Tag: Alicia E. Meuret

NPR: A Tiny Spot In Mouse Brains May Explain How Breathing Calms The Mind

Post author By Margaret Allen
Post date April 13, 2017

SMU psychology professor Alicia Merit was interviewed by NPR as an expert outside source on a new study about calming the mind.

Public radio network NPR interviewed SMU clinical psychologist Alicia Meuret for her expertise on breathing as it relates to fear and anxiety.

The NPR article, “A Tiny Spot In Mouse Brains May Explain How Breathing Calms The Mind,” published March 30, 2017.

Meuret is director of the Anxiety and Depression Research Center at SMU, with expertise in discussing the differences between fear and anxiety and when each is helpful and adaptive and when they are harmful and interfere with our lives.

An associate professor in the Clinical Psychology Division of the SMU Department of Psychology, Meuret received her Ph.D. in Clinical Psychology from the University of Hamburg based on her doctoral work conducted at the Department of Psychiatry and Behavioral Sciences at Stanford University. She completed postdoctoral fellowships at the Center for Anxiety and Related Disorders at Boston University and the Affective Neuroscience Laboratory in the Department of Psychology at Harvard University.

Her research program focuses on novel treatment approaches for anxiety and mood disorders, biomarkers in anxiety disorders and chronic disease, fear extinction mechanisms of exposure therapy, and mediators and moderators in individuals with affective dysregulations, including non-suicidal self-injury.

The article “A Tiny Spot In Mouse Brains May Explain How Breathing Calms The Mind,” cites new findings from Meuret’s research, which found patients undergoing exposure therapy for anxiety fared better when sessions were held in the morning when levels of the helpful natural hormone cortisone are higher in the brain.

Read the full story.

EXCERPT:

By Jessica Boddy
NPR
Take a deep breath in through your nose, and slowly let it out through your mouth. Do you feel calmer?

Controlled breathing like this can combat anxiety, panic attacks and depression. It’s one reason so many people experience tranquility after meditation or a pranayama yoga class. How exactly the brain associates slow breathing with calmness and quick breathing with nervousness, though, has been a mystery. Now, researchers say they’ve found the link, at least in mice.

The key is a smattering of about 175 neurons in a part of the brain the researchers call the breathing pacemaker, which is a cluster of nearly 3,000 neurons that sit in the brainstem and control autonomic breathing. Through their research is in mice, the researchers found that those 175 neurons are the communication highway between the breathing pacemaker and the part of the brain responsible for attention, arousal and panic. So breathing rate could directly affect feeling calm or anxious, and vice versa.

If that mouse pathway works the same way in humans, it would explain why we get so chilled out after slowing down our breathing. […]

[…] Alicia Meuret, an associate professor of psychology at Southern Methodist University who also wasn’t involved in the study, wasn’t sure if what the authors described as calm mouse behavior could be described as such. “It’s hard to determine what calm behavior is [in mice],” Meuret says. “We can see their behavior, but we don’t know what effect the loss of neurons has on their emotions.”

Banzett echoed that concern, noting the authors inferred emotion because “they equate the increase in grooming behavior with the emotional state of calmness.”

Read the full story.

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Wall Street Journal: For better talk therapy, try taking a nap

Post author By Margaret Allen
Post date November 28, 2016

Doctors are finding creative ways to make cognitive behavioral therapy more effective

The Wall Street Journal has covered the latest research of SMU clinical psychologist Alicia Meuret, quoting her as an expert source.

The article, “For better talk therapy, try taking a nap,” published Nov. 28.

An associate professor in the Clinical Psychology Division at the SMU Department of Psychology, Meuret received her Ph.D. in Clinical Psychology from the University of Hamburg based on her doctoral work conducted at the Department of Psychiatry and Behavioral Sciences at Stanford University. She completed postdoctoral fellowships at the Center for Anxiety and Related Disorders at Boston University and the Affective Neuroscience Laboratory in the Department of Psychology at Harvard University.

The article “For better talk therapy, try taking a nap,” cites new findings from Meuret’s research, which found patients undergoing exposure therapy for anxiety fared better when sessions were held in the morning when levels of the helpful natural hormone cortisone are higher in the brain.

Read the full story.

EXCERPT:

By Andrea Petersen
Wall Street Journal
New tweaks are improving the age-old practice of talk therapy.

Doing therapy in the morning, taking a nap afterward or adding a medication that enhances learning are just a few of the methods scientists are discovering that can make cognitive behavioral therapy work better.

CBT, which involves changing dysfunctional patterns of thoughts and behaviors, is one of the most well-researched and effective treatments for a range of mental health issues, including anxiety disorders, depression and eating disorders.

But about a quarter to half of people with depression and anxiety don’t get significant relief after a course of CBT, which usually consists of about 12 to 15 weekly sessions. Some patients find the treatment time-consuming and difficult. Anywhere from 15% to 30% of people who begin it don’t finish, says David H. Barlow, founder of the Center for Anxiety and Related Disorders at Boston University. “There’s still plenty of room for improvement,” he says.

A study published in September in the journal Psychoneuroendocrinology that involved 24 patients with anxiety disorders found that therapy appointments earlier in the day were more effective than those later in the day.

In the study, subjects—who all had panic disorder with agoraphobia (fear of situations where escape may be difficult)—were treated with exposure therapy, a common component of CBT: They repeatedly confronted situations they feared, such as being in elevators or crowds. Subjects with sessions early in the day reported less severe anxiety symptoms at their next session than those who had sessions later in the day.

The researchers found that higher levels of the stress hormone cortisol that naturally occur in the morning were responsible for at least part of the benefit of the earlier sessions. “Acute boosts of cortisol can actually facilitate learning,” says Alicia E. Meuret, associate professor of psychology at Southern Methodist University and lead author of the study.

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Tags Alicia E. Meuret, David Rosenfield, Dedman College, Lavanya Bhaskara, SMU Department of Psychology, Thomas Ritz

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Huffington Post: The Science-Backed Reason To See Your Therapist In The Morning

Post author By Margaret Allen
Post date October 31, 2016
No Comments on Huffington Post: The Science-Backed Reason To See Your Therapist In The Morning

Your daily hormone cycle plays an important role.

Huffington Post sleep writer Sarah DiGiulio covered the latest research of SMU clinical psychologist Alicia Meuret for the online news hub.

The article, “The Science-Backed Reason To See Your Therapist In The Morning,” published Oct. 25.

The article “The Science-Backed Reason To See Your Therapist In The Morning,” cites new findings from Meuret’s research, which found patients undergoing exposure therapy for anxiety fared better when sessions were held in the morning when levels of the helpful natural hormone cortisone are higher in the brain.

Read the full story.

EXCERPT:

By Sarah DiGiulio
Huffington Post
Not a morning person? There still might be a good reason to get up and at it when it comes to booking time with your therapist.

A new study found that patients actually made more progress in overcoming anxiety, fears and phobias when they went to psychotherapy in the morning versus the afternoon. In fact, a test of panic symptoms revealed that patients had nearly 30 percent more improvement after an a.m. appointment than an afternoon session.

It’s not about whether or not you’re a morning person or a night owl, study author Alicia E. Meuret, a clinical psychologist at Southern Methodist University in Dallas, told The Huffington Post. The new data suggests morning therapy sessions are aided by higher levels of cortisol, the stress hormone that our bodies naturally release throughout the day.

The regular release of cortisol plays a role in ramping up metabolism and your immune system to get your body ready to go for the day, she explained. But more cortisol is released in the morning.

“There is already good evidence that learning is facilitated in the morning. There is also good evidence that cortisol facilitates learning,” she said. But this study is the first to suggest that your morning cortisol boost may also help you better face ― and deal with ― your fears and anxieties.

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Real Simple: This Is the Best Time of Day to See Your Therapist

Post author By Margaret Allen
Post date October 19, 2016
No Comments on Real Simple: This Is the Best Time of Day to See Your Therapist

If you’re struggling to overcome anxiety or a phobia, you’ll want to schedule a session at this time.

Real Simple health writer Amanda MacMillan covered the research of SMU clinical psychologist Alicia Meuret in the latest issue of the magazine and web site.

The article, “This Is the Best Time of Day to See Your Therapist,” published Oct. 16.

The article “This Is the Best Time of Day to See Your Therapist,” cites new findings from Meuret’s research, which found patients undergoing exposure therapy for anxiety fared better when sessions were held in the morning when levels of the helpful natural hormone cortisone are higher in the brain.

