Dissertations / Theses: 'Panikstörung'

1

Mahler, Claus. "Hyperventilation bei Patienten mit Panikstörung." Diss., lmu, 2005. http://nbn-resolving.de/urn:nbn:de:bvb:19-41310.

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2

Wichmann, Susann [Verfasser]. "Cortisol Stressreaktion bei der Panikstörung / Susann Wichmann." München : GRIN Verlag, 2019. http://d-nb.info/1188524569/34.

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3

Amrhein, Christine [Verfasser]. "Kognitive und psychophysiologische Verarbeitungsmechanismen bei der Panikstörung und bei Personen mit einem erhöhten Risiko für die Panikstörung / Christine Amrhein." München : GRIN Verlag, 2009. http://d-nb.info/1186266473/34.

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4

Lang, Thomas, Sylvia Helbig-Lang, Andrew T. Gloster, Jan Richter, Alfons O. Hamm, Lydia Fehm, Thomas Fydrich, et al. "Effekte therapeutenbegleiteter versus patientengeleiteter Exposition bei Panikstörung mit Agoraphobie." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-117711.

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Theoretischer Hintergrund: Die Rolle der Therapeutenbegleitung während Expositionsübungen bei Panikstörung mit Agoraphobie (P/A) ist bislang ungeklärt. Eine kürzlich durchgeführte klinische Studie (MAC-Studie) lieferte Hinweise auf ein günstigeres Behandlungsergebnis bei Therapeutenbegleitung. Fragestellung: Wie lassen sich Effekte therapeutenbegleiteter Exposition (T+) im Vergleich zu Exposition ohne Therapeutenbegleitung (T–) erklären? Methode: Daten von 301 Patienten, die eine expositionsbasierte KVT mit bzw. ohne Therapeutenbegleitung erhalten hatten, wurden analysiert. Untersucht wurden der Einfluss der initialen Störungsschwere, des Sicherheitsverhaltens sowie differenzielle Effekte der Bedingungen auf die Angst vor der Angst. Zusätzlich wurde überprüft, inwieweit die Übungshäufigkeit in den Behandlungsbedingungen variiert und einen Mediator des Behandlungserfolgs darstellt. Ergebnisse: Störungsschwere und Sicherheitsverhalten zeigten keine differenziellen Effekte zwischen den Bedingungen; die T+ Bedingung führte jedoch zu stärkeren Reduktionen der Angst vor der Angst im Angstsensitivitätsindex. Patienten der T+ Bedingung führten häufiger selbständig Expositionsübungen durch, während Patienten in T– im Durchschnitt länger übten. Die Übungshäufigkeit stellte dabei einen Mediator des Behandlungserfolgs dar. Schlussfolgerungen: Günstigere Effekte einer therapeutenbegleiteten Exposition gehen auf stärkere Reduktionen der Angst vor der Angst sowie auf eine höhere Übungshäufigkeit im Selbstmanagement zurück
Theoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapist-guided exposure compared to programmed practice. Objectives: Examining potential mechanisms of therapist-guided exposure. Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework. Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome. Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear

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5

Lang, Thomas, Sylvia Helbig-Lang, Andrew T. Gloster, Jan Richter, Alfons O. Hamm, Lydia Fehm, Thomas Fydrich, et al. "Effekte therapeutenbegleiteter versus patientengeleiteter Exposition bei Panikstörung mit Agoraphobie." Technische Universität Dresden, 2012. https://tud.qucosa.de/id/qucosa%3A27044.

