On distinguishing types of panic (original) (raw)
Related papers
The phenomenology of panic attacks in panic disorder with and without agoraphobia
Comprehensive Psychiatry, 1993
The frequency of symptoms during panic attacks and anticipation of the panic consequences were compared in patients with the subtypes of panic disorder (PD). Patients with moderate and severe agoraphobic avoidance reported that they had experienced more symptoms than patients with an uncomplicated PD (without agoraphobia [AG]); they also experienced almost all of the symptoms more frequently, with the difference being significant for a quarter of the examined panic symptoms. Panic patients with moderate T HE DSM-III-RI lists a number of panic symptoms that serve as guidelines for making a diagnosis of panic disorder (PD). Several studies suggest that some of these symptoms are more important in distinguishing panic attacks and PD from other forms of anxiety and other anxiety disorders. Thus tachycardia, palpitations, shortness of breath, sweating, dizziness, trembling, and hot flushes are a prominent feature of most panic attacks,2-4 and therefore they might be considered first-rank or core symptoms of panic attacks and panic anxiety.
Prediction of panic attacks and related variables
Behavior Therapy, 1999
Twenty-six participants who met conservative criteria for having experienced one or more panic attacks were compared with 26 nonpanickers on various measures associated with panic attacks. In addition, regression analyses were used to determine if anxiety sensitivity or suffocation fears better predicted panic frequency and panic related phenomena (e.g., agoraphobic avoidance). The results showed the anxiety sensitivity was the better predictor of agoraphobic avoidance and perceived seriousness of the panic attacks. Both suffocation fears and anxiety sensitivity predicted bodily sensations associated with panic attacks with suffocation fears contributing the greater amount of unique variance. The importance and value of using nonclinical panickers (NPAs) is discussed in relation to our understanding of panic attacks and panic disorder. Recommendations for defining NPAs are provided. Panic attacks can and do occur in stressful situations and, sometimes, in the absence of definable stimuli (Norton, Dorward, & Cox, 1986). In addition, panic attacks can occur in people with all anxiety disorders and depression (Barlow, 1988). Finally, panic attacks can occur in the presence of phobic stimuli (situational), when contemplating a fearful event (situationally predisposed), or "out of the blue" (unexpected; Klein & Klein, 1989). For over a decade, researchers have been evaluating the prevalence and nature of panic attacks in groups of people who are not seeking treatment. These people have been labeled "nonclinical panickers" (NPAs) (Norton, Harrison, Hauch, & Rhodes, 1985). In a review of the research on nonclinical panickers, Norton, Cox, and Malan (1992) showed that (a) panic attacks are fairly common in the general population, (b) the symptom structure of nonclinical panic attacks are very similar to those of people with panic disorder, (c) people with NPAs have similar, albeit lesser, psychopathology profiles when compared to patients
A comparison of panic disorder and agoraphobia with panic attacks
Comprehensive Psychiatry, 1985
The validity of distinguishing between the diagnoses of panic disorder and agoraphobia with panic attacks was examined in a study of 20 patients with each disorder. Comparison of demographic, psychometric, and clinical features of the two groups revealed few differences. Agoraphobics scored higher on ratings of interpersonal sensitivity, phobic anxiety, paranoid ideation, and alcohol use. Panic disorder patients more frequently reported periods of remissions from anxiety symptomatology. These results support the validity of conceptualizing agoraphobia with panic attacks and panic disorder as subcategories of a core endogenous anxiety disorder.
The Symptom Structure of Panic Attacks in Depressed and Anxious Patients
The Canadian Journal of Psychiatry, 1993
This study examined the panic symptom profiles of three diagnostic groups: those with panic disorder and no history of major depression; those with panic disorder with a history of major depressive episode but no current depression; and those current major depression with panic disorder. Patients were compared on the frequency of specific panic attack symptoms based on structured interview responses. The symptom profiles of all three groups were significantly correlated. The patients with past and current depressive episodes had the most similar symptom structure.
The phenomenology of the first panic attack in clinical and community-based samples
Journal of Anxiety Disorders, 2014
The purpose of the study was to contrast first panic attacks (PAs) of patients with panic disorder (PD) with vs. without agoraphobia and to explore differences between first PAs leading to the development of PD and those that remain isolated. Data were drawn from a community survey (N = 2260 including 88 isolated PAs and 75 PD cases). An additional sample of 234 PD patients was recruited in a clinical setting. A standardized interview assessed the symptoms of the first PA, context of its occurrence and subsequent coping attempts. Persons who developed PD reported more severe first PAs, more medical service utilization and exposure-limiting coping attempts than those with isolated PAs. The context of the first PA did not differ between PD and isolated PAs. PD with agoraphobia was specifically associated with greater symptom severity and occurrence of first attacks in public. Future research should validate these findings using a longitudinal approach.
