Respiratory Training in the Treatment of Transdiagnostic Pathological Anxiety

Last updated: August 18, 2025
Sponsor: University of Texas at Austin
Overall Status: Active - Recruiting

Phase

N/A

Condition

Social Phobia

Mood Disorders

Hypochondriasis

Treatment

Interoceptive Exposure

Psycho-Education

Capnometry-Guided Respiratory Intervention

Clinical Study ID

NCT05427708
STUDY00002306
  • Ages > 18
  • All Genders

Study Summary

Purpose of the Research: The primary aim of the proposed study is to conduct a randomized parallel-group 2-arm clinical trial investigating capnometry-guided respiratory intervention (CGRI) for pathological anxiety. CGRI aims to raise end-tidal CO2 levels thereby lowering hyperventilation-induced respiratory alkalosis and its associated fear-eliciting somatic reactions. Psycho-education about anxiety and its effects (PsyEd) will serve as a credible control comparator.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Clinically elevated anxiety as indicated by an eight or higher on the OverallAnxiety Severity and Impairment Scale (OASIS).

  2. Meets DSM-5 criteria for one or more of the following anxiety or trauma-relateddisorders as their "primary" mental disorder:

  • Generalized Anxiety Disorder

  • Panic Disorder

  • Health Anxiety

  • Agoraphobia

  • Social Anxiety Disorder

  • Posttraumatic Stress Disorder

  • Acute Stress Disorder

  • Adjustment Disorder with primary anxious mood

  • Anxiety disorder not otherwise specified

  1. No current use of psychotropic medications or stable on current medications for atleast 6 weeks

  2. Age 18+.

  3. Able to arrange transportation to our laboratory for study appointments.

  4. Fluent in English.

Exclusion

Exclusion Criteria:

  1. No history of medical conditions that would contraindicate participation infear-provocation or respiratory challenges, including:

  • Cardiovascular or respiratory disorders

  • High blood pressure

  • Epilepsy

  • Strokes

  • Seizures

  • History of fainting

  • Pregnant or lactating

  1. Not currently receiving other psychological treatment for anxiety.

  2. No history of a suicide attempt within the past 6 months.

  3. No history of psychosis within the past 6 months.

  4. No history of moderate to severe alcohol or substance use disorder (with theexception of nicotine) within the past 3 months.

  5. Does not endorse COVID-19 symptoms during the screening phase.

Study Design

Total Participants: 180
Treatment Group(s): 3
Primary Treatment: Interoceptive Exposure
Phase:
Study Start date:
August 22, 2022
Estimated Completion Date:
May 31, 2027

Study Description

Low end-tidal CO2 (ETCO2), which is an accompanying feature of hyperventilation, has been associated with a variety of anxiety disorders, including panic disorder and social phobia. More recently, researchers have examined the efficacy of capnometry-guided respiratory intervention (CGRI) as a method for increasing ETCO2 and thereby reducing hyperventilation-induced anxiety/panic symptoms. Promising preliminary efficacy studies have shown that CGRI results in decreased panic symptom frequency and severity at a rate comparable to that of cognitive therapy. A recent uncontrolled proof-of-concept study showed that CGRI led to significant reductions in trauma symptoms in a sample of patients meeting DSM-5 criteria for PTSD. However, CGRI has not been adequately evaluated in the treatment of anxiety disorders other than panic disorder with or without agoraphobia.

Connect with a study center

  • University of Texas at Austin

    Austin, Texas 78712
    United States

    Site Not Available

  • University of Texas at Austin

    Austin 4671654, Texas 4736286 78712
    United States

    Active - Recruiting

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