Panic Disorder: Pathogenesis and clinical findings

Social Factors

 • Parenting and infant attachment

 • Childhood illness/abuse

 • Prolonged stress or trauma

 • Substance abuse

Biological Factors

 • Dysregulation of autononomic nervous system and hypothalamic-pituitary-adrenal (HPA) axis

 • GABA abnormalities

Psychological Factors

 • Strong belief/fear of physical or mental harm from bodily sensations

 • Neurotic personality

Genetics ~30-40% heritability



>> Panic Disorder - Panic Attack most often in absence of external cue/trigger 



Physical Symptoms

 • Incr Heart rate, hyperventilation, sweating, trembling, nausea, dyspnea, chest pain, heart palpitations, diaphoresis

 • Hyperventilation -> respiratory alkalosis

 • Dizziness, lightheadedness, numbness, shortness of breath

Psychological Symptoms

 • Uncontrollable fear about symptoms/losing control/dying

 • Sense of altered reality

Experiential Avoidance

 • Avoidance of situations that reproduce bodily sensations similar to panic attacks (exercise, caffeine, alcohol, saunas)

Safety Behaviours

 • I.e. carrying anti-anxiety medication, locating the nearest hospital (to sense of security in the event of a panic attack)

Anticipatory Anxiety

 • Intrusive thoughts and worries about where/when a panic attack will occur and the consequences (embarrassment, discomfort)



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