Into the DSM - Panic Disorder

Panic disorder can be summed up in four words: Recurrent unexpected panic attacks. But there's more to it than that. First, what's a panic attack (and what's not a panic attack)? The DSM answers: A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes. During that time, four of the following symptoms occur:

1. Palpitations, pounding heart, or accelerated heart rate.
2. Sweating.
3. Trembling or shaking.
4. Sensations of shortness of breath or smothering.
5. Feelings of choking.
6. Chest pain or discomfort.
7. Nausea or abdominal distress.
8. Feeling dizzy, unsteady, light-headed, or faint.
9. Chills or heat sensations.
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
12. Fear of losing control or "going crazy."
13. Fear of dying.

With that you know most of what you need to know about the diagnosis, but not all. There's a crucial addition--criterion B: At least one of the attacks has been followed by one month (or more) of one or both of the following:

1. Persistent concern or worry about additional panic attacks or their consequences.
2. A significant maladaptive change in behavior related to the attacks (e.g., avoidance)

Of course, there are the usual "not better explained by" caveats. And that's it.

Risk factors for panic disorder include:

• Family history of panic.
• Major life stress or life changes.
• Trauma.
• Excessive caffeine intake and/or smoking.
• History of childhood physical or sexual abuse.

With the above information digested, consider yourself readied for a panic disorder question on the ASWB exam. For further study try: Panic attacks and panic disorder at MayoClinic.org.