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An Analysis of Uncued Panic Attacks in
Jasmine Arthur-Jones and Bronwyn
- Role of fear triggering within uncued panic attacks are investigated.
A model for the physiological structure of an uncued panic attack is developed
by investigation into "energy" movement, dissociative experiences,
physical symptoms, light and sound phenomenon, breathing, perceived physical
changes. Also investigated meditation as an effective recovery method for
Panic Disorder and Anxiety Disorder.
Panic Disorder, the experience of Panic Attacks, was included for the
first time in the DSM-111(1) in 1980. Over the last fourteen years, research
has increased the knowledge and understanding of this Disorder which is
clearly evident in the recently released DSM-4(2).
In 1980 Panic Disorder was diagnosed when a person experienced at least
three panic attacks over a three week period. In the DSM-111 and the DSM-111R(3)
there was no specific distinction made in the type of Panic attacks people
experienced. While the DSM-111R acknowledged that the avoidance behaviour
(Agoraphobia) relating to the Panic Disorder was a result of a fear of having
a Panic Attack, this lack of distinction upheld the prevailing view of the
time that a panic attack and the avoidance behaviour resulting from the
attack was a "phobic" response to situations and/or places. Many
of the earlier treatment methods for Panic Disorder/ Agoraphobia focussed
on gradual exposure to the avoided situation and/or place and did not directly
deal with the panic attack itself.
Specific distinctions in the type of panic attacks experienced have now
been clearly stated in the DSM-4. The first type of attack and the one which
is pivotal to this paper is the "unexpected" (Uncued) panic attack
in which the onset of the Panic Attack is not associated with a situational
trigger, i.e. occurring spontaneously ("out of the blue").
The second is "situationally bound (cued) panic attacks, in which the
panic attack almost invariably occurs immediately on exposure to or in anticipations
of the situational cue or trigger.
The third is "situationally predisposed panic attacks, which are more
likely to occur on exposure to the situational cue or trigger, but do not
necessarily occur immediately after the exposure(2).
Agoraphobia in Panic Disorder is recognised "as anxiety about being
in situations and places from which escape may be difficult or embarrassing
or in which help may not be available in the event of having an unexpected
or situationally predisposed panic attack or panic like symptoms(2)".
Besides Agoraphobia, other secondary conditions and effects of Panic Disorder
are major depression, drug and/or alcohol abuse and suicide(2).
Another feature of Panic Disorder included in the DSM-4 is the experience
of nocturnal panic attacks which are said to occur between stage two and
stage three of sleep(4).
The symptoms of a panic attack are described in the DSM-4 as a "discrete
period of intense fear or discomfort in which four (or more) of the following
symptoms developed abruptly and reached a peak within ten minutes. Palpitations,
pounding heart or accelerated heart rate, sweating, trembling or shaking,
sensations of shortness of breath or smothering, feeling of chocking, chest
pain or discomfort, nausea or abdominal distress, feeling dizzy, unsteady,
lightheadedness or faint, Derealisation or depersonalisation, fear of losing
control or going crazy, fear of dying, numbness or tingling sensations,
chills or hot flushes(2)."
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