Panic Attacks: New Approaches to an Old Problem

Abstract

Anxiety attacks were included in the first descriptions of the syndrome of anxiety neurosis. Recently it has been suggested that such attacks (now usually called panic attacks) characterize a distinct form of anxiety disorder--panic disorder. It has also been proposed that panic attacks result from a biochemical disorder and require pharmacological treatment. Some of the evidence for these ideas is presented, and two other explanations for panic attacks are reviewed: that they are caused by hyperventilation, and that they result from a cognitive disorder. It is concluded that although it is not possible on the present evidence to choose between the three theories, there is strong indirect support for the cognitive theory and good reason to investigate cognitive factors more thoroughly. Future work on biochemical causes of, and pharmacological treatments for panic attacks should take account of such factors.

Chronic Treatment with Imipramine Does Not Reverse the Effects of 3 Anxiogenic Compounds in a Test of Anxiety in the Rat

“…Some investigators feel that the distinction between panic disorder and generalised anxiety is unjustified [Marks, 1985[Marks, , 1986Gelder, 1986], Instead they prefer to view these conditions as variants of the same disorder, with perhaps panic representing a severe form of anxiety [Cobb, 1985]. If this theory is true we would expect to detect drugs effective in the treatment of panic in our existing animal tests of anxiety.…”

Severe Threat in the Genesis of Panic Disorder

“…Despite this reconceptualisation of anxiety, a number of authorities have questioned whether panic disorder does form a separate entity (Jablensky 1985;Detre 1985;Barlow et al 1985), or whether a purely biological theory of panic disorder is defensible (Clark 1986;Gelder 1986). Beck et a/.…”

Comparison Between the Panic Disorder with Agoraphobia Patients and Normal Controls on the Basis of Cognitions Affect and Physiology

“…Episodes of panic and avoidance have been known under different names for many years (Gelder, 1986) and numerous explanations have been proposed. Previously, it has been argued that biological and physiological factors are primary in panic disorder, with or without agoraphobia (Carr and Sheehan, 1984;Klein, 1980).…”