Read the full story.

EXCERPT:

By Amanda MacMillan
Real Simple
If you see a therapist for anxiety or a phobia, you might make more progress in sessions scheduled for the morning hours. Cortisol, a hormone that regulates stress and fear, is highest at this time of day—and a new study suggests this could make a real difference in overcoming emotional difficulties.

The new research, conducted by researchers at Southern Methodist University and the University of Michigan, focused specifically on a treatment known as exposure therapy. During exposure therapy, patients work with mental-health professionals to put themselves in situations that would normally cause panic or fear. The goal, with repeated exposures, is to diminish those stress responses over time.

“For example, a patient may think that standing in an elevator could cause him or her to lose control or faint, suffocate, or may create physical symptoms that would be intolerable,” explained Alicia E. Meuret, PhD, director of the SMU Anxiety and Depression Research Center, in a press release. “By having them stand in an elevator for a prolonged time, the patient learns that their feared outcome does not occur, despite high levels of anxiety. We call this corrective learning.”

Read the full story.

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Psychotherapy sessions are best in the morning when levels of helpful hormone are high

Post author By Margaret Allen
Post date October 3, 2016

New study found patients with anxiety, phobias and fears showed greater improvement from therapy that was scheduled in the morning, when levels of cortisol — a naturally occurring hormone — test higher.

Patients make more progress toward overcoming anxiety, fears and phobias when their therapy sessions are scheduled in the morning, new research suggests.

The study found that morning sessions helped psychotherapy patients overcome their panic and anxiety and phobic avoidance better, in part, because levels of cortisol — a naturally occurring hormone — are at their highest then, said clinical psychologist Alicia E. Meuret, Southern Methodist University, Dallas.

“The hormone cortisol is thought to facilitate fear extinction in certain therapeutic situations,” said Meuret, lead author on the research. “Drugs to enhance fear extinction are being investigated, but they can be difficult to administer and have yielded mixed results. The findings of our study promote taking advantage of two simple and naturally occurring agents – our own cortisol and time of day.”

The findings were reported in the article “Timing matters: Endogenous cortisol mediates benefits from early-day psychotherapy” in the journal Psychoneuroendocrinology.

Co-authors from the SMU Department of Psychology are David Rosenfield, Lavanya Bhaskara and Thomas Ritz. Co-authors from the Department of Psychiatry at the University of Michigan are Richard Auchus, Israel Liberzon, and James L. Abelson.

The study taps into research that anxiety and phobias are best treated by learning corrective information. Patients with anxiety and phobic disorders will overestimate the threat that a sensation or situation can cause. But by direct exposure, a patient learns that the likelihood of an expected catastrophe is very low.

“For example, a patient may think that standing in an elevator could cause him or her to lose control or faint, suffocate, or may create physical symptoms that would be intolerable,” Meuret said. “By having them stand in an elevator for a prolonged time, the patient learns that their feared outcome does not occur, despite high levels of anxiety. We call this corrective learning.”

However, since not all patients benefit equally from exposure therapy, researchers seek to identify ways to enhance corrective learning. To date, no simple way to augment fear extinction has been established.

The hormone cortisol is thought to help the extinction of fear. It appears to suppress the fear memory established by earlier distressing encounters while at the same time helping a patient better absorb and remember the new corrective information.

“In a prior study, we have shown that higher levels of cortisol during and in anticipation of exposure facilitate corrective learning,” said Meuret, an associate professor in the SMU Psychology Department and director of the SMU Anxiety and Depression Research Center in the Clinical Psychology Division of the department. “We also know that cortisol is higher early in the day. But we did not know whether cortisol would act as a mediator between time of day and therapeutic gains. This is what our study investigated.”

Exposure therapy in general resulted in significant improvements
Participants in the study were 24 people diagnosed with panic disorder and agoraphobia, which is a fear of public places where a person feels panicked, trapped or helpless.

For the study, participants underwent a standard psychotherapeutic treatment of “exposure therapy,” in which patients are exposed to situations that can typically induce their panic or fear with the goal that repeated exposure can help diminish a disabling fear response over time.

Patients received weekly sessions over three weeks, each lasting, on average, 40 minutes. Exposure situations included tall buildings, highways and overpasses, enclosed places such as elevators, supermarkets, movie theaters, and public transportation such as subways and intercity trains and boats. In addition, levels of cortisol were measured at various times during each exposure session by swabbing inside the mouth for saliva.

In the session following exposure, the researchers measured patients’ appraisals of the threats, their avoidance behavior, how much control they perceived themselves as having, and the severity of their panic symptoms.

Assessing the results from those measurements, the researchers found the exposure therapy in general resulted in significant improvements in all measures over all time periods.

Biggest gains after sessions that started earlier in the day
However, patients made the biggest gains in overcoming their fears after the sessions that started earlier in the day. At the next session, patients reported less severe symptoms for threat misappraisal, avoidance behaviors and panic symptom severity. They also perceived greater control over their panic symptoms.

“Notably, higher cortisol was related to greater reductions in threat appraisal, perceived control and panic symptom severity at the next session,” Meuret said, “and that was the case over-and-above the effects of time-of-day, with large effect sizes.”

That finding suggests that cortisol accounts for some of the therapeutic effects associated with time-of-day, she said.

Because cortisol levels are generally higher in the morning, the authors speculate that higher cortisol levels may aid extinction learning, and contribute to enhanced early-day benefits of exposure sessions through such a mechanism.

However, Meuret cautioned that the precise mechanism by which cortisol enhances the effectiveness of morning exposure sessions remains unclear and can’t be directly addressed from the data in this study. The sample size of the study was small and findings need to be confirmed independently in larger studies, she said.

Meuret and her team suspect additional mechanisms are at play to explain the time-of-day effect. Other factors could include memory and learning and the body’s natural circadian rhythm, quantity and quality of sleep, attention control, and interactions between those factors and others. — Margaret Allen, SMU

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For more SMU research see www.smuresearch.com.

SMU is a nationally ranked private university in Dallas founded 100 years ago. Today, SMU enrolls nearly 11,000 students who benefit from the academic opportunities and international reach of seven degree-granting schools. For more information, www.smu.edu.

SMU has an uplink facility located on campus for live TV, radio, or online interviews. To speak with an SMU expert or book an SMU guest in the studio, call SMU News & Communications at 214-768-7650.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, Lavanya Bhaskara, SMU Department of Psychology, Thomas Ritz

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$2 million NIH grant to help team from SMU and U-Maryland develop pediatric asthma monitor

Post author By Margaret Allen
Post date November 3, 2015

Goal is to create wearable device that helps pediatric patients avoid asthma attacks

Two SMU psychology professors working with University of Maryland engineers have been awarded a National Institutes of Health grant in October that will bring nearly $2 million to their joint project to create a wearable device for pediatric asthma patients that helps them avoid asthma triggers.

The asthma device will monitor air quality (including pollen levels and temperature), carbon dioxide levels in the blood, physical activity, breathing, emotional states and other stimuli to identify each patient’s individual asthma triggers and alert them when conditions are ripe for an attack. The concept is similar to the glucose monitor that alerts diabetes patients when their blood sugar is low, but it also includes much more complex monitoring of the patients’ environment.

The device’s current iteration is a portable unit, but the Maryland team is miniaturizing it so that it can be worn as a vest.

SMU psychology professors Alicia E. Meuret and Thomas Ritz, have teamed up with University of Maryland Center for Advanced Sensor Technology professors Yordan Kostov, Xudong Ge and Govind Rao, which provides a natural extension of each team’s research.

“Most of my early research has been developing a treatment that addresses hyperventilation using portable CO2 measurement devices, and teaching patients who suffer from panic disorders to normalize their CO2 levels and stop hyperventilating,” said Meuret, an associate professor in SMU’s Department of Psychology. “The colleagues at University of Maryland contacted me because they wanted to use one of the refined devices as a therapeutic measure, and the partnership grew from there.”

One eventual goal for the academic partnership is for the device to provide Meuret’s treatment instructions to patients during an attack so they can more quickly recover.

How patients perceive asthma triggers and how they can better manage them has been Ritz’ major research interest. He says 25 percent to 30 percent of patients have asthma symptoms triggered by emotional stimuli, which can be demonstrated by experiments with mood induction.

“That percentage is clinically significant,” Ritz says. “It’s a large endeavor with researchers from across the United States working on it and exchanging experience to develop their projects further.”

