Panic and posttraumatic stress disorder: implications for culture, risk, and treatment.

Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
Cognitive behaviour therapy 02/2008; 37(2):131-4. DOI: 10.1080/16506070801969120
Source: PubMed

ABSTRACT The articles in this special series reflect productive cross-fertilization between the fields of panic disorder and posttraumatic stress disorder. The purpose of this commentary is to elucidate the implications of this research for the broader themes of culture, risk factors, and treatment.

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    ABSTRACT: While there is general agreement that, across cultures, panic disorder appears to be characterized by sudden onset of bodily sensations, such as dizziness and heart palpitations, followed by catastrophic misinterpretations of these symptoms, there remains a need for research investigating ethnic/cultural differences in the experience of panic attacks. In addition to investigating ethnic differences in the experience of panic, it is important to assess whether increased endorsement of panic symptoms translates into increased dysfunction. The present study investigated differences in the experience of panic attacks and examined the relation between symptom endorsement and overall distress and impairment in a large multiracial/ethnic student population. Preliminary analyses indicated that although overall endorsement of panic symptoms was similar across groups, differences did emerge on specific symptoms. Participants identifying as Asian tended to endorse symptoms such as dizziness, unsteadiness, choking, and feeling terrified more frequently than those identifying as Caucasian, and individuals identifying as African American reported feeling less nervous than those identifying as Caucasian. Participants of Hispanic/Latino(a) descent showed no differences from any other group on symptom endorsement. Panic symptom severity was not found to differ across racial/ethnic groups; however, the correlation between panic symptoms and panic severity was stronger for Asian and Caucasian participants than for African Americans. These results suggest that symptoms of panic may be experienced differently across racial/ethnic groups, and highlight the need for clinicians and researchers to assess panic symptoms within the context of culture.
    Journal of anxiety disorders 12/2010; 24(8):873-8. DOI:10.1016/j.janxdis.2010.06.010 · 2.68 Impact Factor
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    ABSTRACT: Panic disorder is a relatively common anxiety disorder that is often disabling. It may or may not be associated with agoraphobia. Panic disorder can be imitated by various medical illnesses, which, even when treated, can get cued with panic symptoms. It is also frequently comorbid with other psychiatric disorders including depression, generalized anxiety disorder, and substance use disorders. Although often initially seen in early adulthood, panic disorder can also present in childhood or in the geriatric population. Clinicians should thus be aware of the variability in clinical presen- tations that may be associated with both the pediatric and geriatric age groups. This article provides a broad overview of various screening and assessment tools used to evaluate panic disorder across the lifespan. The article also highlights some of the developmental differences and variability in the clinical presentation of pediatric and geriatric panic disorder.
    01/2008; 6(4). DOI:10.1176/foc.6.4.foc438
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    ABSTRACT: This article addresses post-traumatic stress disorder symptoms in Sri Lankan children in response to war and the 2004 tsunami. Exposure to war and the tsunami each predicted severity of posttraumatic symptomatology. In both studies, reexperiencing and arousal symptoms were reported more than avoidance-numbing. Furthermore, symptom severity was greater in groups reporting many symptoms compared to those reporting fewer symptoms, and there was no difference in symptom severity when the DSM–IV set of six symptoms was compared to a different set of 6 symptoms (with just one avoidance-numbing symptom). The relative primacy of reexperiencing and arousal symptoms are highlighted in this understudied South Asian population, informing cultural variation in diagnostic criteria and clinical interventions for post-traumatic stress symptoms.
    Journal of Aggression Maltreatment & Trauma 09/2013; 22(8):896-915. DOI:10.1080/10926771.2013.824056