Skip to main content

Exposure Therapy when Patients Present with Asthma

  • Chapter
  • First Online:
Clinical Guide to Exposure Therapy
  • 1210 Accesses

Abstract

Asthma is a major chronic health problem affecting over 300 million individuals worldwide. Asthma and anxiety are highly comorbid, causing reciprocal poorer outcomes in illness management and treatment. This chapter explores basic information about the asthma disease process, comorbid psychological presentations, disease management and medication interactions, symptom differentiation, and important considerations for therapists treating a patient with asthma. The chapter additionally reviews how exposure-based therapies can be safely and effectively harnessed to help alleviate both psychological and physical suffering in patients with asthma. Presentations illustrate how brief exposure-based interventions can be used in both outpatient and medical inpatient settings. Finally, specific exposure ideas, as well as traditional exposures, contraindicated for patients with asthma are provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahmed, A., & Graber, M. A. (2020, September). Evaluation of the adult with dyspnea in the emergency department. UpToDate. Retrieved October 2020, from https://www.uptodate.com/contents/evaluation-of-the-adult-with-dyspnea-in-the-emergency-department

  • Alius, M. G., Pané-Farré, C. A., Von Leupoldt, A., et al. (2013). Induction of dyspnea evokes increased anxiety and maladaptive breathing in individuals with high anxiety sensitivity and suffocation fear. Psychophysiology, 50(5), 488–497.

    Article  PubMed  Google Scholar 

  • Balkrishnan, R., Christensen, D. B., & Bowton, D. L. (2002). Self-reported health status, prophylactic medication use, and healthcare costs in older adults with asthma. Journal of the American Geriatrics Society, 50(5), 924–929.

    Article  PubMed  Google Scholar 

  • Bobb, C., Ritz, T., Rowlands, G., et al. (2010). Effects of allergen and trigger factor avoidance advice in primary care on asthma control: A randomized-controlled trial. Clinical and Experimental Allergy, 40(1), 143–152.

    PubMed  Google Scholar 

  • Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2007). Anxiety disorders and suicidal behaviours in adolescence and young adulthood: Findings from a longitudinal study. Psychological Medicine, 37(3), 431–440.

    Article  PubMed  Google Scholar 

  • Bonala, S. B., Pina, D., Silverman, B. A., et al. (2003). Asthma severity, psychiatric morbidity, and quality of life: Correlation with inhaled corticosteroid dose. Journal of Asthma, 40(6), 691–699.

    Article  Google Scholar 

  • Bonnert, M., Andersson, E., Serlachius, E., et al. (2020). Exposure-based cognitive behavior therapy for anxiety related to asthma: A feasibility study with multivariate baseline design. Scandinavian Journal of Psychology, 61(6), 827–834.

    Article  PubMed  Google Scholar 

  • Boudreau, M., Bacon, S. L., Paine, N. J., et al. (2017). Impact of panic attacks on bronchoconstriction and subjective distress in asthma patients with and without panic disorder. Psychosomatic Medicine, 79(5), 576–584.

    Article  PubMed  Google Scholar 

  • Bruzzese, J. M., Sheares, B. S., Vincent, E. J., et al. (2011). Effects of a school-based intervention for urban adolescents with asthma a controlled trial. American Journal of Respiratory and Critical Care Medicine, 183(8), 998–1006.

    Article  PubMed  Google Scholar 

  • Bruzzese, J. M., Unikel, L., Gallagher, R., et al. (2008). Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: Results from a randomized pilot trial. Family Process, 47(1), 95–113.

    Article  PubMed  Google Scholar 

  • Butler, A. C., Chapman, J. E., Forman, E. M., et al. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17–31.

    Article  PubMed  Google Scholar 

  • Carr, R. E. (1998). Panic disorder and asthma: Causes, effects and research implications. Journal of Psychosomatic Research, 44(1), 43–52.

    Article  PubMed  Google Scholar 

  • Center for Disease Control (2016). Behavioral Risk Factor Surveillance System (BRFSS)— Adult Asthma Call-back Survey Data.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2019). CDC’s National Asthma Control Program Asthma stats. July 2019. Accessed January 20, 2021. Available at: https://www.cdc.gov/asthma/asthma_stats/default.htm

  • D’Alba, I., Carloni, I., Ferrante, A. L., et al. (2015). Hyperventilation syndrome in adolescents with and without asthma. Pediatric Pulmonology, 50(12), 1184–1190.

