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The role of menstrual cycle phase and anxiety sensitivity in catastrophic misinterpretation of physical symptoms during a CO2 challenge

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Abstract

The current study examined the interactive effects of anxiety sensitivity (AS; fear of anxiety and anxiety-related sensations) and menstrual cycle phase (premenstrual phase vs. follicular phase) on panic-relevant responding (i.e., cognitive and physical panic symptoms, subjective anxiety, and skin conductance level). Women completed a baseline session and underwent a 3-min 10 % CO2-enriched air biological challenge paradigm during her premenstrual and follicular menstrual cycle phases. Participants were 55 women with no current or past history of panic disorder recruited from the general community (M age = 26.18, SD = 8.9) who completed the biological challenge during both the premenstrual and follicular cycle phases. Results revealed that women higher on AS demonstrated increased cognitive panic symptoms in response to the challenge during the premenstrual phase as compared to the follicular phase, and as compared to women lower on AS assessed in either cycle phase. However, the interaction of AS and menstrual cycle phase did not significantly predict physical panic attack symptoms, subjective ratings of anxiety, or skin conductance level in response to the challenge. Results are discussed in the context of premenstrual exacerbations of cognitive, as opposed to physical, panic attack symptoms for high AS women, and the clinical implications of these findings.

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Notes

  1. Additional models were run including a variable indicating which menstrual phase was tested first to examine whether the ordering influenced response, and including a variable indicating whether or not the participant completed one or both laboratory visits. These factors did not predict any of the outcomes and were not included in any of the final models. Additionally, a total of three participants (5.5 %) met criteria for PMDD, and all analyses were run including PMDD diagnostic status as a covariate. Results did not vary as a function of PMDD diagnosis, therefore, final models presented in this manuscript do not include PMDD diagnosis as a covariate.

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Acknowledgments

This research was supported by a National Institute of Mental Health Dissertation grant awarded to Yael I. Nillni (1R36MH086170-01A1). We would like to thank Dr. Alessandra Rellini, Dr. Keith Burt, and Dr. Magdalena Naylor for their comments on a prior version of this manuscript.

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Authors and Affiliations

  1. Department of Psychology, University of Vermont, Burlington, VT, 05401, USA

    Yael I. Nillni & Kelly J. Rohan

  2. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State St, Jackson, MS, 39216, USA

    Yael I. Nillni

  3. Department of Psychology, University of Houston, Houston, TX, 77204, USA

    Michael J. Zvolensky

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  1. Yael I. Nillni
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  2. Kelly J. Rohan
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  3. Michael J. Zvolensky
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Correspondence to Yael I. Nillni.

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Nillni, Y.I., Rohan, K.J. & Zvolensky, M.J. The role of menstrual cycle phase and anxiety sensitivity in catastrophic misinterpretation of physical symptoms during a CO2 challenge. Arch Womens Ment Health 15, 413–422 (2012). https://doi.org/10.1007/s00737-012-0302-2

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