What concept explains the pairing of somatic discomfort, such as dizziness, with impending panic attacks?

The pairing of somatic discomfort, such as dizziness, with impending panic attacks is best explained by interoceptive conditioning. This concept refers to the process by which physiological sensations that occur during a panic attack become associated with the experience of anxiety, leading an individual to interpret these body sensations as indicators of an upcoming panic attack.

For example, if a person begins to feel dizzy and has previously experienced a panic attack under similar conditions, the dizziness may become a conditioned stimulus that triggers anxiety and panic, even in situations where they might not be at risk for an actual panic attack. This means that interoceptive cues—internal body sensations—become linked to the emotional response of panic, thereby perpetuating the cycle of anxiety and panic attacks.

Other options, such as interpersonal therapy, cognitive dissonance, and behavioral reinforcement, do not specifically address the unique relationship between physiological sensations and panic attacks in the same way. Interpersonal therapy focuses on the social aspects of mental health, cognitive dissonance deals with conflicting beliefs or attitudes, and behavioral reinforcement relates to the modification of behavior through rewards or punishments, neither of which directly explains the learned association between bodily sensations and the onset of panic.