Catastrophic interpretations and anxiety sensitivity as predictors of panic-spectrum psychopathology in chronic obstructive pulmonary disease

J Psychosom Res. 2012 May;72(5):388-92. doi: 10.1016/j.jpsychores.2012.02.001. Epub 2012 Feb 25.


Objective: Panic-spectrum psychopathology (denoting panic attacks and panic disorder) is highly prevalent in chronic obstructive pulmonary disease (COPD), and the cognitive model of panic has been proposed as an explanation of this high prevalence. In the current cross-sectional study we investigated factors predicting panic-spectrum psychopathology in COPD, and hypothesized that, consistent with the cognitive model, both the catastrophic interpretation of shortness of breath and elevated anxiety sensitivity would be significant predictors when variance shared with confounding variables was controlled.

Methods: Sixty-two participants with COPD were interviewed with the Anxiety Disorders Interview Schedule for DSM-IV, Panic Disorder section, and completed measures of interpretation of breathing difficulty, anxiety sensitivity, anxiety, depression, disease-specific quality of life, and stressful life events. Objective disease severity was measured using forced expiratory volume in the first second.

Results: Direct logistic regression was performed, and worse depressive symptoms, more catastrophic interpretations of shortness of breath, higher anxiety sensitivity, higher magnitude of recent stressful life events, and worse disease severity were each found to be significant unique predictors of panic-spectrum psychopathology in COPD after shared variance was controlled.

Conclusions: The results of the study provide support for the cognitive model of panic, and also suggest a diathesis-stress explanation of the development of panic-spectrum psychopathology in COPD. The findings have implications for future preventative psychological interventions.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / complications
  • Anxiety / psychology*
  • Catastrophization / complications
  • Catastrophization / psychology*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Panic Disorder / complications
  • Panic Disorder / diagnosis*
  • Panic Disorder / psychology
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / psychology*