Panic reactions to terrorist attacks and probable posttraumatic stress disorder in adolescents

Abstract

A number of factors, including subjective reactions and appraisal of danger, influence one's reaction to a traumatic event. This study used telephone survey methodology to examine adolescent and parent reactions to the 2001 World Trade Center attacks 6 to 9 months after they occurred. The prevalence of probable posttraumatic stress disorder (PTSD) in adolescents was 12.6%; 26.2% met study criteria for probable subthreshold PTSD. A probable peri-event panic attack in adolescents was strongly associated with subsequent probable PTSD and probable subthreshold PTSD. This study suggests that the early identification of peri-event panic attacks following mass traumatic events may provide an important gateway to intervention in the subsequent development of PTSD. Future studies should use longitudinal designs to examine the course and pathogenic pathways for the development of panic, PTSD, and other anxiety disorders after exposure to disasters.

Mental Health Consequences of September 11: A Five-Year Review of the Behavioral Sciences Literature

“…The prevalence of PTSD in adolescents was 12.6% and an additional 26% met criteria for probable PTSD. A strong correlation was found between probable panic attacks in the initial stages of the disaster and the development of probable PTSD subsequently (Pfefferbaum et al 2006a).…”

Social relations and PTSD symptoms: A prospective study on earthquake‐impacted adolescents in Taiwan

“…Those who met Criterion A as well as meeting criteria in two of the three B, C, and D categories were "partial PTSD diagnosis likely." This procedure was employed by Pfefferbaum and colleagues (Pfefferbaum, Stuber, Galea & Fairbrother, 2006) in their study of PTSD after the terrorist attacks on the World Trade Center. The PTSD Reaction Index has good psychometric properties (Steinberg et al, 2004) and has been used in Taiwan in several studies (Chen et al, 2002;Chen & Wu, 2006).…”

Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V

“…From the NCS-R data, Kessler et al [47] reported 45.0% comorbidity with other anxiety disorders in their PA-only group (i.e., PAs without a history of PD or agoraphobia), with highest comorbidity rates for specific phobia (21.0%) and social phobia (18.8%). Other studies have suggested that the presence of panic symptoms at the time of a traumatic event (i.e., a ''cued'' PA in response to trauma) may be associated with higher rates of an ensuing acute stress disorder [48,49] or posttraumatic stress disorder [50][51][52] compared to individuals who do not show panic symptomatology at trauma. As discussed by, [48] the association of PAs and acute stress disorder may be explained by an overlap in their symptomatology (e.g., derealization, fear of dying), a common predisposition to develop both conditions, and PAs intensifying the level of stress during the traumatic event.…”