Key result
High anxiety sensitivity linked to ~104% greater perceived obstruction and discomfort during intercostal muscle tension.
Why the study?
Respiratory muscle tension as a source of dyspnea in individuals with high anxiety sensitivity has not been considered in respiratory theories of panic disorder.
Does intercostal muscle tension elicit dyspnea in individuals with high anxiety sensitivity?
Cross-Sectional (n=62)
Does intercostal muscle tension elicit dyspnea in individuals with high anxiety sensitivity?
Absolute Event Rate: 5.1% vs 2.5%
p-value: p=<.05
Respiratory muscle tension may contribute to respiratory sensations (dyspnea) experienced by panic-prone individuals with high anxiety sensitivity.
May link intercostal tension to amplified dyspnea sensations in high anxiety sensitivity; hypothesis-generating, requires larger trials before clinical relevance.
OBJECTIVE: Anxiety and panic are associated with the experience of a range of bodily symptoms, in particular unpleasant breathing sensations (dyspnea). Respiratory theories of panic disorder have focused on disturbances in blood gas regulation, but respiratory muscle tension as a source of dyspnea has not been considered. We therefore examined the potential of intercostal muscle tension to elicit dyspnea in individuals with high anxiety sensitivity, a risk factor for developing panic disorder. METHODS: Individuals high and low in anxiety sensitivity (total N=62) completed four tasks: electromyogram biofeedback for tensing intercostal muscle, electromyogram biofeedback for tensing leg muscles, paced breathing at three different speeds, and a fine motor task. Global dyspnea, individual respiratory sensations, nonrespiratory sensations, and discomfort were assessed after each task, whereas respiratory pattern (respiratory inductance plethysmography) and end-tidal carbon dioxide (capnography) were measured continuously. RESULTS: In individuals with high compared to low anxiety sensitivity, intercostal muscle tension elicited a particularly strong report of obstruction (M=5.1, SD=3.6 versus M=2.5, SD=3.0), air hunger (M=1.9, SD=2.1 versus M=0.4, SD=0.8), hyperventilation symptoms (M=0.6, SD=0.6 versus M=0.1, SD=0.1), and discomfort (M=5.1, SD=3.2 versus M=2.2, SD=2.1) (all p values<.05). This effect was not explained by site-unspecific muscle tension, voluntary manipulation of respiration, or sustained task-related attention. Nonrespiratory control sensations were not significantly affected by tasks (F<1), and respiratory variables did not reflect any specific responding of high-Anxiety Sensitivity Index participants to intercostal muscle tension. CONCLUSIONS: Respiratory muscle tension may contribute to the respiratory sensations experienced by panic-prone individuals. Theories and treatments for panic disorder should consider this potential source of symptoms.
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Ritz et al. (2013) conducted a cross-sectional in High anxiety sensitivity (n=62). High anxiety sensitivity vs. Low anxiety sensitivity was evaluated on Report of obstruction during intercostal muscle tension (p=<.05). In individuals with high anxiety sensitivity, intercostal muscle tension elicited significantly stronger reports of obstruction (mean 5.1 vs 2.5) and discomfort compared to those with low sensitivity.
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