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Sample records for adolescent panic attacks

  1. Parent-Reported Predictors of Adolescent Panic Attacks.

    ERIC Educational Resources Information Center

    Hayward, Chris; Wilson, Kimberly A.; Lagle, Kristy; Killen, Joel D.; Taylor, C. Barr

    2004-01-01

    Objective: To identify parent-reported risk factors for adolescent panic attacks. Method: Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder…

  2. Duloxetine-related panic attacks.

    PubMed

    Sabljić, Vladimir; Rakun, Radmir; Ružić, Klementina; Grahovac, Tanja

    2011-03-01

    Side-effects arising on the grounds of antidepressant administration pose as a substantial obstacle hindering successful depressive disorder treatment. Side-effects, especially those severe or those manifested through dramatic clinical presentations such as panic attacks, make the treatment far more difficult and shake patients' trust in both the treatment and the treating physician. This case report deals with a patient experiencing a moderately severe depressive episode, who responded to duloxetine treatment administered in the initial dose of 30 mg per day with as many as three panic attacks in two days. Upon duloxetine withdrawal, these panic attacks ceased as well. The patient continued tianeptine and alprazolam treatment during which no significant side-effects had been seen, so that she gradually recovered. Some of the available literature sources have suggested the possibility of duloxetine administration to the end of generalised anxiety disorder and panic attack treatment. However, they are outnumbered by the contributions reporting about duloxetine-related anxiety, aggressiveness and panic attacks. In line with the foregoing, further monitoring of each and every duloxetine-administered patient group needs to be pursued so as to be able to evaluate treatment benefits and weigh them against risks of anxiety or panic attack onset.

  3. Panic Disorder in Children and Adolescents

    MedlinePlus

    ... for Families Guide Panic Disorder In Children And Adolescents No. 50; Updated July 2013 Panic disorder is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...

  4. Panic attacks during sleep: a hyperventilation-probability model.

    PubMed

    Ley, R

    1988-09-01

    Panic attacks during sleep are analysed in terms of a hyperventilation theory of panic disorder. The theory assumes that panic attacks during sleep are a manifestation of severe chronic hyperventilation, a dysfunctional state in which renal compensation has led to a relatively steady state of diminished bicarbonate. Reductions in respiration during deep non-REM sleep lead to respiratory acidosis which triggers hyperventilatory hypocapnea and subsequent panic. A probability model designed to predict when during sleep panic attacks are likely to occur is supported by relevant data from studies of sleep and panic attacks. Implications for treatment are discussed.

  5. Panic attacks after treatment with zuclopenthixol decanoate.

    PubMed

    Srivastava, Anil; Soni, Jorge

    2007-01-01

    The association between neuroleptics and anxiety is unclear: neuroleptics have been used to treat anxiety though may also themselves be anxiogenic. We present the case of a man who developed new onset panic attacks after treatment with zuclopenthixol decanoate, a commonly administered depot antipsychotic. We review the literature on the association between antipsychotics and anxiety and present possible pathophysiological mechanisms.

  6. Nortriptyline in the treatment of panic disorder and agoraphobia with panic attacks.

    PubMed

    Munjack, D J; Usigli, R; Zulueta, A; Crocker, B; Adatia, N; Buckwalter, J G; Baltazar, P; Kurvink, W; Inglove, H; Kelly, R

    1988-06-01

    Thirty-four consecutive patients with panic disorder or agoraphobia with panic attacks were treated with nortriptyline at the LAC-USC Medical Center's Anxiety Disorders Clinic. Fourteen (67%) of the 21 completers totally lost their panic attacks, five (24%) showed partial improvement, and two (10%) showed no improvement. The relationship of treatment outcome to pretreatment and posttreatment measures of depression is discussed, in addition to the potential role of nortriptyline in treating panic attacks in clinical practice.

  7. Orthostatic panic attacks among Vietnamese refugees.

    PubMed

    Hinton, Devon E; Hinton, Ladson; Tran, Minh; Nguyen, Men; Nguyen, Lim; Hsia, Curtis; Pollack, Mark H

    2007-12-01

    Viewed historically and cross-culturally, orthostatic-induced dizziness, i.e., dizziness caused by standing up from a sitting or a lying position, forms a key aspect of many syndromes: irritable heart (American Civil War), effort syndrome (World War I and World War II), chronic fatigue syndrome (contemporary USA), Gulf War syndrome (contemporary USA), and orthostatic dysregulation (contemporary Japan). Among Vietnamese refugees attending a psychiatric clinic, this study documents a high rate of orthostatic panic (OP), as well as certain processes seemingly generating these panic attacks, viz., flashbacks and culturally specific catastrophic cognitions. Case examples are used to demonstrate OP's phenomenology and relevance to clinical care. To illustrate the mechanisms producing OP, we adduce the multiplex model of panic generation. Culturally appropriate care of Vietnamese refugees should include assessment and treatment of OP.

  8. Recurrence of Panic Attacks after Influenza Vaccination: Two Case Reports

    PubMed Central

    Kim, Han-Joon; Jeon, Sang-Won; Yoon, Ho-Kyoung

    2016-01-01

    Human influenza is a contagious respiratory illness caused by the influenza virus. The influenza vaccination is recommended annually, but several adverse effects related to allergic reactions have been reported. Panic attacks are also known to occur, but no case of a panic attack adverse effect has been reported in South Korea. We present two cases of panic disorder patients whose symptoms were aggravated by the influenza vaccination. We assumed that dysregulation of T-lymphocytes in panic disorder patients could have a role in activating various kinds of cytokines and chemokines, which then can lead to panic attack aggravation. PMID:27776395

  9. Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.

    PubMed

    Munjack, D J; Crocker, B; Cabe, D; Brown, R; Usigli, R; Zulueta, A; McManus, M; McDowell, D; Palmer, R; Leonard, M

    1989-02-01

    Fifty-five patients completed a 5-week double-blind study comparing alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks. There was no concomitant behavioral treatment. Patient and therapist rating scales included Sheehan's Panic and Anxiety Attack Scales, the Marks-Sheehan Phobia Scale, the Hamilton Anxiety Scale, the Hamilton Depression Scale, and the Side Effects Checklist. The results generally support the efficacy of alprazolam, but not propranolol, in the treatment of panic disorder and agoraphobia with panic attacks. The significance of the results are discussed, as well as a number of the unique aspects of our procedures and patient population.

  10. Assessment and treatment of nocturnal panic attacks.

    PubMed

    Craske, Michelle G; Tsao, Jennie C I

    2005-06-01

    Nocturnal panic (NP), waking from sleep in a state of panic, is a common occurrence among patients with panic disorder, with 44-71% reporting at least one such attack. NP is a non-REM event that is distinct from sleep terrors, sleep apnea, nightmares or dream-induced arousals. This review outlines recent advances in the characterization of NP, as well as current approaches to the assessment and treatment of NP. In contrast to earlier work, more recent studies suggest that patients with NP do not differ from patients without NP on sleep architecture, sleep physiology, self-reported sleep quality and severity of panic disorder. However, more precise measurement of physiological precipitants and features is warranted. Assessment of NP focuses on ruling out other explanations for NP, with differential diagnosis based on interviews, sleep polysomnography and ambulatory recording of sleep. Psychological treatment (cognitive-behavioral therapy) targets misappraisals of anxiety sensations, hyperventilatory response, and conditioned reactions to internal, physical cues. Recent evidence supports the efficacy of this approach, however, controlled studies on pharmacological agents in the treatment of NP are lacking. Research is needed to examine the effects of combined cognitive-behavioral therapy and medications, compared to medication alone in the treatment of NP.

  11. Is There Anybody There? A Psychodynamic View of Panic Attack.

    ERIC Educational Resources Information Center

    Rizq, Rosemary

    2002-01-01

    Presents a process analysis of a psychodynamic intervention for a client with panic attacks. Discusses how a psychodynamic understanding of the complex etiology of the client's panic attacks that ultimately produced improved coping skills and a subjective sense of improvement for her. Process analysis is used to illustrate the theoretical base,…

  12. Myocardial perfusion imaging study of CO(2)-induced panic attack.

    PubMed

    Soares-Filho, Gastão L F; Machado, Sergio; Arias-Carrión, Oscar; Santulli, Gaetano; Mesquita, Claudio T; Cosci, Fiammetta; Silva, Adriana C; Nardi, Antonio E

    2014-01-15

    Chest pain is often seen alongside with panic attacks. Moreover, panic disorder has been suggested as a risk factor for cardiovascular disease and even a trigger for acute coronary syndrome. Patients with coronary artery disease may have myocardial ischemia in response to mental stress, in which panic attack is a strong component, by an increase in coronary vasomotor tone or sympathetic hyperactivity setting off an increase in myocardial oxygen consumption. Indeed, coronary artery spasm was presumed to be present in cases of cardiac ischemia linked to panic disorder. These findings correlating panic disorder with coronary artery disease lead us to raise questions about the favorable prognosis of chest pain in panic attack. To investigate whether myocardial ischemia is the genesis of chest pain in panic attacks, we developed a myocardial perfusion study through research by myocardial scintigraphy in patients with panic attacks induced in the laboratory by inhalation of 35% carbon dioxide. In conclusion, from the data obtained, some hypotheses are discussed from the viewpoint of endothelial dysfunction and microvascular disease present in mental stress response.

  13. The "suffocation alarm" theory of panic attacks: a critical commentary.

    PubMed

    Ley, R

    1994-12-01

    In 1993 Klein proposed a "false suffocation alarm" theory of panic attacks, claiming that many spontaneous panic attacks are due to a "suffocation monitor" in the brain erroneously signaling a lack of useful air, and triggering an evolved "suffocation alarm system". He proposed that carbon dioxide acts as a panic stimulus because rising arterial CO2 suggests suffocation may be imminent." The present paper provides a critical analysis of Klein's theory and concludes that there is neither empirical evidence nor compelling argument to support the assumptions or the proposed neurological mechanism of a "suffocation alarm", true or false, or a CO2 "suffocation monitor." Data relevant to the role of breathing in the phenomenon of panic can be parsimoniously subsumed within the domain of dyspnea.

  14. Examining the Panic Attack Specifier in Social Anxiety Disorder.

    PubMed

    Allan, Nicholas P; Oglesby, Mary E; Short, Nicole A; Schmidt, Norman B

    2016-04-01

    Panic attacks (PAs) are characterized by overwhelming surges of fear and discomfort and are one of the most frequently occurring symptoms in psychiatric populations. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (i.e. DSM-5) allows for a panic attack (PA) specifier for all disorders, including social anxiety disorder (SAD). However, there is little research examining differences between individuals diagnosed with SAD with the PA specifier versus individuals diagnosed with SAD without the PA specifier. The current study examined social anxiety, mood, anxiety, and anxiety sensitivity social concerns, a risk factor for social anxiety in SAD-diagnosed individuals without (N = 52) and with (N = 14) the PA specifier. The groups differed only in somatic symptoms of anxiety. Result of the current study provides preliminary evidence that the presence of the PA specifier in social anxiety does not result in elevated levels of comorbidity or a more severe presentation of social anxiety.

  15. Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide.

    PubMed

    Hagengimana, Athanase; Hinton, Devon; Bird, Bruce; Pollack, Mark; Pitman, Roger K

    2003-01-25

    The present study is the first to attempt to determine rates of panic attacks, especially 'somatically focused' panic attacks, panic disorder, symptoms of post-traumatic stress disorder (PTSD), and depression levels in a population of Rwandans traumatized by the 1994 genocide. The following measures were utilized: the Rwandan Panic-Disorder Survey (RPDS); the Beck Depression Inventory (BDI); the Harvard Trauma Questionnaire (HTQ); and the PTSD Checklist (PCL). Forty of 100 Rwandan widows suffered somatically focused panic attacks during the previous 4 weeks. Thirty-five (87%) of those having panic attacks suffered panic disorder, making the rate of panic disorder for the entire sample 35%. Rwandan widows with panic attacks had greater psychopathology on all measures. Somatically focused panic-attack subtypes seem to constitute a key response to trauma in the Rwandan population. Future studies of traumatized non-Western populations should carefully assess not only somatoform disorder but also somatically focused panic attacks.

  16. Panic Disorder in Clinically Referred Children and Adolescents

    ERIC Educational Resources Information Center

    Doerfler, Leonard A.; Connor, Daniel F.; Volungis, Adam M.; Toscano, Peter F., Jr.

    2007-01-01

    The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective…

  17. Panic Disorder

    MedlinePlus

    ... your head? No. Most likely, you had a panic attack.Panic attacks can last from minutes to hours. They may ... made after a person experiences at least 2 panic attacks that occur without reason and are followed by ...

  18. Cognitive-Behavior Therapy for Vietnamese Refugees with PTSD and Comorbid Panic Attacks

    ERIC Educational Resources Information Center

    Hinton, Devon E.; Safren, Steven A.; Pollack, Mark H.; Tran, Minh

    2006-01-01

    For Vietnamese refugees, we describe (a) how headache- and orthostasis-focused panic attacks are generated, (b) a culturally sensitive treatment for PTSD with comorbid headache- and orthostasis-focused panic attacks, and (c) the outcome of a treatment series. In a multiple-baseline, across-subjects design (N = 3), all patients demonstrated…

  19. The many faces of Pan: psychological and physiological differences among three types of panic attacks.

    PubMed

    Ley, R

    1992-07-01

    The thesis of this paper is that failure to recognize the psychological and physiological differences among panic attacks within DSM-IIIR precludes meaningful comparisons and evaluations of research findings, confounds theoretical issues, and impairs the development of more specific, and thereby more effective, programs of treatment. To remedy this, a recommendation is made to define panic attacks on the basis of psychological and physiological distinctions that fit three categories of severity: Type I (classic panic attack), Type II (anticipatory panic attack), and Type III (cognitive panic attack). The logical-empirical rationale for the categories recommended is presented in the context of relevant research findings. Implications for theory, experimental design, and treatment are discussed.

  20. Panic attacks and possession by djinns: lessons from ethnopsychiatry

    PubMed Central

    Bragazzi, Nicola Luigi; Del Puente, Giovanni

    2012-01-01

    This clinical case report shows how important it is for a psychiatrist to have a knowledge of the cultural and religious context of the patient, in order to understand fully his or her complaints. Culture and religion, in fact, are not neutral, but convey symbols, meanings, and myths that should be properly explored to shed light on the patient’s inner world. Patient D was a 19-year-old Muslim Italo-Tunisian girl, who consulted a psychiatrist for anxiety and panic attacks, and reported being possessed by djinns (ie, “evil creatures”, as described in the Qur’an). A culturally informed interview was carried out, together with administration of psychometric scales, including the Symptom Checklist-90 Revised and Psychological Measure of Islamic Religiousness. Based on her scores and the results of this multidimensional assessment, patient D was treated with transcultural psychotherapy and fluoxetine. After a year of follow-up, she reported no further episodes of panic disorder. For proper assessment and treatment, a combined anthropological, sociological, and psychopathological approach was necessary. PMID:23293545

  1. Panic attacks and possession by djinns: lessons from ethnopsychiatry.

    PubMed

    Bragazzi, Nicola Luigi; Del Puente, Giovanni

    2012-01-01

    This clinical case report shows how important it is for a psychiatrist to have a knowledge of the cultural and religious context of the patient, in order to understand fully his or her complaints. Culture and religion, in fact, are not neutral, but convey symbols, meanings, and myths that should be properly explored to shed light on the patient's inner world. Patient D was a 19-year-old Muslim Italo-Tunisian girl, who consulted a psychiatrist for anxiety and panic attacks, and reported being possessed by djinns (ie, "evil creatures", as described in the Qur'an). A culturally informed interview was carried out, together with administration of psychometric scales, including the Symptom Checklist-90 Revised and Psychological Measure of Islamic Religiousness. Based on her scores and the results of this multidimensional assessment, patient D was treated with transcultural psychotherapy and fluoxetine. After a year of follow-up, she reported no further episodes of panic disorder. For proper assessment and treatment, a combined anthropological, sociological, and psychopathological approach was necessary.

  2. Panic Disorder

    MedlinePlus

    ... by recurrent episodes of paralyzing fear, known as panic attacks. Panic disorder, which affects three million to six ... Americans, typically surfaces between ages fifteen and nineteen. Panic attacks may be precipitated by specific events, but they ...

  3. Anxiety Sensitivity and Panic Attacks: A 1-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Li, Wen; Zinbarg, Richard E.

    2007-01-01

    The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among…

  4. Associations between psychedelic use, abuse, and dependence and lifetime panic attack history in a representative sample.

    PubMed

    Bonn-Miller, Marcel O; Bernstein, Amit; Sachs-Ericsson, Natalie; Schmidt, Norman B; Zvolensky, Michael J

    2007-01-01

    The present investigation evaluated the associations between lifetime psychedelic use, abuse, and dependence and panic attacks. The study consisted of a representative epidemiological sample from a state wide survey of the Colorado general adult population (n=4745; 52% female). Consistent with prediction, after controlling for theoretically relevant variables, psychedelic abuse and dependence, but not use, were significantly related to an increased lifetime risk of panic attacks. The results are discussed in terms of better understanding the role of psychedelic use in relation to the occurrence of panic attacks.

  5. Olfactory-Triggered Panic Attacks Among Khmer Refugees: A Contextual Approach

    PubMed Central

    Hinton, Devon; Pich, Vuth; Chhean, Dara; Pollack, Mark

    2009-01-01

    One hundred Khmer refugees attending a psychiatric clinic were surveyed to determine the prevalence of olfactory-triggered panic attacks as well as certain characteristics of the episodes, including trigger (i.e. type of odor), frequency, length, somatic symptoms, and the rate of associated flashbacks and catastrophic cognitions. Forty-five of the 100 patients had experienced an olfactory-triggered panic attack in the last month. Trauma associations and catastrophic cognitions (e.g. fears of a ‘wind attack,’ ‘weakness,’ and ‘weak heart’) were common during events of olfactory panic. Several case examples are presented. A multifactorial model of the generation of olfactory panic is adduced. The therapeutic implications of this model for the treatment of olfactory panic are discussed. PMID:15446720

  6. Cerebral blood flow changes during sodium-lactate-induced panic attacks

    SciTech Connect

    Stewart, R.S.; Devous, M.D. Sr.; Rush, A.J.; Lane, L.; Bonte, F.J.

    1988-04-01

    Dynamic single-photon emission computed axial tomography (CAT) with inhaled xenon-133 was used to measure regional cerebral blood flow in 10 drug-free patients with DSM-III-diagnosed panic disorder and in five normal control subjects. All subjects underwent regional cerebral blood flow studies while at rest or during normal saline infusion and during sodium lactate infusion. Six of the 10 patients and none of the control subjects experienced lactate-induced panic attacks. Lactate infusion markedly raised hemispheric blood flow levels in both control subjects and patients who did not panic. Patients who did panic experienced either a minimal increase or a decrease in hemispheric blood flow.

  7. Symptom Induction and De-escalation in the Treatment of Panic Attacks.

    ERIC Educational Resources Information Center

    Dattilio, Frank M.

