Examination of mask disturbance behavior during a carbon dioxide-enriched air challenge

Background and objectives: The present investigation examined mask disturbance behavior in the context of a biological challenge. Method: Participants included 128 adults (63.3% women; M_age = 23.2, SD = 8.9) who underwent a 10% carbon dioxide-enriched air challenge. Results: Mask disturbance behavior, including complete or partial mask removal, was common during the challenge. Moreover, mask removal behavior during the challenge was significantly related to a greater increase in anxiety pre- to post-challenge, as well as greater levels of self-reported avoidance of a future challenge administration. However, mask touching and lifting behaviors were not related to other challenge criterion variables. Limitations: The current study consisted primarily of young adults and did not include individuals with a panic disorder diagnosis. Replication and extension of the current findings is recommended. Conclusions: Results suggest that mask removal behavior during the challenge may represent a possible behavioral marker of panic-relevant risk, although further work is necessary to determine its usefulness as a challenge measure.