Anxiety Sensitivity, Menstrual Cycle Phase, and Panic-Relevant Responding

焦虑敏感性、月经周期阶段和恐慌相关反应

• 批准号: 7822180
• 负责人: Yael I Nillni
• 金额: $ 3.87万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-03 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7822180
• 关键词: Adult; Air; Anxiety; Behavioral Research; Biological; Biological Assay; Breathing; Carbon Dioxide; Cognitive; Development; Disease susceptibility; Esthesia; Etiology; Exhibits; Female; Fright; Future; Galvanic Skin Response; Gender; Grant; High Risk Woman; Individual; Laboratories; Maintenance; Measures; Menstrual cycle; Mental Health; Mental disorders; Mission; National Institute of Mental Health; Ovulation; Panic; Panic Attack; Panic Disorder; Pathology; Pathway interactions; Patient Self-Report; Phase; Prevalence; Prevention; Prevention program; Progesterone; Psychophysiology; Public Health; Recurrence; Relative (related person); Reporting; Research; Risk; Risk Factors; Severities; Sex Characteristics; Stimulus; Stress; Symptoms; Time; Vision; Woman; Work; bodily sensation; burden of illness; male; men; mental disorder prevention; proliferative phase Menstrual cycle; public health relevance; response; stressor

DESCRIPTION (provided by applicant): The prevalence of panic disorder, a debilitating mental health problem characterized by recurrent, unexpected panic attacks, is 2 times higher among females relative to males. However, research on potential explanations for this gender difference is limited. There is a prominent gender difference, favoring females over males, on anxiety sensitivity (AS; i.e., the tendency to respond fearfully to anxiety symptoms), an identified cognitive risk factor for panic pathology. Specifically, women score higher than men on measures of AS; and individuals with high AS have an increased risk of developing spontaneous panic attacks and panic disorder over 1- to 3-year follow ups. Given the tendency for high AS individuals to misinterpret bodily sensations as dangerous, the premenstrual phase of the menstrual cycle may constitute a gender-specific, cyclical stressor that contributes to the onset of maladaptive anxiety, uncued panic attacks, and panic disorder in women with a vulnerability to anxiety (i.e., high AS). Therefore, a gender-specific vulnerability-stress pathway to panic-relevant responding in women may involve an interaction between a known cognitive risk factor for panic pathology (AS) and a naturally occurring, gender-specific, internal stressor (premenstrual phase). As a first step in exploring this proposed pathway, the primary aim of this proposed R36 Mental Health Dissertation Grant to Increase Diversity project is to examine the interactive effects of AS and menstrual cycle phase (premenstrual phase vs. follicular phase) in predicting anxious- and panic-relevant responding to a laboratory biological challenge that elicits panic-relevant responses (i.e., 3 minutes of inhaling 10% CO2-enriched air). Normally menstruating adult women (N = 60) will undergo the CO2 challenge once in their premenstrual phase and once in their follicular phase. Cycle phase will be estimated by day count and ovulation kits and confirmed via progesterone assay. It is expected that women higher on AS will report greater post-challenge panic and anxiety sensations and exhibit heightened psychophysiological responses (skin conductance level) during the biological challenge when assessed in their premenstrual phase in comparison to when assessed in their follicular phase and in comparison to women lower on AS assessed in either cycle phase. A secondary aim of the proposed project is to examine the interactive effects of AS and menstrual cycle phase (premenstrual vs. follicular) on self-reported current menstrual symptom severity. Identifying gender-specific vulnerability-stress pathways will provide information pertinent to the potential etiology and maintenance of panic pathology in women and will also aid in developing prevention programs for women at high risk for panic pathology. This study's focus on identifying mechanisms that may explain vulnerability to panic pathology in women is relevant to the National Institute of Mental Health's mission to reduce the burden of mental disorders through behavioral research and to the NIMH's vision to transform the prevention of mental disorders, paving the way for a cure. PUBLIC HEALTH RELEVANCE: The 2:1 female-to-male gender difference in the prevalence of panic disorder is an important public health challenge. To further understand this gender difference, the proposed study seeks to identify etiological risk factors and/or stressors specific to women by focusing on an underlying diathesis that is elevated in women relative to men (i.e., anxiety sensitivity or fear of fear) and a cyclical, gender-specific stressor (i.e., premenstrual cycle phase) that may interact to elicit anxious responding. Results will have implications for prevention, assessment, treatment, and future research using laboratory paradigms to study panic vulnerability in women.

描述（由申请人提供）：恐慌症的患病率是一种以复发性，意外的恐慌发作为特征的令人衰弱的心理健康问题，是女性相对于男性而言的2倍。但是，对这种性别差异的潜在解释的研究是有限的。有一个显着的性别差异，有利于女性而不是男性，对焦虑敏感性（例如；即对焦虑症状的可怕反应趋势），这是恐慌病理学的认知风险因素。具体而言，女性在AS的措施下得分高于男性；以及高于1至3年随访的自发性惊恐发作和恐慌症的风险增加的人。鉴于高个子倾向于将身体感觉误解为危险的趋势，月经周期的经前期阶段可能构成一个性别特异性的，周期性的压力源，有助于不良适应性焦虑，未发生的恐慌发作和与女性的恐慌症的发作焦虑的脆弱性（即高）。因此，针对女性的恐慌反应的性别特异性脆弱性途径可能涉及已知的恐慌病理学认知危险因素（AS）与天然发生的，性别特异性的内部压力源（经前期阶段）之间的相互作用。作为探索这一拟议途径的第一步，该提议的R36心理健康论文赠款的主要目的是研究AS和月经周期阶段和月经循环阶段（术前阶段与卵泡阶段）的互动效果，以预测焦虑和焦虑阶段与恐慌相关的反应，应对引起恐慌反应的实验室生物学挑战（即，吸入10％的二氧化碳富集空气）。通常，月经的成年女性（n = 60）将在其前阶段和卵泡阶段一次接受二氧化碳挑战。周期阶段将按日计和排卵试剂盒进行估算，并通过孕激素测定确认。可以预期，随着女性在生物学阶段进行评估时，在生物学挑战期间，在生物学挑战期间的挑战后恐慌和焦虑感将更高，并表现出更高的心理生理反应（皮肤电导水平），与在卵泡相中的评估相比，以及相比之下在两个周期阶段评估的妇女较低。拟议项目的次要目的是检查AS和月经周期阶段（经结前与卵泡）对自我报告的当前月经症状严重程度的交互作用。确定特定性别的脆弱性压力途径将提供与女性潜在病因和维持恐慌病理学有关的信息，还将有助于制定针对高风险恐慌病理风险的妇女的预防计划。这项研究的重点是确定可能解释女性恐慌病理的机制，与国家心理健康研究所通过行为研究减轻精神障碍的负担以及NIMH转变精神障碍的预防，铺平了精神障碍的负担有关治愈方法。 公共卫生相关性：2：1女性对恐慌症患病率的男性性别差异是重要的公共卫生挑战。为了进一步了解这种性别差异，拟议的研究试图通过专注于女性相对于男性（即焦虑敏感或对恐惧的恐惧）和周期性的妇女的潜在素质来识别女性特有的病因风险因素和/或压力源。 ，可能相互作用以引起焦虑反应的性别特异性压力源（即，经前周期阶段）。结果将对使用实验室范例进行预防，评估，治疗和未来研究具有影响女性的恐慌脆弱性。