    1990-01-01

    Describes technique known as symptom induction and de-escalation for panic attacks in which goal is to reproduce the type of situation that may precipitate an attack and then to show the client how the attacks can be "turned on" as well as "turned off." (ABL)

  8. Panic attacks during relaxation and relaxation-induced anxiety: a hyperventilation interpretation.

    PubMed

    Ley, R

    1988-12-01

    This paper explains how a hyperventilation theory of panic disorder accounts for panic attacks during relaxation and relaxation-induced anxiety. The explanation is based on the observation that chronic hyperventilators maintain a steady state of low pCO2 (arterial carbon dioxide tension) and are, therefore, sensitive to relatively small increases in ventilation when metabolism is low and to relatively sudden reductions in metabolism when ventilation is relatively constant. Thus, if minute volume of air breathed remains constant while the metabolic production of CO2 decreases, as in the case of one who sits down or lies down to relax, respiratory hypocapnea may increase in intensity until it produces the familiar sensations which mark the panic attack. Data from relevant studies of panic attacks during relaxation support the hyperventilation interpretation.

  9. A bibliotherapy approach to relapse prevention in individuals with panic attacks.

    PubMed

    Wright, J; Clum, G A; Roodman, A; Febbraro, G A

    2000-01-01

    The present study examined a relapse prevention (RP) program delivered via bibliotherapy in the treatment of individuals with panic attacks. Compared with a wait list control group, individuals receiving RP exhibited significant reductions on measures of frequency of panic attacks, panic cognitions, anticipatory anxiety, avoidance, and depression. In addition, individuals in the RP group were more likely to attain a "clinically significant change" in status on both panic-free status and level of avoidance more frequently than individuals in the control group. When compared with treatment effects evaluated in two prior phases of the study, the obtained results appear to be the product of a synchronous effect of bibliotherapy and minimal phone contact during the 6-month follow-up period. The results reflect the importance of brief therapist contact in increasing motivation for active participation in bibliotherapy interventions.

  10. Panic Disorder

    MedlinePlus

    ... is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there ... or a cold chill Tingly or numb hands Panic attacks can happen anytime, anywhere, and without warning. You ...

  11. Panic attack triggering myocardial ischemia documented by myocardial perfusion imaging study. A case report

    PubMed Central

    2012-01-01

    Background Chest pain, a key element in the investigation of coronary artery disease is often regarded as a benign prognosis when present in panic attacks. However, panic disorder has been suggested as an independent risk factor for long-term prognosis of cardiovascular diseases and a trigger of acute myocardial infarction. Objective Faced with the extreme importance in differentiate from ischemic to non-ischemic chest pain, we report a case of panic attack induced by inhalation of 35% carbon dioxide triggering myocardial ischemia, documented by myocardial perfusion imaging study. Discussion Panic attack is undoubtedly a strong component of mental stress. Patients with coronary artery disease may present myocardial ischemia in mental stress response by two ways: an increase in coronary vasomotor tone or a sympathetic hyperactivity leading to a rise in myocardial oxygen consumption. Coronary artery spasm was presumed to be present in cases of cardiac ischemia linked to panic disorder. Possibly the carbon dioxide challenge test could trigger myocardial ischemia by the same mechanisms. Conclusion The use of mental stress has been suggested as an alternative method for myocardial ischemia investigation. Based on translational medicine objectives the use of CO2 challenge followed by Sestamibi SPECT could be a useful method to allow improved application of research-based knowledge to the medical field, specifically at the interface of PD and cardiovascular disease. PMID:22999016

  12. The Use of Paradoxical Intention in the Treatment of Panic Attacks.

    ERIC Educational Resources Information Center

    Dattilio, Frank M.

    1987-01-01

    Discusses the counseling use of paradoxical intention, in which clients are told to perform responses that seem incompatible with the goal for which they are seeking help. The use of paradoxical intention in the treatment of panic attacks is described and a case example is included. The nature and implementation of the technique are discussed.…

  13. Developmental Course(s) of Lifetime Cigarette Use and Panic Attack Comorbidity

    ERIC Educational Resources Information Center

    Bernstein, Amit; Zvolensky, Michael J.; Schmidt, Norman B.; Sachs-Ericcson, Natalie

    2007-01-01

    The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M[Age] = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand…

  14. Hot Flashes and Panic Attacks: A Comparison of Symptomatology, Neurobiology, Treatment, and a Role for Cognition

    ERIC Educational Resources Information Center

    Hanisch, Laura J.; Hantsoo, Liisa; Freeman, Ellen W.; Sullivan, Gregory M.; Coyne, James C.

    2008-01-01

    Despite decades of research, the causal mechanisms of hot flashes are not adequately understood, and a biopsychosocial perspective on hot flashes remains underdeveloped. This article explores overlooked parallels between hot flashes and panic attacks within 5 areas: course and symptomatology, physiological indicators, neurocircuitry and…

  15. A panic attack in therapeutic recreation over being considered therapeutic.

    PubMed

    Lee, L L

    1987-01-01

    Ancillary professions have been called upon to account for therapeutic benefits from their services or be eliminated from the health care system. A singular focus on therapy, however, would negate the unique contribution of therapeutic recreation within, while simultaneously restricting services to health care settings. It is proposed that panic over therapeutic recreation services meeting health care goals has hindered evaluation and solidification of the leisure-based philosophy presented in the NTRS Philosophical Position Statement (NTRS, 1982). It is argued that emphasizing the leisure orientation of the philosophical position statement can secure therapeutic recreation's position within, yet, not deny services to those outside of the health care system. An overview is presented on the adequacy of the position statement philosophy for therapeutic recreation. A potential danger of attempting to explain therapeutic recreation in terms of non-leisure based philosophies is also discussed.

  16. Panic Disorder: When Fear Overwhelms

    MedlinePlus

    ... for several minutes or longer. These are called panic attacks . Panic attacks are characterized by a fear of disaster or ... also have a strong physical reaction during a panic attack. It may feel like having a heart attack. ...

  17. The effect of 5-hydroxytryptophan on cholecystokinin-4-induced panic attacks in healthy volunteers.

    PubMed

    Maron, Eduard; Tõru, Innar; Vasar, Veiko; Shlik, Jakov

    2004-06-01

    Previous studies suggest a modulatory role of serotonin (5-HT) in experimentally-induced panic attacks. In the current study, we investigated the acute effects of 5-HT precursor l-5-hydroxytryptophan (5-HTP) on the response to panicogenic challenge with cholecystokinin-tetrapeptide (CCK-4) in healthy volunteers. Thirty-two subjects were randomized to receive either 200 mg of 5-HTP or placebo with the CCK-4 challenge following in 90 min in a double-blind, parallel-group design. The results showed a nonsignificant difference between the groups in panic rate (19% after 5-HTP and 44% after placebo, p = 0.13) with a trend for lower intensity of symptoms after 5-HTP (p = 0.08). Further analysis by gender revealed that females in the 5-HTP group had a significantly lower panic rate and intensity of cognitive symptoms whereas, in males, the effect of 5-HTP was limited to lowering the intensity of somatic panic symptoms. Thus, an increased availability of 5-HT may have a gender-dependent protective effect in CCK-4-induced panic.

  18. ETIOLOGY, TRIGGERS AND NEUROCHEMICAL CIRCUITS ASSOCIATED WITH UNEXPECTED, EXPECTED, AND LABORATORY-INDUCED PANIC ATTACKS

    PubMed Central

    Johnson, Philip L.; Federici, Lauren M.; Shekhar, Anantha

    2014-01-01

    Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable trigger) or expected (ePA). Panic typically involves an abrupt feeling of catastrophic fear or distress accompanied by physiological symptoms such as palpitations, racing heart, thermal sensations, and sweating. Recurrent uPA and ePA can also lead to agoraphobia, where subjects with PD avoid situations that were associated with PA. Here we will review recent developments in our understanding of PD, which includes discussions on: symptoms and signs associated with uPA and ePAs; Diagnosis of PD and the new DSM-V; biological etiology such as heritability and gene x environment and gene x hormonal development interactions; comparisons between laboratory and naturally occurring uPAs and ePAs; neurochemical systems that are associated with clinical PAs (e.g. gene associations; targets for triggering or treating PAs), adaptive fear and panic response concepts in the context of new NIH RDoc approach; and finally strengths and weaknesses of translational animal models of adaptive and pathological panic states. PMID:25130976

  19. Ventilatory control of heart rate during inhalation of 5% CO2 and types of panic attacks.

    PubMed

    Ley, R

    1991-09-01

    Differences in the magnitude of increases in heart rate during prolonged inhalation of 5% CO2 range from a mean of 25 b/min for a group of eight panic-disorder patients who panicked (Woods, Charney, Goodman, & Heninger, 1988. Archives of General Psychiatry, 45, 43-52) to zero b/min for 16 patients, eight of whom panicked (Craske & Barlow, 1990. Journal of Abnormal Psychology, 99, 302-307). What accounts for this disparity? The present paper describes how heart rate can be increased by means of voluntary overbreathing during prolonged inhalation of 5% CO2 in air. This suggests that differences in the degree of overbreathing may explain differences in the magnitude of increases in heart rate during inhalation of 5% CO2. An explanation is also offered for the curious finding that some patients experience "panic attacks" with zero increase in heart rate. Evidence suggests that this is likely to happen in cognitively based panic attacks, in contrast to hyperventilatory attacks or anticipatory attacks.

  20. Treatment of Adolescent Panic Disorder: A Nonrandomized Comparison of Intensive versus Weekly CBT

    ERIC Educational Resources Information Center

    Chase, Rhea M.; Whitton, Sarah W.; Pincus, Donna B.

    2012-01-01

    This study compared the relative efficacy of intensive versus weekly panic control treatment (PCT) for adolescent panic disorder with agoraphobia (PDA). Twenty-six adolescents participated in weekly sessions and 25 received intensive treatment involving daily sessions. Both groups demonstrated significant and comparable reductions in panic…

  1. Psychopathology in the Adolescent Offspring of Parents with Panic Disorder and Depression

    ERIC Educational Resources Information Center

    Bhat, Amritha S.; Srinivasan, K.

    2006-01-01

    Aim: To study the prevalence of psychiatric diagnosis and psychopathology in adolescent offspring of parents with panic disorder, depression and normal controls. Methods: Adolescent offspring (11-16 years) of parents with a diagnosis of panic disorder and major depression, and normal controls were interviewed using Missouri Assessment of Genetics…

  2. Identifying Efficacious Treatment Components of Panic Control Treatment for Adolescents: A Preliminary Examination

    ERIC Educational Resources Information Center

    Micco, Jamie A.; Choate-Summers, Molly L.; Ehrenreich, Jill T.; Pincus, Donna B.; Mattis, Sara G.

    2007-01-01

    Panic Control Treatment for Adolescents (PCT-A) is a developmentally sensitive and efficacious treatment for adolescents with panic disorder. The present study is a preliminary examination of the relative efficacy of individual treatment components in PCT-A in a sample of treatment completers; the study identified when rapid improvements in panic…

  3. CBT for Vietnamese refugees with treatment-resistant PTSD and panic attacks: a pilot study.

    PubMed

    Hinton, Devon E; Pham, Thang; Tran, Minh; Safren, Steven A; Otto, Michael W; Pollack, Mark H

    2004-10-01

    We examined the feasibility, acceptability, and therapeutic efficacy of a culturally adapted cognitive-behavior therapy (CBT) for twelve Vietnamese refugees with treatment-resistant posttraumatic stress disorder (PTSD) and panic attacks. These patients were treated in two separate cohorts of six with staggered onset of treatment. Repeated measures Group x Time ANOVAs and between-group comparisons indicated significant improvements, with large effect sizes (Cohen's d) for all outcome measures: Harvard Trauma Questionnaire (HTQ; d = 2.5); Anxiety Sensitivity Index (ASI: d = 4.3); Hopkins Symptom Checklist-25 (HSCL-25), anxiety subscale (d = 2.2); and Hopkins Symptom Checklist-25, depression subscale (d = 2.0) scores. Likewise, the severity of (culturally related) headache-and orthostasis-cued panic attacks improved significantly across treatment

  4. 1st International Conference on Panic Attacks: diversity of theories and treatments. september 5-8, 2003, London.

    PubMed

    Perry, David

    2004-04-01

    The 1st International Conference on Psychophysiology of Panic Attacks focused on the diversity of treatments and theories in this complex condition. Experimental research topics were featured, as well as treatment strategies, case studies and patient perspectives. The conference aimed to create a strong multi-cultural emphasis through international, interdisciplinary and patient-professional interaction. The experimental techniques of lactate provocation of panic, carbon dioxide provocation, respiratory measures and cholecystokinin tetrapeptide infusion were used in various ongoing studies aimed at investigating familial markers, protocols for inducing panic in subjects (including opioid-receptor blockade), brain stem mechanisms involved in mediating anxiety and correlation of respiratory variability with panic severity and treatment outcome. Internet-based questionnaire surveys of panic attack (PA) in subjects that had been sexually abused and of subjective feelings about PAs in patients undergoing fertility treatment were presented, as was a survey of panic epidemiology in Iranian students. Some novel treatment modes were discussed, including non-verbal imagery and art therapy and a telephone-conferencing delivery of cognitive-behavioural therapy. Several case studies were used to illustrate treatments and a personal account of panic disorder combined some time after onset with post-traumatic stress disorder highlighted the different responses of the two disorders to psychotherapies.

  5. Panic Disorder and Women

    MedlinePlus

    ... in your state. Panic Attacks, Panic Disorder, and Agoraphobia (Copyright © American Academy of Family Physicians) - This online ... and examples of co-existing conditions. Panic Disorder & Agoraphobia (Copyright © Anxiety Disorders Association of America) - This web ...

  6. Cerebral correlates of heart rate variations during a spontaneous panic attack in the fMRI scanner.

    PubMed

    Spiegelhalder, Kai; Hornyak, Magdolna; Kyle, Simon David; Paul, Dominik; Blechert, Jens; Seifritz, Erich; Hennig, Jürgen; Tebartz van Elst, Ludger; Riemann, Dieter; Feige, Bernd

    2009-12-01

    We report the first published case study of a suddenly occurring panic attack in a patient with no prior history of panic disorder during combined functional magnetic resonance imaging (fMRI, 1.5 Tesla) and electrocardiogram (ECG) recording. The single case was a 46-year-old woman who developed a panic attack near the planned end of the fMRI acquisition session, which therefore had to be aborted. Correlational analysis of heart rate fluctuations and fMRI data revealed a significant negative association in the left middle temporal gyrus. Additionally, regions-of-interest (ROI) analyses indicated significant positive associations in the left amygdala, and trends towards significance in the right amygdala and left insula.

  7. Multiple Channel Exposure Therapy: Combining Cognitive-Behavioral Therapies for the Treatment of Posttraumatic Stress Disorder with Panic Attacks

    ERIC Educational Resources Information Center

    Falsetti, Sherry A.; Resnick, Heidi S.; Davis, Joanne

    2005-01-01

    A large proportion of patients who present for treatment of posttraumatic stress disorder (PTSD) experience comorbid panic attacks, yet it is unclear to what extent currently available PTSD treatment programs address this problem. Here we describe a newly developed treatment, multiple-channel exposure therapy (M-CET), for comorbid PTSD and panic…

  8. "Panic attacks" in Parkinson's disease. A long-term complication of levodopa therapy.

    PubMed

    Vázquez, A; Jiménez-Jiménez, F J; García-Ruiz, P; García-Urra, D

    1993-01-01

    A series of 31 Parkinson's disease (PD) patients suffering from panic attacks (PA), late in the evolution of their disease, was analyzed from a group of 131 levodopa-treated PD patients. We found that many of motor, sensory, and vegetative symptoms, previously described as complicating phenomena in PD, constituted some of the symptoms of panic disorders. Comparing PA series with the series of PD patients who did not complain of PA, we discovered a clear-cut relationship of PA with the presence of standing/gait troubles (p < 0.001), depression (p < 0.001), and dyskinesias/fluctuations (p < 0.001). The patients of the PA series also presented a more precocious age of PD onset, were put on levodopa therapy earlier, and needed to be treated with higher doses of levodopa than the patients without PA. Finally, we hypothesize that PA could be considered to be a sort of abstinence syndrome from levodopa, because they appears mostly (90.3%) in the OFF phase of fluctuations, and are relieved administering new doses of levodopa or dopaminergic agonists. Nevertheless, we suggest PA are not directly related to the pharmacological properties of levodopa, but to alterations of the noradrenergic systems in the CNS.

  9. 'The ghost pushes you down': sleep paralysis-type panic attacks in a Khmer refugee population.

    PubMed

    Hinton, Devon E; Pich, Vuth; Chhean, Dara; Pollack, Mark H

    2005-03-01

    Among a psychiatric population of Cambodian refugees (N = 100), 42% had current--i.e. at least once in the last year--sleep paralysis (SP). Of those experiencing SP, 91% (38/42) had visual hallucinations of an approaching being, and 100% (42/42) had panic attacks. Among patients with post-traumatic stress disorder (PTSD; n = 45), 67% (30/45) had SP, whereas among those without PTSD, only 22.4% (11/45) had SP (chi2 = 20.4, p < .001). Of the patients with PTSD, 60% (27/45) had monthly episodes of SP. The Cambodian panic response to SP seems to be greatly heightened by elaborate cultural ideas--with SP generating concerns about physical status, 'good luck' status, 'bad luck' status, sorcery assault, and ghost assault--and by trauma associations to the figure seen in SP. Case vignettes illustrate cultural beliefs about, and trauma resonances of, SP. A model to explain the high rate of SP in this population is presented. SP is a core aspect of the Cambodian refugees response to trauma; when assessing Cambodian refugees, and traumatized refugees in general, clinicians should assess for its presence.

  10. Blood, breath, fears redux, and panic attacks: comment on Roth, Wilhelm, and Pettit (2005).

    PubMed

    Ley, Ronald

    2005-03-01

    This article discusses the hyperventilation theory (HVT) of panic attacks (PAs) proposed by R. Ley in the context of criticisms raised by W. T. Roth, F. H. Wilhelm, and D. Pettit. Their interpretation of HVT is flawed by misunderstanding, misinterpretation, and oversimplification of the complex psychophysiological principles on which current HVT is based. Consequently, the "propositions" they derive are inappropriate. Further, Roth et al. disregarded/overlooked: (a) differences among types of PAs, (b) abundant empirical evidence that PA patients are distinguished by presence or absence of prominent respiratory symptoms (e.g., overbreathing), and (c) Ley's (1992b) classification of PAs based on 10 psychophysiological distinctions. The review by Roth et al. falls short of standards required to falsify HVT. Current HVT of PAs is tenable and testable.

  11. An investigation into the effectiveness of bibliotherapy and minimal contact interventions in the treatment of panic attacks.

    PubMed

    Febbraro, Greg A R

    2005-06-01

    The present study investigated the effectiveness of bibliotherapy and minimal therapist-contact interventions in the treatment of panic attacks. Individuals were randomly assigned to one of three conditions: (1) bibliotherapy alone (BT); (2) bibliotherapy plus phone contact (BT+PC); or (3) phone contact alone (PC). Assessment (pre- and post-treatment) and treatment (8 weeks in duration) were conducted via mail and phone. Individuals receiving BT and BT+PC exhibited significant reductions from pre- to post-treatment on panic cognitions and fear of having a panic attack. Individuals receiving BT+PC exhibited significant reductions from pre- to post-treatment on panic symptoms and avoidance. In addition, individuals in the BT and BT+PC groups were more likely to exhibit clinically significant improvement on most dependent measures relative to PC alone. On some measures, individuals in the BT+PC group did clinically better than individuals in the BT group. Results of the present study also suggest that diagnosis may play some role in outcome.

