Induction of dyspnea evokes increased anxiety and maladaptive breathing in individuals with high anxiety sensitivity and suffocation fear


  • This study was funded by Landesgraduiertenförderung Mecklenburg-Vorpommern, Germany, and by the sub-project P5D “Psychophysiological correlates of CBT treatment effects in panic disorder: Anticipatory anxiety and defensive activation in PD patients during anticipation of exposure to dyspnea” (project number 01GV0614).

Address correspondence to: Manuela G. Alius, Department of Biological and Clinical Psychology, University of Greifswald, Franz-Mehring-Str. 47, 17487 Greifswald, Germany. E-mail:


Although respiratory symptoms are relevant for diagnosis and etiology of panic disorder, anxiety responses and breathing behavior evoked by induction of dyspnea have rarely been studied. Therefore, dyspnea sensations and affective evaluations evoked by inspiratory resistive loads of different intensities were first assessed in 23 individuals with high versus 24 participants with low anxiety sensitivity (AS). High AS participants with high fear of suffocation rated loads of the same physical intensity as more unpleasant and reported more intense feelings of dyspnea and more respiratory and panic symptoms than low AS individuals. In the second experiment assessing physiological responses to physically comparable loads, high suffocation fear participants showed an increase in minute ventilation to compensate for fear-induced air hunger. This ventilation behavior results in increased frequency of dyspnea sensations, thus increasing fear of suffocation.