    Article  PubMed  Google Scholar 

  • Dal Negro, R., & Allegra, L. (1989). Blood gas changes during and after nonspecific airway challenge in asthmatic and normal subjects. Journal of Applied Physiology (Bethesda, Md. : 1985), 67(6), 2627–2630.

    Google Scholar 

  • de Groot, E. P., Duiverman, E. J., & Brand, P. L. (2013). Dysfunctional breathing in children with asthma: A rare but relevant comorbidity. European Respiratory Journal, 41(5), 1068–1073.

    Article  PubMed  Google Scholar 

  • Dirks, J. F., Fross, K. H., & Paley, A. (1978). Panic-fear in asthma—State-trait relationship and rehospitalization. Journal of Chronic Diseases, 31(9–10), 605–609.

    Article  PubMed  Google Scholar 

  • Dirks, J. F., Schraa, J. C., Brown, E. L., et al. (1980). Psycho-maintenance in asthma: Hospitalization rates and financial impact. British Journal of Medical Psychology, 53(4), 349–354.

    Article  PubMed  Google Scholar 

  • Fardet, L., Petersen, I., & Nazareth, I. (2012). Suicidal behaviors and severe neuropsychiatric disorders following glucocorticoid therapy in primary care. American Journal of Psychiatry, 169(5), 491–497.

    Article  PubMed  Google Scholar 

  • Favreau, H., Bacon, S. L., Labrecque, M., et al. (2014). Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up. Psychosomatic Medicine, 76(2), 147–155.

    Article  PubMed  Google Scholar 

  • Feldman, J. M., Matte, L., Interian, A., et al. (2016). Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial. Behaviour Research and Therapy, 87, 142–154.

    Article  PubMed  PubMed Central  Google Scholar 

  • Feldman, J. M., Siddique, M. I., Morales, E., et al. (2005). Psychiatric disorder and asthma outcomes among high-risk inner-city patients. Psychosomatic Medicine, 67(6), 989–996.

    Article  PubMed  Google Scholar 

  • Freire, R. C., Perna, G., & Nardi, A. E. (2010). Panic disorder respiratory subtype: Psychopathology, laboratory challenge tests, and response to treatment. Harvard Review of Psychiatry, 18(4), 220–229.

    Article  PubMed  Google Scholar 

  • GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the global burden of disease study 2016. Lancet (London, England), 390(10100), 1211–1259.

    Article  Google Scholar 

  • Gibson, P. G., Powell, H., Coughlan, J., et al. (2003). Self-management education and regular practitioner review for adults with asthma. Cochrane Database Systematic Reviews, 1, CD001117.

    Google Scholar 

  • Gillespie, D. J., & Staats, B. A. (1994). Unexplained dyspnea. Mayo Clinic Proceedings, 69(7), 657–663.

    Article  PubMed  Google Scholar 

  • Global Initiative for Asthma (GINA). (2005). Global strategy for asthma management and prevention: NHLIB/WHO workshop report. National Institutes of Health, National Heart, Lung and Blood Institute.

    Google Scholar 

  • Goodwin, R. D., & Eaton, W. W. (2003). Asthma and the risk of panic attacks among adults in the community. Psychological Medicine, 33(5), 879–885.

    Article  PubMed  Google Scholar 

  • Goodwin, R. D., Messineo, K., Bregante, A., et al. (2005). Prevalence of probable mental disorders among pediatric asthma patients in an inner-city clinic. Journal of Asthma, 42(8), 643–647.

    Article  Google Scholar 

  • Goodwin, R. D., Olfson, M., Shea, S., et al. (2003). Asthma and mental disorders in primary care. General Hospital Psychiatry, 25(6), 479–483.

    Article  PubMed  Google Scholar 

  • Greaves, C. J., Eiser, C., Seamark, D., et al. (2002). Attack context: An important mediator of the relationship between psychological status and asthma outcomes. Thorax, 57(3), 217–221.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gridina, I., Bidat, E., Chevallier, B., et al. (2013). Prévalence du syndrome d’hyperventilation chronique chez les enfants et les adolescents [Prevalence of chronic hyperventilation syndrome in children and teenagers]. Archives de pediatrie: organe officiel de la Societe francaise de pediatrie, 20(3), 265–268.

    Article  Google Scholar 

  • Haarasilta, L., Marttunen, M., Kaprio, J., et al. (2003). Major depressive episode and health care use among adolescents and young adults. Social Psychiatry and Psychiatric Epidemiology, 38(7), 366–372.

