Examining the latent class structure of CO2 hypersensitivity using time course trajectories of panic response systems

J Behav Ther Exp Psychiatry. 2015 Jun:47:68-76. doi: 10.1016/j.jbtep.2014.10.013. Epub 2014 Nov 15.

Abstract

Background and objectives: Carbon dioxide (CO2) hypersensitivity is hypothesized to be a robust endophenotypic marker of panic spectrum vulnerability. The goal of the current study was to explore the latent class trajectories of three primary response systems theoretically associated with CO2 hypersensitivity: subjective anxiety, panic symptoms, and respiratory rate (fR).

Methods: Participants (n = 376; 56% female) underwent a maintained 7.5% CO2 breathing task that included three phases: baseline, CO2 air breathing, and recovery. Growth mixture modeling was used to compare response classes (1…n) to identify the best-fit model for each marker. Panic correlates also were examined to determine class differences in panic vulnerability.

Results: For subjective anxiety ratings, a three-class model was selected, with individuals in one class reporting an acute increase in anxiety during 7.5% CO2 breathing and a return to pre-CO2 levels during recovery. A second, smaller latent class was distinguished by elevated anxiety across all three phases. The third class reported low anxiety reported during room air, a mild increase in anxiety during 7.5% CO2 breathing, and a return to baseline during recovery. Latent class trajectories for fR yielded one class whereas panic symptom response yielded two classes.

Limitations: This study examined CO2 hypersensitivity in one of the largest samples to date, but did not ascertain a general population sample thereby limiting generalizability. Moreover, a true resting baseline measure of fR was not measured.

Conclusions: Two classes potentially representing different risk pathways were observed. Implications of results will be discussed in the context of panic risk research.

Keywords: Anxiety; Carbon dioxide hypersensitivity; Latent class; Panic; Respiratory; Risk.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / chemically induced
  • Anxiety / diagnosis*
  • Anxiety / psychology
  • Carbon Dioxide / administration & dosage
  • Carbon Dioxide / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Panic Disorder / chemically induced
  • Panic Disorder / diagnosis*
  • Panic Disorder / psychology
  • Psychiatric Status Rating Scales
  • Respiratory Hypersensitivity / chemically induced
  • Respiratory Hypersensitivity / psychology*
  • Respiratory Rate / drug effects
  • Risk Factors
  • Time Factors
  • Young Adult

Substances

  • Carbon Dioxide