Panic and comorbid depression and their associations with stress reactivity, interoceptive awareness and interoceptive accuracy of various bioparameters

Background: While current theories on perception of interoceptive signals suggest impaired interoceptive processing in psychiatric disorders such as panic disorder or depression, heart-rate (HR) interoceptive accuracy (lAc) of panic patients under resting conditions is superior to that of healthy controls. Thus, in this study, we chose to assess further physiological parameters and comorbicl depression in order to get information on how these potentially conflicting findings are linked together. Design: We used a quasi-experimental laboratory design which included multi-parametric physiological data collection 40 panic subjects and 53 matched no-panic controls, as well as experimental induction of stress and relaxation over a time-course. Methods: Stress reactivity, interoceptive awareness (IAw; from the Body Perception Questionnaire (BPQ)) and lAc (as correlation between self-estimation and physiological data) were major outcome variables. Self-estimation of bioparametrical change was measured via numeric rating scales. Result: Panic subjects had stronger HR-reaction and more accurate HR-interoception. Concurrently, though, their lAc of skin conductance level, pulse amplitude and breathing amplitude was significantly lower than that of the control group. Interestingly, comorbid depression was found to be associated with increased lAw but attenuated lAc. Limitations: Demand characteristics and a categorical approach to panic confine the results. Conclusion: The potentially conflicting findings coalesce, as panic was associated with an increase of the ability to perceive the fear -related parameter and a simultaneous decrease of the ability to perceive other parameters. The superordinate integration of afferent signals might be impaired (C) 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (hop://creaivecommons.urgIlicenses/by-nc-nd/4.0/).