CoChat
Sign Up
Cited by 180Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their TreatmentsHeart Rate Variability and Autonomic Control

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Physiologic instability in panic disorder and generalized anxiety disorder

Open access
Wilhelm, Frank H, Trabert, Werner, Roth, Walton T·2001·Biological Psychiatry
DOI 10.1016/s0006-3223(00)01000-3
Open this paper in CoChat — free account

Abstract

Background Because panic attacks can be accompanied by surges in physiologic activation, we tested the hypothesis that panic disorder is characterized by fluctuations of physiologic variables in the absence of external triggers. Methods Sixteen patients with panic disorder, 15 with generalized anxiety disorder, and 19 normal control subjects were asked to sit quietly for 30 min. Electrodermal, cardiovascular, and respiratory measures were analyzed using complex demodulation to quantify variability in physiologic indices. Results Both patient groups reported equally more anxiety and cardiac symptoms than control subjects, but certain other somatic symptoms, including breathlessness, were elevated only in panic disorder patients. Mean end-tidal pCO(2) and respiratory rates were lower, and tidal volume and the number of sighs were higher in panic disorder patients than control subjects. Neither cardiovascular (heart rate, arterial pressure, cardiac output), nor electrodermal instability including sighs distinguished the groups; however, tidal volume instability was greater in panic disorder than generalized anxiety disorder patients or control subjects. Several other respiratory measures (pCO(2), respiratory rate, minute volume, duty cycle) showed greater instability in both patient groups than in control subjects. Conclusions Respiration is particularly unstable in panic disorder, underlining the importance of respiratory physiology in understanding this disorder. Whether our f…

Overview

Integrity signals

Registry

Crossref · 10.1016/s0006-3223(00)01000-3

Cites

6 of 6 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Sigh breathing may produce short-term relief from symptoms but is dysfunctional in that it lowers PCO2 levels and may thereby contribute to symptoms and fear levels in susceptible individuals.

    “While such sigh breathing may produce short-term relief from symptoms, it is also dysfunctional in that it lowers PCO2 levels and may thereby contribute to symptoms and fear levels in susceptible individuals (Papp et al., 1993; Abelson et al., 2001; Wilhelm, Trabert, et al., 2001).”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Wilhelm, Trabert, et al., 2001

