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
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.
Available from: Terri L Barrera
- "These findings correspond with previous studies that suggest some Asian individuals tend to endorse more somatic symptoms than do individuals indentifying as Caucasian (Lee, Lei, & Sue, 2001). Furthermore, the increased endorsement of dizziness and unsteady feelings is similar to what might be expected in some indigenous Asian populations such as native Cambodians (Hinton et al., 2008; McNally, 2008). It is possible that individuals identifying as Asian are particularly sensitive to such bodily sensations due to cultural interpretations attached to the meaning of these symptoms. "
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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.
Available from: ncbi.nlm.nih.gov
- "Significant differences were expected only between – but not within --the clinical (PTSD; PD) and nonclinical (PA; C) groups. These hypotheses were guided by theoretical models of PTSD and PD and their co-occurrence (Asmundson & Stapleton, 2008; Falsetti & Resnick, 2000; Hinton et al., 2008; Jones & Barlow, 1990; McNally, 2008), which suggest these conditions may be characterized by a number of similar underlying (generalized) vulnerability processes. The present study differs from that by Marshall and colleagues (2008) by being expressly focused on cognitive-affective vulnerability among the studied groups. "
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ABSTRACT: The present study evaluated differences among daily smokers with posttraumatic stress disorder (PTSD), panic disorder (PD), panic attacks (PA), and no axis I psychopathology (past 6 months) in terms of several cognitive-affective variables implicated in both the onset and maintenance of anxiety psychopathology and cigarette smoking. The sample consisted of 123 daily smokers (62% women: M(age)=29.7, SD=11.9). Compared to the PA and no psychopathology groups, the PTSD group reported significantly higher levels of anxiety sensitivity, discomfort intolerance, negative affectivity, anxious arousal, and anhedonic depression; and, the PTSD group reported significantly lower levels of perceived control over anxiety-related events than the PA group. The PD group, compared to those in the PA and no psychopathology groups, reported significantly higher levels of anxiety sensitivity, negative affectivity, and anxious arousal; and significantly lower levels of perceived control over anxiety-related events. No significant differences were evident between the PTSD and PD groups. Theoretical and clinical implications of the present findings are discussed in terms of smoking and emotional vulnerability.
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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.
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