Panic Disorder Flashcards
What defines a panic disorder according to the DSM-5?
Panic disorder is characterized by recurrent unexpected panic attacks, which are abrupt surges of intense fear or discomfort peaking within minutes.
A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the symptoms.
What symptoms characterize a panic attack in panic disorder?
Symptoms include palpitations, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills or heat sensations, numbness or tingling, derealization or depersonalization, fear of losing control or dying. Culture-specific symptoms may also occur but are not among the four required symptoms.
What post-attack concerns or behaviors indicate panic disorder?
Following at least one attack, there is a persistent concern or worry about additional attacks or their consequences, or a significant maladaptive change in behavior related to the attacks, such as avoidance of activities or situations that might trigger an attack.
What are the exclusion criteria for a panic disorder diagnosis according to the DSM-5?
The panic disorder is not due to the physiological effects of a substance or another medical condition. It is not better explained by another mental disorder, such as social anxiety disorder, specific phobia, obsessive-compulsive disorder, PTSD, or separation anxiety disorder.
What qualifies panic attacks as recurrent and unexpected in panic disorder?
Recurrent means more than one panic attack. Unexpected panic attacks have no obvious cue or trigger at the time of occurrence, appearing to occur “out of the blue,” such as during relaxation or from sleep (nocturnal panic attack).
Expected panic attacks, which have an obvious cue or trigger, do not preclude the diagnosis of panic disorder. Cultural interpretations may influence the perception of attacks as expected or unexpected.
How do the frequency and severity of panic attacks vary in panic disorder?
The frequency of panic attacks can range from moderately frequent (e.g., once per week) to short bursts of daily attacks, with possible long intervals of minimal or no attacks. Severity can also vary, with both full-symptom (four or more symptoms) and limited-symptom (fewer than four symptoms) attacks occurring.
The diagnosis of panic disorder requires more than one unexpected full-symptom panic attack.
What types of worries and concerns are associated with panic attacks in panic disorder?
Worries about panic attacks or their consequences often relate to physical health (fear of life-threatening illnesses), social concerns (fear of embarrassment or negative judgment), and concerns about mental health (fear of “going crazy” or losing control). These worries reflect the individual’s fears about the implications of their panic attacks.
What maladaptive behaviors may individuals with panic disorder exhibit?
Individuals may attempt to minimize or avoid panic attacks or their consequences through behaviors like avoiding physical exertion, ensuring help is available, restricting daily activities, and avoiding situations that might induce panic.
If agoraphobia is present, it is diagnosed separately.
What are nocturnal panic attacks and how common are they in panic disorder?
Nocturnal panic attacks involve waking from sleep in a state of panic, distinct from panicking after fully waking. In the U.S., these attacks occur at least once in roughly 25% to 33% of individuals with panic disorder, with the majority also experiencing daytime panic attacks.
This subtype highlights the unpredictable nature of panic attacks, extending even into periods of sleep.
How do health and mental health concerns manifest in panic disorder?
Individuals with panic disorder may experience constant or intermittent anxiety related to health and mental health, often anticipating catastrophic outcomes from mild symptoms or medication side effects.
This can lead to a heightened state of health-related anxiety, where even minor physical sensations are interpreted as signs of serious illness.
How does intolerance to medication side effects relate to panic disorder?
Many individuals with panic disorder are relatively intolerant of medication side effects, potentially complicating treatment. This intolerance often stems from their heightened sensitivity to bodily sensations and fear that these sensations indicate a severe medical condition.
What pervasive concerns and behaviors are associated with panic disorder?
Individuals may have pervasive concerns about their ability to complete daily tasks or withstand stressors, and some engage in excessive use of substances (e.g., alcohol, prescribed medications, illicit drugs) to control panic attacks.
Such behaviors indicate an attempt to manage or mitigate the intensity and frequency of panic attacks and their perceived impact.
What extreme behaviors may individuals with panic disorder exhibit to control panic attacks?
Extreme behaviors can include severe dietary restrictions or avoidance of specific foods and medications due to fears of inducing physical symptoms that provoke panic attacks. These behaviors reflect the lengths to which individuals go to prevent panic attacks, underscoring the significant impact of panic disorder on daily life choices and health management strategies.
What is the general 12-month prevalence of panic disorder in adults and adolescents?
The 12-month prevalence estimate for panic disorder in the general population across the United States and several European countries is about 2%-3% in adults and adolescents. This indicates that panic disorder is a relatively common mental health condition within these populations.
How does the prevalence of panic disorder vary by race and ethnicity in the United States?
In the United States, the prevalence of panic disorder is significantly lower among Latinos, African Americans, Caribbean Blacks, and Asian Americans compared with non-Latino whites.
American Indians, in contrast, have significantly higher rates of panic disorder. These differences may reflect cultural, environmental, and possibly genetic factors influencing the occurrence of panic disorder.