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Theoretischer Hintergrund: Die Rolle der Therapeutenbegleitung während Expositionsübungen bei Panikstörung mit Agoraphobie (P/A) ist bislang ungeklärt. Eine kürzlich durchgeführte klinische Studie (MAC-Studie) lieferte Hinweise auf ein günstigeres Behandlungsergebnis bei Therapeutenbegleitung. Fragestellung: Wie lassen sich Effekte therapeutenbegleiteter Exposition (T+) im Vergleich zu Exposition ohne Therapeutenbegleitung (T–) erklären? Methode: Daten von 301 Patienten, die eine expositionsbasierte KVT mit bzw. ohne Therapeutenbegleitung erhalten hatten, wurden analysiert. Untersucht wurden der Einfluss der initialen Störungsschwere, des Sicherheitsverhaltens sowie differenzielle Effekte der Bedingungen auf die Angst vor der Angst. Zusätzlich wurde überprüft, inwieweit die Übungshäufigkeit in den Behandlungsbedingungen variiert und einen Mediator des Behandlungserfolgs darstellt. Ergebnisse: Störungsschwere und Sicherheitsverhalten zeigten keine differenziellen Effekte zwischen den Bedingungen; die T+ Bedingung führte jedoch zu stärkeren Reduktionen der Angst vor der Angst im Angstsensitivitätsindex. Patienten der T+ Bedingung führten häufiger selbständig Expositionsübungen durch, während Patienten in T– im Durchschnitt länger übten. Die Übungshäufigkeit stellte dabei einen Mediator des Behandlungserfolgs dar. Schlussfolgerungen: Günstigere Effekte einer therapeutenbegleiteten Exposition gehen auf stärkere Reduktionen der Angst vor der Angst sowie auf eine höhere Übungshäufigkeit im Selbstmanagement zurück.
Theoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapist-guided exposure compared to programmed practice. Objectives: Examining potential mechanisms of therapist-guided exposure. Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework. Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome. Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear.

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6

Golfels, Fabian [Verfasser]. "D-Cycloserin-augmentierte Expositionstherapie bei Patienten mit Agoraphobie und Panikstörung / Fabian Golfels." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/1026883075/34.

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7

Stender, Jan Philip [Verfasser]. "Die Rolle initialer Panikattacken in der Ätiologie der Panikstörung / Jan Philip Stender." Greifswald : Universitätsbibliothek Greifswald, 2017. http://d-nb.info/1128448432/34.

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8

Hamm, Anna Franziska [Verfasser]. "GABAerge Neurotransmission bei der Panikstörung - psychophysische und neurochemische Korrelate / Anna Franziska Hamm." Lübeck : Zentrale Hochschulbibliothek Lübeck, 2016. http://d-nb.info/1104749718/34.

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9

Westphal, Dorte, Alexander L. Gerlach, Thomas Lang, Hans-Ulrich Wittchen, Alfons O. Hamm, Andreas Ströhle, Thomas Fydrich, et al. "Die Effekte interozeptiver Expositionsübungen in der Kognitiven Verhaltenstherapie von Panikstörung mit Agoraphobie." Karger, 2015. https://tud.qucosa.de/id/qucosa%3A70595.

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Hintergrund: In der Kognitiven Verhaltenstherapie (KVT) der Panikstörung mit Agoraphobie (PD/AG) werden häufig Körperübungen zur Symptomprovokation (interozeptive Exposition) eingesetzt, jedoch liegen kaum systematische, empirische Untersuchungen zu Wirkung und Wirkweise dieser Übungen vor. Ziel der vorliegenden Studie war die Charakterisierung individueller Reaktionen auf interozeptive Übungen sowie die mit der Wiederholung der Übungen verbundenen Veränderungen dieser Reaktionen. Patienten und Methoden: Selbstberichtdaten zu ausgelösten Körpersymptomen sowie Symptom- und Angststärken von 301 Patienten mit PD/AG, die verschiedene interozeptive Übungen durchführten, wurden ausgewertet. Die Durchführung der interozeptiven Exposition erfolgte im Rahmen einer manualisierten KVT des Psychotherapieverbundes «Panik-Netz». Ergebnisse: Interozeptive Exposition löste Körpersymptome und damit verbunden Angst aus. Am häufigsten wurden vestibuläre, respiratorische und kardiovaskuläre Symptome ausgelöst. Die stärkste Symptomausprägung verbunden mit der stärksten Angst erzeugten die Übungen «Drehen», «Hyperventilieren» und «Strohhalmatmung». Übungswiederholung bewirkte eine Reduktion der Symptom- und Angststärken, insbesondere die Übungen «Drehen», «Strohhalmatmung» und «Hyperventilieren». Diskussion und Schlussfolgerungen: Interozeptive Exposition ist gut geeignet zur Auslösung von Körpersymptomen und zur Reduktion der damit verbundenen Symptom- und Angststärke, insbesondere über die Übungen «Drehen», «Hyperventilieren» und «Strohhalmatmung». Zur größeren Angst- und Symptomstärkenreduktion empfiehlt sich eine hohe Wiederholungsrate. Die Relevanz respiratorischer, vestibulärer und kardiovaskulärer Symptome für den Behandlungserfolg sollte weiterführend untersucht werden.
Background: Although interoceptive exposure is a frequent component of cognitive-behavioral therapies (CBT) in panic disorder with agoraphobia, there is a lack of evidence investigating the effect of this treatment component and its underlying mechanisms of change. The present study aimed at characterizing individual responses to interoceptive exposure and response changes after repeated exposure. Patients and Methods: Under the national research initiative ‘Panic Net’, self-report data were analyzed including bodily symptoms, symptom intensity and experienced anxiety during interoceptive exposure of 301 PD/AG patients who participated in a manualized CBT trial. Results: Interoceptive exposure induced bodily symptoms and anxiety. Respiratory, vestibular and cardiovascular symptoms were most frequently reported. Spinning, breathing through a straw and hyperventilation produced most intense symptom reports and anxiety ratings. Repeating the interoceptive exposure reliably reduced reported symptom intensity and anxiety ratings particularly after spinning, breathing through a straw and hyperventilation. Discussion and Conclusions: In PD/AG patients, interoceptive exposure induces bodily symptoms and reduces reported symptom intensity and anxiety, particularly through spinning, hyperventilation and breathing through a straw. Repeated rehearsal is encouraged given that larger reduction of anxiety and symptom reports were associated with more training. Further research is needed to assess the relevance of respiratory, vestibular and cardiovascular symptoms for CBT treatment.