  12. Trajectories of change across outcomes in intensive treatment for adolescent panic disorder and agoraphobia.

    PubMed

    Gallo, Kaitlin P; Cooper-Vince, Christine E; Hardway, Christina L; Pincus, Donna B; Comer, Jonathan S

    2014-01-01

    Much remains to be learned about typical and individual growth trajectories across treatment for adolescent panic disorder with and without agoraphobia and about critical treatment points associated with key changes. The present study examined the rate and shape of change across an 8-day intensive cognitive behavioral therapy for adolescent panic disorder with and without agoraphobia (N = 56). Participants ranged in age from 12 to 17 (M = 15.14, SD = 1.70; 58.9% female, 78.6% Caucasian). Multilevel modeling evaluated within-treatment linear and nonlinear changes across three treatment outcomes: panic severity, fear, and avoidance. Overall panic severity showed linear change, decreasing throughout treatment. In contrast, fear and avoidance ratings both showed cubic change, peaking slightly at the first session of treatment, starting to decrease at the second session of treatment, and with large gains continuing then plateauing at the fourth session. Findings are considered with regard to the extent to which they may elucidate critical treatment components and sessions for adolescents with panic disorder with and without agoraphobia.

  13. Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

    ERIC Educational Resources Information Center

    Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

    2012-01-01

    This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

  14. Concordance between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

    ERIC Educational Resources Information Center

    Bacow, Terri Landon; May, Jill Ehrenreich; Choate-Summers, Molly; Pincus, Donna B.; Mattis, Sara G.

    2010-01-01

    This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment…

  15. Parental Involvement in Intensive Treatment for Adolescent Panic Disorder and Its Impact on Depression

    PubMed Central

    Pincus, Donna B.; Gallo, Kaitlin P.; Comer, Jonathan S.

    2015-01-01

    The present study investigated whether an 8-day intensive treatment for panic disorder in adolescents conferred a corollary benefit of ameliorating symptoms of depression. Participants included 57 adolescents between the ages of 11 and 18 who were randomly assigned to an intensive panic treatment for adolescents with or without parental involvement. Paired samples t tests and hierarchical linear models (HLM) indicated that participants' total depression score and scores on depression subscales declined from baseline to the 3-month follow-up. Additional HLM analyses indicated that the interaction term between age and parent involvement was a significant moderator in the negative slope for adolescent depression, with younger participants benefitting more from treatment without parent involvement than older participants with regard to depression symptoms. PMID:26715827

  16. Parental Involvement in Intensive Treatment for Adolescent Panic Disorder and Its Impact on Depression.

    PubMed

    Hardway, Christina L; Pincus, Donna B; Gallo, Kaitlin P; Comer, Jonathan S

    2015-11-01

    The present study investigated whether an 8-day intensive treatment for panic disorder in adolescents conferred a corollary benefit of ameliorating symptoms of depression. Participants included 57 adolescents between the ages of 11 and 18 who were randomly assigned to an intensive panic treatment for adolescents with or without parental involvement. Paired samples t tests and hierarchical linear models (HLM) indicated that participants' total depression score and scores on depression subscales declined from baseline to the 3-month follow-up. Additional HLM analyses indicated that the interaction term between age and parent involvement was a significant moderator in the negative slope for adolescent depression, with younger participants benefitting more from treatment without parent involvement than older participants with regard to depression symptoms.

  17. Psychological sequelae of remote exposure to the September 11th terrorist attacks in Canadians with and without panic.

    PubMed

    Asmundson, Gordon J G; Carleton, R Nicholas; Wright, Kristi D; Taylor, Steven

    2004-01-01

    The purpose of the present investigation was to examine the psychological impact of remote exposure to the events and aftermath of the terrorist attacks in the USA on September 11th, 2001, and to assess what differences, if any, exist between individuals classified with probable panic disorder and those without. Telephone interviews were conducted with 122 residents of the capital city of the Canadian prairie province of Saskatchewan in spring 2002 in order to gather information regarding current mood, fears and avoidance behaviours as well as current post-traumatic stress disorder symptoms specific to September 11th. Consistent with previous findings and despite the remote nature of exposure, results indicated that the psychological well-being and behaviour of participants with probable panic disorder was more adversely affected by the events and aftermath of September 11th than those without panic disorder. These results suggest that remote viewing of traumatic events can have a significant and lingering impact on psychological well-being and behaviour and that these effects are more pronounced in those with panic disorder. Implications of the findings and future research directions are discussed.

  18. Orthostatically Induced Panic Attacks among Cambodian Refugees: Flashbacks, Catastrophic Cognitions, and Associated Psychopathology

    ERIC Educational Resources Information Center

    Hinton, Devon E.; Pollack, Mark H.; Pich, Vuth; Fama, Jeanne M.; Barlow, David H.

    2005-01-01

    Consecutive Cambodian refugees (N = 100) attending a psychiatric clinic were assessed for the presence and severity of current orthostatic panic (OP), which is defined as panic triggered by standing up. The patients with current OP (n = 36) had significantly greater psychopathology than patients without current OP. During OP, trauma associations…

  19. An examination of the relation between traumatic event exposure and panic-relevant biological challenge responding among adolescents.

    PubMed

    Hawks, Erin; Blumenthal, Heidemarie; Feldner, Matthew T; Leen-Feldner, Ellen W; Jones, Rachel

    2011-09-01

    The current study uniquely extended research that has linked traumatic event exposure to panic-spectrum problems among adolescents. It was hypothesized that among 127 adolescents (age range: 10 to 17 years; M = 14.63, SD = 2.24), those who endorsed a history of traumatic event exposure would evidence significantly greater anxious and fearful reactivity to a well-established 3-min voluntary hyperventilation procedure compared to nonexposed individuals. Results were consistent with hypotheses, suggesting traumatic event exposure is associated with anxious and fearful reactivity to abrupt increases in bodily arousal among adolescents. Moreover, consistent with hypotheses, anxiety sensitivity significantly mediated the relations between traumatic event exposure and both self-reported panic symptoms and panic symptoms elicited by the challenge. Future prospective research is now needed to better understand temporal relations between traumatic event exposure and indices of panic and related vulnerability.

  20. Israeli Adolescents' Coping Strategies in Relation to Terrorist Attacks

    ERIC Educational Resources Information Center

    Tatar, Moshe; Amram, Sima

    2007-01-01

    Exposure to terrorism seriously threatens the well-being of children and adolescents. Israeli citizens have witnessed massive ongoing terrorist attacks during the last few years. The present research, conducted among 330 Israeli adolescents, examined coping strategies in relation to terrorist attacks. We found that adolescents utilize more…

  1. A psychometric evaluation of the panic disorder severity scale for children and adolescents.

    PubMed

    Elkins, R Meredith; Pincus, Donna B; Comer, Jonathan S

    2014-06-01

    The Panic Disorder Severity Scale (PDSS; Shear et al., 1997) is a well-validated measure that assesses symptoms of panic disorder with or without agoraphobia (PDA) in adults. The Panic Disorder Severity Scale for Children (PDSS-C) is an adaptation of the PDSS for youth ages 11-17. The current study evaluated the psychometric properties of the PDSS-C. Participants included 60 adolescents from a randomized controlled trial investigating the efficacy of an intensive cognitive behavioral treatment (CBT) for adolescent PDA. Convergent and discriminant validity of PDSS-C scores were evaluated via observed associations between the PDSS-C and the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Multidimensional Anxiety Scale for Children (MASC; March, Parker, Sullivan, Stallings, & Conners, 1997), and Children's Depression Inventory (CDI; Kovacs, 2003). Baseline and posttreatment data afforded the opportunity to evaluate the measure's sensitivity to treatment-related change. PDSS-C scores demonstrated acceptable internal consistency (α = .82) and adequate 1-day test-retest reliability (r = .79). Convergent and discriminant validity of the PDSS-C scores were supported through significant associations with the CASI and the MASC, and nonsignificant associations with the CDI, respectively. Linear regression analysis demonstrated sensitivity to treatment-related changes-that is, greater PDSS-C change scores were significantly associated with assignment to CBT vs. waitlist condition. Clinical utility was further established through significant associations between PDSS-C change scores and MASC and CASI change scores, and through nonsignificant associations with CDI change scores. Results support the use of PDSS-C scores as reliable, valid, and clinically useful for the assessment of youth panic disorder in research and clinical settings.

  2. Emotion Regulation Difficulties Associated with the Experience of Uncued Panic Attacks: Evidence of Experiential Avoidance, Emotional Nonacceptance, and Decreased Emotional Clarity

    ERIC Educational Resources Information Center

    Tull, Matthew T.; Roemer, Lizabeth

    2007-01-01

    Emotion regulation difficulties among nonclinical uncued panickers were examined in two studies. In Study 1, participants with a recent history of uncued panic attacks (n=91), compared to a nonpanic sample (n=91), reported significantly greater levels of experiential avoidance, lack of emotional acceptance, and lack of emotional clarity. In Study…

  3. Panic Attacks and Panic Disorder

    MedlinePlus

    ... disorder and other psychiatric disorders Increased risk of suicide or suicidal thoughts Alcohol or other substance misuse ... work and personal relationships? Did you experience major stress or a traumatic event shortly before your first ...

  4. Negative reinforcement/negative affect reduction cigarette smoking outcome expectancies: incremental validity for anxiety focused on bodily sensations and panic attack symptoms among daily smokers.

    PubMed

    Zvolensky, Michael J; Gonzalez, Adam; Bonn-Miller, Marcel O; Bernstein, Amit; Goodwin, Renee D

    2008-02-01

    The present investigation evaluated the incremental validity of negative reinforcement/negative affect reduction smoking outcome expectancies in the prediction of anxious and fearful responding to bodily sensations. Participants included 171 daily smokers (82 women, 89 men; mean age = 25.67 years, SD = 10.54). Consistent with prediction, negative reinforcement/negative affect reduction smoking outcome expectancies were significantly predictive of anxiety focused on bodily sensations and postchallenge intensity of cognitive panic attack symptoms, but not of physical panic symptoms. The observed effects were evident above and beyond the statistically significant variance accounted for by the covariates of anxiety sensitivity, negative affectivity, cigarettes per day, and weekly alcohol use and independent of other smoking outcome expectancy factors. Findings are discussed in terms of the role of negative reinforcement/negative affect reduction smoking outcome expectancies and vulnerability for panic symptoms and psychopathology.

  5. Isolated Sleep Paralysis and Fearful Isolated Sleep Paralysis in Outpatients With Panic Attacks

    PubMed Central

    Sharpless, Brian A.; McCarthy, Kevin S.; Chambless, Dianne L.; Milrod, Barbara L.; Khalsa, Shabad-Ratan; Barber, Jacques P.

    2013-01-01

    Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors’ lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology. PMID:20715166

  6. Isolated sleep paralysis and fearful isolated sleep paralysis in outpatients with panic attacks.

    PubMed

    Sharpless, Brian A; McCarthy, Kevin S; Chambless, Dianne L; Milrod, Barbara L; Khalsa, Shabad-Ratan; Barber, Jacques P

    2010-12-01

    Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors' lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology.

  7. Moderators of intensive CBT for adolescent panic disorder: the of fear and avoidance

    PubMed Central

    Elkins, R. Meredith; Gallo, Kaitlin P.; Pincus, Donna B.; Comer, Jonathan S.

    2015-01-01

    Background Research supports the efficacy of intensive cognitive behavioral therapy (CBT) for the treatment of adolescent panic disorder with or without agoraphobia (PDA). However, little is known about the conditions under which intensive treatment is most effective. The current investigation examined the moderating roles of baseline fear and avoidance in the intensive treatment of adolescent PDA. Methods Adolescents with PDA (ages 11–17; N = 54) were randomized to either an intensive CBT treatment (n = 37) or a waitlist control condition (n = 17). PDA diagnosis, symptom severity, and number of feared and avoided situations were assessed at baseline and 6-week post-treatment/post-waitlist. Hierarchical regression analyses examined the relative contributions of treatment condition, number of baseline feared or avoided situations, and their interactions in the prediction of post-treatment/waitlist PDA symptoms. Results The main effect of intensive CBT on post-treatment PDA symptoms was not uniform across participants, with larger treatment effects found among participants with lower, relative to higher, baseline levels of fear and avoidance. Conclusions Findings help clarify which adolescents suffering with PDA may benefit most from an intensive treatment format. PMID:26929742

  8. Understanding Panic Disorder.

    ERIC Educational Resources Information Center

    Hendrix, Mary Lynn

    This booklet is part of the National Institute of Mental Health's efforts to educate the public and health care professionals about panic disorder. Discussed here are the causes, definition, and symptoms of the disorder. Panic attacks, which can seriously interfere with a person's life, may strike more than three million U.S. citizens at some time…

  9. Depression and panic attacks related to phenol-formaldehyde composite material exposure in an aerospace manufacturing plant.

    PubMed

    Sparks, P J; Ayars, G H; Simon, G E; Katon, W J; Altman, L C; Johnson, R L

    1991-01-01

    In a case series study we evaluated 53 composite-materials workers in an aerospace plant who filed workers' compensation claims for illness allegedly related to phenol-formaldehyde resin exposure. Symptoms ranged from mucosal and skin irritation to depression and cognitive impairment. Certain health practitioners implying they had immunologic dysfunction and organic brain injury, led workers to believe they were chemically poisoned. Industrial hygiene evaluation failed to show levels of chemicals above permissible levels. Thorough evaluation by our multidisciplinary panel failed to find significant objective abnormalities by physical exam and laboratory testing. Thirty-nine percent of the workers had sensory irritation and/or skin complaints that generally resolved rapidly with removal from exposure. Psychiatric diagnoses (including major depression and/or panic attacks) were made in 74% of the workers, but only 26% of these had antecedent disease. Fourteen (26%) had multiple somatic complaints that generally persisted despite removal from exposure, but they also had long histories of significant pre-existing psychological illness. Detailed neuropsychologic testing failed to show any definite evidence or organic brain dysfunction in any of the workers tested. We speculate that sensory irritation from low-level volatile organic compounds with autonomic arousal, reinforced by the belief they were "chemically poisoned," led to psychogenic illness.

  10. Panic Attack or Heart Attack?

    MedlinePlus

    ... with echocardiography. It is a good first-line test for a woman with symptoms and risk factors for heart disease. Echocardiography uses sound waves technology to give detailed information about the heart muscle, ...

  11. Anxiety in adolescent epilepsy. A clinimetric analysis.

    PubMed

    Carrozzino, Danilo; Marchetti, Daniela; Laino, Daniela; Minna, Maria; Verrocchio, Maria Cristina; Fulcheri, Mario; Verrotti, Alberto; Bech, Per

    2016-08-01

    Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms. Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy. Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls. Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p = 0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p = 0.001). Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy.

  12. [Pharmacotherapy of panic disorder].

    PubMed

    Bougerol, T; Farisse, J

    1996-12-01

    The concept of Panic Disorders has itself been developed on the strength of therapeutic effects of drug treatments and it is therefore not surprising that psychotropic medications are currently the main therapeutic tool for this condition. Their use may be indicated in two differing circumstances, as treatment for Panic Attack itself or as a long-term treatment for what is properly called Panic Disorder. The latter scenario is that which has been most actively studied and represents the more original side of the question. Treatment of acute Panic Attack involves administration of sedative anxiolytics, principally benzodiazepines (BZD). Long-term treatment aiming to prevent repeated attacks is the core strategy for treatment for Panic Disorder. For the past fifteen years, a large number of research projects have shown the elective anti-panic efficacy of a number of drugs, principally antidepressants and anxiolytics. The response profile to anti-depressant treatment is characterized by a lag time which is sometimes longer than that observed when they are used solely as antidepressants; frequently they are also less well tolerated which necessitates a very gradual step-up in dosage. The "classic" MAOI (non-selective and irreversible) have a proven anti-panic effect. Selective serotonin reuptake inhibitor (SSRI) anti-depressants are currently drugs of choice in the treatment of Panic Disorder. Although the anti-panic effect appears to be common to all the various SSRI drugs available, and directly attributable to their mechanism of action, not all of them however have undergone controlled studies. In France, paroxetine is the first anti-depressant in this group to obtain a marketing authorization for this particular indication. The advantages of the SSRI drugs are principally related to their limited adverse effects and lack of toxicity, thereby making them particularly straightforward to use. Benzodiazepines (BZD) are the second group of psychotropic medications which

  13. Panic anxiety, under the weather?

    NASA Astrophysics Data System (ADS)

    Bulbena, A.; Pailhez, G.; Aceña, R.; Cunillera, J.; Rius, A.; Garcia-Ribera, C.; Gutiérrez, J.; Rojo, C.

    2005-03-01

    The relationship between weather conditions and psychiatric disorders has been a continuous subject of speculation due to contradictory findings. This study attempts to further clarify this relationship by focussing on specific conditions such as panic attacks and non-panic anxiety in relation to specific meteorological variables. All psychiatric emergencies attended at a general hospital in Barcelona (Spain) during 2002 with anxiety as main complaint were classified as panic or non-panic anxiety according to strict independent and retrospective criteria. Both groups were assessed and compared with meteorological data (wind speed and direction, daily rainfall, temperature, humidity and solar radiation). Seasons and weekend days were also included as independent variables. Non-parametric statistics were used throughout since most variables do not follow a normal distribution. Logistic regression models were applied to predict days with and without the clinical condition. Episodes of panic were three times more common with the poniente wind (hot wind), twice less often with rainfall, and one and a half times more common in autumn than in other seasons. These three trends (hot wind, rainfall and autumn) were accumulative for panic episodes in a logistic regression formula. Significant reduction of episodes on weekends was found only for non-panic episodes. Panic attacks, unlike other anxiety episodes, in a psychiatric emergency department in Barcelona seem to show significant meteorotropism. Assessing specific disorders instead of overall emergencies or other variables of a more general quality could shed new light on the relationship between weather conditions and behaviour.

  14. The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses.

    PubMed

    Gallo, Kaitlin P; Chan, Priscilla T; Buzzella, Brian A; Whitton, Sarah W; Pincus, Donna B

    2012-03-01

    Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.

  15. Your Adolescent: Anxiety and Avoidant Disorders

    MedlinePlus

    ... of uneasiness. At other times, it develops into panic attacks and phobias. Identifying the Signs Anxiety disorders vary ... specific situations, in which case they are called panic attacks. A panic attack is an abrupt episode of ...

  16. PRETYPHOON PANIC ATTACK HISTORY MODERATES THE RELATIONSHIP BETWEEN DEGREE OF TYPHOON EXPOSURE AND POSTTYPHOON PTSD AND DEPRESSION IN A VIETNAMESE SAMPLE

    PubMed Central

    Berenz, Erin C.; Trapp, Stephen K.; Acierno, Ron; Richardson, Lisa; Kilpatrick, Dean G.; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Gaboury, Mario; Amstadter, Ananda B.

