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Journal of Clinical Psychology Jan 2021The present study examined the contribution of panic appraisal (PA) dimensions to the prediction of panic and agoraphobic symptoms, above and beyond anxiety sensitivity...
OBJECTIVE
The present study examined the contribution of panic appraisal (PA) dimensions to the prediction of panic and agoraphobic symptoms, above and beyond anxiety sensitivity (AS), among patients with panic disorder. PA dimensions consist of anticipated panic, perceived panic consequences, and panic coping efficacy.
METHOD
Panic disorder patients (N = 84, 60.7% female, M = 38 years) completed self-report measures of panic and agoraphobic symptoms, three dimensions of PA, AS, anxiety, and depression symptoms.
RESULTS
PA dimensions significantly contributed to the prediction of overall and all facets of panic and agoraphobic symptoms, as well as anxiety symptoms, but not depressive symptoms, above and beyond AS. Of the three PA dimensions, both anticipated panic and panic coping efficacy uniquely contributed to agoraphobic avoidance after controlling for AS and the other dimensions of PA.
CONCLUSION
PA dimensions may emerge as an important predictor of panic and agoraphobic or anxiety symptoms.
Topics: Adaptation, Psychological; Agoraphobia; Anxiety; Female; Humans; Male; Panic Disorder
PubMed: 32662523
DOI: 10.1002/jclp.23028 -
Dialogues in Clinical Neuroscience Jun 2017Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents,... (Review)
Review
Cultural factors have influenced the presentation, diagnoses, and treatment of anxiety disorders in India for several centuries. This review covers the antecedents, prevalence, phenomenology, and treatment modalities of anxiety disorders in the Indian cultural context. It covers the history of the depiction of anxiety in India and the concept of culture in the classification of anxiety disorders, and examines the cultural factors influencing anxiety disorders in India. We review the prevalence and phenomenology of various disorders, such as generalized anxiety disorder, panic disorder, social anxiety, and phobic disorder, as well as culture-specific syndromes such as dhat and koro in India. Finally, the review examines the wide range of therapeutic modalities practiced in India, such as faith healing, psychotherapy, ayurveda, psychopharmacology, Unani medicine, homeopathy, yoga, meditation, and mindfulness. We conclude by emphasizing the significance of cultural factors in making relevant diagnoses and offering effective and holistic treatments to individuals with anxiety disorders.
Topics: Anxiety; Anxiety Disorders; Cultural Characteristics; Humans; India; Male; Panic Disorder; Prevalence
PubMed: 28867936
DOI: 10.31887/DCNS.2017.19.2/rparikh -
Journal of Anxiety Disorders May 2017Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the...
Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian (AI) tribes (N=3084). A culturally-adapted version of the Composite International Diagnostic Interview assessed panic attacks, panic disorder, and various psychiatric comorbidities. After adjusting for age, gender, and tribe, linear and logistic regression analyses were conducted to compare AIs with panic disorder to those with panic attacks only on clinical characteristics and panic symptoms. Approximately 8.5% (N=234) of American Indians reported a lifetime history of panic attacks. Among individuals with panic attacks, comorbid posttraumatic stress disorder was higher in females (p=0.03) and comorbid alcohol-related disorders were higher in males (p≤0.001). The prevalence and clinical features of panic attacks and panic disorder in American Indians were similar to epidemiologic studies with majority populations. However, in contrast to earlier research, panic symptoms were similar in both males and females, and different patterns of comorbidity emerged. Future research should examine the availability and accessibility of evidence-based panic treatments for this traditionally underserved population.
Topics: Adolescent; Adult; Alcohol-Related Disorders; Comorbidity; Female; Humans; Indians, North American; Interview, Psychological; Male; Middle Aged; Panic; Panic Disorder; Prevalence; Stress Disorders, Post-Traumatic; United States; Young Adult
PubMed: 27720578
DOI: 10.1016/j.janxdis.2016.10.004 -
Human Psychopharmacology Nov 2014Although a great deal of information about the neurobiology of panic disorder is now available, there is a need for an updated etiological model integrating recent... (Review)
Review
Although a great deal of information about the neurobiology of panic disorder is now available, there is a need for an updated etiological model integrating recent findings on the neurobiology of the arousal system and its relationship with higher cortical functions in panic disorder. The current mini-review presents psychophysiological, molecular biological/genetic and functional neuroimaging evidence for dysfunction in major arousal systems of the brain. Such dysfunction may influence the development of panic disorder by precipitating autonomic bodily symptoms and at the same time increasing vigilance to these sensations by modulating cortical attentional networks. A multilevel model of arousal, attention and anxiety-including the norepinephrine, orexin, neuropeptide S and caffeine-related adenosine systems-may be useful in integrating a range of data available on the pathogenesis of panic disorder.