A discussion of various aspects of panic disorder depending on presence or absence of agoraphobia
Comprehensive Psychiatry, 2016
Objective: The quality of life of individuals with panic disorder and agoraphobia can be improved by the alleviation of agoraphobia. In other words, examining panic disorder in terms of whether agoraphobia is present is crucial. The current study examined panic disorder from this perspective. Methods: Subjects were 253 patients who met the diagnostic criteria for panic disorder (lifetime) according to the Mini International Neuropsychiatric Interview (MINI). Of those patients, 179 had agoraphobia and 74 did not. Statistical analysis was used to examine gender differences in the presence (or absence) of agoraphobia, comorbidities, and the effects of the presence of agoraphobia (severity, assessment of depression, assessment of anxiety, and personality) in these patients. Results: Results indicated gender differences in the presence (or absence) of agoraphobia. Compared to patients without agoraphobia, significantly more patients with agoraphobia were female (p b .001), and had a higher prevalence of comorbidities. Patients with agoraphobia had a higher suicide risk (p b .05), more hypomanic episodes (current) (p b .05), and more frequent episodes of social phobia (p b .05). In addition, patients with agoraphobia had more severe panic disorder and a higher level of neuroticism, sensitivity to anxiety, and trait anxiety [PDSS-J, P&A, NEON: p b .01, ASI, STAI (Trait Anxiety): p b .05]. Conclusions: The current findings suggest that when treating a panic disorder, diagnosing the presence of agoraphobia is extremely important.
American Journal of Epidemiology, 1990
and W. W. Eaton. Risk factors for the onset of panic disorder and other panic attacks in a prospective, population-based study. Am J Epidemiol 1990;131:301-11. A total of 383 cases of incident panic attack were identified among 12,823 participants in the Epidemiologic Catchment Area Program over various 12-month periods in 1980-1983. These cases not phobia-stimulated were compared with 766 controls. Risk factors were examined for the onset of panic attacks, with attacks categorized as panic disorder, severe and unexplained panic attacks, or other panic attacks. Risk factors were also examined for the onset of attacks in which cardiovascular symptoms were experienced and those in which psychologic symptoms were experienced. Females were at greater risk than males for each category of attacks (relative odds ranged from 1.36 to 2.25). Persons aged 65 years or older were at lower risk than younger persons (relative odds, compared with 30-to 44-year-olds, ranged from 0.26 to 0.71). A history of cardiac symptoms, shortness of breath, depression or a major grief episode, drug abuse or dependence, alcohol abuse or dependence, and seizures were each strongly associated with panic attacks. A history of cardiac symptoms was more strongly associated with attacks in which cardiovascular symptoms were experienced than with attacks in which psychologic symptoms were experienced (relative odds, 8.36 vs. 2.23). A history of seizures was more strongly associated with attacks with psychologic symptoms than with attacks with cardiovascular symptoms (relative odds, 5.21 vs. 1.58).
A Prospective Study of Panic and Anxiety in Agoraphobia with Panic Disorder
British Journal of Psychiatry, 1992
The features of panic and anxiety in the natural environment were studied by prospective self-monitoring in 39 patients with chronic agoraphobia and panic disorder. Panics overlapped greatly with anxiety episodes but were more intense. Panics occurred more often in public places than did anxiety episodes, but had otherwise similar symptom profile, time of occurrence, and antecedents. Most panics surged out of a pre-existing plateau of tonic anxiety which lasted most of the day. Spontaneous panics were less frequent than situational panics and occurred more often at home but were otherwise similar. These findings do not support the sharp distinction between panic and anxiety in DSM–III–R, not its emphasis on spontaneous panic in classifying anxiety disorders. Thoughts of dying and ‘going crazy’/losing control accompanied only a minority of panic/anxiety episodes and seemed to be a product of intense panic rather than a cause.
BioPsychoSocial Medicine, 2012
Background: The place where a patient experiences his/her first panic attack (FPA) may be related to their agoraphobia later in life. However, no investigations have been done into the clinical features according to the place where the FPA was experienced. In particular, there is an absence of detailed research examining patients who experienced their FPA at home. In this study, patients were classified by the location of their FPA and the differences in their clinical features were explored (e.g., symptoms of FPA, frequency of agoraphobia, and severity of FPA). Methods: The subjects comprised 830 panic disorder patients who were classified into 5 groups based on the place of their FPA (home, school/office, driving a car, in a public transportation vehicle, outside of home), The clinical features of these patients were investigated. Additionally, for panic disorder patients with agoraphobia at their initial clinic visit, the clinical features of patients who experienced their FPA at home were compared to those who experienced their attack elsewhere. Results: In comparison of the FPAs of the 5 groups, significant differences were seen among the 7 descriptors (sex ratio, drinking status, smoking status, severity of the panic attack, depression score, ratio of agoraphobia, and degree of avoidance behavior) and 4 symptoms (sweating, chest pain, feeling dizzy, and fear of dying). The driving and public transportation group patients showed a higher incidence of co-morbid agoraphobia than did the other groups. Additionally, for panic disorder patients with co-morbid agoraphobia, the at-home group had a higher frequency of fear of dying compared to the patients in the outside-of-home group and felt more severe distress elicited by their FPA. Conclusion: The results of this study suggest that the clinical features of panic disorder patients vary according to the place of their FPA. The at-home group patients experienced "fear of dying" more frequently and felt more distress during their FPA than did the subjects in the other groups. These results indicate that patients experiencing their FPA at home should be treated with a focus on the fear and distress elicited by the attack.
"Panic Disorder and Its Underlying Causes: An In-depth Exploration"
Panic Disorder and Panic Atack, 2023
Panic Disorder (PD), classified as an anxiety disorder, presents as recurrent, unanticipated panic attacks characterized by intense fear and discomfort. This research work delves into the intricacies of PD and explicates its underlying causes. Drawing from clinical criteria and relevant scholarly literature, this paper examines the symptoms, impact on quality of life, subtypes, diagnostic criteria, and differentiation from other anxiety disorders. It explores the multifaceted origins of PD, focusing on four primary risk factors-temperament, environment,