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10

Held-Poschardt, Dada [Verfasser]. "Motivationale und emotionale Verarbeitung bei Patienten mit Panikstörung : drei fMRT-Studien / Dada Held-Poschardt." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2019. http://d-nb.info/119552823X/34.

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11

Grätz, Barbara [Verfasser]. "Der akut antipanische Effekt von Sport bei Patienten mit Panikstörung und gesunden Probanden / Barbara Graetz." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/103038228X/34.

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12

Meves, Anna Magdalena [Verfasser]. "Das Stresshormonsystem während In-vivo-Expositionstherapie bei Patienten mit Panikstörung und Agoraphobie / Anna Magdalena Meves." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/1030381461/34.

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13

Schmidt, Brigitte [Verfasser], and Jürgen [Gutachter] Deckert. "Veränderungen von Angstsensitivität und allgemeiner Selbstwirksamkeit bei der Therapie der Panikstörung / Brigitte Schmidt ; Gutachter: Jürgen Deckert." Würzburg : Universität Würzburg, 2018. http://d-nb.info/1161671471/34.

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14

Roggenhofer, Christian [Verfasser], and Hans-Christoph [Akademischer Betreuer] Friederich. "Neuronale Korrelate der Interozeption bei Patienten mit Panikstörung - eine funktionelle Bildgebungsstudie / Christian Roggenhofer ; Betreuer: Hans-Christoph Friederich." Heidelberg : Universitätsbibliothek Heidelberg, 2018. http://d-nb.info/1177253712/34.

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15

Depping, Anna-Mareike. "Habituation auf psychosozialen Stress bei gesunden Probanden und Patienten mit Panikstörung in Abhängigkeit von Persönlichkeitsmerkmalen, Stressverarbeitung und Lebensereignissen." Diss., lmu, 2008. http://nbn-resolving.de/urn:nbn:de:bvb:19-95128.

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16

Heupel, Julia Katharina [Verfasser], and Andreas [Akademischer Betreuer] Reif. "Stathmin als Kandidatengen für Cluster C Persönlichkeitsstörungen, Panikstörung und Agoraphobie / Julia Katharina Heupel (geb. Haderlein). Betreuer: Andreas Reif." Würzburg : Universitätsbibliothek der Universität Würzburg, 2013. http://d-nb.info/1042614679/34.

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17

Leyh, Miriam Verfasser], and Hans [Akademischer Betreuer] [Reinecker. "Therapeutische Beziehung und Interaktion bei Panikstörung und Agoraphobie. Eine Serie von sieben Einzelfallanalysen / Miriam Leyh. Betreuer: Hans Reinecker." Bamberg : Otto-Friedrich-Universität Bamberg, 2012. http://d-nb.info/1058477986/34.