    Article  PubMed  Google Scholar 

  • Herxheimer, H. (1946). Hyperventilation asthma. Lancet, 247(6386), 83–87.

    Article  Google Scholar 

  • Jaunay, E., Consoli, A., Greenfield, B., et al. (2006). Treatment refusal in adolescents with severe chronic illness and borderline personality disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 15(3), 135–142.

    Google Scholar 

  • Jeter, A. M., Kim, H. C., Simon, E., et al. (2012). Hypoventilation training for asthma: A case illustration. Applied Psychophysiology and Biofeedback, 37(1), 63–72.

    Article  PubMed  PubMed Central  Google Scholar 

  • Joseph, K. S., Blais, L., Ernst, P., et al. (1996). Increased morbidity and mortality related to asthma among asthmatic patients who use major tranquillisers. BMJ (Clinical research ed.), 312(7023), 79–82.

    Article  Google Scholar 

  • Judd, L. L., Schettler, P. J., Brown, E. S., et al. (2014). Adverse consequences of glucocorticoid medication: Psychological, cognitive, and behavioral effects. The American Journal of Psychiatry, 171(10), 1045–1051.

    Article  PubMed  Google Scholar 

  • Karnani, N. G., Reisfield, G. M., & Wilson, G. R. (2005). Evaluation of chronic dyspnea. American Family Physician, 71(8), 1529–1537.

    PubMed  Google Scholar 

  • Katon, W. J., Richardson, L., Lozano, P., et al. (2004). The relationship of asthma and anxiety disorders. Psychosomatic Medicine, 66(3), 349–355.

    PubMed  Google Scholar 

  • Kew, K. M., Nashed, M., Dulay, V., et al. (2016). Cognitive behavioural therapy (CBT) for adults and adolescents with asthma. The Cochrane Database of Systematic Reviews, 9(9), CD011818.

    PubMed  Google Scholar 

  • Kim, S., Wollburg, E., & Roth, W. T. (2012). Opposing breathing therapies for panic disorder: Randomized controlled trial of lowering vs raising end-tidal PCO2. The Journal of Clinical Psychiatry, 73(7), 931–939.

    Article  PubMed  Google Scholar 

  • Kinsman, R. A., Dirks, J. F., Jones, N. F., et al. (1980). Anxiety reduction in asthma: Four catches to general application. Psychosomatic Medicine, 42(4), 397–405.

    Article  PubMed  Google Scholar 

  • Kullowatz, A., Rosenfield, D., Dahme, B., et al. (2008). Stress effects on lung function in asthma are mediated by changes in airway inflammation. Psychosomatic Medicine, 70, 468–475.

    Article  PubMed  Google Scholar 

  • Kummer, F. (2010). Panic attacks in COPD and the somato-psycho-somatic feedback. The European Respiratory Journal, 36(2), 457–458.

    Article  PubMed  Google Scholar 

  • Laforest, L., Van Ganse, E., Devouassoux, G., et al. (2008). Factors influencing dispensing of psychotropic medications to patients with asthma: A community pharmacy-based survey. Annals of Allergy, Asthma, and Immunology, 100(3), 230–236.

    Article  PubMed  Google Scholar 

  • Laveneziana, P., Lotti, P., Coli, C., Binazzi, B., Chiti, L., Stendardi, L., … Scano, G. (2006). Mechanisms of dyspnoea and its language in patients with asthma. European Respiratory Journal, 27(4), 742–747.

    Article  PubMed  Google Scholar 

  • Lavoie, K. L., Bouthillier, D., Bacon, S. L., Lemiere, C., Martin, J., Hamid, Q., … Ernst, P. (2010). Psychologic distress and maladaptive coping styles in patients with severe vs moderate asthma. Chest, 137(6), 1324–1331.

    Article  PubMed  Google Scholar 

  • Lavoie, K. L., Cartier, A., Labrecque, M., et al. (2005). Are psychiatric disorders associated with worse asthma control and quality of life in asthma patients? Respiratory Medicine, 99(10), 1249–1257.

    Article  PubMed  Google Scholar 

  • Lehrer, P. M., Karavidas, M. K., Lu, S. E., et al. (2008). Psychological treatment of comorbid asthma and panic disorder: A pilot study. Journal of Anxiety Disorders, 22(4), 671–683.

