Instructional Set and Physiological Response to CO2 Inhalation
OBJECTIVE: Previous studies have suggested that manipulations in patient instructions before inhalation of carbon dioxide (CO2) may blunt its anxiogenic effects. The authors examined the effects of a range of instructional types on panic rates and physiological responses to CO2 inhalation. METHOD: T...
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| Veröffentlicht in: | The American journal of psychiatry 1999-05, Vol.156 (5), p.745-748 |
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| container_title | The American journal of psychiatry |
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| creator | Welkowitz, Lawrence A. Papp, Laszlo Martinez, Jose Browne, Susan Gorman, Jack M. |
| description | OBJECTIVE: Previous studies have suggested that manipulations in patient instructions before inhalation of carbon dioxide (CO2) may blunt its anxiogenic effects. The authors examined the effects of a range of instructional types on panic rates and physiological responses to CO2 inhalation. METHOD: Thirty-seven patients with panic disorder and 16 normal subjects were exposed to CO2 inhalation under one of three instructional conditions: 1) reassurance (reiterated safety assurances), 2) control dial (patients were instructed on using an operative dial to reduce the concentration of CO2 in the breathing canopy), and 3) basic instructions (standard information). Perceived breathlessness was measured with the Borg Scale of Respiratory Exertion. RESULTS: Manipulation of instructional sets did not affect panic rates among patients. The reassurance condition, however, produced a significant reduction in perceived breathlessness. CONCLUSIONS: CO2-induced panic is a robust biological effect that occurs independent of cognitive set changes, such as illusion of control or reassurance of safety. Conclusions drawn from this study are bolstered by the fact that it is methodologically rigorous: it had a large number of subjects, used random assignment to one of three instructions, included a full array of both subjective and biological measures, and included independent ratings. |
| doi_str_mv | 10.1176/ajp.156.5.745 |
| format | Article |
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The authors examined the effects of a range of instructional types on panic rates and physiological responses to CO2 inhalation. METHOD: Thirty-seven patients with panic disorder and 16 normal subjects were exposed to CO2 inhalation under one of three instructional conditions: 1) reassurance (reiterated safety assurances), 2) control dial (patients were instructed on using an operative dial to reduce the concentration of CO2 in the breathing canopy), and 3) basic instructions (standard information). Perceived breathlessness was measured with the Borg Scale of Respiratory Exertion. RESULTS: Manipulation of instructional sets did not affect panic rates among patients. The reassurance condition, however, produced a significant reduction in perceived breathlessness. CONCLUSIONS: CO2-induced panic is a robust biological effect that occurs independent of cognitive set changes, such as illusion of control or reassurance of safety. Conclusions drawn from this study are bolstered by the fact that it is methodologically rigorous: it had a large number of subjects, used random assignment to one of three instructions, included a full array of both subjective and biological measures, and included independent ratings.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.156.5.745</identifier><identifier>PMID: 10327908</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Administration, Inhalation ; Adult and adolescent clinical studies ; Anxiety disorders. Neuroses ; Attitude ; Awareness ; Biological and medical sciences ; Carbon dioxide ; Carbon Dioxide - administration & dosage ; Carbon Dioxide - pharmacology ; Chi-Square Distribution ; Cognition ; Humans ; Medical sciences ; Panic attacks ; Panic disorder ; Panic Disorder - chemically induced ; Panic Disorder - diagnosis ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Research Design ; Respiration - drug effects ; Respiration Disorders - chemically induced ; Respiration Disorders - diagnosis ; Respiratory Physiological Phenomena - drug effects ; Set (Psychology) ; Videotape Recording</subject><ispartof>The American journal of psychiatry, 1999-05, Vol.156 (5), p.745-748</ispartof><rights>1999 INIST-CNRS</rights><rights>Copyright American Psychiatric Association May 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.156.5.745$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.156.5.745$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,21626,21627,21628,27869,27924,27925,77794,77799</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1785613$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10327908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Welkowitz, Lawrence A.</creatorcontrib><creatorcontrib>Papp, Laszlo</creatorcontrib><creatorcontrib>Martinez, Jose</creatorcontrib><creatorcontrib>Browne, Susan</creatorcontrib><creatorcontrib>Gorman, Jack M.