CCK-4: Psychophysiological conditioning elicits features of spontaneous panic attacks |
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Authors: | Kim Hinkelmann Alexander Yassouridis Reinhard Mass Henrike Tenge Michael Kellner Holger Jahn Klaus Wiedemann Karsten Wolf |
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Affiliation: | a Department of Psychiatry and Psychotherapy, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany;b RG Statistics, Max-Planck-Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany;c Center of Mental Health Marienheide, Leppestr. 65-67, 51709 Marienheide, Germany |
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Abstract: | IntroductionCholecystokinin-tetrapeptide (CCK-4) is an established model to generate subjective panic anxiety. CCK-4 injection also results in consistent and dose-dependent rise of stress hormones. Effects other than upon subjective panic and stress hormone activity have barely been examined. The purpose of the study was to investigate CCK-4 effects on emotional facial expression and especially on fear relevant facial muscles establishing therewith a more objective method to measure subjective panic anxiety.Methods20 healthy male subjects were randomly and double-blindedly assigned in two groups (dose groups), each of which was investigated three times once with placebo and twice with 25 μg or 50 μg CCK-4 respectively. Subjects of each group were randomly assigned in two different balanced orders of investigations: CCK-CCK-Placebo vs. Placebo-CCK-CCK. Facial muscle and hypothalamo-pituitary-adrenocortical (HPA)-axis activity were recorded.ResultsCCK-4 led dose-dependently to an increase of panic anxiety, an activation of fear relevant facial muscles and a rise of stress hormones. Whereas placebo administration before CCK-4 revealed no significant panic and stress response, during placebo following CCK-4 stimulations a psychophysiological conditioning effect could be observed without rise in HPA-axis activity.DiscussionOur findings indicate the possibility to measure different intensities of panic anxiety and conditioning effects with a facial EMG method. Dissociation of HPA-activity and fear relevant facial muscle activity is in accordance with former results about spontaneous panic attacks. |
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Keywords: | Panic anxiety CCK-4 Emotional facial expression Facial EMG HPA-axis Conditioning Activation density |
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