Anxiety disorders are one of the most prevalent mental disorders in society worldwide. These are of different types, and can significantly disable the life of the person who suffers from them.
In this article we will talk about anxiety attacks or panic attacks, very common in different anxiety disorders. Currently, in the DSM-5, they are considered a specifier of any other disorder. They are defined as the sudden appearance of fear or intense discomfort, which reaches its maximum expression within minutes.
Panic attacks, also called panic attacks or panic or anxiety attacks, are included in the DSM (Diagnostic and Statistical Manual of Mental Disorders). The DSM-5 includes panic attacks as a specifier of any other disorder, and not so much as a disorder in itself (in the DSM-IV-TR the panic attack was considered as an independent “disorder”, the so-called panic disorder or panic attack).
On the other hand, the ICD-10 (International Classification of Diseases) requires, to diagnose a panic attack, that at least one of the symptoms be: palpitations, tremors, dry mouth or sweating
Symptoms
The DSM-5 defines a panic attack as sudden appearance of fear or intense discomfort, which reaches its maximum expression within minutes During this time, 4 (or more) of the following symptoms occur:
On the other hand, the most frequent somatic symptoms in anxiety attacks They are: firstly palpitations, followed by vertigo-dizziness and tremors (they are common in both children and adults).
Children, unlike adults, present cognitive symptoms to a lesser extent (fear of going crazy, for example).
Types of panic attacks
The sudden appearance of fear or discomfort can occur from a state of calm or, conversely, from a state of anxiety. On the other hand, panic attacks are very common in different anxiety disorders.
According to the DSM, a panic attack can be diagnosed in the absence of fear or anxiety, which is defined as “cognitive or alexithymic panic attacks”
Attacks that do not present all 4 symptoms are called “limited asymptomatic seizures.”
Differences in clinical and non-clinical population
It is known that panic attacks also occur in the non-clinical population (without a mental disorder), as well as in the clinical population (with a mental disorder). These attacks are similar in the similar physiological experience, in which occur in times of stress and that there is a similar family history of panic attacks.
Regarding the differences, we find that:
Causes
We find different types of causes that have been referred to to try to explain the appearance of anxiety attacks. These are, broadly speaking, of 3 types (although in most cases there is an interaction between several of them that end up causing the disorder).
1. Biological
The biological hypotheses allude to a certain predisposition to anxiety disorders, as well as neurobiological aspects (GABA alterations, hyperactivity of the locus coeruleus, hypersensitivity of serotonin receptors, etc.), neuroendocrine and psychophysiological aspects
2. Learning
Learning theories refer to classical conditioning, Mowrer’s two-factor model (which includes operant and classical conditioning as originators and maintainers of anxiety), Eysenck’s law of incubation and Seligman’s preparation theory.
3. Cognition
Cognitive models refer to aspects more related to how we process information referring for example to brain networks or structures of “fear” and a selectivity to attend to aversive stimuli, among others.
Treatment
The disorder of choice to treat panic disorder or panic attacks is a multicomponent cognitive-behavioral treatment which includes among its components:
On the other hand, treatments with good efficacy are considered: Barlow’s panic control treatment, and Clark’s cognitive therapy
As slightly less effective treatments, we find:
Finally, in the experimental phase, there are three types of treatments with favorable data to treat anxiety attacks:
He exposure treatment through virtual reality (for panic disorder with agoraphobia)
Intensive therapy focused on sensations (by Baker Morissette)
Augmented cognitive-behavioral therapy for panic (Levitt’s)
WHO (2000). ICD-10. International classification of diseases, tenth edition. Madrid. Panamericana.
Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Vol. 1 and 2. Madrid. XXI century
Belloch, A.; Sandín, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
American Psychiatric Association –APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
