Clinical Psychology

Panic Disorder (PD) is an anxiety disorder characterized by recurrent unexpected episodes of sudden panic and fear. The unexpected panic attack has no obvious cue or trigger at the time of occurrence (Lim, Lee, Jang & Choi, 2018). Not all panic attacks are indicative signs for the existence of a Panic Disorder.  The same cognitive and physical symptoms can be experienced for instance, by individuals with specific phobias when face the feared stimulus (i.e., heights, snake etc.). The difference, amongst these anxiety disorders though, is that the individual, who suffer from panic disorder experiences physical and cognitive sensations unexpected and “out of the blue”. Contrary to specific phobias, whereas the individual recognizes the source of their fearful sensations. (Roy-Byrne, Craske & Stein, 2006)

The cause of panic disorder is not known yet, but there are studies, which indicate  that genetic and family factors plays an important role. Moreover, the presence of life events i.e., involving loss, separation, conflicts, new responsibilities can be responsible for the onset of panic attacks. Usually individuals, who experienced panic attacks experience greater amount of life stress (Scocco, Barbieri & Frank, 2006; Taylor, 2006 ). The majority of studies demonstrate that people when they face threat or danger they adopt the” fight or flight” response, which is activated from Sympathetic Nervous System. However,  in case of PD, people adopt this “fight or flight “ response without the existence of an actual fear or threat (Good & Hinton, 2009) .Anxiety sensitivity also has been recognized as risk factor. According to cognitive model for panic disorder, individuals who experience panic attacks have a tendency to interpret sensations in a catastrophic way. The sensations which are misinterpreted are those which most of the times participated in normally anxiety reactions, i.e. palpitations, breathlessness, dizziness, paraesthesia. The catastrophic misinterpretations make people perceive the above reactions more dangerous/ harmful than they actually are and link those reactions with fear of an impending panic attack (Clark & Ehlers, 1993; Gardenswartz & Craske, 2001). The fear of experiencing these sensations, leads to adoption of safety behaviours in order to minimize or prevent feared catastrophes. Safety behaviours can be both situational avoidance but also subtle behaviours which prevent disconfirmation of feared situations (Casey, Oei & Newcombe, 2004).

People who suffer from panic attacks,  demonstrate  higher levels of functional impairment and are in risk for the onset of other disorders too, i.e., depression, other anxiety disorders and substance use disorder. Most of the times panic disorder is related to poor emotional and physical health and increased use of medication, marital, social and financial problems (Gardenswartz & Craske, 2001; Telch, Schmidt, Jaimez, Jacquin & Harrington, 1995).Panic disorder can be treated, by usage of medication and more specifically antidepressant medication combined with psychotherapy. As far as psychotherapy is concerned Cognitive Behavioral Therapy is the evidence-based treatment for Panic Disorder. (“Panic disorder – NICE Pathways”, 2020)

References

• Casey, L., Oei, T., & Newcombe, P. (2004). An integrated cognitive model of panic disorder: The role of positive and negative cognitions. Clinical Psychology Review, 24(5), 529-555. doi: 10.1016/j.cpr.2004.01.005
• Clark, D., & Ehlers, A. (1993). An overview of the cognitive theory and treatment of panic disorder. Applied And Preventive Psychology, 2(3), 131-139. doi: 10.1016/s0962-1849(05)80119-2
• Gardenswartz, C., & Craske, M. (2001). Prevention of panic disorder. Behavior Therapy, 32(4), 725-737. doi: 10.1016/s0005-7894(01)80017-4
• Lim, J., Lee, Y., Jang, J., & Choi, S. (2018). Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder. Medicine, 97(38), e12422. doi: 10.1097/md.0000000000012422
• Panic disorder – NICE Pathways. Pathways.nice.org.uk. (2020). Retrieved 16 December 2020, from https://pathways.nice.org.uk/pathways/panic-disorder#content=view-node%3Anodes-step-3-psychological-interventions.
• Roy-Byrne, P., Craske, M., & Stein, M. (2006). Panic disorder. The Lancet, 368(9540), 1023-1032. doi: 10.1016/s0140-6736(06)69418-x
• Scocco, P., Barbieri, I., & Frank, E. (2006). Interpersonal Problem Areas and Onset of Panic Disorder. Psychopathology, 40(1), 8-13. doi: 10.1159/000096384
• Taylor, C. (2006). Panic disorder. BMJ, 332(7547), 951-955. doi: 10.1136/bmj.332.7547.951
• Telch, M., Schmidt, N., Jaimez, T., Jacquin, K., & Harrington, P. (1995). Impact of cognitive-behavioral treatment on quality of life in panic disorder patients. Journal Of Consulting And Clinical Psychology, 63(5), 823-830. doi: 10.1037/0022-006x.63.5.823
• Good, B., & Hinton, D. (2009). Culture and Panic Disorder. Stanford University Press