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18

Thierfelder, Kolja [Verfasser]. "Neuronale Mechanismen der Angstreduktion durch Expositionstherapie : eine fMRT-basierte Studie bei Agoraphobie-Patienten mit und ohne Panikstörung / Kolja Thierfelder." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2011. http://d-nb.info/1025489756/34.

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19

Dresler, Thomas [Verfasser], and Paul [Akademischer Betreuer] Pauli. "Die neuronale Verarbeitung emotionaler Reize bei Patienten mit Panikstörung : eine Betrachtung der neuroanatomischen Hypothese / Thomas Dresler. Betreuer: Paul Pauli." Würzburg : Universitätsbibliothek der Universität Würzburg, 2011. http://d-nb.info/1014932807/34.

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20

Liebscher, Carolin [Verfasser]. "Neuronale Korrelate der kognitiv-behavioralen und pharmakologischen Behandlung von Patienten mit Agoraphobie mit Panikstörung : eine fMRT-Studie / Carolin Liebscher." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2017. http://d-nb.info/1126503959/34.

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21

Daneshi, Jasmine Safieh [Verfasser], and Michael [Akademischer Betreuer] Kellner. "Kohlendioxid-induzierte Panikattacken bei Patienten mit Posttraumatischer Belastungsstörung (PTBS) und Patienten mit Panikstörung / Jasmine Safieh Daneshi. Betreuer: Michael Kellner." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2014. http://d-nb.info/1049281233/34.

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22

Gaudlitz, Katharina Anna [Verfasser]. "Der Einfluss körperlicher Aktivität auf den Effekt einer Verhaltenstherapie bei Patienten mit Panikstörung mit/ohne Agoraphobie / Katharina Anna Gaudlitz." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2015. http://d-nb.info/1075493404/34.

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23

Böhme, Carsten [Verfasser], Katja [Gutachter] Petrowski, and Hendrik [Gutachter] Berth. "Vergleich der Hypothalamus-Hypophysen-Nebennieren-Achsen-Reaktivität bei Panikstörung und Posttraumatischer Belastungsstörung / Carsten Böhme ; Gutachter: Katja Petrowski, Hendrik Berth." Dresden : Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://d-nb.info/1227196512/34.

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24

Steinhäuser, Nina [Verfasser], and Paul [Akademischer Betreuer] Pauli. "Die Rolle von Sicherheitsverhalten in der Expositionstherapie bei Panikstörung mit Agoraphobie : Moderatoren, Mediatoren und Prädiktoren / Nina Steinhäuser. Betreuer: Paul Pauli." Würzburg : Universitätsbibliothek der Universität Würzburg, 2012. http://d-nb.info/1020570857/34.

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25

Baur, Simon Matthias [Verfasser], Alexander [Gutachter] Gerlach, and Charlotte [Gutachter] Hanisch. "Interozeptive Exposition für Subtypen der Panikstörung: Adjustierung der Methode = Verbesserung des Effekts? / Simon Matthias Baur ; Gutachter: Alexander Gerlach, Charlotte Hanisch." Köln : Universitäts- und Stadtbibliothek Köln, 2020. http://d-nb.info/1213897076/34.

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26

Gechter, Johanna [Verfasser]. "Der molekulargenetische Einfluss und die neuronale Aktivierung bei phobischen Reizen bei Patienten mit Panikstörung und Agoraphobie und Gesunden / Johanna Gechter." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1223928934/34.

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27

Tittel, Thomas [Verfasser]. "Veränderungen der Serumkonzentration des Interleukin-10 infolge Stressinduktion mittels des Trier Social Stress Test bei Menschen mit Panikstörung / Thomas Tittel." Mainz : Universitätsbibliothek der Johannes Gutenberg-Universität Mainz, 2020. http://d-nb.info/1224810635/34.

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28

Berking, Ann-Cathrine [Verfasser], Jürgen [Gutachter] Deckert, and Heike [Gutachter] Weber. "Assoziationsuntersuchung von ausgewählten Polymorphismen der Gene DNMT3A und DNMT3B mit der Panikstörung / Ann-Cathrine Berking ; Gutachter: Jürgen Deckert, Heike Weber." Würzburg : Universität Würzburg, 2021. http://d-nb.info/1232178500/34.

