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In this case, a given situation (i.e., feeling one’s heart pounding) is actively interpreted as signaling something else (i.e., having a heart attack). Such thoughts are common in patients with PD or agoraphobia, but also occur in patients with other anxiety disorders (e.g., social anxiety disorder and generalized anxiety disorder ).Ĭatastrophic misinterpretation describes the act of interpreting a stimulus as a sign of an impending catastrophe, for example, “My pounding heart means that I will have a heart attack”. We will briefly outline the distinguishing aspects of both concepts.Ĭatastrophic cognition describes acute thoughts about an impending catastrophe, e.g., “I will have a heart attack”. We follow the idea that catastrophic misinterpretation is a cognitive process and catastrophic cognition a possible result of that process. The present meta-analysis focuses on catastrophic misinterpretation in contrast to the closely related concept of catastrophic cognition. Ĭatastrophic misinterpretation and catastrophic cognitionīoth catastrophic misinterpretation and catastrophic cognition have been found to occur in a wide range of mental disorders (for a comprehensive review, see ). Instead, catastrophic cognitions (rather than catastrophic misinterpretations) are assumed to be an epiphenomenon of panic and to play no causal role in the emergence of panic. According to the alarm theory, a process of catastrophic misinterpretation is not assumed to take place. Subsequently, the perception of bodily sensations can trigger the conditioned fear, thus leading to a panic attack. The repeated occurrence of such false alarms can lead to the conditioning of fear to internal cues (i.e., bodily sensations). The alarm theory postulates that a panic attack is the occurrence of fear in a situation that does not actually pose a threat (“false alarm”). These assumptions distinguish the cognitive theory from another prominent theory of panic disorder, the alarm theory. It is further assumed that the catastrophic misinterpretation of bodily sensations is an enduring characteristic of patients with panic disorder (PD) and can therefore be measured in non-panic situations. Hence, the catastrophic misinterpretation of bodily sensations is assumed to be the cognitive process that is causally responsible for the emergence of fear that ultimately leads to a panic attack. It is assumed that panic attacks result from the interpretation of (per se) harmless bodily sensations as signs of an impending physical, mental, or social catastrophe (e.g., interpreting a pounding heart as sign of an upcoming heart attack).
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The findings support the assumption that the catastrophic misinterpretation of bodily sensations is a distinctive characteristic of panic disorder and thus lend support to the catastrophic misinterpretation model of PD.Ĭatastrophic misinterpretation plays a central role in the cognitive model of panic disorder. For the catastrophic misinterpretation of external events, analyses showed medium to large effects between patients with PD and healthy controls and a small negative effect between patients with PD and patients with other anxiety disorders. For the catastrophic misinterpretation of bodily sensations, analyses showed medium to large effects between patients with PD and healthy controls and between patients with PD and patients with other anxiety disorders. Following a systematic screening, seven studies were included in the meta-analysis. This paper presents a systematic review and meta-analysis of studies comparing the strength of catastrophic misinterpretation of bodily sensations and external events in patients with PD, patients with other anxiety disorders, and healthy controls. Existing research on this prediction has produced mixed findings. The catastrophic misinterpretation model of panic disorder (PD) predicts that the catastrophic misinterpretation of bodily sensations is a distinctive characteristic of PD.