Psychology
Panic Disorders
Panic disorder is a type of anxiety disorder characterized by recurrent, unexpected panic attacks. These attacks are accompanied by intense physical symptoms such as heart palpitations, sweating, trembling, and a feeling of impending doom. People with panic disorder often experience persistent worry about having future attacks, which can significantly impact their daily functioning and quality of life.
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10 Key excerpts on "Panic Disorders"
eBook - PDF- Ronald Comer, Elizabeth Gould, Adrian Furnham(Authors)
- 2014(Publication Date)
- Wiley(Publisher)
Laboratory research has indicated repeatedly that fears can indeed be acquired through classical conditioning or model- ling (Wilson, 2011). Panic Disorder Sometimes anxiety takes the form of panic, in which suffer- ers may lose control of their behaviour and sometimes be unaware of what they are doing. Anyone can react with panic when a real threat looms up suddenly. A number of people, however, experience panic attacks , peri- odic, discrete bouts of panic that occur suddenly, reach a peak within 10 minutes and gradually pass. And some of those individuals have panic attacks repeatedly and often unexpectedly without apparent reason, which is termed panic disorder . In addition to panic attacks, people with this disorder experience changes in their thinking or behaviour as a result of the attacks. For example, they may believe that their attacks mean they are having a heart attack or losing their mind. Panic disorder is often accompanied by agoraphobia , a fear of venturing into public places, especially when alone. Because of their panic attack history, sufferers develop a fear of being in loca- tions where escape might be difficult or help unavailable should panic symptoms develop. Around 2.8% of individuals suffer from panic disorder in a given year (Kessler et al., 2005b). The disorder is likely to develop during late adolescence or young adulthood, and it is at least twice as common among women as among men (APA, 2000). The leading explanation for panic disorder is one that combines neuroscience and cognitive-behavioural principles. Based on neuroscientists linking emotional reactions to brain circuits, panic attacks seem to involve the amygdala, hypothalamus and locus coeruleus (Etkin, 2010). Research considers that these brain areas and the associated neuro- transmitters, such as noradrenaline, function improperly in people who experience panic disorder (Bremner & Charney, 2010; Burijon, 2007).
eBook - PDF- Federico Durbano(Author)
- 2015(Publication Date)
- IntechOpen(Publisher)
Chapter 3 Psychobiological Aspects of Panic Disorder Daniel C. Mograbi, Vitor Castro-Gomes, Elie Cheniaux and J. Landeira-Fernandez Additional information is available at the end of the chapter http://dx.doi.org/10.5772/60663 Abstract Anxiety is a useful warning sign that helps an individual face potential or real danger. At appropriate levels, it serves as a warning for the presence of internal or external threats, causing a person to be alert and prepare to deal appropriate‐ ly with such situations. Moreover, moderate levels of anxiety can lead to improved performance in several activities. However, anxiety becomes pathological when its duration is excessively long or its intensity is extremely high and leads to significant suffering and distress. In such cases, anxiety is appropriately described as part of a pathological response, characterizing an anxiety disorder. The historical concept of a unitary anxiety disorder has been replaced by a heterogeneous group of psychopathologies with different etiologies. Panic disorder is a complex anxiety disorder that involves both recurrent, unexpected panic attacks, and persistent concern about having additional attacks. The present chapter reviews current psychobiological perspectives in the etiology and treatment of panic disorder. The first section describes the current classification of this anxiety disorder. We then explore possible neural circuitry associated with panic disorder. Finally, the chapter addresses current treatment approaches, considering the efficacy of different forms of psychotherapy and pharmacological treatments. Keywords: Anxiety, Panic Disorder, Neural Circuitry, Behavioral Therapy, Pharma‐ cological Therapy © 2015 The Author(s).
