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Panic Disorder01:27

Panic Disorder

Panic disorder is an anxiety disorder characterized by recurrent and sudden minutes-long episodes of intense fear, known as panic attacks. These attacks may feel like heart attacks and often happen without warning or a specific cause. They can include symptoms such as rapid heart rate, shortness of breath, chest pain, trembling, sweating, dizziness, and a sense of helplessness. During a panic attack, individuals may feel as though they are experiencing a heart attack or are in a...
Physiological Foundation of Stress01:24

Physiological Foundation of Stress

Stress triggers a coordinated physiological response involving the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This dual activation ensures that the body is prepared for both immediate and prolonged stress management. The process begins with the perception of a stressor. This initial phase activates the SNS, leading to the rapid release of adrenaline (epinephrine) from the adrenal glands.
Role of the Sympathetic Nervous System
Adrenaline triggers the...
Stress Response System01:21

Stress Response System

The stress response system, also known as the fight-or-flight response, is the body's automatic physiological reaction to perceived threats. Hans Selye introduced the concept of General Adaptation Syndrome (GAS) to describe the predictable pattern of changes that occur in response to stress. GAS consists of three sequential stages: alarm, resistance, and exhaustion. This model helps explain how chronic stress can contribute to health problems.
Alarm stage
In the alarm stage, the body's initial...
Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
Psychological Responses to Stress01:20

Psychological Responses to Stress

Psychological responses to stress encompass the various cognitive and emotional reactions individuals experience when faced with challenging or threatening situations, such as a job loss. Prolonged exposure to stressors can disturb emotional balance, increasing negative emotions (e.g., anxiety and sadness) and diminishing positive emotions (e.g., joy and satisfaction). These persistent emotional shifts are associated with an increased risk of both physical illness and mental health issues, such...
Introduction to Stress and Lifestyle01:27

Introduction to Stress and Lifestyle

Stress is a multifaceted response to events perceived as challenging or threatening, highlighting physical, emotional, cognitive, and behavioral reactions. Physically, stress can lead to fatigue, sleep disruptions, and various health issues such as frequent colds, chest pains, and nausea. Emotionally, it can manifest as anxiety, depression, irritability, and anger triggered by both minor and major life events. Cognitively, it may result in difficulty in concentration, memory, and...

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Related Experiment Video

Updated: May 22, 2026

Social Threat-Safety Test Uncovers Psychosocial Stress-Related Phenotypes
05:03

Social Threat-Safety Test Uncovers Psychosocial Stress-Related Phenotypes

Published on: December 15, 2023

Stress response regulation in panic disorder.

Marcus Ising1, Nina Höhne, Anna Siebertz

  • 1Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany. ising@mpipsykl.mpg.de

Current Pharmaceutical Design
|May 29, 2012
PubMed
Summary

Panic disorder involves intense fear attacks linked to stress response dysregulation. Patients may over-monitor stress, causing a subjective-to-physiological response gap, suggesting targeted therapies.

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A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
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A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents

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Last Updated: May 22, 2026

Social Threat-Safety Test Uncovers Psychosocial Stress-Related Phenotypes
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A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
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Published on: July 10, 2017

Area of Science:

  • Neuroscience
  • Psychiatry
  • Stress Response Research

Background:

  • Panic disorder is a common mental health condition marked by recurrent panic attacks.
  • The pathophysiology of panic disorder is thought to involve disrupted stress response regulation.
  • The hypothalamus-pituitary-adrenocortical (HPA) axis plays a crucial role in the body's stress response.

Purpose of the Study:

  • To review findings from challenge tests assessing HPA axis function in panic disorder.
  • To examine studies utilizing psychosocial challenge paradigms in panic disorder patients.
  • To integrate these findings into a cognitive stress control model for panic disorder.

Main Methods:

  • Review of existing literature on HPA axis challenge tests in panic disorder.
  • Overview of studies employing psychosocial challenge paradigms.
  • Integration of findings into a theoretical cognitive stress control model.

Main Results:

  • HPA axis challenge tests indicate increased hypothalamic neuropeptide expression but intact pituitary negative feedback in panic disorder.
  • Psychosocial challenge tests reveal a dissociation between subjective stress experience and HPA axis activation.
  • This dissociation may stem from heightened self-monitoring leading to increased stress perception despite normal HPA axis response.

Conclusions:

  • Panic disorder patients may develop coping strategies for somatic stress responses, driven by hypothalamic HPA axis hyperactivity.
  • Enhanced perception of stress symptoms is acquired to time these control strategies, causing subjective-HPA axis response dissociation.
  • Combined cognitive behavioral therapy and pharmacotherapy targeting hypothalamic neuropeptides may effectively treat severe panic disorder.