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29

Neumann, Marie-Charlott Verfasser], Borwin [Akademischer Betreuer] [Bandelow, Eberhard [Akademischer Betreuer] Fuchs, and Rainer [Akademischer Betreuer] Mausberg. "Störungsspezifische, visuelle emotionale Stimuli bei der Agoraphobie mit Panikstörung / Marie-Charlott Neumann. Gutachter: Borwin Bandelow ; Eberhard Fuchs ; Rainer Mausberg. Betreuer: Borwin Bandelow." Göttingen : Niedersächsische Staats- und Universitätsbibliothek Göttingen, 2012. http://d-nb.info/1042926107/34.

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Grenzemann, Karina Verfasser], Eric [Akademischer Betreuer] [Leibing, Dirk [Gutachter] Wedekind, and Thomas [Gutachter] Meyer. "Überprüfung der Wirksamkeit der kognitiv-behavioralen Therapie der Panikstörung mit und ohne Agoraphobie / Karina Grenzemann ; Gutachter: Dirk Wedekind, Thomas Meyer ; Betreuer: Eric Leibing." Göttingen : Niedersächsische Staats- und Universitätsbibliothek Göttingen, 2017. http://d-nb.info/1149958642/34.

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31

Geiger, Maximilian Johannes [Verfasser], Katharina [Gutachter] Domschke, Paul [Gutachter] Pauli, Susanne [Gutachter] Neufang, and Peter [Gutachter] Klaver. "Das neuronale Aufmerksamkeitsnetzwerk aus dem Gleichgewicht – Ein ‚imaging genetics‘ Modell der Panikstörung / Maximilian Johannes Geiger ; Gutachter: Katharina Domschke, Paul Pauli, Susanne Neufang, Peter Klaver." Würzburg : Universität Würzburg, 2020. http://d-nb.info/121042634X/34.

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32

Gajewska, Agnieszka [Verfasser], and Paul [Akademischer Betreuer] Pauli. "Einfluss von ADORA2A Rezeptorgen Polymorphismus und Koffein auf emotionale und frühe Informationsverarbeitungsprozesse - Ein mehrstufiges Modell für die Pathogenese der Panikstörung / Agnieszka Gajewska. Betreuer: Paul Pauli." Würzburg : Universitätsbibliothek der Universität Würzburg, 2013. http://d-nb.info/103375188X/34.

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33

Mann, Julia [Verfasser], Jürgen [Gutachter] Deckert, and Katharina [Gutachter] Domschke. "Die Rolle des Ile408Val-Polymorphismus im Orexin-/Hypocretin- Rezeptor-1 (HCRTR1)-Gen bei Panikstörung und intermediären Phänotypen von Angst / Julia Mann ; Gutachter: Jürgen Deckert, Katharina Domschke." Würzburg : Universität Würzburg, 2020. http://d-nb.info/1217599169/34.

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34

Goodwin, Renee D., Carlo Faravelli, S. Rosi, F. Cosci, E. Truglia, Ron de Graaf, and Hans-Ulrich Wittchen. "The epidemiology of panic disorder and agoraphobia in Europe." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110237.

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A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7–2.2) and 1.3% (0.7–2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.

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35

Mumm, Jennifer Lara Maria [Verfasser]. "Analyse von Herzfrequenzvariabilität sowie der Effekte von D-Cycloserin und körperlicher Aktivität bei Patient*innen mit Agoraphobie und Panikstörung im Verlauf einer kognitiven Verhaltenstherapie / Jennifer Lara Maria Mumm." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1223928047/34.

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36

Wittchen, Hans-Ulrich, Agnes Nocon, Katja Beesdo, Daniel S. Pine, Michael Höfler, Roselind Lieb, and Andrew T. Gloster. "Agoraphobia and Panic." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100091.