Topics: Animals; Arousal; Attention; Brain; Humans; Neural Pathways; Panic Disorder
PubMed: 25311787
DOI: 10.1002/hup.2436 -
Journal of Affective Disorders Sep 2023It has been suggested that gender differences in anxiety and depressive symptoms characterize panic disorder (PD) in terms of vulnerability to stressful life events,...
BACKGROUND
It has been suggested that gender differences in anxiety and depressive symptoms characterize panic disorder (PD) in terms of vulnerability to stressful life events, anxiety, depressive symptom patterns, and brain structure. However, few studies have investigated the gender differences in PD using a network approach.
METHODS
This study included 619 participants with PD (313 men). The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, and Beck Depression Inventory-II were used to evaluate symptomatology. To investigate the PD-related white matter (WM) neural correlates, tract-based spatial statistics were used. The PD-related clinical scales and WM neural correlates were included in the network analysis to identify associations between variables. To evaluate network differences between genders, network comparison tests were conducted.
RESULTS
Our findings revealed that agoraphobia in men was the strongest central symptom. In addition, loss of pleasure, and not anxiety or panic symptoms, was the strongest central symptom in women with PD. The network comparison test revealed that the bridge strength score was higher in agoraphobia and tiredness in men and in self-criticalness in women. Furthermore, in the network that includes neural correlates of WM, the bridge strength score was higher in the cingulate gyrus WM in men and the cingulum hippocampus in women.
LIMITATIONS
Since this is a cross-sectional network study of PD patients, the causal relationship between interactions in this network analysis for both genders may not be accurately determined.
CONCLUSION
Network structures of anxiety and depressive symptomatology and related WM neural correlates can differ according to gender in PD patients.
Topics: Humans; Female; Male; Panic Disorder; Sex Factors; Cross-Sectional Studies; Anxiety; Anxiety Disorders; Agoraphobia
PubMed: 37247787
DOI: 10.1016/j.jad.2023.05.087 -
ACS Chemical Neuroscience Aug 2014Chemotherapeutic agents nauseate cancer patients. Some individuals with schizophrenia hear voices. Chronic pain can be reduced by analgesics. Nausea, voices, and pain... (Review)
Review
Chemotherapeutic agents nauseate cancer patients. Some individuals with schizophrenia hear voices. Chronic pain can be reduced by analgesics. Nausea, voices, and pain are examples of internal (interoceptive) stimuli closely linked with a disease and/or its treatment. There is evidence that the perception and, hence, role of these internal stimuli can be modified by one's learning history. There is also increased awareness by researchers and practitioners of the potential import of learning involving internal states to some diseases and psychopathologies. Unfortunately, the science, theory, and practice appear to be trailing behind awareness. In this mini-review, we describe two examples: smoking and panic disorder. While doing so, we discuss the need to develop translationally relevant animal models that will allow investigators to better understand the behavioral and neural mechanisms underlying interoception and learning.
Topics: Animals; Brain; Humans; Interoception; Learning; Panic Disorder; Smoking
PubMed: 25010473
DOI: 10.1021/cn5001028 -
Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis.Evidence-based Mental Health May 2018Recent data suggest that anxiety disorders are as often comorbid with bipolar disorder (BD) as with unipolar depression. The literature on panic disorder (PD) comorbid... (Meta-Analysis)
Meta-Analysis Review
QUESTION
Recent data suggest that anxiety disorders are as often comorbid with bipolar disorder (BD) as with unipolar depression. The literature on panic disorder (PD) comorbid with BD has been systematically reviewed and subject to meta-analysis.
STUDY SELECTION AND ANALYSIS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were thoroughly followed for literature search, selection and reporting of available evidence. The variance-stabilising Freeman-Tukey double arcsine transformation was used in the meta-analysis of prevalence estimates. Both fixed-effect and random-effects models with inverse variance method were applied to estimate summary effects for all combined studies. Heterogeneity was assessed and measured with Cochran's Q and I statistics.