</creatorcontrib><title>Instructional Set and Physiological Response to CO2 Inhalation</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: Previous studies have suggested that manipulations in patient instructions before inhalation of carbon dioxide (CO2) may blunt its anxiogenic effects. The authors examined the effects of a range of instructional types on panic rates and physiological responses to CO2 inhalation. METHOD: Thirty-seven patients with panic disorder and 16 normal subjects were exposed to CO2 inhalation under one of three instructional conditions: 1) reassurance (reiterated safety assurances), 2) control dial (patients were instructed on using an operative dial to reduce the concentration of CO2 in the breathing canopy), and 3) basic instructions (standard information). Perceived breathlessness was measured with the Borg Scale of Respiratory Exertion. RESULTS: Manipulation of instructional sets did not affect panic rates among patients. The reassurance condition, however, produced a significant reduction in perceived breathlessness. CONCLUSIONS: CO2-induced panic is a robust biological effect that occurs independent of cognitive set changes, such as illusion of control or reassurance of safety. Conclusions drawn from this study are bolstered by the fact that it is methodologically rigorous: it had a large number of subjects, used random assignment to one of three instructions, included a full array of both subjective and biological measures, and included independent ratings.</description><subject>Administration, Inhalation</subject><subject>Adult and adolescent clinical studies</subject><subject>Anxiety disorders. Neuroses</subject><subject>Attitude</subject><subject>Awareness</subject><subject>Biological and medical sciences</subject><subject>Carbon dioxide</subject><subject>Carbon Dioxide - administration & dosage</subject><subject>Carbon Dioxide - pharmacology</subject><subject>Chi-Square Distribution</subject><subject>Cognition</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Panic attacks</subject><subject>Panic disorder</subject><subject>Panic Disorder - chemically induced</subject><subject>Panic Disorder - diagnosis</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Research Design</subject><subject>Respiration - drug effects</subject><subject>Respiration Disorders - chemically induced</subject><subject>Respiration Disorders - diagnosis</subject><subject>Respiratory Physiological Phenomena - drug effects</subject><subject>Set (Psychology)</subject><subject>Videotape Recording</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNp1kctLw0AQxhdRbK0evUpQT0Li7kw2m14EKT4KhYoP8LZMNxubEpOYTQ79793Sil48DTP85vHNx9ip4JEQKrmmVRMJmUQyUrHcY0MhUYYKIN1nQ845hGOJ7wN25NzKpxwVHLKB4AhqzNMhu5lWrmt70xV1RWXwYruAqix4Wq5dUZf1R2F89dm6pq6cDbo6mMwhmFZLKmnTcswOciqdPdnFEXu7v3udPIaz-cN0cjsLCSHpwkWGuSBpVJwi5jJXtMhjwwliA1xmVoGBFC1JGwOAQMzQjqU1xpCwaAyO2Pl2btPWX711nV7VfesvdhqAx6lXlnjo4j9ISJHiGP0vPHW2o_rFp8100xaf1K71z088cLkDyHn1eUuVKdwvp1KZiM2cqy1GTVP82cT1xhftffFbEy219wW_AXhce9s</recordid><startdate>19990501</startdate><enddate>19990501</enddate><creator>Welkowitz, Lawrence A.</creator><creator>Papp, Laszlo</creator><creator>Martinez, Jose</creator><creator>Browne, Susan</creator><creator>Gorman, Jack M.</creator><general>American Psychiatric Publishing</general><general>American Psychiatric Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>HAWNG</scope><scope>HBMBR</scope><scope>IBDFT</scope><scope>K30</scope><scope>PAAUG</scope><scope>PAWHS</scope><scope>PAWZZ</scope><scope>PAXOH</scope><scope>PBHAV</scope><scope>PBQSW</scope><scope>PBYQZ</scope><scope>PCIWU</scope><scope>PCMID</scope><scope>PCZJX</scope><scope>PDGRG</scope><scope>PDWWI</scope><scope>PETMR</scope><scope>PFVGT</scope><scope>PGXDX</scope><scope>PIHIL</scope><scope>PISVA</scope><scope>PJCTQ</scope><scope>PJTMS</scope><scope>PLCHJ</scope><scope>PMHAD</scope><scope>PNQDJ</scope><scope>POUND</scope><scope>PPLAD</scope><scope>PQAPC</scope><scope>PQCAN</scope><scope>PQCMW</scope><scope>PQEME</scope><scope>PQHKH</scope><scope>PQMID</scope><scope>PQNCT</scope><scope>PQNET</scope><scope>PQSCT</scope><scope>PQSET</scope><scope>PSVJG</scope><scope>PVMQY</scope><scope>PZGFC</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>19990501</creationdate><title>Instructional Set and Physiological Response to CO2 Inhalation</title><author>Welkowitz, Lawrence A. ; Papp, Laszlo ; Martinez, Jose ; Browne, Susan ; Gorman, Jack M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a326t-bd3f1a5c74833f5f7abf4c0a24c205de72c283ea5e4222133d3e95eccca1e3cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Administration, Inhalation</topic><topic>Adult and adolescent clinical studies</topic><topic>Anxiety disorders. Neuroses</topic><topic>Attitude</topic><topic>Awareness</topic><topic>Biological and medical sciences</topic><topic>Carbon dioxide</topic><topic>Carbon Dioxide - administration & dosage</topic><topic>Carbon Dioxide - pharmacology</topic><topic>Chi-Square Distribution</topic><topic>Cognition</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Panic attacks</topic><topic>Panic disorder</topic><topic>Panic Disorder - chemically induced</topic><topic>Panic Disorder - diagnosis</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Research Design</topic><topic>Respiration - drug effects</topic><topic>Respiration Disorders - chemically induced</topic><topic>Respiration Disorders - diagnosis</topic><topic>Respiratory Physiological Phenomena - drug effects</topic><topic>Set (Psychology)</topic><topic>Videotape Recording</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Welkowitz, Lawrence A.