    2013-01-01

    Background Predisaster risk factors are related to postdisaster psychopathology even at relatively low levels of disaster exposure. A history of panic attacks (PA) may convey risk for postdisaster psychopathology and has been linked to a wide range of psychiatric disorders in Western and non-Western samples. The present study examined the main and interactive effects of pretyphoon PA and level of typhoon exposure in the onset of posttyphoon posttraumatic stress disorder (PTSD), major depression (MDD), and generalized anxiety disorder (GAD) in a Vietnamese sample of typhoon survivors. Methods Typhoon Xangsane interrupted a Vietnamese epidemiological mental health needs assessment, providing a rare opportunity for preand posttyphoon assessments. Hierarchical logistic regression analyses evaluated whether the main and interactive effects of typhoon exposure severity and PA history were significantly related to posttyphoon diagnoses, above and beyond age, health status, pretyphoon psychiatric screening results, and history of potentially traumatic events. Results PA history moderated the relationship between severity of typhoon exposure and posttyphoon PTSD and MDD, but not GAD. Specifically, greater degree of exposure to the typhoon was significantly related to increased likelihood of postdisaster PTSD and MDD among individuals without a history of PA, above and beyond variance accounted for by pretyphoon psychiatric screening results. Individuals with a history of PA evidenced greater risk for postdisaster PTSD and MDD regardless of severity of typhoon exposure. Conclusions Preexisting PA may affect the nature of the relationship between disaster characteristics and prevalence of postdisaster PTSD and MDD within Vietnamese samples. PMID:23495143

  17. Simultaneous prepubertal onset of panic disorder, night terrors, and somnambulism.

    PubMed

    Garland, E J; Smith, D H

    1991-07-01

    Concurrent acute onset of night terrors, somnambulism, and spontaneous daytime panic attacks meeting the criteria for panic disorder is reported in a 10-year-old boy with a family history of panic disorder. Both the parasomnias and the panic disorder were fully responsive to therapeutic doses of imipramine. A second case of night terrors and infrequent full symptom panic attacks is noted in another 10-year-old boy whose mother has panic disorder with agoraphobia. The clinical resemblance and reported differences between night terrors and panic attacks are described. The absence of previous reports of this comorbidity is notable. It is hypothesized that night terror disorder and panic disorder involve a similar constitutional vulnerability to dysregulation of brainstem altering systems.

  18. Treatment of Panic Disorder: A Clinical Update.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; Belcastro, Amy L.; Granello, Darcy Haag

    This article presents specific, practical information to guide mental health counselors in treating individuals who meet the criteria for panic disorder. It delineates the specific strategies identified in the research literature for use by mental health counselors. Full resolution of panic attacks by one form of treatment may not always be…

  19. Determining Adolescent Struggling Readers' Word Attack Skills with the CORE Phonics Survey

    ERIC Educational Resources Information Center

    Nelson, Kristin L.; Alexander, Melina; Williams, Natalie A.; Sudweeks, Richard R.

    2014-01-01

    Students beyond the primary grades who struggle with reading lack basic word attack ability and are thus unable to read new words with accuracy. However, there has been little research that reveals the specific word attack errors students exhibit. In this study, 123 struggling adolescent readers receiving special education services were given the…

  20. Help-Seeking Behaviours of Adolescents in Relation to Terrorist Attacks: The Perceptions of Israeli Parents

    ERIC Educational Resources Information Center

    Tatar, Moshe; Amram, Sima; Kelman, Talia

    2011-01-01

    Exposure to terrorism poses a challenge for children and adolescents as well as parents. For many years, Israeli citizens have been exposed to ongoing terrorist attacks. The present article is aimed at revealing the reactions of Israeli parents when facing terrorist attacks and their perceptions regarding the help-seeking behaviours of their…

  1. Modeling panic disorder in rodents.

    PubMed

    Moreira, Fabrício A; Gobira, Pedro H; Viana, Thércia G; Vicente, Maria A; Zangrossi, Hélio; Graeff, Frederico G

    2013-10-01

    Panic disorder (PD) is a subtype of anxiety disorder in which the core phenomenon is the spontaneous occurrence of panic attacks. Although studies with laboratory animals have been instrumental for the understanding of its neurobiology and treatment, few review articles have focused on the validity of the currently used animal models for studying this psychopathology. Therefore, the aim of the present paper is to discuss the strengths and limits of these models in terms of face, construct and predictive validity. Based on the hypothesis that panic attacks are related to defensive responses elicited by proximal threat, most animal models measure the escape responses induced by specific stimuli. Some apply electrical or chemical stimulation to brain regions proposed to modulate fear and panic responses, such as the dorsal periaqueductal grey or the medial hypothalamus. Other models focus on the behavioural consequences caused by the exposure of rodents to ultrasound or natural predators. Finally, the elevated T-maze associates a one-way escape response from an open arm with panic attacks. Despite some limitations, animal models are essential for a better understanding of the neurobiology and pharmacology of PD and for discovering more effective treatments.

  2. Adolescent Vulnerability Following the September 11th Terrorist Attacks: A Study of Parents and Their Children

    ERIC Educational Resources Information Center

    Gil-Rivas, Virginia; Holman, E. Alison; Silver, Roxane Cohen

    2004-01-01

    Approximately 2 weeks after September 11th, adolescents from a national sample of households who were indirectly exposed to the terrorist attacks through the media completed a Web-based survey that assessed event-related acute stress symptoms. One year later, these adolescents (N = 142) and a randomly selected parent from their household completed…

  3. Adolescents' Mental Health Outcomes According to Different Types of Exposure to Ongoing Terror Attacks

    ERIC Educational Resources Information Center

    Braun-Lewensohn, Orna; Celestin-Westreich, Smadar; Celestin, Leon-Patrice; Verte, Dominique; Ponjaert-Kristoffersen, Ingrid

    2009-01-01

    This study investigates the impact of several types of exposure to terror attacks on adolescents' psychological outcomes in the context of ongoing terror. A total of 913 adolescents (51 girls) aged 12 to 18 years (12-13.6 = 33%; 13.7-15.6 = 38%; 15.7-18 = 28%) took part in the study. Detailed data were collected concerning objective, subjective…

  4. Reexperiencing symptoms, dissociation, and avoidance behaviors in daily life of patients with PTSD and patients with panic disorder with agoraphobia.

    PubMed

    Pfaltz, Monique C; Michael, Tanja; Meyer, Andrea H; Wilhelm, Frank H

    2013-08-01

    Panic attacks are frequently perceived as life threatening. Panic disorder (PD) patients may therefore experience symptoms of posttraumatic stress disorder (PTSD). The authors explored this in 28 healthy controls, 17 PTSD patients, and 24 PD patients with agoraphobia who completed electronic diaries 36 times during 1 week. Patient groups frequently reported dissociation as well as thoughts, memories, and reliving of their trauma or panic attacks. PTSD patients reported more trauma/panic attack thoughts (incidence rate ratio [IRR] = 2.9) and memories (IRR = 2.8) than PD patients. Patient groups relived their trauma or panic attacks equally frequently, and reported comparable bodily reactions and distress associated with trauma or panic attack memories. Clinical groups avoided trauma or panic attack reminders more often than healthy controls (avoidance of trauma- or panic attack-related thoughts (IRR = 8.0); avoidance of things associated with the trauma or panic attack (IRR = 40.7). PD patients avoided trauma or panic attack reminders less often than PTSD patients (avoidance of trauma- or panic attack-related thoughts [IRR = 2.5]; avoidance of things associated with the trauma or panic attack [IRR = 4.1]), yet these differences were nonsignificant when controlling for functional impairment. In conclusion, trauma-like symptoms are common in PD with agoraphobia and panic attacks may be processed similarly as trauma in PTSD.

  5. Sense of Coherence, Hope and Values among Adolescents under Missile Attacks: A Longitudinal Study

    ERIC Educational Resources Information Center

    Braun-Lewensohn, Orna; Sagy, Shifra

    2010-01-01

    This study aimed to explore measures of spirituality--sense of coherence (SOC), hope and values--among adolescents living in a violent political area and experiencing missile attacks. The three variables represent attributes of spirituality, such as searching for meaning and purpose in life, hope and feelings about the future, as well as values…

  6. Validation of the diagnoses of panic disorder and phobic disorders in the US National Comorbidity Survey Replication Adolescent (NCS-A) supplement.

    PubMed

    Green, Jennifer Greif; Avenevoli, Shelli; Finkelman, Matthew; Gruber, Michael J; Kessler, Ronald C; Merikangas, Kathleen R; Sampson, Nancy A; Zaslavsky, Alan M

    2011-06-01

    Validity of the adolescent version of the World Health Organization Composite International Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent (NCS-A) supplement, a large (n = 10,148) community epidemiological survey of the prevalence and correlates of adolescent mental disorders in the United States. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses [area under the receiver operating characteristic curve (AUC) = 0.81-0.94], although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.

  7. [The psychoimmunological network og panic disorders, agoraphobia and allergic reactions].

    PubMed

    Schmidt-Traub, S

    1995-02-01

    While treating panic and agoraphobia patients with behaviour therapy, a high frequency of allergic reaction of the IgE-mediated type I was observed. Panic disorder, agoraphobia, allergic disorder, and vasomotor reactions are briefly discussed in the framework of psycho-endocrino-immunological research. A pilot study had shown a high correlation between panic disorder with and without agoraphobia and allergic reaction. A controlled study was then planned to test the hypothesized psychoimmunological relationship. 100 allergic patients, 79 panic/agoraphobic patients, and 66 controls underwent psychodiagnostic and allergic screening. 70% of the anxiety patients responded to test allergens with IgE-mediated type-I immediate reactions in comparison to 28% of the control persons. Another 15% of the panic patients reacted to nickle compound with type-IV delayed skin reactions (7% of the controls). Conversely, 10% of the allergic patients suffered from panic disorder (45% had experienced panic attacks) in contrast to 2% of the controls (24% of these reported panic attacks). The relative risk for allergic patients to develop panic disorder with and without agoraphobia is obviously five times as high as for controls. With this assumption of a psychoimmunological preparedness in mind, a behavioural medical diagnostic and therapeutic concept seems more adequate in coping both with panic/agoraphobia and allergic disorder.

  8. Panic, Suffocation False Alarms, Separation Anxiety and Endogenous Opioids

    PubMed Central

    Preter, Maurice; Klein, Donald F.

    2008-01-01

    This review paper presents an amplification of the suffocation false alarm theory (SFA) of spontaneous panic (Klein, 1993). SFA postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. That panic is distinct from Cannon’s emergency fear response and Selye’s General Alarm Syndrome is shown by the prominence of intense air hunger during these attacks. Further, panic sufferers have chronic sighing abnormalities outside of the acute attack. Another basic physiologic distinction between fear and panic is the counter-intuitive lack of hypothalamic-pituitary-adrenal (HPA) activation in panic. Understanding panic as provoked by indicators of potential suffocation, such as fluctuations in pCO2 and brain lactate, as well as environmental circumstances fits the observed respiratory abnormalities. However, that sudden loss, bereavement and childhood separation anxiety are also antecedents of “spontaneous” panic requires an integrative explanation. Because of the opioid system’s central regulatory role in both disordered breathing and separation distress, we detail the role of opioidergic dysfunction in decreasing the suffocation alarm threshold. We present results from our laboratory where the naloxone-lactate challenge in normals produces supportive evidence for the endorphinergic defect hypothesis in the form of a distress episode of specific tidal volume hyperventilation paralleling challenge-produced and clinical panic. PMID:17765379

  9. Ambulatory Assessment in Panic Disorder and Specific Phobia

    ERIC Educational Resources Information Center

    Alpers, Georg W.

    2009-01-01

    Anxiety disorders are among the most prevalent mental disorders. In panic disorder, panic attacks often occur at unpredictable times, making it difficult to study these episodes in the laboratory. In specific phobias, symptoms occur in very circumscribed situations and specific triggers are sometimes difficult to reproduce in the laboratory.…

  10. Anxiety Sensitivity: A Missing Piece to the Agoraphobia-without-Panic Puzzle

    ERIC Educational Resources Information Center

    Hayward, Chris; Wilson, Kimberly A.

    2007-01-01

    This article reviews the controversy surrounding the diagnosis of agoraphobia without panic attacks and proposes a key role for anxiety sensitivity in explaining agoraphobic avoidance among those who have never experienced panic. Although rare in clinical samples, agoraphobia without panic is commonly observed in population-based surveys,…

  11. A Comparison of Alprazolam and Behavior Therapy in Treatment of Panic Disorder.

    ERIC Educational Resources Information Center

    Klosko, Janet S.; And Others

    1990-01-01

    Compared panic control treatment (PCT), behavior therapy for panic disorders, with alprazolam medication, placebo, and waiting-list control groups. Percentage of clients (N=57) completing study who were free of panic attacks following PCT was 87 percent, compared with 50 percent for alprazolam, 36 percent for placebo, and 33 percent for…

  12. Content Specificity in Imaginal Exposure: Evaluation of Subjective and Physiological Responding in Patients with Panic Disorder

    DTIC Science & Technology

    1996-06-18

    devoted to anxiety disorders, and related symptomatology; panicuJarly Panic Disorder. agoraphobia , and panic attacks (Freedman and Glass, 1984). Numerous...of Panic The popular biological models ofpanic have had major consequences for the conceptualization and treatment ofpanic disorder and agoraphobia ...diagnoses (as well as those with depresssion), PO patients (and those with agoraphobia ), scored significantly higher scores on items describing

  13. On the verge of a respiratory-type panic attack: Selective activations of rostrolateral and caudoventrolateral periaqueductal gray matter following short-lasting escape to a low dose of potassium cyanide.

    PubMed

    Müller, Cláudia Janaina Torres; Quintino-Dos-Santos, Jeyce Willig; Schimitel, Fagna Giacomin; Tufik, Sérgio; Beijamini, Vanessa; Canteras, Newton Sabino; Schenberg, Luiz Carlos

    2017-02-20

    Intravenous injections of potassium cyanide (KCN) both elicit escape by its own and facilitate escape to electrical stimulation of the periaqueductal gray matter (PAG). Moreover, whereas the KCN-evoked escape is potentiated by CO2, it is suppressed by both lesions of PAG and clinically effective treatments with panicolytics. These and other data suggest that the PAG harbors a hypoxia-sensitive alarm system the activation of which could both precipitate panic and render the subject hypersensitive to CO2. Although prior c-Fos immunohistochemistry studies reported widespread activations of PAG following KCN injections, the employment of repeated injections of high doses of KCN (>60µg) in anesthetized rats compromised both the localization of KCN-responsive areas and their correlation with escape behavior. Accordingly, here we compared the brainstem activations of saline-injected controls (air/saline) with those produced by a single intravenous injection of 40-µg KCN (air/KCN), a 2-min exposure to 13% CO2 (CO2/saline), or a combined stimulus (CO2/KCN). Behavioral effects of KCN microinjections into the PAG were assessed as well. Data showed that whereas the KCN microinjections were ineffective, KCN intravenous injections elicited escape in all tested rats. Moreover, whereas the CO2 alone was ineffective, it potentiated the KCN-evoked escape. Compared to controls, the nucleus tractus solitarius was significantly activated in both CO2/saline and CO2/KCN groups. Additionally, whereas the laterodorsal tegmental nucleus was activated by all treatments, the rostrolateral and caudoventrolateral PAG were activated by air/KCN only. Data suggest that the latter structures are key components of a hypoxia-sensitive suffocation alarm which activation may trigger a panic attack.

  14. Caffeine challenge test and panic disorder: a systematic literature review.

    PubMed

    Vilarim, Marina Machado; Rocha Araujo, Daniele Marano; Nardi, Antonio Egidio

    2011-08-01

    This systematic review aimed to examine the results of studies that have investigated the induction of panic attacks and/or the anxiogenic effect of the caffeine challenge test in patients with panic disorder. The literature search was performed in PubMed, Biblioteca Virtual em Saúde and the ISI Web of Knowledge. The words used for the search were caffeine, caffeine challenge test, panic disorder, panic attacks and anxiety disorder. In total, we selected eight randomized, double-blind studies where caffeine was administered orally, and none of them controlled for confounding factors in the analysis. The percentage of loss during follow-up ranged between 14.3% and 73.1%. The eight studies all showed a positive association between caffeine and anxiogenic effects and/or panic disorder.

  15. Depersonalization in panic disorder: a clinical study.

    PubMed

    Seguí, J; Márquez, M; García, L; Canet, J; Salvador-Carulla, L; Ortiz, M

    2000-01-01

    Panic disorder (PD) has been hypothesized to be a heterogeneous entity, with distinct clinical subgroups. The presence of depersonalization during panic attacks may distinguish a specific subgroup of PD. We sought to analyze the differential features of a subgroup of PD patients with depersonalization. A total of 274 patients with PD were assessed and divided into 2 groups according to the presence or absence of depersonalization. The Structured Clinical Interview for DSM-III-R (SCID-UP-R) was used to assess PD and comorbid disorders. The clinical scales administered included the Hamilton Anxiety and Depression Rating Scale (HARS and HDRS), the Marks and Mathews Fears and Phobia Scale, Panic-Associated Symptom Scale (PASS), and a panic attack symptoms inventory. A total of 66 patients (24.1%) exhibited depersonalization during the attacks. Patients with depersonalization appeared to be younger and had an earlier age at onset. PD was more severe in the depersonalization group (greater number of attacks, worse level of functioning, and higher scores on most self-rating scales). Also, depersonalization patients showed more comorbidity with specific phobia. Our results support the view that PD with depersonalization may be considered a distinct and more severe subcategory of PD.

  16. Are Current Theories of Panic Falsifiable?

    ERIC Educational Resources Information Center

    Roth, Walton T.; Wilhelm, Frank H.; Pettit, Dean

    2005-01-01

    The authors examine 6 theories of panic attacks as to whether empirical approaches are capable of falsifying them and their heuristic value. The authors conclude that the catastrophic cognitions theory is least falsifiable because of the elusive nature of thoughts but that it has greatly stimulated research and therapy. The vicious circle theory…

  17. Adolescents' mental health outcomes according to different types of exposure to ongoing terror attacks.

    PubMed

    Braun-Lewensohn, Orna; Celestin-Westreich, Smadar; Celestin, Leon-Patrice; Verté, Dominique; Ponjaert-Kristoffersen, Ingrid

    2009-07-01

    This study investigates the impact of several types of exposure to terror attacks on adolescents' psychological outcomes in the context of ongoing terror. A total of 913 adolescents (51% girls) aged 12 to 18 years (12-13.6 = 33%; 13.7-15.6 = 38%; 15.7-18 = 28%) took part in the study. Detailed data were collected concerning objective, subjective and "mixed" types of exposure to terror, as well as demographics, post-traumatic stress symptoms (PTSS), emotional and behavioral problems and overall psychological and psychiatric difficulties. Subjective exposure was found to be the most important contributor to adolescents' post-traumatic stress and other mental health problems in this context. Gender also had important effects. The effects of objective and mixed types of exposure, as well as age, were less prominent. We did find, however, that the more adolescents consulted media, the less they experienced behavioral and emotional problems. Given that subjective experiences appear to be the best factor in explaining mental health outcomes when adolescents are confronted with persistent terror, the cognitive and emotional dynamics along with the coping behavior linked to such experiences merit further investigation.

