Emotional responding to biological challenge as a function of panic disorder and smoking

The present investigation evaluated anxious and fearful responding to bodily sensations as a function of panic disorder (PD) and smoking status. Participants completed a voluntary hyperventilation procedure that elicits panic-relevant bodily sensations. Psychophysiological data were collected throughout the study procedures. Assessments of anxiety and bodily distress were conducted pre-challenge baseline, post-hyperventilation, and during a recovery period following the challenge. Results indicated that smokers with PD reported greater levels of anxiety and bodily distress than smokers without PD and than nonsmokers with PD at the post-challenge assessment and recovery period. No differences in autonomic responding were evident during the challenge or in the recovery phase. In terms of rate of recovery, the linear decrease in anxiety, but not bodily distress, was significantly more steep for nonsmokers with PD than for smokers with PD. These findings are discussed in relation to better understanding the potential role that smoking may play in terms of anxious and fearful responding to bodily sensations.

Smoking behaviors across anxiety disorders

The purpose of this study was to test the theory put forth by Zvolensky et al. [Clin. Psychol. Sci. Pract. 10 (2003) 29] that smoking is specifically associated with panic disorder (PD) and not more generally associated with other anxiety disorders. Smoking behaviors were examined across three anxiety disorders: panic disorder with or without agoraphobia, social phobia (SP), and obsessive-compulsive disorder (OCD). A greater proportion of the PD group (40.4%) reported smoking compared to the SP (20%) and OCD (22.4%) groups. Those in the PD group were also more likely than those in the other groups to report being a heavy smoker (greater than 10 cigarettes daily). No significant interaction between diagnosis and smoking status was found for any of the symptom measures. However, participants who smoked had significantly higher scores than nonsmokers on a number of scales, including measures of depression, general anxiety, and distress. Differences in anxiety sensitivity between smokers and nonsmokers approached significance. These findings provide support for Zvolensky et al.'s [Clin. Psychol. Sci. Pract. 10 (2003) 29] theoretical conceptualization and suggest a specific link between smoking and panic disorder. Further investigation is warranted to determine the causal direction of this association.

Anxiety and substance use disorders: introduction to the special series

The interplay between anxiety pathology and substance use disorders is increasingly recognized in empirical and clinical work. The present article serves as a general introduction to the special series highlighting the relationship between a number of anxiety conditions and a variety of substance use disorders. In this overview, we first discuss the importance of better understanding the association between anxiety and substance use and abuse followed by a brief review of each study and their major findings. This set of studies has implications for our understanding of the nature of these conditions as well as their treatment. We hope that this body of work will inspire future research in this important area.

The impact of smoking on panic disorder: an initial investigation of a pathoplastic relationship

A disproportionate number of persons with panic disorder (PD) smoke cigarettes compared to individuals with other anxiety disorders and people in the general population. Currently, there is little theoretical or empirical understanding as to how smoking impacts those with PD. The present descriptive psychopathology study provided a test of the pathoplastic relationship between smoking and PD by investigating the additive negative impact of smoking on PD in terms of emotional, functional, and physical health impairment indices. Patients with PD who regularly smoke (PDSM) were compared to PD alone (N=122) in a cross-sectional analysis. As expected, persons with PDSM reported significantly more severe and intense anxiety symptoms and social impairment compared to persons with PD alone. No differences were evident for panic attacks or physical illness variables. These findings are discussed in relation to Pathoplastic models of dysfunction.