    Article  PubMed  Google Scholar 

  • Leong, A. B., Ramsey, C. D., & Celedon, J. C. (2012). The challenge of asthma in minority populations. Clinical Reviews in Allergy and Immunology, 43(1–2), 156–183.

    Article  PubMed  Google Scholar 

  • McGovern, C. M., Arcoleo, K., & Melnyk, B. (2019). COPE for asthma: Outcomes of a cognitive behavioral intervention for children with asthma and anxiety. School Psychology, 34(6), 665–676.

    Article  PubMed  Google Scholar 

  • Meuret, A. E., Ehrenreich, J. T., Pincus, D. B., et al. (2006). Prevalence and correlates of asthma in children with internalizing psychopathology. Depression and Anxiety, 23(8), 502–508.

    Article  PubMed  Google Scholar 

  • Meuret, A. E., Kroll, J. L., & Ritz, T. (2017). Panic disorder comorbidity with medical conditions and treatment implications. Annual Reviews of Clinical Psychology, 13, 209–240.

    Article  Google Scholar 

  • Meuret, A. E., & Ritz, T. (2021). In M. P. Lehrer, R. L. Woolfolk, & W. E. Sime (Eds.), End-tidal CO2 biofeedback. Principles and practice of stress management (4th ed.). Guilford Press.

    Google Scholar 

  • Meuret, A. E., Ritz, T., Wilhelm, F. H., et al. (2007). Targeting pCO2 in asthma: Pilot evaluation of a capnometry-assisted breathing training. Applied Psychophysiology and Biofeedback, 32(2), 99–109.

    Article  PubMed  Google Scholar 

  • Meuret, A. E., Ritz, T., Wilhelm, F. H., et al. (2018). Hypoventilation therapy alleviates panic by repeated induction of dyspnea. Biological Psychiatry. Cognitive Neuroscience and Neuroimaging, 3(6), 539–545.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meuret, A. E., Rosenfield, D., Seidel, A., et al. (2010). Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity. Journal of Consulting and Clinical Psychology, 78(5), 691–704.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meuret, A. E., Rosenfield, D., Steele, A. M., et al. (2014, September 19–21). Pilot study of hypoventilation treatment on anxiety in patients with asthma. Paper presented at the 21st annual meeting of the International Society for the Advancement of Respiratory Psychophysiology, New Brunswick, NJ.

    Google Scholar 

  • Meuret, A. E., Tunnell, N., & Roque, A. (2020). Anxiety disorders and medical comorbidity: Treatment implications. Advances in Experimental Medicine and Biology, 1191, 237–261.

    Article  PubMed  Google Scholar 

  • Meuret, A. E., Wilhelm, F. H., Ritz, T., et al. (2003). Breathing training for treating panic disorder – Useful intervention or impediment? Behavior Modification, 27(5), 731–754.

    Article  PubMed  Google Scholar 

  • Meuret, A. E., Wilhelm, F. H., Ritz, T., et al. (2008). Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder. Journal of Psychiatric Research, 42(7), 560–568.

    Article  PubMed  Google Scholar 

  • Nathan, R. A., Sorkness, C. A., Kosinski, M., et al. (2004). Development of the asthma control test: A survey for assessing asthma control. Journal of Allergy and Clinical Immunology, 113(1), 59–65.

    Article  PubMed  Google Scholar 

  • Nelson, K. L., Lu, S. E., Oken, T., et al. (2020). Further exploration of treatment response in Latinos with comorbid asthma and panic disorder: A brief report of HRV and ETCO2 as potential mediators of treatment response. Applied Psychophysiology and Biofeedback, 45(2), 67–74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nishimura, K., Hajiro, T., Oga, T., et al. (2004). Health-related quality of life in stable asthma: What are remaining quality of life problems in patients with well-controlled asthma? Journal of Asthma, 41(1), 57–65.

    Article  Google Scholar 

  • Nowobilski, R., FurgaÅ‚, M., Czyz, P., et al. (2007). Psychopathology and personality factors modify the perception of dyspnea in asthmatics. The Journal of Asthma: Official Journal of the Association for the Care of Asthma, 44(3), 203–207.

    Article  Google Scholar 

  • Nozaki-Taguchi, N., Isono, S., Nishino, T., et al. (1995). Upper airway obstruction during midazolam sedation: Modification by nasal CPAP. Canadian Journal of Anesthesia, 42(8), 685–690.