  18. Panic disorder among Vietnamese refugees attending a psychiatric clinic: prevalence and subtypes.

    PubMed

    Hinton, D; Chau, H; Nguyen, L; Nguyen, M; Pham, T; Quinn, S; Tran, M

    2001-01-01

    This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: "orthostatic dizziness" (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark's spiral of panic.

  19. Panic disorder among Vietnamese refugees attending a psychiatric clinic: Prevalence and subtypes

    PubMed Central

    Hinton, Devon; Chau, Ha; Nguyen, Lim; Nguyen, Mai; Pham, Thang; Quinn, Sarah; Tran, Minh

    2009-01-01

    This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subtypes during the month prior to interview. Of 100 patients surveyed, 50 (50%) currently suffered PD. Among the 50 patients suffering PD, the most common panic attack subtypes during the previous month were the following: “orthostatic dizziness” (74% of the 50 panic disorder patients [PDPs]), headache (50% of PDPs), wind-induced/temperature-shift-induced (24% of PDPs), effort-induced (18% of PDPs), gastro-intestinal (16% of PDPs), micturition-induced (8% of PDPs), out-of-the-blue palpitations (24% of PDPs), and out-of-the-blue shortness of breath (16% of PDPs). Five mechanisms are adduced to account for this high PD prevalence as well as the specific profile of subtypes: 1) a trauma-caused panic attack diathesis; 2) trauma-event cues; 3) ethnic differences in physiology; 4) catastrophic cognitions generated by cultural syndromes; and 5) a modification of Clark’s spiral of panic. PMID:11738465

  20. Panic of 1907.

    ERIC Educational Resources Information Center

    Federal Reserve Bank of Boston, MA.

    This pamphlet recaps the chain of events known as The Bank Panic of 1907. Historians view this as a watershed event that had a lasting impact on the financial system of the United States. The panic resulted from the collapse of the United Copper Company and was averted with the intervention of John D. Rockefeller and the J. P. Morgan Company. The…

  1. Dissemination of Cognitive Therapy for Panic Disorder in Primary Care

    PubMed Central

    Grey, Nick; Salkovskis, Paul; Quigley, Alexandra; Clark, David M.; Ehlers, Anke

    2011-01-01

    This study investigated whether brief training in cognitive therapy for panic disorder (Clark et al., 1994) can improve the outcomes that primary care therapists obtain with their patients. Seven primary care therapists treated 36 patients meeting DSM-IV (APA, 1994) criteria for panic disorder with or without agoraphobia in general practice surgeries. Outcomes for the cohort of patients whom the therapists treated with their usual methods (treatment-as-usual) before the training (N = 12) were compared with those obtained with similar patients treated by the same therapists after brief training and ongoing supervision in cognitive therapy (CT) for panic disorder (N = 24). Treatment-as-usual led to significant improvements in panic severity, general anxiety, and depression. However, only a small proportion (17% of the intent-to-treat sample) became panic free and there was no improvement in agoraphobic avoidance. Patients treated with CT achieved significantly better outcomes on all measures of panic attacks, including panic-free rate (54%, intent-to-treat), and showed significantly greater improvements in agoraphobic avoidance and patient-rated general anxiety. In conclusion, cognitive therapy for panic disorder can be successfully disseminated in primary care with a brief therapist training and supervision programme that leads to significant improvements in patient outcomes. PMID:22661906

  2. Brief Report: Adolescents under Missile Attacks: Sense of Coherence as a Mediator between Exposure and Stress-Related Reactions

    ERIC Educational Resources Information Center

    Braun-Lewensohn, Orna; Sagy, Shifra; Roth, Guy

    2011-01-01

    Employing the salutogenic approach (Antonovsky, 1987), this pilot study aimed at exploring the mediation effect of Sense of Coherence (SOC) on the relationships between exposure to missile attacks and stress-related reactions among adolescents. A strong SOC means a tendency to see the world as more comprehensible, manageable and meaningful. Data…

  3. Long-term evaluation of paroxetine, clomipramine and placebo in panic disorder. Collaborative Paroxetine Panic Study Investigators.

    PubMed

    Lecrubier, Y; Judge, R

    1997-02-01

    Paroxetine has been shown to be effective in panic disorder in three 10- to 12-week studies. This trial studied the longer term effects of paroxetine in patients with DSM-III-R defined panic disorder. Patients who satisfactorily completed a 12-week, double-blind, placebo-controlled study of paroxetine and clomipramine could choose to continue receiving their randomized treatment for a further 36 weeks. Efficacy assessments included the daily panic attack diary, the Clinical Global Impression Scale, the Hamilton Anxiety Rating Scale, the Marks Sheehan Phobia Scale and the Sheehan Disability Scale. In total, 176 patients were included in the intention-to-treat population. The number of full panic attacks decreased in all three groups during the 12-week study, and improvements continued with long-term therapy. Paroxetine was statistically significantly more effective than placebo throughout the long-term study with respect to reduction from baseline of full panic attacks, and at the end of treatment with respect to the proportion of patients who eventually experienced no panic attacks. There were no significant differences between paroxetine and clomipramine. The proportion of patients who withdrew from the study due to adverse effects was greater in the clomipramine group (19%) than in either the paroxetine group (7%) or the placebo group (9%). Paroxetine was significantly more effective than placebo and as effective as (but better tolerated than) clomipramine in the long-term treatment of panic disorder. Not only was efficacy maintained, but continued improvement was also seen, indicating the importance of long-term treatment in patients with panic disorder.

  4. Acid–base dysregulation and chemosensory mechanisms in panic disorder: a translational update

    PubMed Central

    Vollmer, L L; Strawn, J R; Sah, R

    2015-01-01

    Panic disorder (PD), a complex anxiety disorder characterized by recurrent panic attacks, represents a poorly understood psychiatric condition which is associated with significant morbidity and an increased risk of suicide attempts and completed suicide. Recently however, neuroimaging and panic provocation challenge studies have provided insights into the pathoetiology of panic phenomena and have begun to elucidate potential neural mechanisms that may underlie panic attacks. In this regard, accumulating evidence suggests that acidosis may be a contributing factor in induction of panic. Challenge studies in patients with PD reveal that panic attacks may be reliably provoked by agents that lead to acid–base dysbalance such as CO2 inhalation and sodium lactate infusion. Chemosensory mechanisms that translate pH into panic-relevant fear, autonomic, and respiratory responses are therefore of high relevance to the understanding of panic pathophysiology. Herein, we provide a current update on clinical and preclinical studies supporting how acid–base imbalance and diverse chemosensory mechanisms may be associated with PD and discuss future implications of these findings. PMID:26080089

  5. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V.

    PubMed

    Craske, Michelle G; Kircanski, Katharina; Epstein, Alyssa; Wittchen, Hans-Ulrich; Pine, Danny S; Lewis-Fernández, Roberto; Hinton, Devon

    2010-02-01

    This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.

  6. Changes in central sodium and not osmolarity or lactate induce panic-like responses in a model of panic disorder.

    PubMed

    Molosh, Andre I; Johnson, Philip L; Fitz, Stephanie D; Dimicco, Joseph A; Herman, James P; Shekhar, Anantha

    2010-05-01

    Panic disorder is a severe anxiety disorder characterized by recurrent panic attacks that can be consistently provoked with intravenous (i.v.) infusions of hypertonic (0.5 M) sodium lactate (NaLac), yet the mechanism/CNS site by which this stimulus triggers panic attacks is unclear. Chronic inhibition of GABAergic synthesis in the dorsomedial hypothalamus/perifornical region (DMH/PeF) of rats induces a vulnerability to panic-like responses after i.v. infusion of 0.5 M NaLac, providing an animal model of panic disorder. Using this panic model, we previously showed that inhibiting the anterior third ventricle region (A3Vr; containing the organum vasculosum lamina terminalis, the median preoptic nucleus, and anteroventral periventricular nucleus) attenuates cardiorespiratory and behavioral responses elicited by i.v. infusions of NaLac. In this study, we show that i.v. infusions of 0.5 M NaLac or sodium chloride, but not iso-osmolar D-mannitol, increased 'anxiety' (decreased social interaction) behaviors, heart rate, and blood pressure responses. Using whole-cell patch-clamp preparations, we also show that bath applications of NaLac (positive control), but not lactic acid (lactate stimulus) or D-mannitol (osmolar stimulus), increases the firing rates of neurons in the A3Vr, which are retrogradely labeled from the DMH/PeF and which are most likely glutamatergic based on a separate study using retrograde tracing from the DMH/PeF in combination with in situ hybridization for vesicular glutamate transporter 2. These data show that hypertonic sodium, but not hyper-osmolarity or changes in lactate, is the key stimulus that provokes panic attacks in panic disorder, and is consistent with human studies.

  7. Emotional intelligence in panic disorder.

    PubMed

    Perna, Giampaolo; Menotti, Roberta; Borriello, Giulia; Cavedini, Paolo; Bellodi, Laura; Caldirola, Daniela

    2010-01-01

    Panic attacks are psychopathological phenomena with a strong emotional activation that often induces subsequent anticipatory anxiety and phobic avoidance. Impairment in emotional processing in patients with Panic Disorder (PD) has been hypothesized. Emotional Intelligence (EI) involves the individual abilities to perceive, understand and manage emotions in order to cope with changes in internal and external environment. We examined EI in 42 patients with PD with Agoraphobia compared to 49 healthy controls and investigated if clinical severity of Agoraphobia is related to EI performance. We assessed EI by Mayer-Salovey-Caruso Emotional Intelligence Test and Agoraphobia by Mobility Inventory for Agoraphobia. Patients with PD and Agoraphobia showed lower Strategic EI ability than healthy controls, in both Understanding and Managing emotion abilities, and a general propensity to attribute negative emotional valence to different stimuli. These preliminary results suggest that impaired mechanisms of understanding and integrating emotions may be involved in the phenomenology of PD. These features might be the target of psychological interventions in PD. On the contrary, Emotional Intelligence did not appear to affect the clinical severity of Agoraphobia.

  8. Psychotherapy for panic disorder.

    PubMed

    Shear, M K; Weiner, K

    1997-01-01

    Although medications and panic-focused cognitive behavior therapy are considered standard treatments for panic disorder, other types of psychotherapy may also be helpful. Many patients with panic disorder have some residual underlying vulnerability, as suggested by the continued occurrence of symptoms. These patients may benefit from a more broad-based psychotherapy, as might those in whom comorbid symptoms occur. Some patients are unable or choose not to participate in a structured prescriptive treatment requiring homework. Our psychotherapeutic approach to treating panic disorder, called emotion-focused treatment, targets identifying and managing negative emotions, especially as they relate to common psychological themes of fear of separation, fear of constriction, and the need for interpersonal control.

  9. Understanding panic disorder in chronic respiratory disease.

    PubMed

    Hallas, Claire; Howard, Claire; Wray, Jo

    As well as being physically debilitating, respiratory diseases present significant challenges to the psychological well-being of individuals and their families and are recognized to have an impact on health-care services, resources and time. Panic attacks and disorder are particularly prevalent in people with respiratory conditions and appear to be associated with reduced lung function. However, recent evidence suggests that the aetiology of panic in this area may be related more to underlying psychological processes, which can influence cognitions that are related to the experience of respiratory disease and its symptoms. The aim of this article is to give a brief overview of the literature to identify key psychological factors associated with panic and respiratory diseases. The article concludes that panic has a complex aetiology, which requires the presence of specific respiratory-related cognitions. The self-regulatory model can foster understanding of the combination of beliefs/cognitions that can increase the prevalence of negative mood for patients with respiratory diseases.

  10. Perceived family social support buffers against the effects of exposure to rocket attacks on adolescent depression, aggression, and severe violence.

    PubMed

    Shahar, Golan; Henrich, Christopher C

    2016-02-01

    The authors compared the protective effects of 3 sources of perceived social support-from family members, friends, and school personnel-on internalizing and externalizing symptoms in adolescents exposed to rocket attacks. Data were based on 362 Israeli adolescents (median age = 14), chronically exposed to rockets from the Gaza Strip, for whom robust effects of exposure on internalizing and externalizing symptoms were reported during the 2009-2010 period (Henrich & Shahar, 2013). New analyses revealed that perceived family social support assessed in 2009 buffered against the effect of exposure to rocket attacks on depression, aggression, and severe violence during 2009-2010. Findings are consistent with a human-ecological perspective exposure to political violence and encourage the employment of family-based preventive interventions in afflicted areas.

  11. [Deleterious Results of Safety Seeking Behaviours in Panic Disorder: Polydipsia and Diabetes Mellitus Type 2].

    PubMed

    Kurt, Emel; Karabaş, Özer; Yorguner, Neşe; Wurz, Axel; Topçuoğlu, Volkan

    2016-01-01

    Panic disorder is an anxiety disorder that involves recurrent panic attacks, which emerge when a harmless stimulus is interpreted as "catastrophic". In an attempt to avoid the panic attack or prevent confrontation, the patient exhibits a dysfunctional attitude and behavior, such as evasion and safety-seeking behavior (SSB). Dysfunctional behavior leads to an increase in the recurrence of panic attacks and affects the patient's life in a negative way. According to the cognitive behavioral therapy model, SSB contributes to the continuation of unrealistic beliefs (e.g. physical experiences) regarding and prevents the patient from grasping new information that may potentially contradict the unrealistic cognitions. In this paper, we present a case with a primary diagnosis of panic disorder. Interestingly, this patient developed diabetes mellitus (DM) type 2 and psychogenic polydipsia (PPD) as a consequence of his SSB. PPD is a common occurrence in patients with psychiatric disorders, especially in schizophrenia. Up to now, no case of a panic disorder with either DM or PPD has been reported in the literature. While it is accepted that major depression poses a risk for DM type 2, panic disorder may also increase this risk. Treatment of the panic disorder with cognitive behavioral therapy (CBT) resulted in improvement of PPD and DM type 2. In conclusion, the role of SSB in medical disorders accompanied by psychiatric disorders should be kept in mind when treating these patients.

  12. Panic disorder and agoraphobia: an overview and commentary on DSM-5 changes.

    PubMed

    Asmundson, Gordon J G; Taylor, Steven; Smits, Jasper A J

    2014-06-01

    The recently published DSM-5 contains a number of changes pertinent to panic disorder and agoraphobia. These changes include separation of panic disorder and agoraphobia into separate diagnoses, the addition of criteria and guidelines for distinguishing agoraphobia from specific phobia, the addition of a 6-month duration requirement for agoraphobia, the addition of panic attacks as a specifier to any DSM-5 diagnosis, changes to descriptors of panic attack types, as well as various changes to the descriptive text. It is crucial that clinicians and researchers working with individuals presenting with panic attacks and panic-like symptoms understand these changes. The purpose of the current paper is to provide a summary of the main changes, to critique the changes in the context of available empirical evidence, and to highlight clinical implications and potential impact on mental health service utilization. Several of the changes have the potential to improve access to evidence-based treatment; yet, although certain changes appear justified in that they were based on converging evidence from different empirical sources, other changes appear questionable, at least based on the information presented in the DSM-5 text and related publications. Ongoing research of DSM-5 panic disorder and agoraphobia as well as application of the new diagnostic criteria in clinical contexts is needed to further inform the strengths and limitations of DSM-5 conceptualizations of panic disorder and agoraphobia.

  13. Ambulatory assessment in panic disorder and specific phobia.

    PubMed

    Alpers, Georg W

    2009-12-01

    Anxiety disorders are among the most prevalent mental disorders. In panic disorder, panic attacks often occur at unpredictable times, making it difficult to study these episodes in the laboratory. In specific phobias, symptoms occur in very circumscribed situations and specific triggers are sometimes difficult to reproduce in the laboratory. Ambulatory assessment, or ecological momentary assessment, can further the understanding of the natural course and scope of symptoms under ecologically valid circumstances. Because bodily symptoms are integral to the diagnosis of anxiety disorders, the objective assessment of physiological responses in the patients' natural environment is particularly important. On the one hand, research has highlighted intriguing discrepancies between the experience of symptoms and physiology during panic attacks. On the other hand, it has validated symptom reporting during therapeutic exposure to phobic situations. Therefore, ambulatory assessment can yield useful information about the psychopathology of anxiety disorders, and it can be used to monitor change during clinical interventions.

  14. Panic disorder in patients with angiographically normal coronary arteries.

    PubMed

    Beitman, B D

    1992-05-27

    Several lines of investigation strongly support the notion that panic disorder afflicts at least one third of patients with angiographically normal coronary arteries and unexplained chest pain. Panic disorder is a common problem, affecting 1-2% of the U.S. population. Current research suggests an etiology that is both psychophysiologic and cognitive. The locus ceruleus and cortico-releasing factor are implicated in the biological circuit associated with panic attacks, while psychological research indicates that catastrophic thinking, phobic responses to somatic sensations, and repressed anger, grief, and traumatic events play a part in triggering attacks. Treatment consists of pharmacologic interventions, including antidepressants and benzodiazepines, as well as psychotherapeutic work focusing on catastrophic thinking and repressed anger, grief responses, and other traumatic experiences.

  15. Kyol Goeu (‘Wind Overload’) Part I: A Cultural Syndrome of Orthostatic Panic among Khmer Refugees

    PubMed Central

    Hinton, Devon; Um, Khin; Ba, Phalnarith

    2009-01-01

    Certain cultural syndromes seem to increase the risk of panic attacks by generating catastrophic cognitions about symptoms of autonomic arousal. These schemas create a constant anxious scanning of the body, hence facilitating, maintaining, and producing panic. As a case in point, a Khmer fainting syndrome,‘wind overload’ (kyol goeu), results in dire expectations concerning the autonomic symptoms experienced upon standing, thus contributing to the high rate of orthostatically induced panic observed in this population. PMID:20852723

  16. The effect of Korean-group cognitive behavioural therapy among patients with panic disorder in clinic settings.

    PubMed

    Choi, Y S; Lee, E J; Cho, Y

    2017-02-01

    WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients. WHAT THIS PAPER ADD TO EXISTING KNOWLEDGE?: In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone. For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general.

  17. [Separation anxiety and panic disorder].

    PubMed

    Seguí, J; Salvador, L; Canet, J; Márquez, M; Ortíz, M; García, L

    1998-01-01

    History od separation anxiety was investigated in several psychiatryc disorders and in 150 patients with panic disorder following DSM III-R criteria. Separation anxiety was reported by 15.3% of patients with panic disorder, 3.3% of the healthy control group, 13.3% of patients with major depression, 16.7% with dystymia, 13.3% with generalized anxiety and 33.3% with social phobia (p < 0.001). Separation anxiety is thus considered a common predisposing factor of anxiety and depressive disorders. Panic disorder patients with a history of separation anxiety had an earlier age at panic onset and greater comorbidity with social phobia and agoraphobia.

