Panic and Anxiety Disorders

Anxiety Disorders - Panic

Anxiety Disorder -- Panic Attacks

The study of abnormal psychology has, in the past three centuries, developed to become a science that provides understanding to professionals and laymen alike about the nature and dynamics of psychological disorders that extraordinarily affects human behavior. Among the identified psychological disorders in the field of abnormal psychology, it is anxiety disorder that can be said as the most common yet unexplored category. The reason for this is that although anxiety disorders are more frequently experienced, this area has not been thoroughly explored, especially in determining its etiology and forms of effective treatment (Barlow, 2000:2529). It is this "peculiar" nature of the disorder that the paper attempts to uncover through a thorough review of current literature on anxiety disorders, focusing specifically on panic disorder.

The texts that follow will cover the theoretical foundations of anxiety and panic disorders from the psychological standpoint. Further into the discussion, a review of research studies and other literature relevant to the disorder would be reviewed, bearing in mind the importance of identifying the nature of the disorder, including groups vulnerable or at-risk to anxiety-panic disorders. This includes a discussion of extant treatment options for the disorder, and which treatment options have been identified as effective or useful in alleviating the impact of the disorder to the behavior and life of the afflicted individual. Finally, the paper concludes with implications and reflections on the previous sections/discussions in the paper would then be shared by the author.

Anxiety disorder, particularly panic disorder, has been analyzed and developed in the context of prevailing theories at specific times in the history of abnormal psychology. One theory from which panic disorder has been identified and analyzed is through the cognitive theoretical perspective, which explained panic disorder as a combination of heightened "internal bodily sensations," such as "catastrophic thoughts" that are then translated to increased bodily sensations, manifested finally as a panic attack (Bouton, 2001:5). However, the weakness of the "catastrophic thoughts" cognitive model is that it does not fully explain the etiology of the panic disorder itself, and this has not been proven quantitatively or based on evidence.

Another model under which panic disorder is determined and analyzed is through the Anxiety Sensitivity (AS) theory. The AS theory posits that individuals susceptible to panic disorder have a "traitlike belief" that is inherent in them, which makes them think that "anxiety and its associated symptoms, particularly somatic symptoms, may cause deleterious physical, psychological, or social consequences that extend beyond any immediate physical discomfort during…panic itself" (6). While this helps describe the nature of panic disorder, as with the cognitive model of "catastrophic thoughts," the AS theory does not adequately explain the etiology of panic disorder. Further, studies have shown that AS theory does not specifically help determine panic disorder and its symptoms, thus making the AS theory an unreliable reference or source on the nature and behavior dynamics for panic disorder.

Using the conditioning perspective, panic disorder is explained to be a process of "fear of fear" (7). Panic disorder is alleviated by introducing the concept of "interoceptive conditioning," which enables the individual to be able to "control" in some degree his/her panic attack through the development of 'spontaneous cues' or reactions when the individual goes into "situational panics." This perspective posits that panic attacks can be unlearned with the introduction of new behavior that will replace the panicked behavior or actions of the individual. The weakness of the conditioning perspective is that there is expressed fear among psychologists that the introduction of new behavior or "interoceptive conditioning" could lead to new behavior that would further worsen the panic attack instead of alleviating or lessening it.

However, literature on panic disorder had also shown that combining different intervention forms proven to be effective in treating panic disorder is 'acceptable.' That is, studies are not conclusive on a specific type of intervention that can best lessen the frequency of occurrence of panic attacks. Literature only demonstrates that among the theories and corresponding interventions mentioned, combined intervention has so far been proven effective than focusing on a specific intervention alone. Thus, as far as research and current intervention programs on panic disorder are concerned, combined interventions are recommended to be more successful in treating panic disorder than the application of a specific intervention only.

Panic disorder in the United States has been identified extensively through demographic studies on health. In one of the studies on mental health and vulnerable or at-risk groups to it, research proponent Young (2001) identified individuals afflicted with panic disorder are profile to be between the ages 30-50 years old, mostly white Americans, and are common among individuals who just attended a few years in college or have only attained high school level of education or less (58). This demographic profile provides an insight into the nature of panic disorder itself, implying that interventions must be responsive to the nature and sensibilities of individuals who fit this profile and are suffering from panic disorder. More understanding of the demographic background of panic disorder patients would aid the counselor or psychologist with insights as to how the individual is likely to behave during panic attacks, and what are the intervention programs best suited for them.

The social environment of the individual has been strongly linked to the occurrence of panic attacks and perpetuation of panic disorder. In a meta-analysis study conducted by Hettema (2001), his group of researchers found out that panic disorder is significantly linked with "a familial component in liability to panic disorder" (1569). Going further into his study's findings, there were indications that the etiology of panic disorder could actually be linked with genetic factors or inheritance, determining that "genes affect panic disorder similarly in men and women" (1570). The influence of both the individual's immediate social environment, coupled with the finding that panic disorder could be inherited or genetically transmitted within the family, provides insights about the disorder itself, particularly in determining the history of the disorder for the patient. However, the meta-analysis only provides indications that these are the possible factors that could contribute to the etiology of the disorder, but it does not definitely claim that panic disorder is caused by genetic inheritance and/or by the individual's social environment. More intensive studies such as Hettema's must be conducted to prove the consistency or reliability of the results reported.