Panic Attacks in Nonclinical Subjects

Abstract

Sudden episodes of intense anxiety accompanied by a number of predominantly somatic symptoms (now usually called panic attacks) are the primary feature of the psychological disturbance termed panic disorder in DSM-IIIR (APA 1987). This diagnosis was introduced based on the idea that panic attacks are a distinct type of anxiety in need of their own diagnostic entity. However, recent research has shown that panic attacks are not specific to panic disorder since they also occur across a wide range of other psychological disorders and even in nonclinical populations. Barlow et al. (1985) studied 108 patients with the DSM-III diagnoses simple phobia, social phobia, generalized anxiety disorder, panic disorder, agoraphobia with panic attacks, obsessive-compulsive disorder, and major depressive episodes. The great majority of patients in each of these categories (at least 83%) reported having experienced panic attacks. Although the frequency of attacks varied across diagnoses, there were only few differences in terms of the symptom pattern associated with the attacks. Furthermore, symptom severity was similar for patients with situational (predictable, expected) and spontaneous (unpredictable, unexpected) attacks. These results are in line with those of the Munich Follow-Up Study (MFS, Wittchen 1986) in which panic attacks were observed in 9.3% of a representative community sample, a percentage higher than the combined frequencies of panic disorder and agoraphobia with panic attacks.