While the Maryland team works on the hardware for the project — and other research teams across the country work on the software — SMU’s Ritz and Meuret are working on the psychology and the clinical testing of the device with patients. Starting in January, the pair will conduct tests where students wearing the sensors change their breathing systematically or watch mood-inducing stimuli, such as sad, frightening or joyful movie clips.

Other tests of the environmental sensors will be done with adolescent asthma patients’ daily life. This will generate the data that will make the device’s components eventually run smoothly.

The SMU allotment of the NIH grant’s funds is $540,737. The University of Maryland team also includes environmental engineering researchers Chris Hennigan and electrical engineering researchers Ryan Robucci and Nilanjan Banerjee. — Kenny Ryan

Follow SMUResearch.com on twitter at @smuresearch.

SMU has an uplink facility located on campus for live TV, radio, or online interviews. To speak with an SMU expert or book an SMU guest in the studio, call SMU News & Communications at 214-768-7650.

Tags Alicia E. Meuret, Dedman College, SMU Department of Psychology, Thomas Ritz

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Asthma patients reduce symptoms, improve lung function with shallow breaths, more CO2

Post author By Margaret Allen
Post date November 3, 2014

New study finds taking deep breaths doesn’t work; sufferers pairing biofeedback with shallow breaths increased carbon dioxide and improved long-term lung health

Asthma patients taught to habitually resist the urge to take deep breaths when experiencing symptoms were rewarded with fewer symptoms and healthier lung function, according to a new study from Southern Methodist University, Dallas.

The findings are from a large clinical trial funded with a grant from the National Institutes of Health’s National Heart, Lung, and Blood Institute.

The results suggest asthma patients using behavioral therapy in conjunction with their daily asthma medicine can improve their lung health over the long-term, said principal investigators Thomas Ritz and Alicia E. Meuret, both SMU clinical psychologists.

Also, sufferers may potentially reduce their dependence on emergency medication, such as rescue inhalers, the researchers said.

SMU behavioral psychologist Dr. Alicia Meuret helps a patient learn shallow breathing with biofeedback to relieve symptoms of air hunger. (Photo: SMU) — SMU clinical psychologist Dr. Alicia Meuret helps a patient learn shallow breathing with biofeedback to relieve symptoms of air hunger. (Photo: SMU)

Asthma can be a life-threatening disease if not managed properly, according to the American Lung Association. Nearly 26 million Americans have asthma, says ALA.

One of the most common chronic disorders in childhood, asthma is the third leading cause of hospitalization among children under 15, ALA says.

Asthma attacks typically provoke sufferers to gulp air and take deep breaths to relieve the frightening fear of asphyxiation, said Ritz and Meuret. In addition, asthma sufferers tend to breathe too much even when not experiencing symptoms.

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But Ritz, Meuret and their co-authors found with their research that deep breathing is exactly the wrong thing to do.

For their study, one group of asthma patients used biofeedback to monitor their breathing for reassurance they were getting sufficient oxygen. The patients practiced shallower, shorter breaths to increase their intake of carbon dioxide, CO2. A second group also practiced slower breathing, but without biofeedback.

“This study goes to the heart of hyperventilation — which is deep, rapid breathing that causes a drop in CO2 gas in the blood. That makes a person feel dizzy and short of breath,” Ritz said. “Patients in our study increased CO2 and reduced their symptoms. And over a six-month period we saw in the biofeedback group an actual improvement in the physiology of their lungs.”

The researchers reported their findings in the pulmonology medical journal Chest, “Controlling asthma by training of capnometry-assisted hypoventilation vs. slow breathing.” Ritz is a professor and Mueret an associate professor in the Department of Psychology in SMU’s Dedman College.

Shallow breathing method is counterintuitive
“When people hyperventilate, there is something very strange happening,” Meuret said. “In essence they are taking in too much air. But the sensation that they get is shortness of breath, choking, air hunger, as if they’re not getting enough air. It’s almost like a biological system error.”

Onlookers commonly give the advice, “Take a deep breath.” But that’s just the opposite of what a struggling breather should do.

“They don’t need any more oxygen,” Meuret said. “But consciously or not, people start to take deeper breaths — and that makes the symptoms worse.”

Among the study’s 120 patients who used the brief, four-week biofeedback therapy to boost their CO2, the researchers found that of 21 clinical indices of pathology more than 80 percent resulted in significant reductions. The researchers saw improvement in asthma symptoms and control, better lung function, reduced oversensitivity of the airways and less use of reliever medication, as well as improvement in physiology and the pathology of the airways.

Biofeedback method tested against tough scientific control group
The biological-behavioral treatment method, called Capnometry-Assisted Breathing Training, or CART for short, was developed by Meuret. Previous randomized controlled studies by Meuret found CART reduced symptoms of panic and hyperventilation in patients with panic and anxiety.

The handheld capnometer, equipped with a digital readout, enables patients via biofeedback to track changes in their CO2 when they alter their breathing during breathing training exercises and instruction sessions. Capnometers are medical devices that can only be purchased by a health care provider.

For the current SMU study, CART patients were compared to a randomized control group that also received a breathing treatment — specifically, slower breathing, or SLOW for short.

Patients in the SLOW group used the CART device also for their home exercises to validate they were breathing slower. The only difference between the CART and SLOW groups was that CART patients received biofeedback about their CO2.

“We tested CART against the toughest scientific control we could devise — another breathing treatment, where patients receive the same amount of attention from their therapist, use equipment to help them alter their breathing, are primed to pay attention to their own asthma management, and receive encouragement to take their medicine more regularly,” Ritz said.

CART and SLOW patients both improved, but CART benefits were long-lasting
Patients in the study were from the Dallas-Fort Worth area, all of them medically diagnosed with asthma. Each patient’s asthma diagnosis was independently validated at Baylor University Medical Center at Dallas by a methacholine airways stress test, a stringent diagnostic procedure to confirm patients met the criteria for asthma.

After four weeks of CART and SLOW training, asthma symptoms for both groups had improved, even when controlling for any change in medication intake.

However at follow up six months later, asthma symptoms for the SLOW control group had returned to higher levels.

“The follow-up period is often viewed as the moment of truth of how effective a treatment is,” said Meuret. “Once a patient doesn’t have to come to treatment, does the treatment continue to be beneficial? After four weeks, both treatments were beneficial, but CART was superior — and showed even greater improvements beyond that.”

CART patients also became less distressed about the methacholine test, indicating higher distress tolerance to their symptoms, Ritz said.

In addition, during treatment, the airways of CART patients widened during treatment in the lab, according to measurements taken by a forced oscillation technique. That was a positive development that allowed patients to breathe easier. Airways in the SLOW group actually narrowed a bit, said Ritz. Nevertheless, SLOW resulted in significant improvement also.

“The long-term goal of the CART research is to test whether we can achieve the same improvements with occasional intervals of capnometer feedback training, or ideally test whether shallow breathing in itself will achieve the same stable increases in CO2,” said the researchers.

CART not a relaxation technique
CART is not relaxation training. Quite the opposite.

“It’s actually very, very, very unrelaxing when patients start,” Meuret said.

For patients with low CO2 in particular, the process of breathing slow and shallow to increase the CO2 level — even just slightly — tends to trigger extreme air hunger.

“Only by reassuring themselves that the symptoms are caused by low CO2 and not low oxygen, they can keep on going,” Meuret said. “And that’s even more difficult for asthmatics than anxious patients who have a normal lung function.”

Patients initially want to take a deep breath, she said. “But I reassure them not to, telling them to ‘Look at the CART device, look at their oxygen, it’s at 100 percent, it can’t get any higher.’”

CART therapy can improve quality of life, reduce health dangers
“The goal is to reduce the need of the emergency medication,” Ritz said. “It’s a quality of life issue.”

Patients with asthma symptoms miss out on sports, limit their physical activity, or are kept out of school P.E. and other activities. They can also become depressed and anxious, and get over-sensitive to sensations.

“The more you can reduce these symptoms the more the person can take part in daily life like a normal person,” Ritz said.

Physiologically, symptoms are also an indicator the asthma patient may have more inflammation and constriction.

While there’s always the risk an attack may be fatal, Ritz said, lesser outcomes are serious also. It’s recommended to intervene in asthma early, ideally during childhood, because the airways become reshaped.

“The longer they’re inflamed, the thicker the tissue of the airways get and the narrower the airways and the less they can relax,” he said.