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Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions. Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview – Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14–24 years at baseline. Results: (1) Incidence patterns for PA (9.4%), PD (with and without AG: 3.4%) and AG (5.3%) revealed differences in age of onset, incidence risk and gender differentiation. (2) Temporally primary PA and PD revealed only a moderately increased risk for subsequent onset of AG, and primary AG had an even lower risk for subsequent PA and PD. (3) In strictly prospective analyses, all baseline groups (PA, PD, AG) had low remission rates (0–23%). Baseline PD with AG or AG with PA were more likely to have follow-up AG, PA and other anxiety disorders and more frequent complications (impairment, disability, help-seeking, comorbidity) as compared to PD without AG and AG without PA. Conclusions: Differences in incidence patterns, syndrome progression and outcome, and syndrome stability over time indicate that AG exists as a clinically significant phobic condition independent of PD. The majority of agoraphobic subjects in this community sample never experienced PA, calling into question the current pathogenic assumptions underlying the classification of AG as merely a consequence of panic. The findings point to the necessity of rethinking diagnostic concepts and DSM diagnostic hierarchies.

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37

Bischoff, Sophie [Verfasser]. "Laufen gegen die Angst? Eine randomisierte kontrollierte Studie zum Einfluss von körperlicher Aktivität (vor in-vivo Exposition) auf die Wirksamkeit einer Kognitiven Verhaltenstherapie bei Panikstörung mit Agoraphobie / Sophie Bischoff." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1206182237/34.

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38

Wollburg, Eileen. "Psychophysiological Effects of Respiratory Challenges before and after Breathing Training in Panic Disorder and Patients suffering from Episodic Anxiety Attacks." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2007. http://nbn-resolving.de/urn:nbn:de:swb:14-1197557728177-22093.

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Panic Disorder (PD) has been associated with abnormalities in the respiratory system for a long time, and treatment programs aimed at reversing these abnormalities have been developed. Panicogenic effects of biological challenges have been shown to be altered after successful treatment. Furthermore, there is evidence that anxious non-PD patients show similar responses to these challenges and hence may benefit from some kind of breathing training (BT). To test these assumptions, we recruited 45 PD patients, 39 Episodic Anxiety (EA) patients who suffered from subclinical panic attacks, and 20 non-anxious controls (NAC). Patients were randomized to one of two versions of a 4-week therapy with BT, either lower or raise end-tidal pCO2, or a waiting list (WL). Before and after treatment, participants underwent in randomized order a Voluntary Hypoventilation (VHO) test and a Voluntary Hyperventilation (VHT) test in which they were asked to either lower or raise their pCO2 while psychophysiological measures were recorded. Each test consisted of 3 segments: 1 min baseline, 3 min paced breathing, and 8 min recovery. Before treatment, PD and EA patients were more anxious, distressed, tense, and worried than NAC, and felt more dizziness, chest pain, and nausea during the laboratory assessment. However, increases in psychological symptoms or physiological sensations from baseline to the paced breathing segments were not different between groups. The two tests produced similar changes except that anxiety and dizziness increased more during the VHT than VHO. We replicated baseline breathing abnormalities previously reported for PD patients, namely greater respiration rate, tidal volume instability, and number of sighs. However, analyses did not find that patients recovered slower to either challenge. After treatment, both therapies improved on the main outcome measure. Furthermore, BT affected baseline pCO2, resulting in lower levels in the hypocapnic groups and higher levels in the hypercapnic groups without affecting any other measures. We conclude that baseline respiratory abnormalities are specific to PD. However, data suggest that the manipulations might have been too weak to elicit other previously reported group differences. Breathing training was equally effective for the lower and raise BT. Hence, factors unrelated to modifying one’s pCO2 must have accounted for the symptomatic improvement. Breathing training should not be restricted to PD but be applied to all patients suffering from anxiety attacks.

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39

Richter, Jan, Alfons O. Hamm, Christiane A. Pané-Farré, Alexander L. Gerlach, Andrew T. Gloster, Hans-Ulrich Wittchen, Thomas Lang, et al. "Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120100.

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Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder.

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40

Goodwin, Renee D., Carlo Faravelli, S. Rosi, F. Cosci, E. Truglia, Ron de Graaf, and Hans-Ulrich Wittchen. "The epidemiology of panic disorder and agoraphobia in Europe." Technische Universität Dresden, 2005. https://tud.qucosa.de/id/qucosa%3A26823.

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A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7–2.2) and 1.3% (0.7–2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.

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41

Karl, Nicole [Verfasser]. "Veränderungen der zentralen Informationsverarbeitung und der Einfluss körperlicher Aktivität auf den Effekt einer kognitiven Verhaltenstherapie bei Panikstörung mit und ohne Agoraphobie : Untersuchung der ereigniskorrelierten Potenziale P 50 und P 300 / Nicole Karl." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2015. http://d-nb.info/1079524800/34.