  18. The efficacy and safety of alprazolam versus other benzodiazepines in the treatment of panic disorder.

    PubMed

    Moylan, Steven; Staples, John; Ward, Stephanie Alison; Rogerson, Jan; Stein, Dan J; Berk, Michael

    2011-10-01

    We performed a meta-analysis of all single- or double-blind, randomized controlled trials comparing alprazolam to another benzodiazepine in the treatment of adult patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Third or Fourth Edition, criteria for panic disorder or agoraphobia with panic attacks. Eight studies met inclusion criteria, describing a total of at least 631 randomized patients. In the pooled results, there were no significant differences in efficacy between alprazolam and the comparator benzodiazepines on any of the prespecified outcomes: improvement in mean panic attack frequency (between-arm weighted mean difference of 0.6 panic attacks per week; 95% confidence interval [CI], -0.3 to 1.6), improvement in Hamilton Anxiety Rating Scale score (weighted mean difference of 0.8 points; 95% CI, -0.5 to 2.1), and proportion of patients free of panic attacks at the final evaluation (pooled relative risk, 1.1; 95% CI, 0.9-1.4). Statistical heterogeneity on prespecified outcomes was not eliminated by stratification on baseline anxiety level. The available evidence fails to demonstrate alprazolam as superior to other benzodiazepines for the treatment of panic disorder.

  19. Social phobia with sudden onset--post-panic social phobia?

    PubMed

    Kristensen, Ann Suhl; Mortensen, Erik Lykke; Mors, Ole

    2008-05-01

    Overlap between social phobia (SP) and panic disorder (PD) has been observed in epidemiological, family, and challenge studies. One possible explanation is that some cases of SP develop as a consequence of a panic attack in a social situation. By definition, these cases of SP have sudden onset. It is hypothesized that patients with SP with sudden onset are more similar to patients with comorbid SP and PD than to patients with SP without sudden onset regarding age of onset, extraversion, and prevalence of anxiety symptoms. One hundred and eighty-two patients with a lifetime diagnosis of PD and/or SP were recruited as part of an etiological study. Patients with SP with sudden onset did, as hypothesized, differ from patients with SP without sudden onset with regard to age of onset and extraversion, but not with regard to symptoms. They did not differ markedly from patients with comorbid SP and PD. The concept of post-panic SP is discussed.

  20. [Panic disorders: differential diagnosis and care in emergencies].

    PubMed

    Damsa, Cristian; Lazignac, Coralie; Iancu, Ruxandra; Niquille, Marc; Miller, Nick; Mihai, Adriana; Virgillito, Salvatore; Adam, Eric

    2008-02-13

    Despite the high prevalence of panic disorders in patients in primary-care settings, this condition is frequently under-recognised and under-treated. After the description of DSM-IV diagnosis criteria of panic disorders, this paper underline the importance of an adequate somatic and psychiatric differential diagnosis. Even if cognitive-behavioural therapy is the best studied psychotherapeutical approach, several efficacious psychodynamic psychotherapies were also described. High-potency benzodiazepines provide a rapid efficacy with beneficial effects during the first days of treatment. However, benzodiazepines should be avoided in the long term, because of the development of tolerance and dependence. Antidepressants (SSRI, venlafaxine) are effective in preventing panic attacks, especially in improving anticipatory anxiety and avoidance behaviour.

  1. The relationship between panic disorder/agoraphobia and personality disorders.

    PubMed

    Mavissakalian, M

    1990-12-01

    This selective review of the relationship between panic disorder/agoraphobia and DSM-III personality disorders points to a preponderance of dependent, avoidant, and histrionic features and reveals a certain degree of covariation between severity of Axis I disorder and personality functioning. However, the link between panic/agoraphobia and Axis II disorders does not appear to be specific because (1) general features such as neuroticism, stress, dysphoric mood, and interpersonal sensitivity, rather than duration and severity of panic attacks and phobias, emerge as unique predictors or determinants of personality disorder; and (2) similar personality profiles are obtained in a heterogenous population of psychiatric outpatients or patients with social phobia, obsessive-compulsive disorder, and major depression.

  2. Diagnosis and treatment of agoraphobia with panic disorder.

    PubMed

    Perugi, Giulio; Frare, Franco; Toni, Cristina

    2007-01-01

    Agoraphobia with panic disorder is a phobic-anxious syndrome where patients avoid situations or places in which they fear being embarrassed, or being unable to escape or get help if a panic attack occurs. During the last half-century, agoraphobia has been thought of as being closely linked to the recurring panic attack syndrome, so much so that in most cases it appears to be the typical development or complication of panic disorder. Despite the high prevalence of agoraphobia with panic disorder in patients in primary-care settings, the condition is frequently under-recognised and under-treated by medical providers. Antidepressants have been demonstrated to be effective in preventing panic attacks, and in improving anticipatory anxiety and avoidance behaviour. These drugs are also effective in the treatment of the frequently coexisting depressive symptomatology. Among antidepressant agents, SSRIs are generally well tolerated and effective for both anxious and depressive symptomatology, and these compounds should be considered the first choice for short-, medium- and long-term pharmacological treatment of agoraphobia with panic disorder. The few comparative studies conducted to date with various SSRIs reported no significant differences in terms of efficacy; however, the SSRIs that are less liable to produce withdrawal symptoms after abrupt discontinuation should be considered the treatments of first choice for long-term prophylaxis. Venlafaxine is not sufficiently studied in the long-term treatment of panic disorder, while TCAs may be considered as a second choice of treatment when patients do not seem to respond to or tolerate SSRIs. High-potency benzodiazepines have been shown to display a rapid onset of anti-anxiety effect, having beneficial effects during the first few days of treatment, and are therefore useful options for short-term treatment; however, these drugs are not first-choice medications in the medium and long term because of the frequent development

  3. Milnacipran in panic disorder with agoraphobia and major depressive disorder: a case report.

    PubMed

    Chen, Mu-Hong; Liou, Ying-Jay

    2011-01-01

    A 51-year-old woman had panic disorder with agoraphobia and major depressive disorder sequentially. The aforementioned symptoms subsided significantly after treatment with milnacipran, 125 mg, administered daily for 2 months. However, panic attacks with agoraphobia were noted frequently when she tapered down milnacipran to 50 mg daily. She consequently experienced depression that gradually increased in degree, with poor energy, poor sleep, thoughts of helplessness, and ideas of death. After administration of a daily dose of 125 mg of milnacipran for 1 month, her panic attacks with agoraphobia and depressed mood were again alleviated. The present report shows significant effects of milnacipran on the comorbidity of panic disorder with agoraphobia and major depressive disorder.

  4. Panic and phobic anxiety: associations among neuroticism, physiological hyperarousal, anxiety sensitivity, and three phobias.

    PubMed

    Longley, Susan L; Watson, David; Noyes, Russell; Yoder, Kevin

    2006-01-01

    A dimensional and psychometrically informed taxonomy of anxiety is emerging, but the specific and nonspecific dimensions of panic and phobic anxiety require greater clarification. In this study, confirmatory factor analyses of data from a sample of 438 college students were used to validate a model of panic and phobic anxiety with six content factors; multiple scales from self-report measures were indicators of each model component. The model included a nonspecific component of (1) neuroticism and two specific components of panic attack, (2) physiological hyperarousal, and (3) anxiety sensitivity. The model also included three phobia components of (4) classically defined agoraphobia, (5) social phobia, and (6) blood-injection phobia. In these data, agoraphobia correlated more strongly with both the social phobia and blood phobia components than with either the physiological hyperarousal or the anxiety sensitivity components. These findings suggest that the association between panic attacks and agoraphobia warrants greater attention.

  5. Lifelong opioidergic vulnerability through early life separation: a recent extension of the false suffocation alarm theory of panic disorder.

    PubMed

    Preter, Maurice; Klein, Donald F

    2014-10-01

    The present paper is the edited version of our presentations at the "First World Symposium On Translational Models Of Panic Disorder", in Vitoria, E.S., Brazil, on November 16-18, 2012. We also review relevant work that appeared after the conference. Suffocation-False Alarm Theory (Klein, 1993) postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. The expanded Suffocation-False Alarm Theory (Preter and Klein, 2008) hypothesizes that endogenous opioidergic dysregulation may underlie the respiratory pathophysiology and suffocation sensitivity in panic disorder. Opioidergic dysregulation increases sensitivity to CO2, separation distress and panic attacks. That sudden loss, bereavement and childhood separation anxiety are also antecedents of "spontaneous" panic requires an integrative explanation. Our work unveiling the lifelong endogenous opioid system impairing effects of childhood parental loss (CPL) and parental separation in non-ill, normal adults opens a new experimental, investigatory area.

  6. Media use by children and adolescents from New York City 6 months after the WTC attack.

    PubMed

    Duarte, Cristiane S; Wu, Ping; Cheung, Anna; Mandell, Donald J; Fan, Bin; Wicks, Judith; Musa, George J; Hoven, Christina W

    2011-10-01

    Six months after the World Trade Center (WTC) attacks of September 11, 2001 (9/11), a representative sample of New York City students (N = 8,236) in Grades 4 through 12 reported their use of TV, Web, and combined radio and print media regarding the WTC attack. Demographic factors, WTC exposure, other exposure to trauma, and probable posttraumatic stress disorder (PTSD) were used to predict intensive use of the 3 types of media. Intensive use was associated with direct exposure to the WTC attack (with the exception of Web use) and to having reported symptoms of PTSD. Stratified analyses indicated that the association between probable PTSD and intensive media use was more consistently present among those who had no direct or familial exposure to the WTC attack. As well, media, particularly TV, was intensively used by children after the WTC attack. Variations existed in the factors associated with intensive media use, which should be considered when planning postdisaster media coverage and advising families.

  7. Heart rate and respiratory response to doxapram in patients with panic disorder.

    PubMed

    Martinez, Jose M; Garakani, Amir; Aaronson, Cindy J; Gorman, Jack M

    2015-05-30

    Panic disorder (PD) is characterized by anticipatory anxiety and panic, both causing physiological arousal. We investigated the differential responses between anticipatory anxiety and panic in PD and healthy controls (HC). Subjects (15 PD and 30 HC) received an injection of a respiratory stimulant, doxapram, with a high rate of producing panic attacks in PD patients, or an injection of saline. PD subjects had significantly higher scores in anxiety and panic symptoms during both conditions. Analysis of heart rate variability (HRV) indices showed higher sympathetic activity (LF) during anticipatory anxiety and panic states, an increase in the ratio of LF/HF during the anticipatory and panic states and a decrease in parasympathetic (HF) component in PD patients. During doxapram PD subjects increased their LF/HF ratio while HC had a reduction in LF/HF. Parasympathetic component of HRV was lower during anticipatory anxiety in PD. In general, PD showed greater sympathetic and psychological responses related to anxiety and sensations of dyspnea, reduced parasympathetic responses during anticipatory and panic states, but no differences in respiratory response. This confirms previous studies showing that PD patients do not have an intrinsic respiratory abnormality (either heightened or dysregulated) at the level of the brain stem but rather an exaggerated fear response.

  8. Missense mutation of the cholecystokinin B receptor gene: Lack of association with panic disorder

    SciTech Connect

    Kato, Tadafumi; Wang, Zhe Wu; Crowe, R.R.; Zoega, T.

    1996-07-26

    Cholecystokinin tetrapeptide (CCK{sub 4}) is known to induce panic attacks in patients with panic disorder at a lower dose than in normal controls. Therefore, the cholecystokinin B (CCK{sub B}) receptor gene is a candidate gene for panic disorder. We searched for mutations in the CCK{sub B} gene in 22 probands of panic disorder pedigrees, using single-strand conformation polymorphism (SSCP) analysis. Two polymorphisms were detected. A polymorphism in an intron (2491 C{yields}A) between exons 4 and 5 was observed in 10 of 22 probands. A missense mutation in the extracellular loop of exon 2 (1550 G{yields}A, Val{sup 125}{yields}Ile) was found in only one proband. This mutation was also examined in additional 34 unrelated patients with panic disorder and 112 controls. The prevalence rate of this mutation was 8.8% in patients with panic disorder (3/34) and 4.4% in controls (5/112). The mutation did not segregate with panic disorder in two families where this could be tested. These results suggest no pathophysiological significance of this mutation in panic disorder. 21 refs., 4 figs., 1 tab.

  9. The role of 5-HT1A receptors in the anti-aversive effects of cannabidiol on panic attack-like behaviors evoked in the presence of the wild snake Epicrates cenchria crassus (Reptilia, Boidae).

    PubMed

    Twardowschy, André; Castiblanco-Urbina, Maria Angélica; Uribe-Mariño, Andres; Biagioni, Audrey Francisco; Salgado-Rohner, Carlos José; Crippa, José Alexandre de Souza; Coimbra, Norberto Cysne

    2013-12-01

    The potential anxiolytic and antipanic properties of cannabidiol have been shown; however, its mechanism of action seems to recruit other receptors than those involved in the endocannabinoid-mediated system. It was recently shown that the model of panic-like behaviors elicited by the encounters between mice and snakes is a good tool to investigate innate fear-related responses, and cannabidiol causes a panicolytic-like effect in this model. The aim of the present study was to investigate the 5-hydroxytryptamine (5-HT) co-participation in the panicolytic-like effects of cannabidiol on the innate fear-related behaviors evoked by a prey versus predator interaction-based paradigm. Male Swiss mice were treated with intraperitoneal (i.p.) administrations of cannabidiol (3 mg/kg, i.p.) and its vehicle and the effects of the peripheral pre-treatment with increasing doses of the 5-HT1A receptor antagonist WAY-100635 (0.1, 0.3 and 0.9 mg/kg, i.p.) on instinctive fear-induced responses evoked by the presence of a wild snake were evaluated. The present results showed that the panicolytic-like effects of cannabidiol were blocked by the pre-treatment with WAY-100635 at different doses. These findings demonstrate that cannabidiol modulates the defensive behaviors evoked by the presence of threatening stimuli, and the effects of cannabidiol are at least partially dependent on the recruitment of 5-HT1A receptors.

  10. Anti-aversive effects of cannabidiol on innate fear-induced behaviors evoked by an ethological model of panic attacks based on a prey vs the wild snake Epicrates cenchria crassus confrontation paradigm.

    PubMed

    Uribe-Mariño, Andrés; Francisco, Audrey; Castiblanco-Urbina, Maria Angélica; Twardowschy, André; Salgado-Rohner, Carlos José; Crippa, José Alexandre S; Hallak, Jaime Eduardo Cecílio; Zuardi, Antônio Waldo; Coimbra, Norberto Cysne

    2012-01-01

    Several pharmacological targets have been proposed as modulators of panic-like reactions. However, interest should be given to other potential therapeutic neurochemical agents. Recent attention has been given to the potential anxiolytic properties of cannabidiol, because of its complex actions on the endocannabinoid system together with its effects on other neurotransmitter systems. The aim of this study was to investigate the effects of cannabidiol on innate fear-related behaviors evoked by a prey vs predator paradigm. Male Swiss mice were submitted to habituation in an arena containing a burrow and subsequently pre-treated with intraperitoneal administrations of vehicle or cannabidiol. A constrictor snake was placed inside the arena, and defensive and non-defensive behaviors were recorded. Cannabidiol caused a clear anti-aversive effect, decreasing explosive escape and defensive immobility behaviors outside and inside the burrow. These results show that cannabidiol modulates defensive behaviors evoked by the presence of threatening stimuli, even in a potentially safe environment following a fear response, suggesting a panicolytic effect.

  11. Anti-Aversive Effects of Cannabidiol on Innate Fear-Induced Behaviors Evoked by an Ethological Model of Panic Attacks Based on a Prey vs the Wild Snake Epicrates cenchria crassus Confrontation Paradigm

    PubMed Central

    Uribe-Mariño, Andrés; Francisco, Audrey; Castiblanco-Urbina, Maria Angélica; Twardowschy, André; Salgado-Rohner, Carlos José; Crippa, José Alexandre S; Hallak, Jaime Eduardo Cecílio; Zuardi, Antônio Waldo; Coimbra, Norberto Cysne

    2012-01-01

    Several pharmacological targets have been proposed as modulators of panic-like reactions. However, interest should be given to other potential therapeutic neurochemical agents. Recent attention has been given to the potential anxiolytic properties of cannabidiol, because of its complex actions on the endocannabinoid system together with its effects on other neurotransmitter systems. The aim of this study was to investigate the effects of cannabidiol on innate fear-related behaviors evoked by a prey vs predator paradigm. Male Swiss mice were submitted to habituation in an arena containing a burrow and subsequently pre-treated with intraperitoneal administrations of vehicle or cannabidiol. A constrictor snake was placed inside the arena, and defensive and non-defensive behaviors were recorded. Cannabidiol caused a clear anti-aversive effect, decreasing explosive escape and defensive immobility behaviors outside and inside the burrow. These results show that cannabidiol modulates defensive behaviors evoked by the presence of threatening stimuli, even in a potentially safe environment following a fear response, suggesting a panicolytic effect. PMID:21918503

  12. When the threat comes from inside the body: a neuroscience based learning perspective of the etiology of panic disorder.

    PubMed

    Hamm, Alfons O; Richter, Jan; Pané-Farré, Christiane A

    2014-01-01

    Unexpected, recurrent panic attacks and anxious apprehension are two distinct emotional phenomena that constitute the core symptoms for diagnosing panic disorder. Taking a neuroscience perspective the current review paper presents both epidemiological and experimental psychophysiological evidence suggesting that panic attacks can be conceptualized as an unconditioned circa defense response pattern to intense internal threat stimuli, characterized by strong autonomic surge and escape behavior and abnormal plastic changes of the brain. Anxious apprehension develops after the experience of such severe panic attacks as conditioned responses to mild body symptoms. Theoretically these conditioned fear responses can be considered as post-encounter defense characterized by increased selective attention, increased threat appraisal and defensive freezing and startle potentiation evidencing altered brain circuits evoked by mild body symptoms. Agoraphobic avoidance starts very early during the defensive cascade and can be conceived as motivated behavior driven by the incentive to be in a safe context that is under control of the individual.

  13. Coping with Disaster: The Case of Israeli Adolescents under Threat of Missile Attack.

    ERIC Educational Resources Information Center

    Zeidner, Moshe

    1993-01-01

    Studied the relationships of coping resources, optimism, perceived control, and coping strategies to anxiety, physical symptoms, and cognitive functioning for 69 male and 40 female Jewish Israeli adolescents in real crisis during the Persian Gulf War. Discusses the implications of the reported mixture of active and palliative coping strategies.…

  14. [Panic disorder and atrial fibrillation].

    PubMed

    Olazabal Eizaguirre, N; Chavez, R; González-Torres, M A; Gaviria, M

    2013-10-01

    This paper studies the relationship between atrial fibrillation and panic disorder. There are often doubts on the differential diagnosis in emergency services and general medical settings. Panic disorder prevalence rates have been found to be high in patients suffering from atrial fibrillation. Various studies have observed that patients diagnosed with anxiety disorders frequently have higher cardiovascular disease rates compared to the general population. Usually, patients suffering from panic disorder exhibit somatic complaints suggesting coronary disease, such as chest pain or palpitations. The aim is to make the correct diagnosis and treatment for these different illnesses, and to decrease the costs due to misdiagnosis.

