Psychophysiology of relaxation-associated panic attacks

Development and Initial Validation of the Relaxation Sensitivity Index

Relaxation sensitivity indexes the fear of relaxation-related events. The purpose of this study was to develop and provide initial validation of a self-report measure of relaxation sensitivity, the Relaxation Sensitivity Index (RSI). Three independent samples of undergraduate students (n=300 unselected, n=349 non-clinical, and n=197 clinical analogs with elevated anxiety/depression symptoms) completed self-report measures to examine the factor structure, reliability, and validity of the RSI. Results of exploratory and confirmatory factor analyses supported a three-factor structure (correlated Physical, Cognitive, and Social Concerns). The RSI demonstrated good internal consistency and construct validity as evidenced by expected correlations with measures of anxiety and depression symptoms. The RSI showed good predictive validity in terms of a history of fearful responding to relaxation. RSI scores were significantly higher in the symptomatic compared to non-clinical sample. Results suggest the RSI is a valid and reliable measure that may be useful in clinical and research settings.

Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks

Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable trigger) or expected (ePA). Panic typically involves an abrupt feeling of catastrophic fear or distress accompanied by physiological symptoms such as palpitations, racing heart, thermal sensations, and sweating. Recurrent uPA and ePA can also lead to agoraphobia, where subjects with PD avoid situations that were associated with PA. Here we will review recent developments in our understanding of PD, which includes discussions on: symptoms and signs associated with uPA and ePAs; Diagnosis of PD and the new DSM-V; biological etiology such as heritability and gene×environment and gene×hormonal development interactions; comparisons between laboratory and naturally occurring uPAs and ePAs; neurochemical systems that are associated with clinical PAs (e.g. gene associations; targets for triggering or treating PAs), adaptive fear and panic response concepts in the context of new NIH RDoc approach; and finally strengths and weaknesses of translational animal models of adaptive and pathological panic states.

Issues and perspectives in meditation research: in search for a definition

Despite the growing interest in the neurobiological correlates of meditation, most research has omitted to take into account the underlying philosophical aspects of meditation and its wider implications. This, in turn, is reflected in issues surrounding definition, study design, and outcomes. Here, I highlight the often ignored but important aspect of definition in the existing scholarship on neuroscience and meditation practice. For a satisfactory account of a neuroscience of meditation, we must aim to retrieve an operational definition that is inclusive of a traditional ontological description as well as the modern neurocognitive account of the phenomena. Moving beyond examining the effects of meditation practice, to take a potential step forward in the direction to establish how meditation works, it becomes crucial to appraise the philosophical positions that underlie the phenomenology of meditation in the originating traditions. This endeavor may challenge our intuitions and concepts in either directions, but issues pertaining to definition, design, and validity of response measures are extremely important for the evolution of the field and will provide a much-needed context and framework for meditation based interventions.

Skin conductance feedback and panic attacks

A method is described for using skin conductance response (SCR) biofeedback to help patients control their panic attacks. The SCR signal is presented as a symptom analogue, and patients practice provoking and subduing the signal, using a combination of cognitive strategies and physiological relaxation.