Anxiety Disorder -- Panic Disorder
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Recurrent unexpected Panic Attack
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≥ 1 month of (1) persistent concern OR (2) maladaptive behavior
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Peak at 10 minute
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≥ 4 symptoms
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Palpitations, pounding heart, or accelerated heart rate.
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Sweating
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Trembling or shaking
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Sensations of shortness of breath or smothering
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Feelings of choking
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Chest pain or discomfort
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Nausea or abdominal distress
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Feeling dizzy, unsteady, light-headed, or faint
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Chills or heat sensations
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Paresthesias (numbness or tingling sensations)
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Derealization (feelings of unreality) or depersonalization (being detached from oneself)
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Fear of losing control or “going crazy”
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Fear of dying
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Avoidance of a particular situations
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Agoraphobia
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fear of the occurrence of a panic attack ⇒ avoid situation where panic attack are expected to occur
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Interoceptive Avoidance
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Avoidance of internal bodily sensation
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Example: Avoidance of exercises, sex, caffeine, alcohol, scary movies, etc.
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Safety seeking Behaviors
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Behaviors to avoid disasters (negative reinforcement of the danger of panic attacks)
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Example: Frequent attendance at medical facilities for fear of medical problems, carrying antianxiety medicine
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Experiential Avoidance
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Unwillingness to experience fear and anxiety (interference with Exposure therapy)
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Example: saying that you have a heart attack instead of acknowledging your panic attack
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Prevalence
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4-6%
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Gender
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2F:1M
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Age of onset
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24 years old
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Anxiety disorders
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Specific phobias, social phobia, and agoraphobia
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Mood Disorder
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Panic disorder precedes the onset of major depressive disorders (33%)
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Substance use disorder
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Alcohol, drugs, etc.
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David Clark Theory of Panic
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Bodily/Psychological symptoms (e.g. dizziness, palpitations)
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Catastrophic misinterpation (e.g. "I might collapse, go crazy, have a heart attack, choke or suffocate")
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Maladaptive Safety behaviors (e.g. Avoid situations and check my pulse excessively)
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Reiss & McNally Theory of Panic
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Anxiety Sensitivity (“fear of anxiety”)
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Medication
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SSRIs
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Alprazolam (antianxiety drugs)
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CBT
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