Review

. 2016 Mar;53(3):312-22.

doi: 10.1111/psyp.12553.

Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative

Affiliations

¹ Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany.
² Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
³ Department of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany.
⁴ Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany.
⁵ Department of Psychology, University of Basel, Basel, Switzerland.
⁶ Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany.
⁷ Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany.
⁸ Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
⁹ Department Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
¹⁰ Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Frankfurt, Frankfurt, Germany.
¹¹ Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Würzburg, Würzburg, Germany.

PMID: 26877119
DOI: 10.1111/psyp.12553

Review

Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative

Alfons O Hamm et al. Psychophysiology. 2016 Mar.

. 2016 Mar;53(3):312-22.

doi: 10.1111/psyp.12553.

Authors

Affiliations

¹ Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany.
² Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
³ Department of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany.
⁴ Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany.
⁵ Department of Psychology, University of Basel, Basel, Switzerland.
⁶ Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany.
⁷ Christoph-Dornier Foundation for Clinical Psychology, Bremen, Germany.
⁸ Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
⁹ Department Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
¹⁰ Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Frankfurt, Frankfurt, Germany.
¹¹ Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Würzburg, Würzburg, Germany.

PMID: 26877119
DOI: 10.1111/psyp.12553

Abstract

In the current review, we reconceptualize a categorical diagnosis-panic disorder and agoraphobia-in terms of two constructs within the domain "negative valence systems" suggested by the Research Domain Criteria initiative. Panic attacks are considered as abrupt and intense fear responses to acute threat arising from inside the body, while anxious apprehension refers to anxiety responses to potential harm and more distant or uncertain threat. Taking a dimensional view, panic disorder with agoraphobia is defined with the threat-imminence model stating that defensive responses are dynamically organized along the dimension of the proximity of the threat. We tested this model within a large group of patients with panic disorder and agoraphobia (N = 369 and N = 124 in a replication sample) and found evidence that panic attacks are indeed instances of circa strike defense. This component of the defensive reactivity was related to genetic modulators within the serotonergic system. In contrast, anxious apprehension-characterized by attentive freezing during postencounter defense-was related to general distress and depressive mood, as well as to genetic modulations within the hypothalamic-pituitary-adrenal (HPA) axis. Patients with a strong behavioral tendency for active and passive avoidance responded better to exposure treatment if the therapist guides the patient through the exposure exercises.

Trial registration: ClinicalTrials.gov NCT01323556.

Keywords: Anxiety; Autonomic; Genetics; Psychopathological; Psychopathology; Startle Blink.

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Comment in

Reconciling RDoC and DSM approaches in clinical psychophysiology and neuroscience.
McTeague LM. McTeague LM. Psychophysiology. 2016 Mar;53(3):323-7. doi: 10.1111/psyp.12602. Psychophysiology. 2016. PMID: 26877120 Free PMC article.
Taking an RDoC lens to the study of panic disorder: A commentary on Hamm et al. and other thoughts on RDoC.
Shankman SA, Katz AC, Langenecker SA. Shankman SA, et al. Psychophysiology. 2016 Mar;53(3):328-31. doi: 10.1111/psyp.12590. Psychophysiology. 2016. PMID: 26877121 Free PMC article.
Applying Research Domain Criteria (RDoC) to the study of fear and anxiety: A critical comment.
Zoellner LA, Foa EB. Zoellner LA, et al. Psychophysiology. 2016 Mar;53(3):332-5. doi: 10.1111/psyp.12588. Psychophysiology. 2016. PMID: 26877122

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Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative

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Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative

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