Panic Disorder Exam 1

Question 1

Panic Disorder DSM-5 Criteria

Answer 1

Recurrent, unexpected, abrupt surge of intense fear/discomfort.
Symptoms such as increased heart rate, sweating, trembling, and shortness of breath.
At least 1 attack followed by at least 1 month or more of persistent concern about additional attacks.
Not due to substance or medical condition.
Not better explained by another disorder.

Question 2

CBT Theory for Panic Disorder

Answer 2

Triple vulnerability:
Genetics, General psychological, early learning experience
Elevated autonomic sensitivity to bodily sensations.
Initial attack has negative bodily sensations.
Develop fear of another panic attack.
Sensations become conditioned cues for panic.

Question 3

Assessment for Panic Disorder

Answer 3

Anxiety Disorder Interview Schedule (ADIS)
SCID-5
Body Sensations and Agoraphobia Cognitions Questionnaire

Question 4

Sessions 1-4

Answer 4

Session 1:
Psychoeducation (describe fear and anxiety)
Treatment overview and rationale.
HW: Create list of avoided activities.
Session 2:
Psychoeducation (describe physiology underlying panic)
Discuss learned cognitively mediated fears and appraisals.
Session 3:
Introduce breathing control.
HW: practice 2xs a day for 10 minutes.
Session 4:
Breathing control.
Cognitive restructuring.
Probability judgments.
HW: Breathing and track overestimation errors

Question 5

Sessions 5-8

Answer 5

Session 5:
Cognitive restructuring related to catasrophizing.
Breathing completed throughout day in various places.
HW: Breathing and cognitive monitoring
Session 6:
Begin interceptive exposure after reviewing HW.
Hierarchy about exercises that produce similar sensations.
HW: Breathing, cognitive monitoring.
Session 7:
Conduct interceptive exposure.
HW: breathing, cognitive restructuring, interceptive exposure
Session 8:
Continue hypothesis testing
Interceptive exposure
Review HW and avoidance
HW: Continue moving up interceptive hierarchy.

Question 6

Sessions 9-11

Answer 6

Session 9:
Extend interceptive exposure to natural activities.
Reinforce hypothesis testing and challenging thoughts.
Gradually remove safety behaviors.
HW: practice 2 items from hierarchy 3+ times.
Session 10:
Review naturalistic exposures.
Provide rationale of habituation.
Eliminate safety behaviors.
Session 11:
Incorporate SO with treatment and assign first in vivo exposure practice.
Roleplay positive communication.
HW: Engage in in-vivo exposure.

Question 7

Sessions 12-15

Answer 7

Review in-vivo exposures.
Give feedback about HW.
Rehearse new in-vivo exposures.
Cognitive restructuring of new cognitive distortions.
Review principles and skills gained in treatment.
Provide coping techniques to use in future, importance of continued practice.