Psychological Trauma: Theory, Research, Practice, and Policy
Volume 2, Issue 1, 2010, Pages 63-70

A psychobiocultural model of orthostatic panic among cambodian refugees: Flashbacks, catastrophic cognitions, and reduced orthostatic blood-pressure response (Article)

Hinton D.E. , Hofmann S.G. , Orr S.P. , Pitman R.K. , Pollack M.H. , Pole N.
  • a Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, United States, Southeast Asian Clinic at the Arbour Counseling Center, United States
  • b Boston University, United States
  • c Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, United States, Veterans Affairs Medical Center, United States
  • d Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, United States
  • e Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, United States
  • f Department of Psychology, Smith College, United States

Abstract

This paper investigates cognitive and physiological precursors of orthostatic panic (OP), that is, panic upon standing, which is a key complaint among traumatized Cambodian refugees. Prior research links OP to hypotension (lower blood pressure) and catastrophic cognitions. A clinical sample of 102 Cambodian refugees were assessed for posttraumatic stress disorder (PTSD), recent OP attacks, and anticipatory anxiety before engaging in an orthostatic challenge (OC) task during which they were monitored for blood pressure. After the task, they were assessed for OC-induced culture-related catastrophic cognitions, flashbacks, and panic attacks. We found that participants with recent OP (n = 60) had more PTSD, greater anticipatory anxiety before the OC, a larger drop in systolic blood pressure during the OC, more OC-induced catastrophic cognitions and flashbacks, and more severe OC-induced panic attack symptoms. Regression models showed that the severity of OC-induced panic symptoms was predicted by the magnitude of SBP drop and mediated by more severe catastrophic cognitions and flashbacks. Implications of the findings for cross-cultural psychopathology research and the treatment of both panic and PTSD in Cambodian refugees are discussed. © 2010 American Psychological Association.

Author Keywords

Panic disorder PTSD blood pressure orthostatic hypotension Cambodian refugees

Index Keywords

[No Keywords available]
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77957862643&doi=10.1037%2fa0018978&partnerID=40&md5=cea91f53b1493c15126ca800968136b9
DOI: 10.1037/a0018978
ISSN: 19429681
Cited by: 18
Original Language: English