摘要
Background Cognitive-behavioural theories of panic disorder posit that panic attacks arise from a positive feedback loop between arousal-related bodily sensations and perceived threat.In a recently develope computational model formalising these theories of pani attacks,it was observed that the response to a simulate perturbation to arousal provided a strong indicator of vulnerability to panic attacks and panic disorder.In this/review,we evaluate whether this observation is borne o in the empirical literature that has examined responses biological challenge(eg,C02 inhalation)and their relatio to subsequent panic attacks and panic disorder.Method We searched PubMed,Web of Science and PsycINFO using keywords denoting provocation agents(eg,sodium lactate)and procedures(eg,infusion)combined with keywords relevant to panic disorder(eg,panic).Articles were eligible if they used response to a biologic challenge paradigm to prospectively predict panic attac or panic disorder.Results We identified four eligible studies.Pooled effect sizes suggest that there is biological challenge response a moderate prospective association with subsequent pani attacks,but no prospective relationship with panic disorde Conclusions These findings provide support for the prediction derived from cognitive-behavioural theories an some preliminary evidence that response to a biological challenge may have clinical utility as a marker of vulnerab to panic attacks pending further research and developme Trial registration number 135908.