eBook - PDF- Devon E. Hinton, Byron J. Good(Authors)
- 2009(Publication Date)
- Stanford University Press(Publisher)
1 PANIC DISORDER (PD) , as currently conceived, is a medical condition that may be diagnosed when a person experiences recurrent, unexpected attacks of panic or anxiety, followed by persistent concern about having additional attacks or about losing control, going crazy, or having a heart attack. Panic attacks are intense periods of fear or discomfort, feelings that sometimes seem quite irrational. They are de-scribed as “attacks” because they often develop rapidly and include such symptoms as palpitations, sweating, trembling, shortness of breath, a feeling of choking, chest pain, nausea, dizziness, derealization or depersonalization, and numbness or chills or hot flushes, as well as fear of losing control or fear of dying. PD, according to contemporary psychiatric classification, belongs to a group of neuropsychiatric conditions for which anxiety is the hallmark symptom. Although anxiety disorders are often thought of as relatively mild conditions, researchers es-timate that in the United States these disorders account for 32 percent of the total economic costs of psychiatric illness, exceeding the costs associated with schizo-phrenia ( 21 percent) and mood disorders, including depression ( 22 percent) (Taylor 2000 : 4 ). Within the costs of panic attacks are emergency room visits and extensive medical tests to determine whether those experiencing the panic are suffering a heart attack or some other life-threatening condition as they fear. PD most com-monly begins when the sufferer is between fifteen and thirty years of age. Studies suggest that between 1 . 5 and 3 . 5 percent of members of a population will suffer PD sometime during their lifetime. 1 Introduction Panic Disorder in Cross-Cultural and Historical Perspective Byron J. Good and Devon E. Hinton
- Graham C.L. Davey, Graham C.L. Davey, Author(Authors)
- 2019(Publication Date)
- SAGE Publications Ltd(Publisher)
8 Panic Disorder as a Psychological Problem: Building on Clark (1986)Clark, D.M. (1986) A cognitive approach to panic, Behaviour Research and Therapy, 24(4): 461–70Louise WaddingtonBackground
This chapter sets out to explain why David Clark’s (1986) paper on panic dis-order was a game changer and to bring to life the phenomenal impact it has had on both research and the psychological treatments people receive today (Clark et al., 1997). The chapter will begin by describing the dominant perspectives on panic disorder at the time the paper was published, give a detailed overview of the paper including a clear explanation of the panic model, and review empirical support for specific predictions offered in the paper. Critique of the paper is discussed along with subsequent modifications to the model and treatment. The impact of the paper is discussed in terms of psychological science and people’s experience of psychological care in England today. Key recommendations are made for further reading.Dominant perspectives on panic disorder at the time the paper was published
Biological, psychoanalytic…and behavioural
Panic disorder is the experience of repeated and sometimes unexpected panic attacks in which a person has such extreme anxiety symptoms that it can feel as if they are dying or losing their mind, and the development of a persistent fear of further attacks. The occurrence of unexpected or ‘spontaneous’ panic attacks was thought to be particularly hard to account for. Back in 1986 the Diagnostic and Statistical Manual of Mental Disorders, Third Edition
eBook - ePubCognitive Therapy of Anxiety Disorders
A Practice Manual and Conceptual Guide
- Adrian Wells(Author)
- 2013(Publication Date)
- Wiley(Publisher)
Chapter 5 PANIC DISORDER A detailed account of cognitive therapy for panic disorder is presented in this chapter. It is helpful to be familiar with the conceptualisation and treatment of panic before considering the treatment of other anxiety states, since panic is one of the simpler problems to model and offers an introduction to themes which are recurrent across other disorders. A central theme is the use of cyclical models for purposes of conceptualisation and socialisation, which illustrate the key relationships between cognition, behaviour, and affect, considered to maintain anxiety problems. In the first part of this chapter a description of panic is presented along with a brief review of the different types of panic attack. A cognitive model of panic (Clark, 1986) is then presented in detail, and the transition from model to practical case conceptualisation is discussed. The remainder of the chapter focuses on how the basic formulation can be developed, and on cognitive therapy treatment techniques. The cognitive therapy approach presented here closely follows the treatment developed by Clark et al. (1994) in the Oxford Cognitive Therapy programme and outcome