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42

Wittchen, Hans-Ulrich, Agnes Nocon, Katja Beesdo, Daniel S. Pine, Michael Höfler, Roselind Lieb, and Andrew T. Gloster. "Agoraphobia and Panic: Prospective-Longitudinal Relations Suggest a Rethinking of Diagnostic Concepts." Karger, 2008. https://tud.qucosa.de/id/qucosa%3A25264.

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Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions. Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview – Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14–24 years at baseline. Results: (1) Incidence patterns for PA (9.4%), PD (with and without AG: 3.4%) and AG (5.3%) revealed differences in age of onset, incidence risk and gender differentiation. (2) Temporally primary PA and PD revealed only a moderately increased risk for subsequent onset of AG, and primary AG had an even lower risk for subsequent PA and PD. (3) In strictly prospective analyses, all baseline groups (PA, PD, AG) had low remission rates (0–23%). Baseline PD with AG or AG with PA were more likely to have follow-up AG, PA and other anxiety disorders and more frequent complications (impairment, disability, help-seeking, comorbidity) as compared to PD without AG and AG without PA. Conclusions: Differences in incidence patterns, syndrome progression and outcome, and syndrome stability over time indicate that AG exists as a clinically significant phobic condition independent of PD. The majority of agoraphobic subjects in this community sample never experienced PA, calling into question the current pathogenic assumptions underlying the classification of AG as merely a consequence of panic. The findings point to the necessity of rethinking diagnostic concepts and DSM diagnostic hierarchies.

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43

Lüken, Ulrike, Markus Mühlhan, Hans-Ulrich Wittchen, Thilo Kellermann, Isabelle Reinhardt, Carsten Konrad, Thomas Lang, et al. "(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120053.

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Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.

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44

Richter, Jan, Alfons O. Hamm, Christiane A. Pané-Farré, Alexander L. Gerlach, Andrew T. Gloster, Hans-Ulrich Wittchen, Thomas Lang, et al. "Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder." Technische Universität Dresden, 2012. https://tud.qucosa.de/id/qucosa%3A27104.

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Abstract:

Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG). Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test. Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks. Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder.

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45

Sprute, Alke Juliane Verfasser], and Borwin [Akademischer Betreuer] [Bandelow. "Eine Untersuchung zur Wirkung von Paroxetin versus Placebo in Kombination mit regelmäßigem Ausdauertraining oder Entspannungstraining auf den Kortisolwert im Nachturin von Patienten mit einer Panikstörung mit und ohne Agoraphobie / Alke Juliane Sprute. Betreuer: Borwin Bandelow." Göttingen : Niedersächsische Staats- und Universitätsbibliothek Göttingen, 2009. http://d-nb.info/1044074094/34.

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46

Brückl, Tanja M., Hans-Ulrich Wittchen, Michael Höfler, Hildegard Pfister, Silvia Schneider, and Roselind Lieb. "Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100057.

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Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

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47

Gloster, Andrew T., Hans-Ulrich Wittchen, Franziska Einsle, Michael Höfler, Thomas Lang, Sylvia Helbig-Lang, Thomas Fydrich, et al. "Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-106614.

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Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.

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48

Lüken, Ulrike, Markus Mühlhan, Hans-Ulrich Wittchen, Thilo Kellermann, Isabelle Reinhardt, Carsten Konrad, Thomas Lang, et al. "(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session." Technische Universität Dresden, 2011. https://tud.qucosa.de/id/qucosa%3A27099.

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Abstract:

Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.

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49

Gloster, Andrew T., Hans-Ulrich Wittchen, Franziska Einsle, Michael Höfler, Thomas Lang, Sylvia Helbig-Lang, Thomas Fydrich, et al. "Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia." Technische Universität Dresden, 2009. https://tud.qucosa.de/id/qucosa%3A26684.

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Abstract:

Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.

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50

Brückl, Tanja M., Hans-Ulrich Wittchen, Michael Höfler, Hildegard Pfister, Silvia Schneider, and Roselind Lieb. "Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study." Karger, 2007. https://tud.qucosa.de/id/qucosa%3A26280.

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Abstract:

Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

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Dissertations / Theses on the topic 'Panikstörung'

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