The purpose of this grant is to study the respiratory psychophysiology of panic disorder patients undergoing pharmacologic and cognitive/behavioral treatment. A number of recent findings point to complex respiratory parameters strongly correlate with self-rated anxiety, many panic patients are in a state of respiratory alkalosis, and carbon-dioxide (CO2) inhalation is becoming recognized as a reliable anxiety inducing method suggesting that some anxiety disorder patients are hypersensitive to CO2. At the same time cognitive/behavioral factors are increasingly acknowledged in the development and treatment of anxiety disorders. The biobehavioral model of panic is based on the success of cognitive/behavioral techniques (breathing retraining, interoceptive exposure, and cognitive restructuring) in normalizing the well documented complex biological and cognitive disturbances in panic disorder. A series of studies are proposed to investigate the differential biological and psychological effects of imipramine and the """"""""Albany Panic Control Treatment"""""""" in panic; to assess the role of hyperventilation in anxiety; to investigate the pathophysiology of CO2 induced anxiety by establishing its specificity and dose dependent nature and by developing objective, reliable and specific respiratory parameters of CO2-panic; and to assess the importance of cognitive/behavioral factors in anxiety as they relate to respiratory physiology. Collaborative respiratory studies will involve patients with late luteal phase dysphoric disorder, and relatives of panic patients. The immediate goal is to systematically describe the complex ventilatory and cognitive changes and their pathophysiological role in panic anxiety. The long range goal is to apply this knowledge to other psychiatric disorders. Training is proposed in the general areas of neurosciences and behavioral medicine. Specific training will focus on the diagnosis, pathophysiology, and treatment of anxiety disorders, the respiratory physiology and cognitive/behavioral factors in anxiety and related psychiatric disorders, and statistics.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Unknown (K20)
Project #
5K20MH000858-02
Application #
3088849
Study Section
Research Scientist Development Review Committee (MHK)
Project Start
1991-03-01
Project End
1996-02-29
Budget Start
1992-03-01
Budget End
1993-02-28
Support Year
2
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Columbia University (N.Y.)
Department
Type
Schools of Medicine
DUNS #
064931884
City
New York
State
NY
Country
United States
Zip Code
10027
Kent, J M; Papp, L A; Martinez, J M et al. (2001) Specificity of panic response to CO(2) inhalation in panic disorder: a comparison with major depression and premenstrual dysphoric disorder. Am J Psychiatry 158:58-67
Coplan, J D; Tamir, H; Calaprice, D et al. (1999) Plasma anti-serotonin and serotonin anti-idiotypic antibodies are elevated in panic disorder. Neuropsychopharmacology 20:386-91
Coplan, J D; Goetz, R; Klein, D F et al. (1998) Plasma cortisol concentrations preceding lactate-induced panic. Psychological, biochemical, and physiological correlates. Arch Gen Psychiatry 55:130-6
Martinez, J M; Coplan, J D; Browne, S T et al. (1998) Hemodynamic response to respiratory challenges in panic disorder. J Psychosom Res 44:153-61
Gorman, J M; Browne, S T; Papp, L A et al. (1997) Effect of antipanic treatment on response to carbon dioxide. Biol Psychiatry 42:982-91
Papp, L A; Martinez, J M; Klein, D F et al. (1997) Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects. Am J Psychiatry 154:1557-65
Coplan, J D; Papp, L A; Pine, D et al. (1997) Clinical improvement with fluoxetine therapy and noradrenergic function in patients with panic disorder. Arch Gen Psychiatry 54:643-8
Martinez, J M; Papp, L A; Coplan, J D et al. (1996) Ambulatory monitoring of respiration in anxiety. Anxiety 2:296-302
Coplan, J D; Papp, L A; Martinez, J et al. (1995) Persistence of blunted human growth hormone response to clonidine in fluoxetine-treated patients with panic disorder. Am J Psychiatry 152:619-22
Papp, L A; Martinez, J M; Klein, D F et al. (1995) Rebreathing tests in panic disorder. Biol Psychiatry 38:240-5

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