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首页> 外文期刊>International journal of psychophysiology: official journal of the International Organization of Psychophysiology >Physiological markers for anxiety: panic disorder and phobias.
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Physiological markers for anxiety: panic disorder and phobias.

机译：焦虑的生理指标：恐慌症和恐惧症。

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Physiological activation is a cardinal symptom of anxiety, although physiological measurement is still not used for psychiatric diagnosis. An ambulatory study of phobics who were afraid of highway driving showed a concordance between self-reported anxiety during driving, autonomic activation, hypocapnia, and sighing respiration. Patients with panic attacks do not exhibit autonomic activation when they are quietly sitting and not having panic attacks, but do have the same respiratory abnormalities as driving phobics, suggesting that these abnormalities could be a marker for panic disorder. Such abnormalities are compatible with both the false suffocation alarm (D. Klein) and hyperventilation (R. Ley) theories of panic. Hypocapnia, however, is often absent during full-blown panic attacks. Since activation functions as preparation for physical activity, it may not occur when a patient has learned that avoidance of fear by flight or fight is futile. We developed a capnometry feedback assisted breathing training therapy for panic disorder designed to reduce hyperventilation and making breathing regular. Without feedback, conventional therapeutic breathing instructions may actually increase hyperventilation by increasing dyspnea. Five weekly therapy sessions accompanied by daily home practice with a capnometer produced marked clinical improvement compared to changes in an untreated group. Improvement was sustained over a 12-month follow-up period. The therapist avoided any statements or procedures designed to alter cognitions. Improvement occurred regardless of whether patients initially reported mostly respiratory or non-respiratory symptoms during their attacks. There is evidence that modifying any of the three systems comprising a fear network can be therapeutic, as exemplified by cognitive therapy modifying thoughts, exposure therapy modifying avoidance, and breathing training procedures modifying pCO(2).
机译：生理激活是焦虑症的主要症状，尽管生理测量仍未用于精神病学诊断。对害怕公路驾驶的恐惧症患者进行的一项动态研究显示，驾驶过程中自我报告的焦虑，自主神经激活，低碳酸血症和叹气呼吸之间存在着一致性。惊恐发作的患者安静地坐着并且没有惊恐发作时，不会表现出自主神经激活，但与驾驶恐惧症的呼吸异常相同，表明这些异常可能是恐慌症的标志。这种异常与错误的窒息警报（D. Klein）和过度换气（R. Ley）的恐慌理论都兼容。但是，在全面的恐慌发作期间通常不会出现低碳酸血症。由于激活功能是体育锻炼的准备，因此当患者得知逃避飞行或战斗避免恐惧是徒劳的时，激活就不会发生。我们针对恐慌症开发了二氧化碳测定法反馈辅助呼吸训练疗法，旨在减少过度换气并使呼吸规则。没有反馈，常规的治疗性呼吸指示实际上可能会通过增加呼吸困难而增加换气过度。与未经治疗的组相比，每周进行五次治疗，并使用二氧化碳监测仪进行日常家庭实践，可产生明显的临床改善。在12个月的随访期内，病情持续改善。治疗师避免使用任何旨在改变认知的陈述或程序。无论患者最初在发作期间报告的主要是呼吸道症状还是非呼吸道症状，症状均得到改善。有证据表明，修改包括恐惧网络的三个系统中的任何一个都可以起到治疗作用，例如，通过改变思想的认知疗法，通过改变避免方式的暴露疗法和通过改变pCO（2）的呼吸训练程序就可以证明这一点。

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