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 36

  1. Abelson, 1996, Persistent respiratory irregularity in patients with panic disorder, Biol Psychiatry, 39, 521, 10.1016/0006-3223(96)84026-1 · DOI
  2. Adler, 1987, Relaxation-induced panic (RIP), Integr Psychiatry, 5, 94
  3. Askanazi, 1980, Effects of respiratory apparatus on breathing pattern, J Appl Physiol, 48, 577, 10.1152/jappl.1980.48.4.577 · DOI
  4. Bass, 1985, Respiratory and psychiatric abnormalities in chronic symptomatic hyperventilation, Br Med J, 290, 1387, 10.1136/bmj.290.6479.1387 · DOI · Paper page
  5. Beck, 1961, An inventory for measuring depression, Arch Gen Psychiatry, 41, 561, 10.1001/archpsyc.1961.01710120031004 · DOI · Paper page
  6. Bloomfield P (1976): Complex demodulation. In: Bloomfield P, editor. Fourier Analysis of Time Series: An Introduction. New York: Wiley, 118–150.
  7. Briggs, 1993, Subtyping of panic disorder by symptom profile, Br J Psychiatry, 163, 201, 10.1192/bjp.163.2.201 · DOI
  8. Bystritsky, 1992, Continuous physiological changes and subjective reports in panic patients, Biol Psychiatry, 32, 766, 10.1016/0006-3223(92)90080-J · DOI
  9. Chambless, 1984, Assessment of fear of fear in agoraphobics, J Consult Clin Psychol, 52, 1090, 10.1037/0022-006X.52.6.1090 · DOI · Paper page
  10. Chambless, 1985, The mobility inventory for agoraphobia, Behav Res Ther, 23, 35, 10.1016/0005-7967(85)90140-8 · DOI · Paper page
  11. Cohen, 1985, Psychophysiology of relaxation-associated panic attacks, J Abnorm Psychol, 94, 96, 10.1037/0021-843X.94.1.96 · DOI
  12. Gorman, 1987, An objective marker of lactate-induced panic, Psychiatry Res, 22, 341, 10.1016/0165-1781(87)90113-2 · DOI
  13. Gratz I, Kraidin J, Jacobi AG, deCastro NG, Spagna P, Larijani GE (1992): Continuous noninvasive cardiac output as estimated from the pulse contour curve. J Clin Monit 8:20–27. · DOI
  14. Hayano, 1994, Assessment of frequency shifts in R-R interval variability and respiration with complex demodulation, J Appl Physiol, 77, 2879, 10.1152/jappl.1994.77.6.2879 · DOI
  15. Hegel, 1997, Psychophysiological assessment of respiratory function in panic disorder, Psychosom Med, 59, 224, 10.1097/00006842-199705000-00003 · DOI · Paper page
  16. Imholz, 1990, Non-invasive continuous finger blood pressure measurement during orthostatic stress compared to intra-arterial pressure, Cardiovasc Res, 24, 214, 10.1093/cvr/24.3.214 · DOI
  17. Lenzenweger, 1999, Schizophrenia, Behav Res Ther, 37, 281, 10.1016/S0005-7967(98)00138-7 · DOI
  18. Liebowitz, 1984, Lactate provocation of panic attacks. I. Clinical and behavioral findings, Arch Gen Psychiatry, 1984, 764, 10.1001/archpsyc.1984.01790190038004 · DOI · Paper page
  19. Liebowitz, 1985, Lactate provocation of panic attacks. II. Biochemical and physiological findings, Arch Gen Psychiatry, 42, 709, 10.1001/archpsyc.1985.01790300077010 · DOI
  20. Milic-Emili, 1982, Recent advances in clinical assessment of control of breathing, Lung, 160, 1, 10.1007/BF02719267 · DOI
  21. Modarreszadeh, 1994, Ventilatory variability induced by spontaneous variations of PaCO2 in humans, J Appl Physiol, 76, 2765, 10.1152/jappl.1994.76.6.2765 · DOI
  22. Morel, 1983, Noninvasive ventilatory monitoring with bellows pneumographs in supine subjects, J Appl Physiol, 55, 598, 10.1152/jappl.1983.55.2.598 · DOI
  23. Papp, 1997, Respiratory psychophysiology of panic disorder, Am J Psychiatry, 154, 1557, 10.1176/ajp.154.11.1557 · DOI · Paper page
  24. Rapee, 1986, Differential response to hyperventilation in panic disorder and generalized anxiety disorder, J Abnorm Psychol, 95, 24, 10.1037/0021-843X.95.1.24 · DOI
  25. Roth, 1998, Autonomic instability during relaxation in panic disorder, Psychiatry Res, 80, 155, 10.1016/S0165-1781(98)00066-3 · DOI
  26. Roth, 1998, Voluntary breath holding in panic and generalized anxiety disorders, Psychosom Med, 60, 671, 10.1097/00006842-199811000-00004 · DOI · Paper page
  27. Schwartz, 1996, Tidal volume of respiration and “sighing” as indicators of breathing irregularities in panic disorder patients, Anxiety, 2, 145, 10.1002/(SICI)1522-7154(1996)2:3<145::AID-ANXI6>3.0.CO;2-O · DOI
  28. Spielberger CD, Gorsuch RL, Luchene RE (1970): State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychology Press.
  29. Stein, 1995, Irregular breathing patterns during sleep in patients with panic disorder, Am J Psychiatry, 152, 1168, 10.1176/ajp.152.8.1168 · DOI
  30. Stok, 1993, Noninvasive cardiac output measurement by arterial pulse analysis compared with inert gas rebreathing, J Appl Physiol, 74, 2687, 10.1152/jappl.1993.74.6.2687 · DOI
  31. Tobin, 1987, Accuracy of the respiratory inductive plethysmograph during loaded breathing, J Appl Physiol, 62, 497, 10.1152/jappl.1987.62.2.497 · DOI
  32. Wilhelm FH, Gerlach AL, Roth WT (in press). Slow recovery from voluntary hyperventilation in panic disorder. Psychosom Med. · DOI
  33. Wilhelm, 1997, Assessment of heart rate variability under non-stationary conditions, Psychophysiology, 34, S96
  34. Wilhelm, 1999, Analysis of cardiovascular regulation, Biomed Sci Instrum, 35, 135
  35. Wilhelm, 1998, Taking the laboratory to the skies, Psychophysiology, 35, 596, 10.1017/S0048577298970196 · DOI
  36. Wilhelm FH, Trabert W, Roth WT (2001): Characteristics of sighing in panic disorder. Biol Psychiatry 49:606–614. · DOI

Cited by

Sorted by citations

Metadata

Authors
Wilhelm, F. H., Trabert, W., & Roth, W. T.
Affiliations
VA Palo Alto Health Care System (US)
Corresponding author
Wilhelm, Frank H
ORCID
Wilhelm, Frank H
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2001-04
Volume
49
Issue
7
Pages
596-605
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/s0006-3223(00)01000-3
OpenAlex
W2037092319
Cited by
180
References
6
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 10 · 2019: 4 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 4 · 2014: 12 · 2013: 7 · 2012: 10
FWCI
10.08
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • edoc (University of Basel) (acceptedVersion)
  • edoc (University of Basel)
Funders
National Institute of Mental Health (R01MH056094)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
panic disorder, generalized anxiety disorder, respiration, tidal volume variability, electrodermal activity, sighs, end-tidal PCO2, respiratory rate, cardiovascular reactivity, somatic symptoms, dyspnea
MeSH terms
Adult, Analysis of Variance, Anxiety, Anxiety Disorders, Autonomic Nervous System, Cardiovascular Physiological Phenomena, Dyspnea, Female, Humans, Immobilization, Male, Middle Aged, Respiratory Function Tests, Respiratory Physiological Phenomena, Case-Control Studies, Panic Disorder

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review