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Panic Disorder Diagnosis Page #1
 Panic
Disorder diagnosis overview:
A panic disorder
diagnosis is characterized by recurrent and unexpected panic attacks.
At least one of these attacks must be followed by (1) persisting
concern for additional attacks for at least a month, (2) worry about
the implications or consequences of the panic attack, or (3) changes
in your typical behavior patterns as a result of the attack, such as
avoidance of school or work activities. In addition, the panic
attacks cannot come from the direct effects of illicit substance use,
medication, or some other type of general medical condition. Also,
the panic attacks cannot be better explained by another mental
disorder such as a social phobia. Additionally, when the criterion
for panic disorder is also accompanied by agoraphobia you may also
have what is defined as a panic disorder diagnosis with agoraphobia.
Panic attacks are
an important feature of panic disorder and in combination with
agoraphobia (i.e. being in a position not easily escaped from or where
help is not easily accessible if panic occurs) are important to a
panic disorder diagnosis with agoraphobia, the criteria for panic
attacks and for agoraphobia stand alone. An accurate diagnosis is
very difficult without an understanding of these features. The
criteria for panic attacks can be quite difficult to understand at
times while the criteria for agoraphobia are generally
straightforward.
Researchers have
found that people frequently report what they believe to be a panic
attack during or in conjunction with a perceived actual physical
threat. It is important however to distinguish between an actual
threat and between a fear reaction in the absence of a “real danger”.
These attacks involve an occurrence of intense fear and discomfort
accompanied by a minimum of 4 of the 13 symptoms identified in the
diagnostic criteria for a panic attack. Diagnostic manuals recognize
three characteristic types of panic attacks, including those that are
situationally bound, those that are unexpected and those
that are situationally predisposed (those that occur when
exposed to situational triggers or when anticipating it. A limited
symptom attack is a term that is sometimes used to refer to
panic-like episodes which involve fewer than four symptoms.
While unexpected
panic attacks are required for a diagnosis of panic disorder, not all
panic attacks are unexpected. Unexpected attacks can wax and wane
over the course of the disorder and overtime they seem to become
situationally bound or predisposed. Also, situationally bound or
predisposed panic attacks can co-occur with other disorders such as
depression or all of the other anxiety disorders. However, in order
to get a clear understanding of the distinction between the different
types of panic attacks in order to have a differential diagnosis, you
must consider the characteristics of panic including frequency of
attacks, duration of attacks, number and intensity of symptoms,
mechanisms responsible for termination of the attack and the nature of
catastrophic thinking. An understanding of these features is important
in identifying, exacerbating and controlling the various factors
related to the attacks.
Information adapted from DSM-IV-TR Mental Disorders Diagnosis,
Etiology & Treatment by Michael B. First and Allan Tasman
Webpage and additional
information By Paul Susic MA Licensed Psychologist Ph.D Candidate
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