The Role of Anxiety Sensitivity and Expectancy Manipulation on Panic-Like Response to the 35% CO2 Challenge in Healthy Subjects

Abstract

Background: The 35% CO2 challenge is a well-established method triggering panic attacks under laboratory-controlled conditions. There is an ongoing debate whether single or the joined effects of the instructional set and anxiety sensitivity (AS) can alter the outcome of the challenge.

Objectives: The present study investigated the effects of instruction manipulation and AS on panic-like response to the 35% CO2 challenge.

Methods: Eighty healthy subjects, with high or low levels of AS, were randomized into 4 groups based on standard/manipulated instructional sets as well as 35% CO2 mixture/room air inhalation. Subjects filled in the Visual Analogue Scale of Anxiety (VAAS), the Visual Analogue Scale of Fear (VAS-F), the VAS of Discomfort (VAS-D), and the Panic Symptom List (PSL). Blood pressure and heart rate were measured at pre- and posttest.

Results: Hierarchical multiple regression analyses showed greater psychological responses at VAAS, VAS-F, VAS-D, and PSL and higher systolic blood pressure under 35% CO2 challenge if compared to room air inhalation while instructional set and AS did not influence the response.

Conclusions: The present study confirms that neither instructional test nor AS alter the outcome of the 35% CO2 challenge.

Keywords: Anxiety sensitivity; CO2 challenge; Instruction manipulation; Panic.