Fearful and non-fearful panic attacks in a student population

The phenomenon of non-fearful panic was investigated in a sample of 83 university students who reported histories of unexpected panic attacks. Based on severity ratings of individual panic symptoms, Ss were classified as having panic attacks characterized by No Fear (N = 22), Low Fear (N = 30) or High Fear (N = 31). The three groups were similar with respect to the age-of-onset of panic attacks, the frequency with which they experienced panic and the severity of panic symptoms unrelated to fear. However, Ss reporting fear during panic attacks were more likely to engage in avoidance behaviour and to use alcohol or drugs as ways of coping with panic. Only High Fear subjects showed significant elevations on self-report measures of depression and global psychopathology. These results indicate that the experience of fear during panic attacks may be important in the transition from non-clinical panic to panic disorder, in a manner proportional to the amount of reported fear.