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BACKGROUND AND OBJECTIVES: One of the central assumptions of cognitive models of Panic Disorder (PD) is that automatic panic-related associations are a core feature of PD. However, empirical findings are mixed and inconsistent, rendering it difficult to evaluate the role of panic-related associations adequately, particularly in relation to the relevant theories. The present study aimed to further advance our understanding of automatic associations in PD, and therefore applied a paradigm novel in this context, namely an Extrinsic Affective Simon Task (EAST). METHODS: Participants involved treatment seeking, unmedicated panic patients (n = 45) and healthy controls (n = 38). The EAST was applied prior to treatment. It included the following stimuli as targets: panic-related bodily sensations and agoraphobia-related situations, and as attributes: pleasant versus unpleasant, fear-related words. RESULTS: Contrary to our expectations, panic patients did not show stronger negative than positive automatic associations for either panic-related symptoms or agoraphobia-related situations, compared to healthy controls. Moreover, EAST effects did not correlate with panic-related self-report measures. LIMITATIONS: Although the present study involved patients who were actively seeking treatment, panic-related associations might not have been activated sufficiently. Hence, a brief activation procedure (e.g., hyperventilation) might have been needed to optimize the assessment condition. CONCLUSIONS: The present findings do not support contemporary theories of panic-related associations. Therefore, follow-up work is needed to disentangle their functional and operational properties more thoroughly.

Original publication




Journal article


J Behav Ther Exp Psychiatry

Publication Date





105 - 109


Anxiety, Automatic associations, Extrinsic affective simon task (EAST), Information processing bias, Panic disorder, Adult, Agoraphobia, Female, Humans, Male, Panic Disorder, Psychiatric Status Rating Scales, Reaction Time, Sensation, Surveys and Questionnaires, Young Adult