A new treatment program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing.
The method has proved better than traditional cognitive therapy at reducing both symptoms of panic and hyperventilation, according to a new study.
The biological-behavioral treatment program is called Capnometry-Assisted Respiratory Training, or CART, said psychologist and panic disorder expert Alicia E. Meuret at Southern Methodist University in Dallas.
CART helps patients learn to breathe in such a way as to reverse hyperventilation, a highly uncomfortable state where the blood stream operates with abnormally low levels of carbon dioxide, said Meuret, one of the researchers conducting the study.
Hyperventilation, a state of excessive breathing, results from deep or rapid breathing and is common in patients with panic disorders.
"We found that with CART it's the therapeutic change in carbon dioxide that changes the panic symptoms — and not vice versa," Meuret said.
CART: Breathing exercises twice a dayDuring the treatment, patients undergo simple breathing exercises twice a day. A portable capnometer device supplies feedback during the exercises on a patient's CO2 levels. The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly. Contrary to lay belief, taking deep breaths actually worsens hyperventilation and symptoms.
The findings, "Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity," appeared in the Journal of Consulting and Clinical Psychology. Meuret, who developed CART, is an assistant professor in the Department of Psychology at SMU and co-directs the department's Stress, Anxiety and Chronic Disease Research Program. The Beth & Russell Siegelman Foundation funded the research.
See www.smuresearch for related links and a video about CART. Get the video html from youtube at http://www.youtube.com/watch?v=AcQsJnLBWpE.
CART breathing a proven biological therapy
The study pitted CART against a conventional cognitive therapy treatment, or CT. Traditional CT teaches patients techniques aimed at helping them change and reverse catastrophic thoughts in order to reduce fear and panic.
In the CART-CT study, 41 patients were assigned to complete either a CART or CT treatment program for panic disorder and agoraphobia, a fear of being trapped with no means of escape or help.
Both treatment programs were equally effective in reducing symptoms, said Meuret. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients. Cognitive therapy didn't change the respiratory physiology, said Meuret.
Treatment helps patients address terror associated with panic
The study is the second randomized control trial to measure CART's effectiveness. By reversing hyperventilation, patients reported a new ability to reduce panic symptoms by means of changing their respiration.
With CT, Meuret said, if a patient reports shortness of breath, the therapist challenges the assumption by asking how often the person actually has suffocated during a panic attack, then hopes that will reverse the patient's thinking.
"I found that process very challenging for some of my patients because it acknowledges the symptom but says it's not a problem," Meuret said.
"CART, however, tells us a patient's CO2 is very low and is causing many of the symptoms feared, but it can also show how to change these symptoms through correct breathing. There has been an assumption that if people worry less about symptoms it will also normalize their physiology, but this study shows that this is not the case," she said. "Hyperventilation remains unchanged, which could be a risk factor for relapse down the road. Apart from hyperventilation being a symptom generator, it is an unhealthy biological state associated with negative health outcomes."
Broader study planned to measure CART
The researchers plan to branch out with their studies on CART by taking the program into the community, particularly to ethnic minorities. They believe CART is a more universally understood treatment due to its physical exercises — as opposed to cognitive therapy's more intellectual methods — and therefore more accessible to a broader range of people with varying levels of education and different cultural backgrounds. Ongoing studies will test the efficacy of CART in patients with asthma and fear of blood.
Co-authors of the study at SMU were David Rosenfield, associate psychology professor, and psychology graduate students Anke Seidel and Lavanya Bhaskara. Stefan G. Hofmann, psychology professor at Boston University, was also an author on the paper.
SMU is a private university in Dallas where nearly 11,000 students benefit from the national opportunities and international reach of SMU's seven degree-granting schools. For more information see www.smu.edu.
SMU has an uplink facility on campus for live TV, radio or online interviews. To speak with Dr. Meuret or to book an interview with her in the SMU studio, call SMU News & Communications at 214-768-7650.
Margaret Allen | EurekAlert!
Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania
The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.
The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...
UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration
"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...
Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.
Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
16.01.2017 | Trade Fair News
16.01.2017 | Architecture and Construction
13.01.2017 | Life Sciences