Genetic and Biological Factors
disorder with or without agoraphobia has a lifetime prevalence of
between 1.5% and 3.8%. The female to male ratio is 2:1. The usual
onset of the first panic attack seems to usually be in the early
20’s. It's a relative rarity for children under the age of 16 to have
a panic attack and also rare for individuals over 45 to have their
first panic attack.
Panic disorder: Genetic and biological factors
there may be a moderate genetic connection associated with panic
disorder and agoraphobia. Some of the biological signs have been
identified as compensated respiratory alkalosis which is related to
the hyperventilation syndrome, which sometimes accompanies panic
disorder. Also, some individuals with panic disorder have increased
responses to lactate infusion and to CO2 inhalation, although these
symptoms are not usually significant enough to diagnose panic
disorder. Panic disorders also have been found to have some effect on
the dysregulation of the serotonergic and noradrenergic systems.
Panic disorders are frequently inhibited by certain medications such
as imipramine and fluvoxamine.
Some experts have
suggested an evolutionary model for panic disorder and agoraphobia,
which suggests that there may be some adaptive quality associated with
it, and sensitivity toward certain conditions and stimuli (such as
being trapped in close spaces, open fields, being at great heights or
being left alone). For example, from an evolutionary standpoint,
crossing an open field may make one more prone to attack by
predators. The normal responses to these threats include flight or
freezing which are similar to the sympathetic and parasympathetic
responses in panic disorder. However, since individuals may also seem
to be unable to escape in modern everyday life (e.g. being a
supermarket line or on a subway), the anxiety may continue to rise
resulting in a panic attack.
Coexisting conditions associated with panic disorder:
There are many
other psychological conditions which frequently coexist with panic
disorder such as major depression, dysthymic disorder, generalized
anxiety disorder, obsessive-compulsive disorder, social phobia,
specific phobia, hypochondriasis, and substance abuse or dependence.
Also, withdrawal from alcohol or other substances may result in panic
attacks. It has also been noted that individuals with panic disorder
who are having other psychological difficulties such as marital
problems, may not report the problems as they are afraid of losing
their “safety persons”. Couple conflict however, is not that uncommon
among these patients because of the strain of agoraphobia on the
patience of an individual's spouse or partner. While one study found
that the risk for suicide was higher among individuals with panic
disorder than with major depression, continued analysis of this
information found that the higher incidence for panic disorder was
probably more related to individuals with coexistent borderline
personality disorder and or comorbid substance abuse problems. Panic
disorder per se is not a strong predictor of a high risk for suicide.
Information adapted from Treatment Plans and Interventions for
Depression and Anxiety Disorders by Robert L. Leahy and Stephen J.
Webpage and additional
information By Paul Susic MA Licensed Psychologist Ph.D Candidate
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