Panic Disorder and Agoraphobia

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30 Terms

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Marked fear/anxiety for two or more
public transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
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Combined psychological and drug treatments are no better than
CBT or drugs alone
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Psychological intervention
* Exposure-based
* Reality testing
* Relaxation and breathing skills
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Panic Control Treatment
Exposure to interoceptive cues

Cognitive therapy

Relaxation/breathing
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CBT is better
long-term
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Multiple systems affected by medication
serotonergic

noradrenergic

GABA
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High relapse rates after
discontinuation of medication
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Causes of nocturnal panic
Generalized biological vulnerability

Cues get associated with situations

Generalized psychological vulnerability
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Generalized biological vulnerability
Alarm reaction to stress
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Cues get associated with situations
Conditioning occurs
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Generalized psychological vulnerability
Anxiety about future attacks

Hypervigilance

Increase interoceptive awareness
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60% with panic disorder experience
nocturnal attacks
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When do nocturnal panic attacks occur?
Occur in non-REM sleep

Occur during delta/slow wave sleep
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Nocturnal attacks are caused by
deep relaxation
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Sensations of “letting go” are
anxiety provoking to people with panic attacks
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\~75% of those with agoraphobia are
female
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In developing countries, somatic symptoms more emphasized than
emotional symptoms
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Diagnostic Criteria for Agoraphobia: Situations always provoke
fear
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Diagnostic Criteria for Agoraphobia: Anxiety not proportional to
real danger
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Diagnostic Criteria for Agoraphobia: Marked fear/anxiety for two or more:
public transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
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Diagnostic Criteria for Agoraphobia: Anxiety is
excessive
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Diagnostic Criteria for Agoraphobia: Not better explained by
another mental disorder
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Diagnostic Criteria for Agoraphobia: Significant
distress
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Diagnostic Criteria for Panic Disorder: Recurrent
unexpected panic attaches
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Diagnostic Criteria for Panic Disorder: At least one attack has been followed by
significant worry or maladaptive change in behavior
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Diagnostic Criteria for Panic Disorder: Not attributable to
substance use
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Diagnostic Criteria for Panic Disorder: Not better explained by
another mental disorder
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What is a common symptom in children with panic disorder?
hyperventilation
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Agoraphobia: fear or avoidance of
situations/events
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Agoraphobia: Concern about being unable to
escape or get help in the event of panic symptoms or other unpleasant physical symptoms (e.g., incontinence, vomiting, falling)