Aversive responding to safety signals in panic disorder: The moderating role of intolerance of uncertainty

Stephanie M. Gorka, Lynne Lieberman, Brady D. Nelson, Casey Sarapas, Stewart A Shankman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


An inability to inhibit aversive responding during conditions that signal safety may be a core dysfunction associated with anxiety disorders. However, there has been inconsistent evidence as to whether individuals with panic disorder (PD) exhibit aversive responding during safety signals. It is therefore possible that only certain subgroups of PD patients, particularly those with high levels of intolerance of uncertainty (IU), evidence this type of abnormal responding. The aim of the current study was to examine whether IU moderates the association between PD and startle potentiation during (a) safety and (b) threat periods during a threat-of-shock task. Participants included 172 adults, 74 of which had current diagnoses of PD. Results indicated that at high levels of IU, PD was associated with greater startle potentiation during safety. At low levels of IU, PD was not associated with startle potentiation during safety. IU did not moderate the effect of PD on threat responding. These results suggest that PD patients with high levels of IU fail to inhibit aversive responding during safety, possibly due to a tendency to interpret distal threat as distressing.

Original languageEnglish (US)
Pages (from-to)731-736
Number of pages6
JournalJournal of Anxiety Disorders
Issue number7
StatePublished - Oct 2014


  • Panic disorder
  • Safety signals
  • Startle
  • Uncertainty

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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