Panic Disorder Outline only

Panic Disorder

I. Definition of a Panic Attack (DSM-IV TR)

A. Period of intense fear in the absence of any real danger.

B. At least 4-13 of the following symptoms:

1. Palpitations

2. Sweating

3. Trembling or shaking

4. Shortness of breath

5. Choking sensations

6. Chest pain or discomfort

7. Nausea or abdominal discomfort

8. Dizziness or lightheadedness

9. Derealization or depersonalization

10. Fear of losing control or going crazy

11. Fear of dying

12. Numbness or tingling in the arms or legs

13. Chills or hot flashes

C. Rapid peak (usually within 10 minutes)

D. Limited symptom attack (< 4 symptoms)

E. 3 types

1. Unexpected panic attack

2. Situationally bound panic attack

3. Situationally predisposed panic attack

F. Panic attacks can occur in different mental disorders (e.g. PTSD or

Social phobia).

II. Panic Disorder Overview

A. Essential features:

1. Presence of recurrent, unexpected panic attacks

2. Persistent concern for at least one month of having another panic attack or significant changes in behavior because of the panic attack.

3. Panic attacks cannot be caused by medical conditions or other mental disorders

4. Must have at least two unexpected panic attacks for diagnoses

B. 2 types

1. Panic disorder without agoraphobia

2. Panic disorder with agoraphobia

C. Occurrence

1. 10 percent of those seeking mental health counseling

2. Usually begins in twenties

3. 1 in 63 have or will have PD

4. Twice as common in women

III. Causes of Panic Disorder

A. Research indicates both biological and psychological components.

1. Biological

a. Fight or flight

b. Low tolerance for body's normal response to stress (false alarm)

c. May not be able to properly utilize the body's own naturally produced anxiety reducing substances.

2. Psychological

a. Catastrophic thinking (heart skips = MI)

b. "What ifs"

B. Diathesis-Stress Model

1. Genetic predisposition

a. Having a first-degree relative with PD makes one 8 times more likely to also have PD.

2. Stress

a. Onset usually after stressful event (most often occurring after recent loss of or separation from a loved one).

IV. Diagnostic Criteria for Panic Disorder With/Without Agoraphobia according to the DSM-IV

A. Both (1) and (2):

1. Recurrent unexpected panic attacks

2. At least one of the attacks has been followed by 1 month (or more) of the following:

a. Persistent concern about having additional attacks

b. Worry about the implications of the attack or its consequences (having a heart attack, going crazy)

c. A significant change in behavior related to the attacks

B. Absence