DSM 5 Diagnostic Criterion
Recurrent unexpected Panic Attack |
≥ 1 month of (1) persistent concern OR (2) maladaptive behavior |
Criteria Panic Attack
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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 |
Maladaptive change in behavior
Avoidance of a particular situations |
Agoraphobia |
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fear of the occurrence of a panic attack ⇒ avoid situation where panic attack are expected to occur |
Interoceptive Avoidance |
Avoidance of internal bodily sensation |
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Example: Avoidance of exercises, sex, caffeine, alcohol, scary movies, etc. |
Safety seeking Behaviors |
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 |
Experiential Avoidance |
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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Epidemiology
Prevalence |
4-6% |
Gender |
2F:1M |
Age of onset |
24 years old |
Comorbidity
Anxiety disorders |
Specific phobias, social phobia, and agoraphobia |
Mood Disorder |
Panic disorder precedes the onset of major depressive disorders (33%) |
Substance use disorder |
Alcohol, drugs, etc. |
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Etiology
David Clark Theory of Panic |
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) |
Reiss & McNally Theory of Panic |
Anxiety Sensitivity (“fear of anxiety”) |
Treatment
Medication |
SSRIs |
Alprazolam (antianxiety drugs) |
CBT |
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Created By
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