  15. Panic Anxiety in Humans with Bilateral Amygdala Lesions: Pharmacological Induction via Cardiorespiratory Interoceptive Pathways

    PubMed Central

    Feinstein, Justin S.; Li, Wei; Feusner, Jamie D.; Adolphs, Ralph; Hurlemann, Rene

    2016-01-01

    We previously demonstrated that carbon dioxide inhalation could induce panic anxiety in a group of rare lesion patients with focal bilateral amygdala damage. To further elucidate the amygdala-independent mechanisms leading to aversive emotional experiences, we retested two of these patients (B.G. and A.M.) to examine whether triggering palpitations and dyspnea via stimulation of non-chemosensory interoceptive channels would be sufficient to elicit panic anxiety. Participants rated their affective and sensory experiences following bolus infusions of either isoproterenol, a rapidly acting peripheral β-adrenergic agonist akin to adrenaline, or saline. Infusions were administered during two separate conditions: a panic induction and an assessment of cardiorespiratory interoception. Isoproterenol infusions induced anxiety in both patients, and full-blown panic in one (patient B.G.). Although both patients demonstrated signs of diminished awareness for cardiac sensation, patient A.M., who did not panic, reported a complete lack of awareness for dyspnea, suggestive of impaired respiratory interoception. These findings indicate that the amygdala may play a role in dynamically detecting changes in cardiorespiratory sensation. The induction of panic anxiety provides further evidence that the amygdala is not required for the conscious experience of fear induced via interoceptive sensory channels. SIGNIFICANCE STATEMENT We found that monozygotic twins with focal bilateral amygdala lesions report panic anxiety in response to intravenous infusions of isoproterenol, a β-adrenergic agonist similar to adrenaline. Heightened anxiety was evident in both twins, with one twin experiencing a panic attack. The twin who did not panic displayed signs of impaired cardiorespiratory interoception, including a complete absence of dyspnea sensation. These findings highlight that the amygdala is not strictly required for the experience of panic anxiety, and suggest that neural systems beyond

  16. Don't panic

    NASA Astrophysics Data System (ADS)

    Harris, Margaret

    2009-06-01

    "Don't panic" is a simple piece of advice, one that usually applies equally well to job-hunting, avoiding pandemic flu or, like the hapless Arthur Dent in the Hitchhiker's Guide to the Galaxy stories, wandering the universe in search of a decent cup of tea. Yet some statistics emerging from the current job market are undeniably alarming. Postings on the recruitment website Milkround.com, which advertises jobs and internships for recent graduates, are down by about 20% compared with this time last year, while a survey earlier this year by High Fliers, a Londonbased research firm, found that top UK employers plan to recruit 17% fewer graduates this year than in 2008. In the same study, half of the 1017 final-year students surveyed believed they would have to take "any graduate job" they were offered, regardless of their interest in the company, and a whopping 91% thought competition for vacancies would be tougher than last year.

  17. Panic symptoms and elevated suicidal ideation and behaviors among trauma exposed individuals: Moderating effects of post-traumatic stress disorder.

    PubMed

    Albanese, Brian J; Norr, Aaron M; Capron, Daniel W; Zvolensky, Michael J; Schmidt, Norman B

    2015-08-01

    Panic attacks (PAs) are highly prevalent among trauma exposed individuals and have been associated with a number of adverse outcomes. Despite high suicide rates among trauma exposed individuals, research to date has not examined the potential relation between panic symptoms and suicidal ideation and behaviors among this high risk population. The current study tested the association of panic with suicidal ideation and behaviors among a large sample of trauma exposed smokers. Community participants (N=421) who reported a lifetime history of trauma exposure were assessed concurrently for current panic, suicidal ideation and behaviors, and psychiatric diagnoses. Those who met criteria for a current panic disorder diagnosis were removed from analyses to allow for the assessment of non-PD related panic in line with the recent addition of the PA specifier applicable to all DSM-5 disorders. Findings indicated that panic symptoms were significantly associated with suicidal ideation and behaviors beyond the effects of depression and number of trauma types experienced. Further, post-traumatic stress disorder (PTSD) diagnostic status significantly moderated this relationship, indicating that the relationship between panic and suicidal ideation and behaviors is potentiated among individuals with a current PTSD diagnosis. This investigation suggests that panic symptoms may be a valuable clinical target for the assessment and treatment of suicidal ideation and behaviors among trauma exposed individuals.

  18. Response to Nadler's Commentary on Arch and Craske's (2011) "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes"

    ERIC Educational Resources Information Center

    Arch, Joanna J.; Craske, Michelle G.

    2012-01-01

    Nadler (this issue), in his commentary of our article, "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes" (Arch & Craske, 2011), argues that we misrepresent the role of panic attacks within learning theory and overlook cognitive treatment targets. He presents several case…

  19. Paroxetine in panic disorder: clinical management and long-term follow-up.

    PubMed

    Dannon, Pinhas N; Lowengrub, Katherine; Iancu, I; Kotler, Moshe

    2004-03-01

    Panic disorder is one of the most common anxiety disorders and has a lifetime prevalence of 3-5%. Panic attacks can begin at any age, but commonly have their onset in early adulthood between the ages of 20 and 40 years. Naturalistic data has shown that panic disorder has a chronic and relapsing course. Panic disorder is reported to be associated with an increased risk of suicidal behavior and comorbid psychiatric diagnoses such as depression and substance abuse. Currently, recommended treatment modalities for panic disorder include the use of antidepressant pharmacotherapy and/or cognitive behavioral therapy. Paroxetine is unique among the selective serotonin reuptake inhibitors since, in addition to its effect on the CNS serotonergic neurotransmission, it also has mild noradrenergic properties demonstrated to be effective in the treatment of anxiety disorders and depression. Paroxetine treatment has the potential to cause weight gain and sexual dysfunction, primarily anorgasmia and ejaculatory dysfunction for the long term. In the short-term, treatment causes nausea, gastrointestinal disturbances, irritability, headaches and eating and sleeping difficulties. Paroxetine is an example of an selective serotonin reuptake inhibitor agent, which has been well studied in the treatment of panic disorder and is efficacious and well-tolerated. Paroxetine pharmacotherapy has been recommended to be continued for 1 year as specified in the treatment guidelines set by the American Psychiatric Association in the treatment of panic disorder.

  20. Adolescent behavior and PTSD 6-7 years after the World Trade Center terrorist attacks of September 11, 2001.

    PubMed

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2-3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11-18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5-12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1-28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners.

  1. Adolescent behavior and PTSD 6–7 years after the World Trade Center terrorist attacks of September 11, 2001

    PubMed Central

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2–3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11–18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5–12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1–28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners. PMID:28229007

  2. Assessing the clinical utility of agoraphobia in the context of panic disorder.

    PubMed

    Schmidt, Norman B; Cromer, Kiara R

    2008-01-01

    In the DSM-IV, a panic disorder (PD) diagnosis includes specification of agoraphobia, which is primarily an index of situational avoidance due to fear of panic. No other anxiety diagnosis requires specification of level of avoidance. This raises the question as to whether agoraphobia provides unique information beyond the core features of PD (i.e., panic attacks and panic-related worry). The incremental validity of agoraphobia, defined using DSM-IV specifiers versus level of situational avoidance, was examined in relation to the expression and treatment of PD (N=146). Analyses indicate that agoraphobia status adds uniquely to the prediction of PD symptoms, impairment, and response to treatment. However, level of situational avoidance, defined either as a continuous or dichotomous variable, appears to have greater utility compared to the DSM-IV method of classifying agoraphobia. In summary, the agoraphobia specifier seems to have clinical utility but this could be improved by focusing on a dimensional assessment of situational avoidance.

  3. The relationship between posttraumatic stress symptoms and narrative structure among adolescent terrorist-attack survivors

    PubMed Central

    Filkuková, Petra; Jensen, Tine K.; Hafstad, Gertrud Sofie; Minde, Hanne Torvund; Dyb, Grete

    2016-01-01

    Background The structure of trauma narratives is considered to be related to posttraumatic stress symptomatology and thus the capacity to make a coherent narrative after stressful events is crucial for mental health. Objective The aim of this study is to understand more of the relationship between narrative structure and posttraumatic stress symptoms (PTSS). More specifically, we investigated whether internal and external focus, organization, fragmentation, and length differed between two groups of adolescent survivors of a mass shooting, one group with low levels of PTSS and one group with high levels of PTSS. Method The sample comprised 30 adolescents who survived the shooting at Utøya Island in Norway in 2011. They were interviewed 4–5 months after the shooting and provided a free narrative of the event. PTSS were assessed using the UCLA Posttraumatic Stress Disorder Reaction Index (PTSD-RI). Results We found that survivors with high levels of PTSS described more external events and fewer internal events in their narratives compared with survivors with low levels of symptoms. The analysis also showed that especially narratives containing more descriptions of dialogue and fewer organized thoughts were related to higher levels of PTSS. The groups did not differ in levels of narrative fragmentation or in length of the narratives. Conclusion Specific attributes of narrative structure proved to be related to the level of PTSS. On the basis of our results, we can recommend that practitioners focus especially on two elements of the trauma narratives, namely, the amount of external events, particularly dialogues, within the narrative and the number of organized thoughts. Participants with high levels of PTSS provided trauma narratives with low amount of organized (explanatory) thoughts accompanied by detailed descriptions of dialogues and actions, which is indicative for “here and now” quality of recall and a lack of trauma processing. PMID:26988972

  4. A Predictive Model of Group Panic Behavior.

    ERIC Educational Resources Information Center

    Weinberg, Sanford B.

    1978-01-01

    Reports results of a study which tested the following model to predict group panic behavior: that panic reactions are characterized by the exercise of inappropriate leadership behaviors in situations of high stress. (PD)

  5. Provocation of panic with carbon dioxide inhalation in patients with premenstrual dysphoria.

    PubMed

    Harrison, W M; Sandberg, D; Gorman, J M; Fyer, M; Nee, J; Uy, J; Endicott, J

    1989-02-01

    The effects of double breath inhalation of a 35% CO2 mixture in oxygen and placebo air inhalation were compared in 14 women seeking treatment for marked premenstrual dysphoric changes who did not have panic disorder and 12 control women. The first exposure to CO2 inhalation induced a panic attack reaction (severe subjective anxiety with autonomic symptoms) in 9 of 14 women with premenstrual dysphoria but none of the controls. Neither patients nor controls panicked in response to the air inhalation. Control subjects experienced mild anxiety and/or somatic symptoms after CO2 inhalation, but these did not resemble panic attacks and were clearly different from the response of the patient group.

  6. The 35% carbon dioxide test in stress and panic research: overview of effects and integration of findings.

    PubMed

    Vickers, Kristin; Jafarpour, Sepehr; Mofidi, Amirsalar; Rafat, Bijan; Woznica, Andrea

    2012-04-01

    The carbon dioxide test--a vital capacity breath of air containing 35% carbon dioxide (CO(2))--provokes panic attacks in many individuals with panic disorder (PD). It has thus been extensively used as an experimental model of panic and less frequently as a clinical method of provoking symptoms for interoceptive exposure treatment. Recently, stress researchers have suggested another use for the CO(2) test: that of an acute physiological stressor indexing the human stress response. The purpose of this review is to synthesize findings about the effects of the CO(2) test from both the panic and stress literatures in order to advance understanding about this increasingly popular test. Both panic and stress researchers have examined the fleeting effects of the CO(2) test, finding that the test engenders transient breathlessness, dizziness, and minor anxiety in most participants and panic attacks in those with or at risk for PD. Physiological measurements after the test indicate a brief homeostatic disruption in many bodily systems, including increased respiration, systolic blood pressure, and noradrenaline, and decreased heart rate. Most studies indicate increased cortisol. Possible benefits of integrating findings from the panic and stress research lines, given their common use of the CO(2) test, are discussed.

  7. Navigating the Zika panic.

    PubMed

    Grubaugh, Nathan D; Andersen, Kristian G

    2016-01-01

    The epidemics of Ebola virus in West Africa and Zika virus in America highlight how viruses can explosively emerge into new territories. These epidemics also exposed how unprepared we are to handle infectious disease emergencies. This is also true when we consider hypothesized new clinical features of infection, such as the associations between Zika virus infection and severe neurological disease, including microcephaly and Guillain-Barré syndrome. On the surface, these pathologies appear to be new features of Zika virus infection, however, causal relationships have not yet been established. Decades of limited Zika virus research are making us scramble to determine the true drivers behind the epidemic, often at the expense of over-speculation without credible evidence. Here we review the literature and find no conclusive evidence at this time for significant biological differences between the American Zika virus strains and those circulating elsewhere. Rather, the epidemic scale in the Americas may be facilitated by an abnormally warm climate, dense human and mosquito populations, and previous exposure to other viruses. Severe disease associated with Zika virus may therefore not be a new trait for the virus, rather it may have been overlooked due to previously small outbreaks. Much of the recent panic regarding Zika virus has been about the Olympics in Brazil. We do not find any substantial evidence that the Olympics will result in a significant number of new Zika virus infections (~10 predicted) or that the Olympics will promote further epidemic spread over what is already expected. The Zika virus epidemic in the Americas is a serious situation and decisions based on solid scientific evidence - not hyped media speculations - are required for effective outbreak response.

  8. Navigating the Zika panic

    PubMed Central

    Grubaugh, Nathan D.; Andersen, Kristian G.

    2016-01-01

    The epidemics of Ebola virus in West Africa and Zika virus in America highlight how viruses can explosively emerge into new territories. These epidemics also exposed how unprepared we are to handle infectious disease emergencies. This is also true when we consider hypothesized new clinical features of infection, such as the associations between Zika virus infection and severe neurological disease, including microcephaly and Guillain-Barré syndrome. On the surface, these pathologies appear to be new features of Zika virus infection, however, causal relationships have not yet been established. Decades of limited Zika virus research are making us scramble to determine the true drivers behind the epidemic, often at the expense of over-speculation without credible evidence. Here we review the literature and find no conclusive evidence at this time for significant biological differences between the American Zika virus strains and those circulating elsewhere. Rather, the epidemic scale in the Americas may be facilitated by an abnormally warm climate, dense human and mosquito populations, and previous exposure to other viruses. Severe disease associated with Zika virus may therefore not be a new trait for the virus, rather it may have been overlooked due to previously small outbreaks. Much of the recent panic regarding Zika virus has been about the Olympics in Brazil. We do not find any substantial evidence that the Olympics will result in a significant number of new Zika virus infections (~10 predicted) or that the Olympics will promote further epidemic spread over what is already expected. The Zika virus epidemic in the Americas is a serious situation and decisions based on solid scientific evidence - not hyped media speculations - are required for effective outbreak response. PMID:27746903

  9. Personality disorder traits as predictors of subsequent first-onset panic disorder or agoraphobia.

    PubMed

    Bienvenu, O Joseph; Stein, Murray B; Samuels, Jack F; Onyike, Chiadi U; Eaton, William W; Nestadt, Gerald

    2009-01-01

    Determining how personality disorder traits and panic disorder and/or agoraphobia relate longitudinally is an important step in developing a comprehensive understanding of the etiology of panic/agoraphobia. In 1981, a probabilistic sample of adult (> or =18 years old) residents of east Baltimore were assessed for Axis I symptoms and disorders using the Diagnostic Interview Schedule (DIS); psychiatrists reevaluated a subsample of these participants and made Axis I diagnoses, as well as ratings of individual Diagnostic and Statistical Manual of Mental Disorders, Third Edition personality disorder traits. Of the participants psychiatrists examined in 1981, 432 were assessed again in 1993 to 1996 using the DIS. Excluding participants who had baseline panic attacks or panic-like spells from the risk groups, baseline timidity (avoidant, dependent, and related traits) predicted first-onset DIS panic disorder or agoraphobia over the follow-up period. These results suggest that avoidant and dependent personality traits are predisposing factors, or at least markers of risk, for panic disorder and agoraphobia-not simply epiphenomena.

  10. Relations between PTSD and distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks.

    PubMed

    Contractor, Ateka A; Mehta, Panna; Tiamiyu, Mojisola F; Hovey, Joseph D; Geers, Andrew L; Charak, Ruby; Tamburrino, Marijo B; Elhai, Jon D

    2014-08-01

    Posttraumatic stress disorder's (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849-854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764-776, 2010). However, debatable is whether the model's dysphoria factor adequately captures all of PTSD's emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126-135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18's depression and somatization factors related more to PTSD's dysphoria than PTSD's avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor's complete accountability for PTSD's inherent distress. Additionally, PTSD's dysphoria factor related more to BSI-18's depression than BSI-18's anxiety/somatization factors; this may explain PTSD's comorbidity mechanism with depressive disorders.

  11. Subregional Shape Alterations in the Amygdala in Patients with Panic Disorder

    PubMed Central

    Kim, Geon Ha; Kang, Hee Jin; Kim, Bori R.; Jeon, Saerom; Im, Jooyeon Jamie; Hyun, Heejung; Moon, Sohyeon; Lim, Soo Mee; Lyoo, In Kyoon

    2016-01-01

    Background The amygdala has been known to play a pivotal role in mediating fear-related responses including panic attacks. Given the functionally distinct role of the amygdalar subregions, morphometric measurements of the amygdala may point to the pathophysiological mechanisms underlying panic disorder. The current study aimed to determine the global and local morphometric alterations of the amygdala related to panic disorder. Methods Volumetric and surface-based morphometric approach to high-resolution three-dimensional T1-weighted images was used to examine the structural variations of the amygdala, with respect to extent and location, in 23 patients with panic disorder and 31 matched healthy individuals. Results There were no significant differences in bilateral amygdalar volumes between patients with panic disorder and healthy individuals despite a trend-level right amygdalar volume reduction related to panic disorder (right, β = -0.23, p = 0.09, Cohen's d = 0.51; left, β = -0.18, p = 0.19, Cohen's d = 0.45). Amygdalar subregions were localized into three groups including the superficial, centromedial, and laterobasal groups based on the cytoarchitectonically defined probability map. Surface-based morphometric analysis revealed shape alterations in the laterobasal and centromedial groups of the right amygdala in patients with panic disorder (false discovery rate corrected p < 0.05). Conclusions The current findings suggest that subregion-specific shape alterations in the right amygdala may be involved in the development and maintenance of panic disorder, which may be attributed to the cause or effects of amygdalar hyperactivation. PMID:27336300

  12. Elites and Panic: More to Fear than Fear Itself

    ERIC Educational Resources Information Center

    Clarke, Lee; Chess, Caron

    2008-01-01

    Attributions of panic are almost exclusively directed at members of the general public. Here, we inquire into the relationships between elites and panic. We review current research and theorizing about panic, including problems of identifying when it has occurred. We propose three relationships: elites fearing panic, elites causing panic and…

  13. 'Hit by the wind' and temperature-shift panic among Vietnamese refugees.

    PubMed

    Hinton, Devon; Hinton, Susan; Pham, Thang; Chau, Ha; Tran, Minh

    2003-09-01

    Surveying 60 Vietnamese patients with either current or past post-traumatic stress disorder, this article aims to phenomenologically characterize the syndrome of 'hit by the wind' in a multidimensional manner. This includes determining the patient conceptualization of the disorder, profiling 'hit by the wind' episodes suffered by patients in the previous month, and presenting case vignettes. Eighteen of the 60 patients (30%) suffered at least one episode of 'hit by the wind' in the last month; all 18 patients had at least one episode of 'hit by the wind' in the last month that met panic attack criteria. For the 18 patients, 33 episodes of'hit by the wind' that met panic attack criteria were experienced in the previous month. For these 33 episodes, the most frequently reported DSM-IV panic attack symptoms were chills (100%; 33/33) and dizziness (88%; 29/33). Flashbacks played a role in the 'hit by the wind' episodes for 5 of the 18 patients (28%). In the discussion, a model of how the syndrome of 'hit by the wind' generates panic is adduced; also, possible Chinese origins of the disorder are discussed.