Other co-authors on the study were SMU psychologist David Rosenfield, graduate student Ashton M. Steele, and physician Mark W. Millard, Baylor University Medical Center Dallas. — Margaret Allen

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Tags Alicia E. Meuret, Ashton M. Steele, David Rosenfield, Dedman College, Psychology, Thomas Ritz

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KERA: The Psychology of Fear

Post author By Margaret Allen
Post date October 7, 2014

We need fear to survive, as a protective and necessary mechanism, but excessive anxiety and fear can interfere with our lives — Meuret

KERA public radio 90.1 hosted SMU psychologist Alicia Meuret on Krys Boyd‘s “Think” program Oct. 6. Meuret, Boyd and Madhukar Trivedi, chair of the University of Texas-Southwestern’s Mental Health Department, discussed “How fear serves us and when it can lead us astray,” particularly in the wake of the much-discussed Ebola case in Dallas.

Meuret is director of the Anxiety and Depression Research Center at SMU and discussed the differences between fear and anxiety and when each is helpful and adaptive and when they are harmful and interfere with our lives.

The program, “The Psychology of Fear,” featured discussions on whether fear is contagious, alternatives to managing thoughts that fuel anxiety, and actual thrill-seeking behavior in which we seek out exciting experiences.

Meuret is an associate professor in the Clinical Psychology Division at the SMU Department of Psychology. Meuret received her Ph.D. in Clinical Psychology from the University of Hamburg based on her doctoral work conducted at the Department of Psychiatry and Behavioral Sciences at Stanford University. She completed postdoctoral fellowships at the Center for Anxiety and Related Disorders at Boston University and the Affective Neuroscience Laboratory in the Department of Psychology at Harvard University.

Listen to the KERA podcast.

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Tags Alicia E. Meuret, Dedman College, Psychology

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Oprah.com: Stress Myths — Debunked!

Post author By Margaret Allen
Post date January 9, 2013

Health journalist Corrie Pikul wrote about the groundbreaking panic and anxiety research of SMU psychologists Dr. Alicia Meuret and Dr. Thomas Ritz in a Jan. 7 post on Oprah.com.

The article, “Stress Myths—Debunked!,” cites the startling findings of Meuret’s anxiety research, which has found that the standard advice to “take a deep breath” actually makes such situations worse.

Read the full post.

EXCERPT:

By Corrie Pikul
Oprah.com
[ … ] “Taking deep, slow breaths can help you calm down when you’re feeling panicked and overwhelmed.”

It makes sense that when you’re short of breath, you should try to compensate with a little extra oxygen, right? The problem is that when you are experiencing an intensely trying situation—waiting to hear the results of a serious medical test, during severe turbulence on an airplane, or when you slice your thumb with a bread knife just as your brunch guests pull into the driveway—you’re probably already taking in too much oxygen and could be at risk of hyperventilating, says Alicia Esperanza Meuret, PhD, associate professor of psychology at Southern Methodist University in Dallas. In her research on patients who suffer from panic disorders and asthma, Meuret has found that a more effective way to calm down is to take shallow, regular and slow breaths through the nose (not the mouth, which makes it too easy to suck more air than you actually need). “Imagine a beach where the water is sliding in and out in time with your breath,” she says. This may feel slightly uncomfortable at first, as you battle the impulse to fill your lungs, but Meuret says you should start to feel more relaxed after practicing a few times.

Read the full post.

Follow SMUResearch.com on Twitter.

For more information, www.smuresearch.com.

SMU is a nationally ranked private university in Dallas founded 100 years ago. Today, SMU enrolls nearly 11,000 students who benefit from the academic opportunities and international reach of seven degree-granting schools. For more information see www.smu.edu.

SMU has an uplink facility located on campus for live TV, radio, or online interviews. To speak with an SMU expert or book an SMU guest in the studio, call SMU News & Communications at 214-768-7650.

Tags Alicia E. Meuret, Dedman College, SMU Department of Psychology, Thomas Ritz

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Prevention: Anxiety Is Draining Your Brain, But It Doesn’t Have To

Post author By Margaret Allen
Post date June 22, 2012

Health journalist Markham Heid wrote about the groundbreaking panic and anxiety research of SMU psychologists Dr. Alicia Meuret and Dr. Thomas Ritz in the June 2012 issue of Prevention magazine.

The article “Anxiety Is Draining Your Brain, But It Doesn’t Have To” cites the startling findings of Meuret’s anxiety research, which has found that the standard advice to “take a deep breath” actually makes such situations worse.

Read the full story.

EXCERPT:

By Markham Heid
Prevention

How’s this for unfair: Women are twice as likely to suffer from anxiety disorders than men are, according to the Anxiety and Depression Association of America. And to top it off, new research finds that those frequent bouts of worrying may be making it hard for your brain to complete even the simplest of tasks.

It’s no secret that feeling anxious isn’t exactly enjoyable, but Michigan State University researchers wanted to find out exactly what goes on inside an anxious brain. They asked 149 men and women who suffer from anxiety to complete a series of puzzles, while tracking the electrical activity in their brains.

The results: Although men and women performed equally well on the simple puzzles, women’s brains were much more active. Later, when the puzzles became more difficult, the women performed worse than their male counterparts.

Why? The researchers speculate that the energy used up on simple tasks robbed the anxious women of the brainpower needed to complete more difficult tasks. In other words, although your brain is technically an organ, it mimics a muscle in that it can be worn down by too much work. And, like carrying around an extra 10-pound weight, anxiety makes everything your brain does more difficult.

But not to worry; you can learn to get a handle on your anxiety with a few easy tips:

Control your breathing. Although you’ve probably been told to breathe deeply when trying to calm down, the opposite is actually true, says Alicia Meuret, PhD, a psychologist and anxiety specialist at Southern Methodist University. “Deep breaths worsen hyperventilation and anxiety-associated symptoms such as shortness of breath and a racing heart,” she says. So how should you breathe? Slowly and shallowly, Dr. Meuret recommends. Try to take in as little air as possible, keeping in the oxygen for a second or two before exhaling, she advises. This will keep your body’s supply of circulating carbon dioxide at its proper level, which will calm you down, she says. […]

Read the full story.

Tags Alicia E. Meuret, Dedman College, SMU Department of Psychology, Thomas Ritz

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Baylor Innovations: Don’t Panic, New Research Shows That Panic Attacks Are Not As Spontaneous As Once Thought

Post author By Margaret Allen
Post date May 7, 2012

Baylor Innovations, the quarterly magazine of Baylor Health Care System, featured the groundbreaking panic attack research of SMU psychologists Dr. Alicia E. Meuret, Dr. David Rosenfield and Dr. Thomas Ritz.

The Spring 2012 article by health and science writer Mark Cantrell, titled “Don’t Panic: New Research Shows That Panic Attacks Are Not As Spontaneous As Once Thought” details the startling findings of Meuret’s newest published study showing significant physiological instability in advance of so-called out-of-the-blue panic attacks.

Read the full story.

EXCERPT:

By Mark Cantrell
Baylor Innovations
YOUR HANDS ARE SHAKING. YOUR KNEES FEEL WEAK. You’re sweating, your heart is pounding like a jackhammer and you feel you can’t catch your breath. You’re having a panic attack, and it seems to have struck without warning.

But did it? A new study conducted at Southern Methodist University in Dallas suggests that panic attacks are actually telegraphed ahead of time by certain physiological changes.

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines a panic attack as a discrete period of intense fear and discomfort in which symptoms such as a racing heart, shortness of breath or dizziness develop suddenly and reach a peak in about 10 minutes.

Those experiencing an attack may believe they’re having a heart attack or stroke. But one of the most distressing things about panic attacks is that they often seem to have no actual cause.

Out of Nowhere?
“Unexpected attacks – as compared to those triggered by certain situations such as flying, being in a closed space or speaking in public – are thought to occur spontaneously, in absence of internal signals or situational triggers,” explains Alicia Meuret, Ph.D., an associate professor at Southern Methodist University and chief investigator of the study.

“The literature on how the body reacts when patients who are prone to them have an unexpected attack is very limited, due to the unexpectedness of the phenomenon. To date we do not know what triggers these attacks, but it is likely that the causes are multifactorial.”

For the study, Dr. Meuret enlisted 43 people with a history of panic attacks to wear portable monitors that captured changes in respiration, heart rate and other bodily functions.

The device was worn in a waist pack, with sensors attached at various points. Elastic bands around the chest and abdomen measured breathing rate, depth and variability.

