Page 1 of 10http://spider.apa.org/ftdocs/abn/1996/november/abn1054658.html 8/28/2000Covariation Bias in Panic-Prone Individuals Paul PauliInstitute of Medical Psychology and Behavioral Neurobiology University of Tübingen Pedro MontoyaInstitute of Medical Psychology and Behavioral Neurobiology University of Tübingen Gertrud-Eva MartzInstitute of Medical Psychology and Behavioral Neurobiology University of Tübingen ABSTRACTCovariation estimates between fear-relevant (FR; emergency situations) or fear-irrelevant (FI; mushrooms and nudes) stimuli and an aversive outcome (electrical shock) were examined in 10 high-fear (panic-prone) and 10 low-fear respondents. When the relation between slide category and outcome was random (illusory correlation), only high-fear participants markedly overestimated the contingency between FR slides and shocks. However, when there was a high contingency of shocks following FR stimuli (83%) and a low contingency of shocks following FI stimuli (17%), the group difference vanished. Reversal of contingencies back to random induced a covariation bias for FR slides in high- and low-fear respondents. Results indicate that panic-prone respondents show a covariation bias for FR stimuli and that the experience of a high contingency between FR slides and aversive outcomes may foster such a covariation bias even in low-fear respondents. This research was supported by the Deutsche Forschungsgemeinschaft (Pa 566/3-1). We acknowledge the help of Rita Yaroush and Ron Mucha in preparing the revised versions of the manuscript. Correspondence may be addressed to Paul Pauli, Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Gartenstrasse 29, Tübingen, Germany, 72074. Electronic mail may be sent to [email protected] Received: January 3, 1995 Revised: October 2, 1995 Accepted: February 22, 1996 Anxiety disorders may be characterized by distorted cognitions ( Beck, Emery, & Greenberg, 1985 ) involving the selective processing of emotional-relevant information. Such a cognitive bias has been investigated with respect to judgment, attention, memory, and associative learning (for a review, see Mineka& Sutton, 1992 ). However, most recent studies have dealt with anxious patients having phobias or generalized anxiety disorder, and it still unknown whether these phenomena can be extended to patients with panic disorder. Patients with panic disorder have been found to have an attentional bias ( Ehlers, Margraf,Davies, & Roth, 1988 ; Pauli et al., in press ), such that they direct attention automatically toward potentially threatening stimuli (i.e., body-related stimuli), and a memory bias ( Becker, Rinck, & Margraf, 1994 ), indicating that these patients selectively memorize and recall fear-relevant stimuli. Journal of Abnormal Psychology © 1996 by the American Psychological Association November 1996 Vol. 105, No. 4, 658-662 For personal use only--not for distribution.Page 2 of 10http://spider.apa.org/ftdocs/abn/1996/november/abn1054658.html 8/28/2000A covariation bias for high-fear respondents was first reported by Tomarken, Mineka, and Cook (1989) . They used an illusory correlation paradigm and exposed respondents with high and low phobic fear to fear-relevant (FR; snake or spider) and fear-irrelevant (FI; mushroom or flower) slides followed by three consequences: shock, tone, or nothing. The relation between slide category and consequence was objectively random, but high-fear respondents markedly overestimated the contingency between FR slides and shocks. The source of the illusory correlation phenomenon is still unknown. It is a matter of controversy whether the a posteriori rated covariation estimates (CEs) reflect a distorted processing of information during the experiment or are based on preexperimental expectancies. De Jong, Merckelbach, and Arntz (1990) used on-line probability ratings and found that the covariation bias in unselected subjects may emerge during the experiment. However, de Jong, Merckelbach, and Arntz (1995) found that a covariation bias in untreated phobics may arise from initial expectancies that survive extinction during the illusory correlation paradigm, whereas in treated phobics the covariation bias may arise from expectencies that are reinstated by incidental FR slide—shock pairings. Patients with panic disorder experience sudden feelings of anxiety that are accompanied by a variety of bodily symptoms such as palpitations, breathlessness, dizziness, and trembling. They interpret bodily sensations as signs of a mental or physical disaster (i.e., perceiving palpitations as evidence of a heart attack), which is associated with a medical emergency situation. In fact, such patients had more emergency room visits than did patients with actual cardiac symptoms ( Barksy, Cleary, Sarnie, & Ruskin, 1994 ). Therefore, slides representing medical emergency situations should be fear-relevant stimuli for panic-prone patients. The main goal of our experiment was to extend the Tomarken et al. (1989) finding of a covariation bias in respondents with high phobic fear to panic-prone respondents. 1 We also examined the influence of experienced contingencies on CEs. Three experimental blocks were administered, two of which had different contingencies between three slide categories and two outcomes: In Blocks 1 and 3, all slides were randomly followed by electrical shocks or by nothing (50% contingency for all categories), whereas in Block 2, emergency slides were followed by shocks 83% of the time and by others 17% of the time. Additionally, we assessed a posteriori and on-line CEs. To achieve these goals and still have an acceptable number of trials, we changed the paradigm first used by Tomarken et al. (1989) and used only two outcomes (shock/no shock). This change clearly renders shocks more salient than the alternative; however, it should influence both groups in the same way and therefore should not affect the desired group differences. Method Participants The participants were 20 paid volunteers selected from a larger sample of undergraduate psychology students or private-interest groups (i.e., from a local chorus). Seventy participants completed the Agoraphobic Cognition Questionnaire (ACQ; Ehlers & Margraf, 1993 ) and the Body Sensation Questionnaire (BSQ; Ehlers & Margraf, 1993 ). The high-fear group was defined as the 10 respondents with the highest ACQ score; the low-fear respondents were the 10
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