trials. CHARACTERISTICS OF PANIC ATTACKS Panic attacks are defined as rapid occurrences of anxiety or rapid escalations in current anxiety in which there are at least 4 of 13 somatic or cognitive symptoms (DSM-IV; APA, 1994). Four or more symptoms have to escalate or occur within a ten-minute period, to meet panic criteria. These symptoms include physical responses such as palpitations, dizziness, sweating, choking, trembling or shaking, breathlessness, depersonalisation, and cognitive symptoms such as fear of dying, suffocating, going crazy, and so on. In some instances fewer than four symptoms occur in an attack, and these are known as limited symptom attacks but the distinction is somewhat arbitrary. Panics can also be differentiated in a way that relates to the conditions under which they occur
eBook - PDF- Paul Fallon(Author)
- 2019(Publication Date)
- Bloomsbury Academic(Publisher)
MADNESS: A BIOGRAPHY 8 of potential negative consequences prepares them to prevent them yet, they also appraise their tendency to worry in a negative way and hence worry about the fact that they worry so often (ibid.). This makes GAD one of the more complex anxiety disorders and there-fore quite difficult to treat. Panic disorder Often, anxiety involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes accompanied by at least four of the following symptoms: breath-lessness; palpitations; dizziness; trembling; nausea; a feeling of chocking; de-realisation; chest pain; and paraesthesia (tingling, numbness or ‘pins and needles’) (WHO, 2018c). These episodes are known as panic attacks and occasional panic attacks are common to all anxiety disorders, however, for an individual to be diagnosed as having panic disorder these attacks have to be recurrent and fol-lowed by one month or more of persistent worry about future attacks. Often the panic attacks occur in the absence of a trigger and the fact that they can occur unexpectedly makes this an unsettling condition for the person that experiences them. It is the unexpected ‘out of the blue’ nature of these panic attacks that distinguishes panic disorder from other anxiety disorders that are often accom-panied by panic attacks. Panic disorder derives its name from the Greek word panikon , meaning “pertaining to Pan,” the Greek god who was known for spreading terror. Phobias As previously mentioned, specific phobia is the most common type of anxiety disorder (Craske & Stein, 2016) and what makes them a disorder is that the anxiety they provoke is disproportionate to the actual situation or object. It is the exaggerated, or unrealistic, sense of danger that distinguishes a phobia from fear of a situation or object. To avoid this perceived danger, people often organise their lives so that they do not come into contact with the thing that provokes
eBook - PDF- Nancy Ogden, Michael Boyes, Evelyn Field, Ronald Comer, Elizabeth Gould(Authors)
- 2021(Publication Date)
- Wiley(Publisher)
These attacks occur suddenly, as a wave of intense fear, reach a peak within 10 minutes, and gradually pass (see photo). Individuals who experience unexpected, repeated panic attacks suffer from panic disorder. People who experience these attacks report that they believe they are having a heart attack or los- ing their mind. Panic disorder is often accompanied by agoraphobia, a fear of venturing into public places, especially when alone. Because of their panic attack history, some sufferers of panic disorder develop a fear of travelling to any location where escape might be difficult or help unavailable should panic symptoms develop. Around 4 percent of people in Canada over 15 years of age have suffered from a panic attack at some point in their lives (Canadian Mental Health Association, 2013; Ramage- Morin, 2004). The lifetime rate is highest (5.1 percent) among 45- to 55-year-olds, and lowest (2.5 percent) among those over 55 years of age. Women are nearly twice as likely than men to have experienced a panic attack in any given year (Scott et al., 2018). As mentioned, neuroscientists have determined that emotional reactions are tied to brain circuits. Panic attacks appear to be produced in part by a brain circuit in the amyg- dala, hypothalamus, and locus ceruleus (Khalsa et al., 2016; Dresler et al., 2011). Many of today’s researchers believe that this brain circuit—including norepinephrine and other neurotransmitters—probably functions improperly, producing an excess amount of norepi- nephrine in people who experience panic disorder (Nardi & Freire, 2016; Noel & Curtis, 2019). According to cognitive theorists, not only are these individuals hypersensitive to changes in arousal, but once they experience particular bodily sensations, they tend to misinterpret the sensations as signs of a medical catastrophe and fear that the symp- toms are signalling that something dire is about to occur (Gellatly & Beck, 2016; Reinecke et al., 2011; Wenzel, 2011a, 2011b).