Electrodes kept track of patients’ cardiac and sweat gland activity, while accelerometers measured body movement. Participants were instructed to press a “panic button” at the moment they felt the onset of an attack, and to write down the symptoms they were feeling at the time.

Read the full story.

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SMU is a nationally ranked private university in Dallas founded 100 years ago. Today, SMU enrolls nearly 11,000 students who benefit from the academic opportunities and international reach of seven degree-granting schools. For more information, www.smu.edu.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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SMU News: 2012 Research Day at Southern Methodist University

Post author By Margaret Allen
Post date February 14, 2012

SMU News covered the annual 2012 Research Day on Feb. 10 where SMU graduate and undergraduate students presented results of their research studies.

Sponsored by SMU’s Office of Research and Graduate Studies, the event sought to foster communication between students in different programs, give students the opportunity to present their work in formats they will use as professionals, and to share with the SMU community and others the outstanding research being done at the University.

The students presented their studies on posters, and were available to discuss their findings and the significance of the research.

Read the full story.

EXCERPT:

Among the projects at the event were:

Psychology student Vanessa Rae Stevens (under Professor Alicia Meuret) is studying whether people with tattoos and body piercings are also prone to intentional self injury by cutting, scratching, burning, etc.

Psychology student Grant Holland (under Professor George Holden) is studying recordings of interactions between mothers and their children with an eye toward better understanding the effects of tone-of-voice on behavior at bedtime.

Statistics student Holly Stovall (under Professor Lynne Stokes) is examining how to more precisely measure success in teaching programs for No Child Left Behind.

Earth sciences student Mary Milleson (under Professor Neil Tabor) is using core samples taken from Dallas’s White Rock Lake to gain a better understanding of how the growing urbanization of the area over the last 100 years is affecting the lake.

Computer science student Ruili Geng (under Professors Jeff Tian and Liguo Huang) is researching how to make the performance of the web and cloud computing more dependable.

Physics students Bedile Karabuga and Mayisha Zeb Nakib (under Professor Jodi Cooley-Sekula) are examining a specific technique for identifying dark matter.
For more information, contact the Office of Research and Graduate Studies at 214-768-4345 or smugrad@smu.edu.

Read the full story.

Tags Alicia E. Meuret, George W. Holden, Grant Holland, Holly Stovall, Jeff Tian, Liguo Huang, Lyle School of Engineering, Lynne Stokes, Mary Milleson, Neil Tabor, Roy M. Huffington Department of Earth Sciences, Ruili Geng, SMU Department of Psychology, SMU Department of Statistical Science, Vanessa Rae Stevens

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HHS Healthbeat: Predicting Panic Attacks

Post author By Margaret Allen
Post date September 22, 2011

Nicholas Garlow with the U.S. Department of Health and Human Services created a podcast about the groundbreaking panic attack research of SMU psychologists Dr. Alicia Meuret, Dr. David Rosenfield and Dr. Thomas Ritz.

The Sept. 22 podcast “Predicting Panic Attacks” details the startling findings of Meuret’s newest published study showing significant physiological instability in advance of so-called out-of-the-blue panic attacks.

Read the text.

Listen to the podcast.

EXCERPT:

By Nicholas Garlow
HHS Healthbeat
From the U.S. Department of Health and Human Services, I???m Nicholas Garlow with HHS HealthBeat.

Your body may give you hints that you’re going to have a panic attack, a short period of intense fear and discomfort. Forty-three panic attack sufferers carried portable recorders that measured respiration, heart rate and other bodily functions, over 2,000 hours.

Alice Meuret is at Southern Methodist University.

“Most of the physiological changes took place long before the patients reported that what they felt was a panic attack.” (10 seconds)

To combat attacks, she suggests:

“Changing respiration when noticing symptoms could be effective in avoiding a full blown panic attack. One should try to breathe as little air as possible, to reverse hyperventilation.’ (14 seconds)

Read the text.

Listen to the podcast.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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The Wall Street Journal: Seeing Signs of a Panic Attack Before One Happens

Post author By Margaret Allen
Post date September 21, 2011

Science journalist Ann Lukits wrote about the groundbreaking panic attack research of SMU psychologists Dr. Alicia Meuret, Dr. David Rosenfield and Dr. Thomas Ritz in the The Wall Street Journal‘s Research Report.

The Sept. 20 article “Seeing Signs of a Panic Attack Before One Happens” details the startling findings of Meuret’s newest published study showing significant physiological instability in advance of so-called out-of-the-blue panic attacks.

Read the full story.

EXCERPT:

By Ann Lukits
The Wall Street Journal
Panic attacks that appeared to strike out of the blue were preceded for almost an hour by significant physiological changes that went undetected by research subjects in a study published in Biological Psychiatry. Panic attacks are intense episodes of terror lasting about 10 minutes that can be unexpected or induced by specific triggers. The disorder, which affects about six million American adults, is twice as common in women as men, according to the National Institute of Mental Health.

Researchers in Texas used portable monitors to record minute-by-minute physiological changes in 43 patients age 23 to 62 with moderate-to-severe panic disorder. Eight indicators, including heart rate, respiration, and skin conductance, an indication of a psychological or physiological reaction to stimuli, were measured during two 24-hour sessions. Patients pressed an event marker when a panic attack occurred and noted the start time. Thirteen attacks averaging eight minutes in length were reported.

Read the full story.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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The Atlantic: The Upside of a Panic Attack: The Worst Is Over Before You Know It

Post author By Margaret Allen
Post date September 16, 2011

Science journalist Hans Villarica wrote about the groundbreaking panic attack research of SMU psychologists Dr. Alicia Meuret, Dr. David Rosenfield and Dr. Thomas Ritz in the The Atlantic.

The Sept. 16 article “The Upside of a Panic Attack: The Worst Is Over Before You Know It” details the startling findings of Meuret’s newest published study showing significant physiological instability in advance of so-called out-of-the-blue panic attacks.

Read the full story.

EXCERPT:

By Hans Villarica
The Atlantic
There are plenty of misperceptions about panic attacks. People often tell the anxiety ridden to “take a deep breath,” for instance, when they may actually already be taking too much oxygen in by hyperventilating. Indeed, what experts say is that breathing should instead be slow, shallow, and regular, so that a constant, very small stream of air comes in through the nose. Paper bags are optional too, as cupped hands do the trick just as well.

New research aims to debunk another myth: Panic attacks occur completely out of the blue. Though those who panic don’t realize it, their attacks are in fact foreshadowed by minute physiological signals, according to a study led by Southern Methodist University’s Alicia Meuret in the journal Biological Psychiatry. “The hour before panic onset was marked by subtle but significant waves of changes in patient’s breathing and cardiac activity, not just the moment of onset of the attack or even during the attack,” she says. “Our analysis provided us with a whole different pattern.”

That pattern goes like this: Physiological instabilities occur in repeated bouts or waves and are often initiated by heart rate accelerations, followed by changes in breathing and carbon dioxide levels. Ultimately, breathing becomes much shallower, causing a spike in carbon dioxide levels that lead to symptoms that could no longer escape the attention of those who panic. More precisely, they experience terrifying sensations, such as dizziness, air hunger, and shortness of breath.

Read the full story.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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Patch: Panic Attack — It May Not Be a Sneak Attack After All

Post author By Margaret Allen
Post date August 8, 2011

The nationally distributed online community news service Patch.com has covered the research of SMU psychologist Dr. Alicia Meuret showing panic attacks that seem to strike out-of-the-blue are not without warning after all.

Meuret’s study found significant physiological instability one hour before patients reported feeling a panic attack. The findings suggest potentially new treatments for panic, and re-examination of other “unexpected” medical problems, including seizures, strokes and manic episodes, says Meuret, an assistant professor in the SMU Department of Psychology. She was lead researcher on the study. Dr. David Rosenfield, an associate professor in SMU’s Department of Psychology, was lead statistician.

They reported the results in the journal Biological Psychiatry in the article “Do Unexpected Panic Attacks Occur Spontaneously?”

Read the full story.

The online community news service Patch has covered the research of SMU psychologist Dr. Alicia Meuret, which found that panic attacks that seem to strike out-of-the-blue are not without warning after all.

EXCERPT:

By Treacy Colbert
Patch.com
It comes on suddenly — your body ambushes you with dizziness, nausea, sweat, a racing pulse and, worst of all, an impending sense of doom. It’s a panic attack, and while it feels like a sneak attack to most sufferers, a new study shows that many people may actually experience warning signs that simply go undetected.

