Attentional focus and fearful responding in patients with panic disorder during a 35% CO2 challenge

Patients with panic disorder show attentional hypervigilance to internal bo dily sensations (i.e., body vigilance), but the role of body vigilance in t he genesis of anxiety has not been evaluated. The present study utilized an experimental paradigm to examine the relationship between attentional focu s and fearful responding to biological challenge. Patients with panic disor der (n = 45) and matched nonclinical controls (n = 45) were randomly assign ed to one of three experimental conditions in which their attentional focus was directed toward internal bodily sensations (Internal Focus) or externa l cues (External Focus), or was allowed to alter freely (No Focus Control) in the context of a 35% CO2 challenge. Subjective and physiological measure s were taken at baseline and during the biological challenge procedure. Con sistent with prediction, patients showed greater attention to internal arou sal cues prior to the challenge, but patient status did not interact with c ondition to predict response to the challenge. On the other hand, level of anxiety sensitivity was found to interact with attentional focus in the exp ected direction. These findings add support for cognitive models of panic d isorder.