</creatorcontrib><creatorcontrib>Papp, Laszlo</creatorcontrib><creatorcontrib>Martinez, Jose</creatorcontrib><creatorcontrib>Browne, Susan</creatorcontrib><creatorcontrib>Gorman, Jack M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Periodicals Index Online Segment 13</collection><collection>Periodicals Index Online Segment 14</collection><collection>Periodicals Index Online Segment 27</collection><collection>Periodicals Index Online</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - West</collection><collection>Primary Sources Access (Plan D) - International</collection><collection>Primary Sources Access & Build (Plan A) - MEA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Midwest</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Northeast</collection><collection>Primary Sources Access (Plan D) - Southeast</collection><collection>Primary Sources Access (Plan D) - North Central</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Southeast</collection><collection>Primary Sources Access (Plan D) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - UK / I</collection><collection>Primary Sources Access (Plan D) - Canada</collection><collection>Primary Sources Access (Plan D) - EMEALA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - North Central</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - International</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - International</collection><collection>Primary Sources Access (Plan D) - West</collection><collection>Periodicals Index Online Segments 1-50</collection><collection>Primary Sources Access (Plan D) - APAC</collection><collection>Primary Sources Access (Plan D) - Midwest</collection><collection>Primary Sources Access (Plan D) - MEA</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - Canada</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - UK / I</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - EMEALA</collection><collection>Primary Sources Access & Build (Plan A) - APAC</collection><collection>Primary Sources Access & Build (Plan A) - Canada</collection><collection>Primary Sources Access & Build (Plan A) - West</collection><collection>Primary Sources Access & Build (Plan A) - EMEALA</collection><collection>Primary Sources Access (Plan D) - Northeast</collection><collection>Primary Sources Access & Build (Plan A) - Midwest</collection><collection>Primary Sources Access & Build (Plan A) - North Central</collection><collection>Primary Sources Access & Build (Plan A) - Northeast</collection><collection>Primary Sources Access & Build (Plan A) - South Central</collection><collection>Primary Sources Access & Build (Plan A) - Southeast</collection><collection>Primary Sources Access (Plan D) - UK / I</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - APAC</collection><collection>Primary Sources Access—Foundation Edition (Plan E) - MEA</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>The American journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Welkowitz, Lawrence A.</au><au>Papp, Laszlo</au><au>Martinez, Jose</au><au>Browne, Susan</au><au>Gorman, Jack M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Instructional Set and Physiological Response to CO2 Inhalation</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1999-05-01</date><risdate>1999</risdate><volume>156</volume><issue>5</issue><spage>745</spage><epage>748</epage><pages>745-748</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: Previous studies have suggested that manipulations in patient instructions before inhalation of carbon dioxide (CO2) may blunt its anxiogenic effects. The authors examined the effects of a range of instructional types on panic rates and physiological responses to CO2 inhalation. METHOD: Thirty-seven patients with panic disorder and 16 normal subjects were exposed to CO2 inhalation under one of three instructional conditions: 1) reassurance (reiterated safety assurances), 2) control dial (patients were instructed on using an operative dial to reduce the concentration of CO2 in the breathing canopy), and 3) basic instructions (standard information). Perceived breathlessness was measured with the Borg Scale of Respiratory Exertion. RESULTS: Manipulation of instructional sets did not affect panic rates among patients. The reassurance condition, however, produced a significant reduction in perceived breathlessness. CONCLUSIONS: CO2-induced panic is a robust biological effect that occurs independent of cognitive set changes, such as illusion of control or reassurance of safety. Conclusions drawn from this study are bolstered by the fact that it is methodologically rigorous: it had a large number of subjects, used random assignment to one of three instructions, included a full array of both subjective and biological measures, and included independent ratings.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>10327908</pmid><doi>10.1176/ajp.156.5.745</doi><tpages>4</tpages></addata></record> |
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| subjects | Administration, Inhalation Adult and adolescent clinical studies Anxiety disorders. Neuroses Attitude Awareness Biological and medical sciences Carbon dioxide Carbon Dioxide - administration & dosage Carbon Dioxide - pharmacology Chi-Square Distribution Cognition Humans Medical sciences Panic attacks Panic disorder Panic Disorder - chemically induced Panic Disorder - diagnosis Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Research Design Respiration - drug effects Respiration Disorders - chemically induced Respiration Disorders - diagnosis Respiratory Physiological Phenomena - drug effects Set (Psychology) Videotape Recording |
| title | Instructional Set and Physiological Response to CO2 Inhalation |
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