eBook - PDFAnxiety
Psychological Perspectives on Panic and Agoraphobia
- Bozzano G Luisa(Author)
- 2013(Publication Date)
- Academic Press(Publisher)
It is not intended that the concept of panic-anxiety should imply a discontinuity between the causes of normal and abnormal behaviour. The cluster of complaints is the end point of a complex interaction be-tween psychological and social factors occurring over many years. Pan-ic-anxiety is, however, an important starting point for research because it is what the client actually reports as distressing him or her. Psychiatric description of a disorder usually carries an implication of underlying dysfunction. Roth and Mountjoy (1982) denied a continuity between complaints of emotional distress in the community and clinic. At some point, normal anxiety becomes a neurotic illness, but the basis of this distinction is not made clear. In fact, the concept of psychiatric illness seems to rest more on professional practice than on any demon-stration of underlying dysfunction. However, the contrasts that are commonly drawn in psychiatry between the form and content of a disor-der and between personality and symptoms suggest the strength of the analogy with physical illness and therefore of a distinction between functional and dysfunctional states of the individual. It is important to determine whether there is, in fact, any real dif-ference between the nature of the determinants of normal behaviour. Panic-Anxiety and the Medical Model 9 such as everyday reports of anxiety, and anxiety described as severe and disabling; that is, whether new psychological or biological processes need to be invoked. Panic may be alarming and incomprehensible, but this is not itself a criterion for underlying abnormality. I will assume that theories of normal anxiety can be used equally well to explain abnormal anxiety. In other words, even though biological dysfunctions or physical illness may contribute (in association with other factors) to the causes of panic-anxiety, they are not assumed to be in any sense necessary factors in causation (see Chapter 5).
eBook - PDF- Douglas Bernstein, , , (Authors)
- 2015(Publication Date)
- Cengage Learning EMEA(Publisher)
It is more common in women, often accompanying other problems such as depression or substance abuse (Ouimet et al., 2012). Panic Disorder For some people, anxiety takes the form of panic disorder . Like José, whom we met at the beginning of this chapter, people suffering from panic disorder experience recurrent, terri-fying panic attacks that seem to come without warning or obvious cause. These attacks are marked by intense heart palpitations, pressure or pain in the chest, sweating, dizziness, and feeling faint. Often, victims believe they are having a heart attack. They may worry so much about having panic episodes that they limit their activities to avoid possible embarrassment (Kinley et al., 2009). As noted earlier, the fear of experiencing panic attacks may lead to agoraphobia as the person begins to fear and avoid places where help won’t be available should panic recur (Koerner, Vorstenbosch, & Antony, 2012). Panic disorder may last for years, during which periods of improvement may be followed by recurrence. As many as 30 percent of the U.S. population have experienced at least one panic attack within the past year, but full-blown panic disorder is seen in only about 2 to 3 percent of the population in any given year (Hollander & Simeon, 2008; Kessler, Chiu et al., 2006; NIMH, 2014). OBSESSIVE-COMPULSIVE AND RELATED DISORDERS What are obsessive rituals? Obsessive-compulsive disorder (OCD) affects about 1 percent of the U.S. population in any given year and about 2 to 3 percent of the world population at some time in their lives (Worden & Tolin, 2014; NIMH, 2014). People displaying OCD are plagued by persistent, upsetting, and unwanted thoughts—called obsessions —that often focus on the possibility of infection, contamination, or doing harm to themselves or others.
eBook - PDF- Jair C. Soares, Samuel Gershon, Jair C. Soares, Samuel Gershon(Authors)
- 2003(Publication Date)
- CRC Press(Publisher)
In addition, some people experience panic attacks but are not unduly distressed or impaired by them. In recognition of these limitations, the DSM-IV system separated the definition of panic attack from the definition of panic disorder. The panic attack criteria remained the same in requiring that four of 13 symptoms must occur and peak within 10 min to denote the acute intensity and sympathetic activity. The defining symptoms of a panic attacks are heart palpitations/pounding, sweating, trembling/shaking, shortness of breath, feeling of choking, chest pain/discomfort, nausea/abdominal dis-tress, dizziness/unsteadiness, derealization, fear of los-ing control/going crazy, fear of dying, paresthesias, and chills/hot flushes. With this separate definition, panic attacks were now viewed as simply the ‘‘defen-sive response’’ that can occur in the context of a per-ceived imminent, severe threat and thus be diagnosed as occurring within any anxiety disorder [10]. Panic disorder, on the other hand, has been concep-tualized to develop as a two-part process [11,12]. Initially, panic disorder may result from the occurrence of ‘‘false alarms’’; the alarm system becomes triggered in the absence of any objective danger. This false alarm may arise from genetic, biological, and life stress vul-nerabilities. For the person who is experiencing the false alarm, however, the phenomenon is inexplicable. The absence of an external source of danger to associ-ate with the alarm results in an internal scanning for the threat. The person then misperceives the occur-rence of the alarm as an indication of an internal dan-ger, such as heart attack, loss of control, or fainting. Further focus on the perception that the attacks them-selves are dangerous results in a secondary process that maintains the panic attacks.
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