A modern learning theory perspective on the etiology of panic disorder.

Bouton, Mark E.; Mineka, Susan; Barlow, David H.

doi:10.1037/0033-295x.108.1.4

Cited by 894 publications

(708 citation statements)

References 238 publications

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“…Bouton et al [22] suggested a model of fear conditioning for panic disorder that we believe fits our hypothesis on the development of cephalalgiaphobia. The exposure to headache, an internal unconditioned aversive stimuli, would cause a conditioning of anxiety to exteroceptive and interoceptive cues.…”

Section: Discussionsupporting

confidence: 83%

Cephalalgiaphobia: a possible specific phobia of illness

et al. 2007

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Psychiatric comorbidity, mainly anxiety and depression, are common in chronic migraine (CM). Phobias are reported by half of CM patients. Phobic avoidance associated with fear of headache or migraine attack has never been adequately described. We describe 12 migraine patients with particular phobic-avoidant behaviours related to their headache attacks, which we classified as a specific illness phobia, coined as cephalalgiaphobia. All patients were women, mean age 42, and all had a migraine diagnosis (11 CM, all overused acute medications). Patients had either a phobia of a headache attack during a pain-free state or a phobia of pain worsening during mild headache episodes. Patients overused acute medication as phobic avoidance. It is a significant problem, associated with distress and impairment, interfering with medical care.Cephalalgiaphobia is a possible specific phobia of illness, possibly linked to progression of migraine to CM and to acute medication overuse headache.

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Section: Discussionsupporting

confidence: 83%

Cephalalgiaphobia: a possible specific phobia of illness

et al. 2007

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“…Through this positive feedback loop, an escalating spiral of arousal leads to panic. High levels of stress will increase both the experiencing of arousal symptoms and the probability that arousal symptoms may escalate to panic (Bouton et al, 2001;Katon, 1989, pp. 33-34).…”

Section: Discussionmentioning

confidence: 99%

Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide

Hagengimana

Hinton

Bird

et al. 2003

Psychiatry Research

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The present study is the first to attempt to determine rates of panic attacks, especially 'somatically focused' panic attacks, panic disorder, symptoms of post-traumatic stress disorder (PTSD), and depression levels in a population of Rwandans traumatized by the 1994 genocide. The following measures were utilized: the Rwandan Panic-Disorder Survey (RPDS); the Beck Depression Inventory (BDI); the Harvard Trauma Questionnaire (HTQ); and the PTSD Checklist (PCL). Forty of 100 Rwandan widows suffered somatically focused panic attacks during the previous 4 weeks. Thirtyfive (87%) of those having panic attacks suffered panic disorder, making the rate of panic disorder for the entire sample 35%. Rwandan widows with panic attacks had greater psychopathology on all measures. Somatically focused panic-attack subtypes seem to constitute a key response to trauma in the Rwandan population. Future studies of traumatized non-Western populations should carefully assess not only somatoform disorder but also somatically focused panic attacks.

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“…Similarly, a hallmark of panic disorder is the experience of panic attacks, episodes of surge of extreme fear with a feeling of impending doom ( American Psychiatric Association 1994). But another key element is anxiety, caused by persistent symptoms of apprehensive anticipation and continuous worry focused on the reoccurrence of future panic attacks (Bouton et al 2001). In addition, one would also expect phobic individuals to exhibit sustained anxiety when anticipating a future confrontation with their phobic objects.…”

Section: Fear and Anxiety In Anxiety Disordersmentioning

confidence: 99%

Models and mechanisms of anxiety: evidence from startle studies

2007

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Rationale-Preclinical data indicates that threat stimuli elicit two classes of defensive behaviors, those that are associated with imminent danger and are characterized by avoidance or fight (fear), and those that are associated with temporally uncertain danger and are characterized by sustained apprehension and hypervigilance (anxiety).Objective-To 1) review evidence for a distinction between fear and anxiety in animal and human experimental models using the startle reflex as an operational measure of aversive states, 2) describe experimental models of anxiety, as opposed to fear, in humans, 3) examine the relevance of these models to clinical anxiety.Results-The distinction between phasic fear to imminent threat and sustained anxiety to temporally uncertain danger is suggested by psychopharmacological and behavioral evidence from ethological studies and can be traced back to distinct neuroanatomical systems, the amygdala and the bed nucleus of the stria terminalis. Experimental models of anxiety, not fear, are relevant to nonphobic anxiety disorders.Conclusions-Progress in our understanding of normal and abnormal anxiety is critically dependent on our ability to model sustained aversive states to temporally uncertain threat.

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A modern learning theory perspective on the etiology of panic disorder.

Cited by 894 publications

References 238 publications

Cephalalgiaphobia: a possible specific phobia of illness

Cephalalgiaphobia: a possible specific phobia of illness

Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide

Models and mechanisms of anxiety: evidence from startle studies

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