FINDINGS
Overall, 15 studies (n=3391) on cross-sectional prevalence and 25 independent lifetime studies (n=8226) were used to calculate pooled estimates. The overall random-effects point prevalence of PD in patients with BD, after exclusion of one potential outlier study, was 13.0% (95% CI 7.0% to 20.3%), and the overall random-effects lifetime estimate, after exclusion of one potential outlier study, was 15.5% (95% CI 11.6% to 19.9%). There were no differences in rates between BD-I and BD-II. Significant heterogeneity (I >95%) was found in both estimates.
CONCLUSIONS
Estimates that can be drawn from published studies indicate that the prevalence of PD in patients with BD is higher than the prevalence in the general population. Comorbid PD is reportedly associated with increased risk of suicidal acts and a more severe course. There is no clear indication on how to treat comorbid PD in BD. Findings from the current meta-analysis confirm the highly prevalent comorbidity of PD with BD, implicating that in patients with BD, PD might run a more chronic course.
Topics: Bipolar Disorder; Comorbidity; Humans; Panic Disorder
PubMed: 29636354
DOI: 10.1136/eb-2017-102858 -
Neuroscience and Biobehavioral Reviews Oct 2014Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable... (Review)
Review
Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable trigger) or expected (ePA). Panic typically involves an abrupt feeling of catastrophic fear or distress accompanied by physiological symptoms such as palpitations, racing heart, thermal sensations, and sweating. Recurrent uPA and ePA can also lead to agoraphobia, where subjects with PD avoid situations that were associated with PA. Here we will review recent developments in our understanding of PD, which includes discussions on: symptoms and signs associated with uPA and ePAs; Diagnosis of PD and the new DSM-V; biological etiology such as heritability and gene×environment and gene×hormonal development interactions; comparisons between laboratory and naturally occurring uPAs and ePAs; neurochemical systems that are associated with clinical PAs (e.g. gene associations; targets for triggering or treating PAs), adaptive fear and panic response concepts in the context of new NIH RDoc approach; and finally strengths and weaknesses of translational animal models of adaptive and pathological panic states.
Topics: Age Factors; Animals; Anxiety; Brain; Disease Models, Animal; Female; Humans; Male; Neural Pathways; Neurochemistry; Panic Disorder
PubMed: 25130976
DOI: 10.1016/j.neubiorev.2014.07.027 -
European Neuropsychopharmacology : the... Apr 2020In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we... (Review)
Review
In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.
Topics: Anxiety, Separation; Carbon Dioxide; Diagnostic and Statistical Manual of Mental Disorders; Humans; Panic Disorder
PubMed: 32046934
DOI: 10.1016/j.euroneuro.2020.01.009 -
Psychological Medicine Oct 2015Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Substantial healthcare resources are devoted to panic disorder (PD) and coronary heart disease (CHD); however, the association between these conditions remains controversial. Our objective was to conduct a systematic review of studies assessing the association between PD, related syndromes, and incident CHD.
METHOD
Relevant studies were retrieved from Medline, EMBASE, SCOPUS and PsycINFO without restrictions from inception to January 2015 supplemented with hand-searching. We included studies that reported hazard ratios (HR) or sufficient data to calculate the risk ratio and 95% confidence interval (CI) which were pooled using a random-effects model. Studies utilizing self-reported CHD were ineligible. Twelve studies were included comprising 1 131 612 persons and 58 111 incident CHD cases.
RESULTS
PD was associated with the primary incident CHD endpoint [adjusted HR (aHR) 1.47, 95% CI 1.24-1.74, p < 0.00001] even after excluding angina (aHR 1.49, 95% CI 1.22-1.81, p < 0.00001). High to moderate quality evidence suggested an association with incident major adverse cardiac events (MACE; aHR 1.40, 95% CI 1.16-1.69, p = 0.0004) and myocardial infarction (aHR 1.36, 95% CI 1.12-1.66, p = 0.002). The risk for CHD was significant after excluding depression (aHR 1.64, 95% CI 1.45-1.85) and after depression adjustment (aHR 1.38, 95% CI 1.03-1.87). Age, sex, length of follow-up, socioeconomic status and diabetes were sources of heterogeneity in the primary endpoint.
CONCLUSIONS
Meta-analysis showed that PD was independently associated with incident CHD, myocardial infarction and MACE; however, reverse causality cannot be ruled out and there was evidence of heterogeneity.
Topics: Anxiety; Anxiety Disorders; Coronary Disease; Humans; Myocardial Infarction; Odds Ratio; Panic Disorder; Proportional Hazards Models; Risk Factors
PubMed: 26027689
DOI: 10.1017/S0033291715000963