Sufferers describe symptoms such as pounding heart, dizziness, nausea, a sense of impending doom, sweating, shaking, and shortness of breath, among others.

Not all panic attacks are unexpected. A person who has an intense fear of enclosed spaces or of flying on an airplane can expect that being in a packed elevator or on a flight will cue a panic attack. However, those who suffer from seemingly unpredictable panic attacks often report that the fear of having another random attack can be paralyzing. Sufferers frequently alter their lifestyle and even isolate themselves out of fear that an attack will come on without warning.

But new research from Southern Methodist University (SMU) in Dallas suggests that the body produces warning signs of an impending panic attack as early as an hour beforehand. Significantly, the study reveals that sufferers were unaware of these advance signals. They report their attack as a sudden, out-of-the-blue experience???but don’t seem to sense the physical changes that were gathering and leading up to the full-blown sense of panic.

In the study, researchers monitored physiological changes in 43 patients who suffer from panic disorder. Electrodes and sensors attached to their bodies measured their respiration, analyzing fast or irregular breathing, as well as heart rate, evidence of sweating, and other physiological signs. Participants in the study wore the monitors for 24 hours on two occasions, and a total of 1,960 hours of data was collected.

During this time participants experienced 13 unexpected panic attacks. However, the data analysis revealed that symptoms such as hyperventilating accumulated and gathered prior to the attack but that the panic attack sufferers did not pick up on these signals.

“It is hard to control something that one does not sense,” noted Alicia Meuret, Ph.D., assistant professor of psychology at Southern Methodist University and lead author of the study.

Read the full story.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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Medscape: Panic Attacks Don’t Come Out of the Blue After All

Post author By Margaret Allen
Post date August 4, 2011

Medscape, the medical blog serving physicians and the healthcare community, has covered the research of SMU psychologist Dr. Alicia Meuret showing panic attacks that seem to strike out-of-the-blue are not without warning after all.

They reported the results in the journal Biological Psychiatry in the article “Do Unexpected Panic Attacks Occur Spontaneously?”

Full article available with free registration with Medscape.

EXCERPT:

By Megan Brooks
Medscape
Panic attacks do not come “out of the blue” but are preceded by physiological changes similar to those that precede seizures, stroke, and even manic episodes, a new study suggests.

“There is reason to believe that waves of physiological instability occur for a substantial period of time before the attack is reported by patients,” Alicia E. Meuret, PhD, an assistant professor from the Department of Psychology, Southern Methodist University, in Dallas, Texas, who led the study, told Medscape Medical News.

The finding may have relevance for other medical disorders where symptoms seemingly happen “out of the blue,” such as seizures, strokes, and even manic episodes, the researchers note.

There is speculation that panic attacks are triggered by marked changes in physiology, in particular breathing, Dr. Meuret explained. However, until now, very little is known on the physiological functioning of those with panic attacks outside the laboratory.

In the current study, 43 patients with panic disorder underwent repeated 24-hour ambulatory monitoring of various physiological indices, including respiration, heart rate, and skin conductance level. During 1960 hours of monitoring, 13 natural panic attacks were recorded.

“We managed to capture spontaneously occurring attacks in these recordings, which we were able to examine closer. The study marks the first to gain an in-depth look into what occurs in early stages before a panic attack occurs,” Dr. Meuret said. The investigators specifically analyzed the 60 minutes before panic onset and during the panic attack.

Full article available with free registration with Medscape.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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UPI: Panic attacks may be predictable

Post author By Margaret Allen
Post date August 4, 2011

The wire service UPI has covered the research of SMU psychologist Dr. Alicia Meuret showing panic attacks that seem to strike out-of-the-blue are not without warning after all.

They reported the results in the journal Biological Psychiatry in the article “Do Unexpected Panic Attacks Occur Spontaneously?“

Read the full wire story.

EXCERPT:

UPI
DALLAS, July 27 (UPI) — Panic attacks that seem to strike out-of-the-blue are not without warning after all, U.S. researchers say.

Lead researcher Alicia E. Meuret, a psychologist at Southern Methodist University in Dallas, says the study is based on 24-hour monitoring of panic sufferers while they went about their daily activities. Portable recorders captured changes in respiration, heart rate and other bodily functions, Meuret says.

The researchers captured panic attacks as they occurred and discovered waves of significant physiological instability for at least 60 minutes before patients’ awareness of the panic attacks, Meuret says.

Read the full wire story.

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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Out-of-the-blue panic attacks aren’t without warning; data show subtle changes before patients’ aware of attack

Post author By Margaret Allen
Post date July 26, 2011

Panic attacks that seem to strike sufferers out-of-the-blue are not without warning after all, according to new research.

A study based on 24-hour monitoring of panic sufferers while they went about their daily activities captured panic attacks as they happened and discovered waves of significant physiological instability for at least 60 minutes before patients’ awareness of the panic attacks, said psychologist Alicia E. Meuret at Southern Methodist University in Dallas.

In a rare study in which patients were monitored around-the-clock, portable recorders captured changes in respiration, heart rate and other bodily functions, said Meuret, lead researcher on the study.

The new findings suggest sufferers of panic attacks may be highly sensitive to — but unaware of — an accumulating pattern of subtle physiological instabilities that occur before an attack, Meuret said.

Monitoring data also showed patients were hyperventilating on a chronic basis.

Simulated panic sufferer and monitoring equipment. (Photo: SMU)

“The results were just amazing,” Meuret said. “We found that in this hour preceding naturally occurring panic attacks, there was a lot of physiological instability. These significant physiological instabilities were not present during other times when the patient wasn’t about to have a panic attack.”

It is notable that patients reported the attacks as unexpected, lacking awareness of either the coming attack or their changing physiology.

“The changes don’t seem to enter the patient’s awareness,” Meuret said. “What they report is what happens at the end of the 60 minutes — that they’re having an out-of-the blue panic attack with a lot of intense physical sensations. We had expected the majority of the physiological activation would occur during and following the onset of the panic attack. But what we actually found was very little additional physiological change at that time.”

Unexpected attacks have been a mystery; little research to explain them
The diagnostic standard for psychological disorders, the DSM-IV, defines panic attacks as either expected or unexpected.

Those that are expected, or cued, occur when a patient feels an attack is likely, such as in closed spaces, while driving or in a crowded place.

“But in an unexpected panic attack, the patient reports the attack to occur out-of-the-blue,” Meuret said. “They would say they were sitting watching TV when they were suddenly hit by a rush of symptoms, and there wasn’t anything that made it predictable.”

To sufferers and researchers alike, the attacks are a mystery.

Change-point analysis uncovered physiological instabilities one hour before attacks
Meuret and her colleagues discovered the significant physiological instabilities using change-point analysis, a statistical method that searches for points when changes occur in a “process” over time.

“This analysis allowed us to search through patients’ physiological data recorded in the hour before the onset of their panic attacks to determine if there were points at which the signals changed significantly,” said psychologist David Rosenfield of SMU, lead statistician on the project.

The study is significant not only for panic disorder, but also for other medical problems where symptoms and events have seemingly “out-of-the blue” onsets, such as seizures, strokes and even manic episodes.

“I think this method and study will ultimately help detect what’s going on before these unexpected events and help determine how to prevent them,” Meuret said. “If we know what’s happening before the event, it’s easier to treat it.”

Meuret, an assistant professor in the SMU Department of Psychology, reported the results in the journal Biological Psychiatry in the article “Do Unexpected Panic Attacks Occur Spontaneously?” Rosenfield is an associate professor in SMU’s Department of Psychology.

A multi-disciplinary collaboration, other authors on the study were psychologist Thomas Ritz, SMU Department of Psychology; psychologist Frank H. Wilhelm, University of Salzburg, Austria; electrical engineer Enlu Zhou, University of Illinois at Urbana-Champaign; and psychologist Ansgar Conrad and psychiatrist Walton T. Roth, both of Stanford University.

Meuret discusses the research in an SMU Research youtube video.

Subtle physical changes impact panic sufferers more severely
People with panic disorder probably won’t be surprised by the results, Meuret said.

By definition, the majority of the 13 symptoms of panic attack are physiological: shortness of breath, heart racing, dizziness, chest pain, sweating, hot flashes, trembling, choking, nausea and numbness. Only three are psychological: feeling of unreality, fear of losing control and fear of dying.

