The psychological models of panic disorder predict that people with this anxiety disorder are able to accurately estimate changes in somatic sensations. This study investigated whether nonclinical panickers, at risk for developing panic disorder, demonstrate enhanced interoceptive ability for changes in sympathetic arousal. Twenty people with nonclinical panic and 36 nonpanic controls estimated changes in overall sympathetic arousal, as measured by pulse transit time. A greater proportion of the nonclinical panickers than nonpanic controls met criterion for accurate interoceptive ability. As a group, nonclinical panickers also demonstrated more accurate perception of sympathetic arousal but only when it changed in predictable ways. Anxiety sensitivity and trait anxiety also appeared related to enhanced interoception, particularly in people who had experienced nonclinical panic. People who are at risk for the development of panic disorder may therefore demonstrate enhanced interoceptive ability for sympathetic arousal.
Elevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, & Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.