behaviour links in the persistence of panic
Abstract
The cognitive theory of panic disorder proposes that panic attacks occur as a result of an enduring tendency to misinterpret bodily sensations as a sign of imminent catastrophe such as a heart attack. The persistence of such catastrophic cognitions is in part due to the tendency of patients to avoid and/or escape situations where panic occurs. It is proposed that within-situation safety seeking behaviours also have the effect of maintaining catastrophic cognitions in the face of repeated panics during which the feared catastrophe does not occur. The association between catastrophic cognitions and within-situation safety behaviours matched the pattern predicted from the cognitive theory in 147 panic disorder patients. The implications of these findings for the way in which therapy is conducted are discussed.
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These results replicated findings from a previous study demonstrating that PCO2 mediated and drove changes in symptom appraisal (anxiety sensitivity) in CART and refute prior notions that breathing techniques are likely to sustain rather than modify catastrophic cognitions.
“These results replicated findings from a previous study demonstrating that PCO2 mediated and drove changes in symptom appraisal (anxiety sensitivity) in CART (Meuret et al., 2009) and refute prior notions that breathing techniques “are likely to sustain rather than modify catastrophic cognitions” (Salkovskis, Clark, & Gelder, 1996, p. 457).”
From Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity. (2010) · cites this paper as Salkovskis, Clark, & Gelder, 1996
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- Authors
- Salkovskis, P. M., Clark, D. M., & Gelder, M. G.
- Affiliations
- Warneford Hospital (GB)
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 1996-05
- Volume
- 34
- Issue
- 5-6
- Pages
- 453-458
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2114083818
- Cited by
- 204
- References
- 4
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 11 · 2020: 6 · 2019: 11 · 2018: 10 · 2017: 12 · 2016: 8 · 2015: 6 · 2014: 12 · 2013: 8 · 2012: 9
- FWCI
- 5.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- panic disorder, catastrophic cognitions, safety-seeking behavior, avoidance, panic attacks, cognitive behavioral therapy
- MeSH terms
- Agoraphobia, Arousal, Behavior Therapy, Cognition Disorders, Fear, Humans, Internal-External Control, Personality Inventory, Cognitive Behavioral Therapy, Panic Disorder
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