“Most patients obviously feel that there must be something going on physically,” Meuret said. “They worry they’re having a heart attack, suffocating or going to pass out. Our data doesn’t indicate there’s something inherently wrong with them physically, neither when they are at rest nor during panic. The fluctuations that we discovered are not extreme; they are subtle. But they seem to build up and may result in a notion that something catastrophic is going on.”

Notably, the researchers found that patients’ carbon dioxide, or C02, levels were in an abnormally low range, indicating the patients were chronically hyperventilating. These levels rose significantly shortly before panic onset and correlated with reports of anxiety, fear of dying and chest pain.

“It has been speculated, but never verified with data recordings in daily life, that increases in CO2 cause feelings of suffocation and can be panic triggers,” Meuret said.

Fanny pack monitor tracked physiological changes before, during and after attacks
To capture the physiological data, 43 patients wore the monitoring devices for 24 hours on two separate occasions. The researchers collected 1,960 hours of ambulatory monitoring data, including 13 unexpected panic attacks.

Participants, all of whom suffer from panic disorder, were each outfitted with an array of electrodes and sensors attached to various parts of their bodies.

The ambulatory monitoring device was toted in a small waist pack the patients wore. Also included was a portable capnometer to measure CO2 collected from exhaled breath. The physiological responses were recorded continuously as digital data in a time series.

Each monitoring pack included a “panic button.” Patients were instructed to press the button if they had an attack and to write down their symptoms. By triggering the panic button, patients inserted a marker into the time-series data, marking the moment the attack began.

The sensors measured eight physiological indices, including changes in respiration, such as how deep, fast or irregular people were breathing; cardiac activity; and evidence of sweating.

Data analysis found strikingly significant changes in the hour before attacks
From the nearly 2,000 hours of data, the change-point analysis program allowed the researchers to slice out 70-minute periods around each of the 13 panic attacks — from one hour before onset until 10 minutes after the attacks began.

For each index, the program checked for any significant change in the signal that remained stable over a specified period of time.

Those results were collapsed across all 13 panic attacks, with minute-by-minute averages. The information was then compared to a 70-minute control period randomly chosen during non-panic periods.

“We found 15 subtle but significant changes an hour before the onset of the panic attacks that followed a logical physiological pattern. These weren’t present during the non-panic period,” Meuret said.

“Why they occurred, we don’t know. We also can’t say necessarily they were causal for the panic attacks. But the changes were strikingly and significantly different to what was observed in the non-panic control period,” she said.

Findings prompt look at “panic” definition and treatment
The study’s results invite a reconsideration of the DSM diagnostic definition that separates “expected” from “unexpected” attacks, Meuret said.

Also, the study might explain why medication or interventions aimed at normalizing respiration for treating panic are effective, she said. Medication generally buffers arousal, keeping it low and regular, thereby preventing unexpected panic attacks.

For psychological treatments such as Cognitive Behavior Therapy (CBT), the results are more challenging. CBT requires a patient to focus on examining thoughts to prevent an attack.

“But a patient can’t work on something they don’t know is going to happen,” Meuret said.

New methodology can be universalized to other unexpected medical problems
The study’s use of change-point analysis can be applied to other medical issues. Traditional statistics are ineffective at analyzing such data, Meuret said, because they look only at level differences at pre-determined times and won’t find a signal for an unknown point.

“This study is a step toward more understanding and hopefully opening more doors for research on medical events that are difficult to predict. The hope is that we can then translate these findings into new therapies,” she said.

The research was funded by the National Institutes of Mental Health, Department of Veterans Affairs and the Beth and Russell Siegelman Foundation. — Margaret Allen

Tags Alicia E. Meuret, David Rosenfield, Dedman College, SMU Department of Psychology, Thomas Ritz

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The Wall Street Journal: Help for Hyperventilating

Post author By Margaret Allen
Post date February 8, 2011

A new treatment that helps people with panic disorder to normalize their breathing works better to reduce panic symptoms and hyperventilation than traditional cognitive therapy, says SMU psychologist Alicia E. Meuret.

Shirley S. Wang, a health reporter for The Wall Street Jounal, interviewed the SMU psychology department’s Meuret for an article about her research findings that the feeling of suffocation that comes with panic attacks can be alleviated by breathing less — not more.

The Feb. 8 article “Help for Hyperventilating” tells readers that deep breathing reduces carbon dioxide in the system, which in turn increases hyperventilation — that scary feeling of suffocating.

The findings, “Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity,” appeared in the Journal of Consulting and Clinical Psychology. Meuret, who developed CART, is an assistant professor in the Department of Psychology at SMU and co-directs the department’s Stress, Anxiety and Chronic Disease Research Program.

Book a live interview

To book a live or taped interview with Alicia Meuret in the SMU News Broadcast Studio call SMU News at 214-768-7650 or email news@smu.edu.

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The study pitted CART against a conventional cognitive therapy treatment, or CT. Traditional CT teaches patients techniques aimed at helping them change and reverse catastrophic thoughts in order to reduce fear and panic.

In the CART-CT study, 41 patients were assigned to complete either a CART or CT treatment program for panic disorder and agoraphobia, a fear of being trapped with no means of escape or help.

EXCERPT:

By Shirley S. Wang The Wall Street Journal Researchers are developing a new therapy for panic attacks by turning the current treatment for one of the most uncomfortable symptoms — hyperventilation — on its head. Instead of urging sufferers to take long, deep breaths when they feel they can’t breathe, as many were taught for years, researchers from Southern Methodist University say a more effective strategy is to take slower, shallow breaths. In the throes of a panic attack, sufferers experience symptoms like heart racing, profuse sweating and feelings of suffocation. They may think they are having a heart attack or believe they will faint or die. It’s unclear if hyperventilation is a cause or a consequence of panic attacks. Some 10% to 15% of the U.S. population experience occasional panic attacks, usually during a stressful situation, but about 2% develop panic disorder, in which people become so anxious about having attacks that they begin avoiding situations for fear for having one, according to anxiety expert David Barlow, a psychology and psychiatry professor at Boston University. Only about two-thirds of patients respond to current treatments, says Dr. Barlow. These include medications known as selective serotonin reuptake inhibitors and cognitive-behavioral therapy. The latter teaches sufferers to refrain from thinking catastrophic thoughts when they experience the physiological symptoms and to accustom themselves to the sensations to show that they aren’t harmful.

Read the full story.

Tags Alicia E. Meuret, SMU Department of Psychology, Wall Street Journal

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Cosmopolitan: Feeling stressed and panicked? Don’t take a deep breath!

Post author By Margaret Allen
Post date January 5, 2011

Cosmopolitan magazine has taken note of the research of SMU psychology department Assistant Professor Alicia E. Meuret. Their Jan. 3 article “The 3-Second Trick to Beat Stress” tells readers that if they want to conquer that panicky feeling of suffocation when stressed and feeling anxious — forget about taking a deep breath.

EXCERPT:

By Zoe Ruderman
Cosmopolitan
You’ve probably been told that one of the first things you should do when you’re feeling panicky is to take a deep breath. But according to a new study, not only will that technique not help you calm down, but it could make you freak out even more.

Researchers at Southern Methodist University in Dallas say that found that when a person faced with nerve-wracking situations takes deep, slow breaths, she may feel like she’s hyperventilating, therefore making her more worked up. So what should you do when your boss calls you into a meeting you forgot about or you’re stuck in traffic? Take shallow, slow breaths.

Read the full story.

Tags Alicia E. Meuret, Anke Seidel, David Rosenfield, Lavanya Bhaskara, SMU Department of Psychology

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Live Science: Less is more when breathing to relieve panic

Post author By Margaret Allen
Post date January 5, 2011

Live Science news site interviewed SMU psychology department Assistant Professor Alicia E. Meuret for an article about her research findings that the hyperventilation that comes with panic attacks can be alleviated by breathing less — not more. The Dec. 26 article “To Stave Off Panic, Don’t Take a Deep Breath” tells readers that deep breathing reduces carbon dioxide in the system, which in turn causes symptoms like dizziness and numbness.

EXCERPT:

By Stephanie Pappas
Live Science
A new treatment for the feeling of suffocation that accompanies a panic attack focuses on getting patients to breathe less.

The treatment, which involves a technique for altering your breathing, is more effective at alleviating both short-term panic disorder symptoms and hyperventilation than traditional psychological therapy, and it may make people less prone to panic attacks in the first place, said study leader Alicia Meuret of Southern Methodist University in Dallas.

The treatment is called capnometry-assisted respiratory training, or CART.