    Article  PubMed  Google Scholar 

  • OÄŸuztűrk, O., Erkici, A., Kara, M., et al. (2005). Psychological status and quality of life in elderly patients with asthma. Psychosomatics, 46(1), 41–46.

    Article  PubMed  Google Scholar 

  • Papneja, T., & Manassis, K. (2006). Characterization and treatment response of anxious children with asthma. Canadian Journal of Psychiatry, 51(6), 393–396.

    Article  PubMed  Google Scholar 

  • Parry, G. D., Cooper, C. L., Moore, J. M., et al. (2012). Cognitive behavioural intervention for adults with anxiety complications of asthma: Prospective randomised trial. Respiratory Medicine, 106(6), 802–810.

    Article  PubMed  Google Scholar 

  • Pateraki, E., & Morris, P. G. (2018). Effectiveness of cognitive behavioural therapy in reducing anxiety in adults and children with asthma: A systematic review. Journal of Asthma, 55(5), 532–554.

    Article  Google Scholar 

  • Potokar, J. P., & Nutt, D. J. (2000). Chest pain: Panic attack or heart attack? International Journal of Clinical Practice, 54(2), 110–114.

    PubMed  Google Scholar 

  • Put, C., van den Bergh, O., Lemaigre, V., et al. (2003). Evaluation of an individualised asthma programme directed at behavioural change. The European Respiratory Journal, 21(1), 109–115.

    Article  PubMed  Google Scholar 

  • Ritz, T., Ayala, E. S., Trueba, A. F., et al. (2011b). Acute stress-induced increases in exhaled nitric oxide in asthma and their association with endogenous cortisol. American Journal of Respiratory and Critical Care Medicine, 183(1), 26–30.

    Article  PubMed  Google Scholar 

  • Ritz, T., Bobb, C., Edwards, M., et al. (2001). The structure of symptom report in asthma: A reevaluation. Journal of Psychosomatic Research, 51(5), 639–645.

    Article  PubMed  Google Scholar 

  • Ritz, T., Dahme, B., & Wagner, C. (1998). Effects of static forehead and forearm muscle tension on total respiratory resistance in healthy and asthmatic participants. Psychophysiology, 35(5), 549–562.

    Article  PubMed  Google Scholar 

  • Ritz, T., Kroll, J. L., Werchan, C. W., et al. (2018). Lung Diseases. In Levison (Ed.), Essentials of psychosomatic medicine, consult liaison psychiatry. American Psychiatric Association Publishing.

    Google Scholar 

  • Ritz, T., Meuret, A. E., Trueba, A. F., et al. (2013). Psychosocial factors and behavioral medicine interventions in asthma. Journal of Consulting and Clinical Psychology, 81(2), 231–250.

    Article  PubMed  Google Scholar 

  • Ritz, T., Rosenfield, D., Meuret, A. E., et al. (2008). Hyperventilation symptoms are linked to a lower perceived health in asthma patients. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 35(1), 97–104.

    Article  Google Scholar 

  • Ritz, T., Rosenfield, D., Steele, A. M., et al. (2014). Controlling asthma by training of capnometry-assisted hypoventilation (CATCH) vs slow breathing. Chest, 146(5), 1237–1247.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ritz, T., & Roth, W. T. (2003). Behavioral interventions in asthma: Breathing training. Behavior Modification, 27(5), 710–730.

    Article  PubMed  Google Scholar 

  • Ritz, T., Steptoe, A., DeWilde, S., et al. (2000). Emotions and stress increase respiratory resistance in asthma. Psychosomatic Medicine, 62(3), 401–412.

    Article  PubMed  Google Scholar 

  • Ritz, T., Wilhelm, F. H., Meuret, A. E., et al. (2011a). Airway response to emotion- and disease-specific films in asthma, blood phobia, and health. Psychophysiology, 48(1), 121–135.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ritz, T., Wittchen, H. U., Klotsche, J., et al. (2016). Asthma trigger reports are associated with low quality of life, exacerbations, and emergency treatments. Annals of the American Thoracic Society, 13(2), 204–211.

    Article  PubMed  Google Scholar 

  • Ross, C. J., Davis, T. M., & MacDonald, G. F. (2005). Cognitive-behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder. Clinical Nursing Research, 14(2), 131–157.

    Article  PubMed  Google Scholar 

  • Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., et al. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30(3), 208–225.

