Panic disorder with and without agoraphobia in adolescents

Panic disorder, a branch of clinical child psychology studies, is attracting a lot of attention in recent years. It is characterized by repeated panic attacks without warning, along with anxiety periods over the possibility of another attack which can range in months, the probable outcomes associated with the attacks and changes in behavior. There are various indicators associated with Panic attacks which can exhibit themselves in spurts, which last for a few minutes. While these seem to appear out of nowhere, there are usually some events which stimulate patients into demonstrating them. A majority of previous research results in this area is restricted to adults. Panic disorder and attacks in the youth is a controversial topic which has ignited multiple arguments. The occurrence of panic disorder coupled with agoraphobia has not been studied enough. Additional investigation is necessary in this area along with cases such as setting avoidance, severity of symptoms and comorbidity (Kearney, Albano, Eisen, Allan & Barlow, 1997).

Description of the study's aims

The current study is targeted at panic disorder patients of adolescent age groups and focus on factors which have not been analyzed experimentally in the past. Outpatient medical samples utilized here include individuals with panic disorder symptoms (which are coupled with or without agoraphobia -- the fear of places without an easy access to help). The characters of these patients are compared with those who have a disorder which is not related to anxiety. The study proceeds taking into contention, a few theories derived from past studies These assume panic disorder patients to have a greater probability of demonstrating behaviors such as separation anxiety, instances of depression, substance usage, self reported anxiety and fearfulness (Kearney, Albano, Eisen, Allan & Barlow, 1997)

Description of the study's method

The study was conducted over 40 Caucasian individuals in the adolescent age range, partitioned into two groups of 20 (each having 8 males and 12 females). The first group was between 8 and 17 years old with or without the symptoms of agoraphobia. They had undergone an analysis of panic disorder up to the primary or additional level. Primary diagnosis implied the occurrence of constant panic attacks coupled with related DSM-III-R conditions. Additional diagnosis is supposed to be a part when they demonstrated symptoms of posttraumatic stress disorder, simple phobia, major depressive disorder, social phobia, generalized anxiety disorder, obsessive stress disorder, obsessive compulsive disorder and separation anxiety disorder (Kearney, Albano, Eisen, Allan & Barlow, 1997)

. The second group was within the age range of 8 to 16 years old with anxiety disorders excluding panic disorder. The constituents of primary diagnosis for this group were overanxious disorder, simple phobia, avoidant disorder, separation anxiety disorder and obsessive compulsive disorder. Targeted interviews constructed using the Anxiety Disorders Interview Schedule-Child version (ADIS-C) were utilized in gathering data about these groups suffering from emotional and behavioral issues, especially anxiety disorders. The composite analysis results obtained from the ADIS-C and ADIS-P (parent version) are recorded by clinicians on a severity scale of 0-8. The severity of the individual indicators is measured by parents and their children on a scale of 0-4. A group of additional measures of variable item counts (ranging from 18 to 80) were used to evaluate the children suffering from anxiety disorders (Kearney, Albano, Eisen, Allan & Barlow, 1997)

Interview sessions were conducted by individuals trained in ADIS-C and ADIS-P techniques, both over the participants and their parents. The procedure included recording the observations from three interviews and matching them against the severity measures of three among five interviews. The results are analyzed and finalized by a clinical treatment team established for each group. Conclusions from the self report were also incorporated at the same time (Kearney, Albano, Eisen, Allan & Barlow, 1997).

Description of the study's results

The results obtained from first group demonstrated symptoms such as nausea, increased heart rate, flashes of heat or cold coupled with physical shivering. Shortness or difficulties in breathing, weakness leading to fainting or the feeling of being choked are some of the more severe symptoms. The participants of this group made efforts to stay clear from some locations such as crowded areas, enclosed places such as rooms, elevators, stores and restaurants (Kearney, Albano, Eisen, Allan & Barlow, 1997)

When compared to the results of the second group, depressive disorder was observed to be more prevalent in the first group than the second one. The results were found to be similar with regards to the scales of RCMAS (a 37 item measure), STAIC (for the 20 item state scale measure only), CDI (a 27 item measure) and FSSC-R (an 80 item measure). The trait scale of STAIC showed a few variations but was not strong enough when the Bonferroni correction was applied. The CASI scale presented a higher occurrence in the second group compared to the first, regardless of Bonferroni corrections. This amounted to at least 16 of the 18 items. The remaining two items, recorded higher in the second group can be considered to be of an external nature. The origins of these differences were obtained using t-test analysis methods (Kearney, Albano, Eisen, Allan & Barlow, 1997)

Strengths/Weaknesses

The study brings forth several important results about panic disorder but is limited in some regards. The individuals of the first group had the presence of primary diagnoses along with additional ones. This was essential in developing a strong outpatient youth sample for panic disorder. A higher severity of the primary form compared to the additional diagnostic form was the only difference observed. Another limitation was the variation in results due to the inclusion of a strategic configuration in the procedures. While this was done in compliance with the original plan, it reduced the chances of the validity of the results being jeopardized. The reliance on self reporting measures in evaluating the groups can be regarded as another limitation. The fact that adolescents themselves are the best ones to convey their own symptoms made this approach acceptable (Kearney, Albano, Eisen, Allan & Barlow, 1997).

My analysis

While the current results are decent enough, future evaluations in the field of panic disorder needs to incorporate physiological parameters such as heart rate and hormonal balance levels, additional ratings from parents and teachers along with direct conclusions drawn from avoidance and escape tendencies. Researchers need to delve deeper into the progress of panic disorders in the younger age groups. The first few instances are usually found in individuals during their developmental stage. The origins of some assumptions presented in the current study can be obtained from longitudinal approaches. The results of this study fell short in establishing a link between anxiety and panic attributed to separation. This necessitates a better examination of adolescents with panic disorder, especially with severe behavioral avoidance tendencies. Adequate information of this group would aid in helping practitioners gain a better understanding in order to devise a potential cure (Kearney, Albano, Eisen, Allan & Barlow, 1997)