“In a certain way, CART was superior because it was changing the psychological symptoms and the abnormal physiological state,” Meuret told LiveScience.

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Tags Alicia E. Meuret, Anke Seidel, David Rosenfield, Lavanya Bhaskara, SMU Department of Psychology

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A new breathing therapy reduces panic and anxiety by reversing hyperventilation

Post author By Margaret Allen
Post date December 16, 2010

Breakthrough “CART” treatment better than traditional cognitive therapy at altering hyperventilation and panic symptoms

http://www.youtube.com/watch?v=AcQsJnLBWpE

A new treatment program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing.

The method has proved better than traditional cognitive therapy at reducing both symptoms of panic and hyperventilation, according to a new study.

The biological-behavioral treatment program is called Capnometry-Assisted Respiratory Training, or CART, said psychologist and panic disorder expert Alicia E. Meuret at Southern Methodist University in Dallas.

CART helps patients learn to breathe in such a way as to reverse hyperventilation, a highly uncomfortable state where the blood stream operates with abnormally low levels of carbon dioxide, said Meuret, one of the researchers conducting the study.

Hyperventilation, a state of excessive breathing, results from deep or rapid breathing and is common in patients with panic disorders.

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To book a live or taped interview with Alicia Meuret in the SMU News Broadcast Studio call SMU News at 214-768-7650 or email news@smu.edu.

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“We found that with CART it’s the therapeutic change in carbon dioxide that changes the panic symptoms — and not vice versa,” Meuret said.

CART: Breathing exercises twice a day
During the treatment, patients undergo simple breathing exercises twice a day. A portable capnometer device supplies feedback during the exercises on a patient’s CO2 levels. The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly. Contrary to lay belief, taking deep breaths actually worsens hyperventilation and symptoms.

“Most panic-disorder patients report they are terrified of physical symptoms such as shortness of breath or dizziness,” Meuret said. “In our study, cognitive therapy didn’t change respiratory physiology, but CART did effectively reduce hyperventilation. CART was proved an effective and powerful treatment that reduces the panic by means of normalizing respiratory physiology.”

CART breathing a proven biological therapy
The study pitted CART against a conventional cognitive therapy treatment, or CT. Traditional CT teaches patients techniques aimed at helping them change and reverse catastrophic thoughts in order to reduce fear and panic.

In the CART-CT study, 41 patients were assigned to complete either a CART or CT treatment program for panic disorder and agoraphobia, a fear of being trapped with no means of escape or help.

Both treatment programs were equally effective in reducing symptoms, said Meuret. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients. Cognitive therapy didn’t change the respiratory physiology, said Meuret.

Treatment helps patients address terror associated with panic
The study is the second randomized control trial to measure CART’s effectiveness. By reversing hyperventilation, patients reported a new ability to reduce panic symptoms by means of changing their respiration.

With CT, Meuret said, if a patient reports shortness of breath, the therapist challenges the assumption by asking how often the person actually has suffocated during a panic attack, then hopes that will reverse the patient’s thinking.

“I found that process very challenging for some of my patients because it acknowledges the symptom but says it’s not a problem,” Meuret said.

“CART, however, tells us a patient’s CO2 is very low and is causing many of the symptoms feared, but it can also show how to change these symptoms through correct breathing. There has been an assumption that if people worry less about symptoms it will also normalize their physiology, but this study shows that this is not the case,” she said. “Hyperventilation remains unchanged, which could be a risk factor for relapse down the road. Apart from hyperventilation being a symptom generator, it is an unhealthy biological state associated with negative health outcomes.”

Broader study planned to measure CART
The researchers plan to branch out with their studies on CART by taking the program into the community, particularly to ethnic minorities. They believe CART is a more universally understood treatment due to its physical exercises — as opposed to cognitive therapy’s more intellectual methods — and therefore more accessible to a broader range of people with varying levels of education and different cultural backgrounds. Ongoing studies will test the efficacy of CART in patients with asthma and fear of blood.

Co-authors of the study at SMU were David Rosenfield, associate psychology professor, and psychology graduate students Anke Seidel and Lavanya Bhaskara. Stefan G. Hofmann, psychology professor at Boston University, was also an author on the paper. The research was funded by the Beth & Russell Siegelman Foundation. — Austin Reed

SMU is a private university in Dallas where nearly 11,000 students benefit from the national opportunities and international reach of SMU’s seven degree-granting schools. For more information see www.smu.edu.

SMU has an uplink facility on campus for live TV, radio or online interviews. To speak with Dr. Meuret or to book an interview with her in the SMU studio, call SMU News & Communications at 214-768-7650.

Tags Alicia E. Meuret, Anke Seidel, David Rosenfield, Lavanya Bhaskara, SMU Department of Psychology

Health & Medicine Mind & Brain

Breathing technique can reduce frequency, severity of asthma attacks

Post author By Margaret Allen
Post date August 14, 2009

Mueret10%2C-9-09%2Clr.jpg As the health care reform debate turns to cutting costs and improving treatment outcomes, two SMU professors are expanding a study that shows promise for reducing both the expense and suffering associated with chronic asthma.

Thomas Ritz and Alicia Meuret, both of SMU’s Psychology Department, have developed a four-week program to teach asthmatics how to better control their condition by changing the way they breathe.

With the help of a four-year, $1.4 million grant from the National Institutes of Health, they plan to engage 120 Dallas County patients in four weeks of breathing training by the study’s projected end in July 2012. Their co-investigators include David Rosenfield, also of SMU’s Psychology Department, and Mark Millard, M.D., of Baylor University Medical Center.

Mueret8%2C-9-09%2Clr.jpg More than 22 million Americans suffer from asthma at an estimated annual economic cost of more than $19 billion, according to the American Lung Association. The number of cases doubled between 1980 and 1995, prompting the U.S. Department of Health and Human Services to classify the disease as an epidemic in 2000.

During an attack, sufferers tend to hyperventilate, breathing fast and deep against constricted airways to fight an overwhelming feeling of oxygen deprivation.

Unfortunately, this makes the problem worse by lowering the body’s carbon dioxide levels, which restricts blood flow to the brain and can further irritate already hypersensitive bronchial passages.

Patients who “overbreathe” on a sustained basis risk chronic CO₂ deficiencies that make them even more vulnerable to future attacks. Rescue medications that relieve asthma symptoms do nothing to correct breathing difficulties associated with hyperventilation.

As part of SMU’s Stress, Anxiety and Chronic Disease Research Program, Ritz and Meuret use their biofeedback-based Capnometry-Assisted Respiratory Training (CART) to teach asthma patients to normalize and reverse chronic overbreathing. A hand-held device called a capnometer measures the amount of CO₂ exhaled. Using this device, patients learn how to breathe more slowly, shallowly and regularly.

Mueret4a%2C-9-09%2Clr.jpg CART techniques could have a positive impact on quality of asthma treatment even as they reduce the need for acute care, Ritz says.

“The research shows that this kind of respiratory therapy can limit both the severity and frequency of asthma attacks,” he says. “That means fewer doctor visits and less frequent use of rescue medications, with the associated savings of both time and money.”

And for those who count any year without a trip to the emergency room as a year with a good treatment outcome, that means a higher quality of life, says Meuret, who lives with asthma herself.

“The training gives patients new ways to deal with acute symptoms, and that helps them to feel more in control,” she says. — Kathleen Tibbetts

(Photos: SMU Professor Alicia Meuret uses biofeedback data to demonstrate the relationship between oxygen and carbon dioxide levels in hyperventilation.)

News coverage:
ScienceDaily
physorg.com
Health.am
e! Science News
RTMagazine.com
medindia.net
Bio-Medicine.org
medicalnewstoday.com

Tags Alicia E. Meuret, Dedman College, SMU Department of Psychology, Thomas Ritz

Health & Medicine Mind & Brain

Deep breathing worsens panic-attack symptoms

Post author By Margaret Allen
Post date September 15, 2008

Southern Methodist University psychology professor Alicia Meuret proves conventional wisdom is dead wrong: A person suffering a panic attack who tries deep breathing to calm themselves only increases his or her level of hyperventilation and overall panic-related symptoms.

Meuret’s solution? Self-training to expel lesser amounts of carbon dioxide using a hand-held, biofeedback device results in the ability to normalize breathing and avoid hyperventilation.

Tags Alicia E. Meuret, Dedman College, SMU Department of Psychology

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Breakthrough “CART” treatment better than traditional cognitive therapy at altering hyperventilation and panic symptoms

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