    Article  PubMed  Google Scholar 

  • Sandberg, S., Paton, J. Y., Ahola, S., et al. (2000). The role of acute and chronic stress in asthma attacks in children. Lancet, 356(9234), 982–987.

    Article  PubMed  Google Scholar 

  • Schneider, A., Löwe, B., Meyer, F. J., et al. (2008). Depression and panic disorder as predictors of health outcomes for patients with asthma in primary care. Respiratory Medicine, 102(3), 359–366.

    Article  PubMed  Google Scholar 

  • Seegan, P. L., Martin, S. R., Boergers, J., et al. (2020). Internalizing symptoms and sleep outcomes in urban children with and without asthma. Journal of clinical sleep medicine: JCSM: Official publication of the American Academy of Sleep Medicine, 16(2), 207–217.

    Google Scholar 

  • Sjoding, M. W., Dickson, R. P., Iwashyna, T. J., et al. (2020). Racial bias in pulse oximetry measurement. New England Journal of Medicine, 383(25), 2477–2478.

    Article  PubMed  Google Scholar 

  • Spinhoven, P., van Peski-Oosterbaan, A. S., Van der Does, A. J., Willems, L. N., & Sterk, P. J. (1997). Association of anxiety with perception of histamine induced bronchoconstriction in patients with asthma. Thorax, 52(2), 149–152.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steele, A., Meuret, A. E., Millard, M., et al. (2012). Discrepancies between lung function and self-reported asthma control: A categorization of asthma perception and its association with demographics and anxiety. Asthma and Allergy Proceedings, 33, 500–507.

    Article  Google Scholar 

  • Sterling, G. M. (1968). The mechanism of bronchoconstriction due to hypocapnia in man. Clinical Science, 34(2), 277–285.

    PubMed  Google Scholar 

  • Stoeckel, M. C., Esser, R. W., Gamer, M., et al. (2015). Amygdala response to anticipation of dyspnea is modulated by 5-HTTLPR genotype. Psychophysiology, 52(7), 973–976.

    Article  PubMed  Google Scholar 

  • ten Brinke, A., Ouwerkerk, M. E., Zwinderman, A. H., et al. (2001). Psychopathology in patients with severe asthma is associated with increased health care utilization. American Journal of Respiratory and Critical Care Medicine, 163(5), 1093–1096.

    Article  PubMed  Google Scholar 

  • ten Thoren, C., & Petermann, F. (2000). Reviewing asthma and anxiety. Respiratory Medicine, 94(5), 409–415.

    Article  PubMed  Google Scholar 

  • Thomas, M., Bruton, A., Moffat, M., & Cleland, J. (2011). Asthma and psychological dysfunction. Primary Care Respiratory Journal, 20(3), 250–256.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tolin, D. F., McGrath, P. B., Hale, L. R., et al. (2017). A multisite benchmarking trial of capnometry guided respiratory intervention for panic disorder in naturalistic treatment settings. Applied Psychophysiology and Biofeedback, 42(1), 51–58.

    Article  PubMed  PubMed Central  Google Scholar 

  • van den Elshout, F. J., van Herwaarden, C. L., & Folgering, H. T. (1991). Effects of hypercapnia and hypocapnia on respiratory resistance in normal and asthmatic subjects. Thorax, 46(1), 28–32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Van Peski-Oosterbaan, A. S., Spinhoven, P., Van der Does, A. J., et al. (1996). Is there a specific relationship between asthma and panic disorder? Behaviour Research and Therapy, 34(4), 333–340.

    Article  PubMed  Google Scholar 

  • Ye, G., Baldwin, D. S., & Hou, R. (2021). Anxiety in asthma: A systematic review and meta-analysis. Psychological Medicine, 51, 11–20.

    Article  PubMed  Google Scholar 

  • Yorke, J., Fleming, S., Shuldham, C., et al. (2015). Non-pharmacological interventions aimed at modifying health and behavioural outcomes for adults with asthma: A critical review. Clinical and Experimental Allergy, 45(12), 1750–1764.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alicia E. Meuret .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kroll, J., Meuret, A.E. (2022). Exposure Therapy when Patients Present with Asthma. In: Smits, J.A.J., Jacquart, J., Abramowitz, J., Arch, J., Margraf, J. (eds) Clinical Guide to Exposure Therapy. Springer, Cham. https://doi.org/10.1007/978-3-031-04927-9_10

Download citation

Publish with us

Policies and ethics