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Panic attack provocation in panic disorder patients with a computer simulation
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DOI：10.1016/j.jad.2019.11.081.png)
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Background: Computer simulations (CS) and virtual reality exposure are promising techniques for research and treatment of panic disorder with agoraphobia (PDA). The objective of this study was to ascertain whether a given CS was a stimulus capable of producing panic attacks (PAs), anxiety and psychophysiological changes in patients with PDA. Methods: Thirty PDA patients and 30 healthy subjects were recruited for this study. Subjects were exposed to a 3-min CS of a situation relevant to agoraphobic patients. Anxiety, panic symptoms, PAs, heart rate, skin conductance and respiration were recorded before, during and after the CS exposure. Results: The CS effectively induced anxiety, hyperventilation and electrodermal responses in PDA patients but not in healthy subjects. Forty percent of PDA patients had a PA while none of the control subjects had a PA. A subgroup of patients who were less sensitive to the CS than the other subgroup of PDA patients and did not present full-blown PAs still had more panic symptoms, higher anxiety levels and more respiratory irregularities than the controls. Limitations: Low immersion and low sense of presence, lack of interaction with the environment. Conclusions: Exposure to the CS produced effects similar to in vivo exposure, respiratory and caffeine challenges. Subsequent studies should: make direct comparisons between CS and other challenges for PDA; investigate if CS can be a tool for predicting effects of medication; determine the potential of CS as a desensitization technique for situational PAs.
Keyword:
Panic disorder
Agoraphobia
Panic attack
Computer simulation
Galvanic skin response
Hyperventilation
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2.1W
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6.9W
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Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders.png)
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