Panic disorders as somatic and neurotic states of personality: conditioning, behavioural learning

Abstract

Panic disorder is examined in the article as a clinical syndrome which sets a context to study relevance of basic principles of conditioning and learning to the questions of origin and development of psychopathologies. It is proven that panic attack is sudden experiencing of strong fear or discomfort accompanied by various somatic and psychical symptoms, for example, heart palpitation, stethalgia, feeling of breath shortage, dizziness, ideas about madness, loss of self-control or death. It is mentioned that experiencing of unexpected panic attacks however is not a sufficient criterion for establishment of panic disorder. Except listed above, an individual must feel substantial anxiety or deep concern about possibility of next attack and/or its consequences, for example, cardiac attack, madness or loss of (sels)control. Nowadays there are at least three main psychological theories related to the origin of panic disorder as a mental disorder. Two of them, cognitive theory and theory of anxiety sensitivity, mark cognitive aspects of the disorder, and historically earlier conditioning theory was yielded to various criticism. Taking into account earlier perspectives of panic disorder, our understanding of this phenomenon underlines the key role of early conditioning episodes in etiology of the disorder. Such perspective can be considered as a strength of learning theories, since it includes empirically verifiable explanation of etiology of panic disorder. Anxiety and panic are examined as separate states within panic disorder; anxiety is not simply weaker version of panic, and panic accordingly isn’t just stronger or more expressed version of anxiety. Anxiety prepares psyche of an individual to future trauma, while panic works (as a mean of mental defense) with a trauma that is being experienced here and now. Conditioned anxiety, caused by interoceptive and exteroceptive signals, serves for augmentation of future panic reactions. Thus anxiety becomes precursor of panic. It is summarized that therapeutic approaches that include extinction or counterconditioning of conditional stimuli which influence the disorder, will be the most successful.