Studied by 1 personMarked fear/anxiety for two or more
public transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
Combined psychological and drug treatments are no better than
CBT or drugs alone
Psychological intervention
Exposure-based
Reality testing
Relaxation and breathing skills
Panic Control Treatment
Exposure to interoceptive cues
Cognitive therapy
Relaxation/breathing
CBT is better
long-term
Multiple systems affected by medication
serotonergic
noradrenergic
GABA
High relapse rates after
discontinuation of medication
Causes of nocturnal panic
Generalized biological vulnerability
Cues get associated with situations
Generalized psychological vulnerability
Generalized biological vulnerability
Alarm reaction to stress
Cues get associated with situations
Conditioning occurs
Generalized psychological vulnerability
Anxiety about future attacks
Hypervigilance
Increase interoceptive awareness
60% with panic disorder experience
nocturnal attacks
When do nocturnal panic attacks occur?
Occur in non-REM sleep
Occur during delta/slow wave sleep
Nocturnal attacks are caused by
deep relaxation
Sensations of “letting go” are
anxiety provoking to people with panic attacks
~75% of those with agoraphobia are
female
In developing countries, somatic symptoms more emphasized than
emotional symptoms
Diagnostic Criteria for Agoraphobia: Situations always provoke
fear
Diagnostic Criteria for Agoraphobia: Anxiety not proportional to
real danger
Diagnostic Criteria for Agoraphobia: Marked fear/anxiety for two or more:
public transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
Diagnostic Criteria for Agoraphobia: Anxiety is
excessive
Diagnostic Criteria for Agoraphobia: Not better explained by
another mental disorder
Diagnostic Criteria for Agoraphobia: Significant
distress
Diagnostic Criteria for Panic Disorder: Recurrent
unexpected panic attaches
Diagnostic Criteria for Panic Disorder: At least one attack has been followed by
significant worry or maladaptive change in behavior
Diagnostic Criteria for Panic Disorder: Not attributable to
substance use
Diagnostic Criteria for Panic Disorder: Not better explained by
another mental disorder
What is a common symptom in children with panic disorder?
hyperventilation
Agoraphobia: fear or avoidance of
situations/events
Agoraphobia: Concern about being unable to
escape or get help in the event of panic symptoms or other unpleasant physical symptoms (e.g., incontinence, vomiting, falling)
Note
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