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The definition of panic attacks, Part I.

N Argyle¹, M Roth

¹Anxiety and Depression Clinic, New York Hospital, Westchester.

Psychiatric Developments

|January 1, 1989

Summary

Panic attacks are distinct anxiety episodes characterized by sudden onset, higher severity, and immediate fears of catastrophic outcomes like death or insanity. These features differentiate them from general anxiety, aiding in a clearer clinical definition.

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Area of Science:

Psychiatry
Clinical Psychology
Anxiety Disorders Research

Background:

Panic attacks are a significant clinical concern within anxiety disorders.
Distinguishing panic attacks from general anxiety is crucial for accurate diagnosis and treatment.
Previous research has explored panic attack phenomenology, but clear diagnostic criteria remain debated.

Purpose of the Study:

To phenomenologically characterize panic attacks and compare them with non-panic anxiety episodes.
To identify distinctive features of panic attacks based on patient-reported experiences.
To propose a refined definition of panic attacks based on empirical findings.

Main Methods:

Analysis of phenomenological data from 159 patients experiencing anxiety episodes.
Comparison of features (severity, duration, symptoms, cognitions) between panic attacks and non-panic anxiety.
Examination of panic attack characteristics across different contexts (situational vs. spontaneous) and patient groups (depressed vs. anxiety disorder patients).

Main Results:

Panic attacks exhibit sudden onset, greater severity, more symptoms, and shorter duration compared to non-panic anxiety.
Distinctive cognitive features, specifically immediate fears of death, collapse, or insanity, characterize panic attacks.
No significant differences were found between situational and spontaneous attacks, or between panic attacks in depressed versus anxiety disorder patients.

Conclusions:

A specific cluster of features, particularly the immediacy of catastrophic cognitions, defines panic attacks.
The findings support a distinction between panic attacks and generalized anxiety based on phenomenological and cognitive aspects.
A revised definition of panic attacks is proposed, emphasizing their unique characteristics.

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