Memory and Covariation Estimation Processes in Panic Disorder Patients

Panic patients are characterized by episodes of intense anxiety accompanied by bodily symptoms like palpitations, breathlessness, sweating, etc. Distorted or biased cognitive processes related to bodily symptoms are assumed to play a major role for the development and maintenance of these panic attacks. In a series of studies, our group has examined biased memory and covariation processes in panic patients compared to healthy participants. Behavioral as well as event-related brain potentials (ERPs) were registered. A memory bias in favor of body-related stimuli was verified for explicit but not for implicit memory processes. An enhanced late positive potential triggered by body-related stimuli during encoding seems to be the basis for this memory bias. Regarding covariation estimates, panic patients seem to selectively overestimate the association between panic-associated stimuli and aversive consequences. This overestimation is reflected in an enhanced contingent negative variation (CNV) in the interval between panic-associated stimulus and aversive consequence. The relevance of these results for theories of panic disorder and for effective treatments will be discussed.