  14. Electroencephalographic findings in panic disorder.

    PubMed

    Carvalho, Marcele Regine de; Velasques, Bruna Brandao; Cagy, Mauricio; Marques, Juliana Bittencourt; Teixeira, Silmar; Nardi, Antonio Egidio; Piedade, Roberto; Ribeiro, Pedro

    2013-12-01

    Some studies have reported the importance of electroencephalography (EEG) as a method for investigating abnormal parameters in psychiatric disorders. Different findings in time and frequency domain analysis with regard to central nervous system arousal during acute panic states have already been obtained. This study aimed to systematically review the EEG findings in panic disorder (PD), discuss them having a currently accepted neuroanatomical hypothesis for this pathology as a basis, and identify limitations in the selected studies. Literature search was conducted in the databases PubMed and ISI Web of Knowledge, using the keywords electroencephalography and panic disorder; 16 articles were selected. Despite the inconsistency of EEG findings in PD, the major conclusions about the absolute power of alpha and beta bands point to a decreased alpha power, while beta power tends to increase. Different asymmetry patterns were found between studies. Coherence studies pointed to a lower degree of inter-hemispheric functional connectivity at the frontal region and intra-hemispheric at the bilateral temporal region. Studies on possible related events showed changes in memory processing in PD patients when exposed to aversive stimuli. It was noticed that most findings reflect the current neurobiological hypothesis of PD, where inhibitory deficits of the prefrontal cortex related to the modulation of amygdala activity, and the subsequent activation of subcortical regions, may be responsible to trigger anxiety responses. We approached some important issues that need to be considered in further researches, especially the use of different methods for analyzing EEG signals.

  15. Cognitive style, alprazolam plasma levels, and treatment response in panic disorder.

    PubMed

    Uhlenhuth, E H; Starcevic, Vladan; Qualls, Clifford; Antal, Edward J; Matuzas, William; Javaid, Javaid I; Barnhill, Jamie

    2008-01-01

    This study investigated an anxiety-prone cognitive style (measured by the Anxious Thoughts and Tendencies Questionnaire, AT&T) as a predictor of the acute response to increasing alprazolam plasma levels in panic disorder. Panic disorder patients (n=26) were treated with escalating doses of alprazolam for 4 weeks, then a fixed dose of 1 mg four times a day for 4 weeks. At 0, 1, 2, 3, 4, 6, and 8 weeks, trough alprazolam plasma levels; clinical, self-report, and performance measures; and vital signs were assessed. Panic attack data were from daily diaries. The repeated response measures were analyzed in relation to alprazolam plasma levels using SAS GENMOD, with patients classified as high or low on the baseline AT&T. Panic attacks, anticipatory anxiety, fear, avoidance, overall agoraphobia, the Hamilton Anxiety Rating Scale, and clinicians' global ratings improved with increasing alprazolam plasma levels. Hopkins Symptom Checklist-90 Anger-Hostility; Profile of Mood States Vigor, Confusion, and Friendliness; and speed and accuracy of performance worsened. Patients with high AT&T scores were worse throughout the study on situational panics, fear, avoidance, overall agoraphobia, the Hamilton Anxiety Rating Scale, the Hamilton Rating Scale for Depression, and Clinical Global Improvement; most Hopkins Symptom Checklist-90 clusters; Profile of Mood States Anxiety, Depression, and Confusion; and Continuous Performance Task omissions. We conclude that in panic disorder: (1) alprazolam has a broad spectrum of clinical activity related to plasma levels in individual patients; (2) sedation, disinhibition, and performance deficits may persist for at least a month after dose escalation ends; (3) marked anxiety-prone cognitions predict more symptoms throughout treatment, but do not modify the response to alprazolam and therefore should not influence the choice of alprazolam as treatment.

  16. Israeli Adolescents' Help-Seeking Behaviours in Relation to Terrorist Attacks: The Perceptions of Students, School Counsellors and Teachers

    ERIC Educational Resources Information Center

    Tatar, Moshe; Amram, Sima

    2008-01-01

    Exposure to terror seriously threatens the well-being of children and adolescents. School mental health professionals cope simultaneously with the counselling needs of their clients and with their own fears and doubts. This report is based on two studies. The first study was concerned with the perceptions of Israeli adolescents of the place of…

  17. Heart attack

    MedlinePlus

    ... infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack ... made up of cholesterol and other cells. A heart attack may occur when: A tear in the ...

  18. Anchoring the Panic Disorder Severity Scale

    ERIC Educational Resources Information Center

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  19. The Genetic Basis of Panic Disorder

    PubMed Central

    Na, Hae-Ran; Kang, Eun-Ho; Lee, Jae-Hon

    2011-01-01

    Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed. PMID:21655053

  20. Charles Darwin and panic disorder.

    PubMed

    Barloon, T J; Noyes, R

    1997-01-08

    Charles Darwin (1809-1882) suffered from a chronic illness that, throughout much of his adult life, impaired his functioning and severely limited his activities. The writings of this famous scientist as well as biographical materials indicate that he probably suffered from an anxiety disorder. His symptoms, when considered individually, suggest a variety of conditions, but taken together they point toward panic disorder with agoraphobia. This diagnosis brings coherence to Darwin's activities and explains his secluded lifestyle, including difficulty in speaking before groups and meeting with colleagues.

  1. Don't panic: interpretation bias is predictive of new onsets of panic disorder.

    PubMed

    Woud, Marcella L; Zhang, Xiao Chi; Becker, Eni S; McNally, Richard J; Margraf, Jürgen

    2014-01-01

    Psychological models of panic disorder postulate that interpretation of ambiguous material as threatening is an important maintaining factor for the disorder. However, demonstrations of whether such a bias predicts onset of panic disorder are missing. In the present study, we used data from the Dresden Prediction Study, in which a epidemiologic sample of young German women was tested at two time points approximately 17 months apart, allowing the study of biased interpretation as a potential risk factor. At time point one, participants completed an Interpretation Questionnaire including two types of ambiguous scenarios: panic-related and general threat-related. Analyses revealed that a panic-related interpretation bias predicted onset of panic disorder, even after controlling for two established risk factors: anxiety sensitivity and fear of bodily sensations. This is the first prospective study demonstrating the incremental validity of interpretation bias as a predictor of panic disorder onset.

  2. A pilot study of cognitive behaviour therapy for panic disorder augmented by panic surfing.

    PubMed

    Lamplugh, Claire; Berle, David; Milicevic, Denise; Starcevic, Vladan

    2008-01-01

    This pilot study reports the outcome of cognitive behaviour therapy for panic disorder augmented by panic surfing. This treatment approach encourages acceptance of feelings rather than control of symptoms and anxiety, at the same time also targeting catastrophic misinterpretations, bodily vigilance and safety-seeking behaviours. Eighteen participants completed a brief group treatment for panic disorder incorporating psychoeducation, panic surfing, interoceptive exposure, graded exposure and cognitive restructuring. Significant improvements occurred over the course of this treatment and were maintained at a 1-month follow-up. Results suggest that cognitive behaviour therapy augmented by panic surfing may be effective in the treatment of panic disorder, but there is a need for controlled studies and investigation of the relative contribution of its various components.

  3. Treatment for Panic Disorder: Practical Guidelines.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; Granello, Darcy Haag; Belcastro, Amy L.

    2002-01-01

    This article presents current research information on the treatment of panic disorder. Specific guidelines are presented to guide the mental health counselor in the delivery of effective psychopharmacological and cognitive-behavioral treatment. (Contains 81 references.) (Author)

  4. [Gabapentin treatment in a female patient with panic disorder and adverse effects under carbamazepine during benzodiazepine withdrawal].

    PubMed

    Himmerich, Hubertus; Nickel, Thomas; Dalal, Mira A; Müller, Marianne B

    2007-03-01

    Despite their addictive potential, benzodiazepines belong to the most often prescribed drugs. We report on a patient with alprazolam dependence, who initially was treated with carbamazepine because of severe withdrawal symptoms. Due to liver enzyme elevation related to carbamazepine, we had to stop this treatment and instead of that started gabapentin treatment. Under this new therapy, the patient showed a dramatic relief of withdrawal symptoms and of the panic attacks recurring during withdrawal. Hence, due to their effectiveness and tolerability, newer anticonvulsants could be considered as medication for benzodiazepine withdrawal and as an alternative for benzodiazepine treatment in panic disorders.

  5. Serum levels of clomipramine and desmethylclomipramine and clinical improvement in panic disorder.

    PubMed

    Marcourakis, T; Gorenstein, C; Ramos, R T; da Motta Singer, J

    1999-01-01

    Several placebo-controlled trials have shown the efficacy of clomipramine (CMI) in panic disorder. However, none has investigated the relationship between CMI, and desmethylclomipramine (DCMI) plasma levels, and outcome. In this trial, 41 patients meeting the DSM-III-R criteria for panic disorder with/without agoraphobia received 50-200 mg of CMI daily in a single-blind, flexible dose regimen for 14 weeks. At the end of treatment, 97% of the patients were free of panic attacks. Patients were classified into two groups of improvement according to the panic symptom items of the 'Patient-Rated Anxiety Scale'. A repeated-measures analysis of variance suggested a significant association between outcome and serum DCMI level/daily dose ratio as well as total serum level/daily dose. Patients with intense improvement showed DCMI and total serum levels lower than those with moderate improvement. The results indicate the importance of monitoring clomipramine and desmethylclomipramine serum levels in this disorder.

  6. A clinical study of autogenic training-based behavioral treatment for panic disorder.

    PubMed

    Sakai, M

    1996-03-01

    The present study investigated the effect of autogenic training-based behavioral treatment for panic disorder and identified the predictors of treatment outcome. Thirty-four patients meeting DSM-III-R criteria for panic disorder received autogenic training-based behavioral treatment from October 1981 to December 1994. They were treated individually by the author. The medical records of the patients were investigated for the purpose of this study. The results showed that this autogenic training-based behavioral treatment had successful results. Fifteen patients were cured, nine much improved, five improved, and five unchanged at the end of the treatment. Improvement trends were found as for the severity of panic attack and the severity of agoraphobic avoidance. No consistent findings about predictors emerged when such pretreatment variables as demographics and severity of symptoms were used to predict the outcome. Also, three treatment variables showed useful predictive power. First, practicing the second standard autogenic training exercise satisfactorily predicted better outcomes. Second, application of in vivo exposure was found to be positively associated with the treatment outcome in patients with agoraphobic avoidance. Third, longer treatment periods were associated with better outcomes. These findings suggested that the autogenic training-based behavioral treatment could provide relief to the majority of panic disorder patients.

  7. Anxiety disorders and onset of cardiovascular disease: the differential impact of panic, phobias and worry.

    PubMed

    Batelaan, Neeltje M; ten Have, Margreet; van Balkom, Anton J L M; Tuithof, Marlous; de Graaf, Ron

    2014-03-01

    Anxiety has been linked to onset of cardiovascular disease. This study examines the differential impact of types of anxiety (panic, phobia and worry) on 3-year onset of non-fatal cardiovascular disease (CVD). By investigating anxiety disorders as opposed to anxiety symptoms and by using a reliable diagnostic instrument to assess anxiety, limitations of previous studies are considered. 5149 persons at risk for CVD were interviewed using the Composite International Diagnostic Interview. The panic-type included panic disorder and panic attacks; the phobic-type included agoraphobia and social phobia, and the worry-type included generalized anxiety disorder. CVD was self-reported and required treatment or monitoring by a doctor. Analyses were adjusted for sociodemographics, behavioral variables, and comorbid somatic and psychiatric disorders. During follow-up, 62 persons (1.2%) developed CVD. Baseline generalized anxiety disorder was strongly associated with onset of CVD (adjusted OR: 3.39). Further research should replicate findings and focus on biological underpinnings of this association.

  8. [Comorbidity of panic disorder and alcoholism in a sample of 100 alcoholic patients].

    PubMed

    Segui, J; Salvador, L; Canet, J; Herrera, C; Aragón, C

    1994-01-01

    Among one hundred patients with alcohol dependence (DSM-III-R) studied in a drug abuse center in the "Bajo Llobregat" area (Barcelona industrial belt it was detected that 27% had life time rate of panic disorder. The age of onset of alcoholism was earlier than the one for panic disorder. In 78.8% of these patients alcoholismo appeared first. 70.4% refer worsening of the panic attacks when drinking large amounts of alcohol. Patients with Panic Disorder: a) are younger (p < 0.05); b) have attended school longer and have higher education (p < 0.01); c) have more alcoholism family history (p < 0.05); d) have more major depressive disorders (0.05) and dysthimic disorder (p < 0.01); e) Worse social functioning according to the GAS (p < 0.01); f) higher score for the Psychological disorders Scale (p < 0.001) and a lower performance at work (p < 0.001) measured by the ASI. The clinical significance of these findings is discussed.

  9. Panic reactivity to voluntary hyperventilation challenge predicts distress tolerance to bodily sensations among daily cigarette smokers.

    PubMed

    Marshall, Erin C; Zvolensky, Michael J; Vujanovic, Anka A; Gregor, Kristin; Gibson, Laura E; Leyro, Teresa M

    2008-08-01

    The present investigation examined the extent to which panic reactivity to bodily sensations is related to distress tolerance (DT) among daily smokers. It was hypothesized that panic reactivity to an initial voluntary hyperventilation (i.e., whether participants met criteria for a DSM-IV panic attack; PA) would predict the relative degree of task persistence on a second hyperventilation trial (DT) above and beyond the variance accounted for by anxiety sensitivity (AS), negative affectivity (NA), cigarette smoking rate, and self-reported discomfort intolerance (DI). Participants were 95 daily smokers (58% women; M-sub(age) = 29.0, SD = 12.2) who completed a battery of questionnaires and two voluntary hyperventilation procedures. Results indicated PA status significantly predicted DT, above and beyond the theoretically relevant covariates of AS, NA, cigarettes per day, and DI ( p < .05). Such a result is consistent with theoretical models and empirical findings on emotional reactivity that suggest panic responsivity to internal cues may represent a key explanatory construct in terms of level of DT to interoceptive stimuli.

  10. Anxiety sensitivity and panic reactivity to bodily sensations: relation to quit-day (acute) nicotine withdrawal symptom severity among daily smokers making a self-guided quit attempt.

    PubMed

    Marshall, Erin C; Johnson, Kirsten; Bergman, Jenna; Gibson, Laura E; Zvolensky, Michael J

    2009-10-01

    The current investigation explored the main and interactive effects of panic attacks in response to laboratory-induced bodily sensations and anxiety sensitivity in predicting acute nicotine withdrawal symptoms among daily smokers making a self-guided quit attempt. Participants were 99 daily smokers (58% women; M(age) = 28.4 years, SD = 11.7) who completed a battery of questionnaires, a voluntary hyperventilation challenge, and a measure of nicotine withdrawal symptoms 12 hr after making a self-guided quit attempt. Results indicated that the interaction of anxiety sensitivity and panic responsivity to the challenge predicted quit-day nicotine withdrawal symptom severity above and beyond the main effects (p < .05). The form of the interaction indicated that the relationship between postchallenge panic attack status and acute nicotine withdrawal was more robust among individuals who were low in anxiety sensitivity. Individuals who did not experience a panic attack posthyperventilation who were also low in anxiety sensitivity reported the lowest levels of nicotine withdrawal. Results suggest that anxiety sensitivity may be less relevant with regard to acute nicotine withdrawal severity among individuals with panic-related problems.

  11. Lack of specific association between panicogenic properties of caffeine and HPA-axis activation. A placebo-controlled study of caffeine challenge in patients with panic disorder.

    PubMed

    Masdrakis, Vasilios G; Markianos, Manolis; Oulis, Panagiotis

    2015-09-30

    A subgroup of patients with Panic Disorder (PD) exhibits increased sensitivity to caffeine administration. However, the association between caffeine-induced panic attacks and post-caffeine hypothalamic-pituitary-adrenal (HPA)-axis activation in PD patients remains unclear. In a randomized, double-blind, cross-over experiment, 19 PD patients underwent a 400-mg caffeine-challenge and a placebo-challenge, both administered in the form of instant coffee. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol and dehydroepiandrosterone sulfate (DHEAS) were assessed at both baseline and post-challenge. No patient panicked after placebo-challenge, while nine patients (47.3%) panicked after caffeine-challenge. Placebo administration did not result in any significant change in hormones' plasma levels. Overall, sample's patients demonstrated significant increases in ACTH, cortisol, and DHEAS plasma levels after caffeine administration. However, post-caffeine panickers and non-panickers did not differ with respect to the magnitude of the increases. Our results indicate that in PD patients, caffeine-induced panic attacks are not specifically associated with HPA-axis activation, as this is reflected in post-caffeine increases in ACTH, cortisol and DHEAS plasma levels, suggesting that caffeine-induced panic attacks in PD patients are not specifically mediated by the biological processes underlying fear or stress. More generally, our results add to the evidence that HPA-axis activation is not a specific characteristic of panic.

  12. Neuronal network of panic disorder: the role of the neuropeptide cholecystokinin.

    PubMed

    Zwanzger, P; Domschke, K; Bradwejn, J

    2012-09-01

    Panic disorder (PD) is characterized by panic attacks, anticipatory anxiety and avoidance behavior. Its pathogenesis is complex and includes both neurobiological and psychological factors. With regard to neurobiological underpinnings, anxiety in humans seems to be mediated through a neuronal network, which involves several distinct brain regions, neuronal circuits and projections as well as neurotransmitters. A large body of evidence suggests that the neuropeptide cholecystokinin (CCK) might be an important modulator of this neuronal network. Key regions of the fear network, such as amygdala, hypothalamus, peraqueductal grey, or cortical regions seem to be connected by CCKergic pathways. CCK interacts with several anxiety-relevant neurotransmitters such as the serotonergic, GABA-ergic and noradrenergic system as well as with endocannabinoids, NPY and NPS. In humans, administration of CCK-4 reliably provokes panic attacks, which can be blocked by antipanic medication. Also, there is some support for a role of the CCK system in the genetic pathomechanism of PD with particularly strong evidence for the CCK gene itself and the CCK-2R (CCKBR) gene. Thus, it is hypothesized that genetic variants in the CCK system might contribute to the biological basis for the postulated CCK dysfunction in the fear network underlying PD. Taken together, a large body of evidence suggests a possible role for the neuropeptide CCK in PD with regard to neuroanatomical circuits, neurotransmitters and genetic factors. This review article proposes an extended hypothetical model for human PD, which integrates preclinical and clinical findings on CCK in addition to existing theories of the pathogenesis of PD.

  13. Cognitive factors in panic disorder, agoraphobic avoidance and agoraphobia.

    PubMed

    Berle, David; Starcevic, Vladan; Hannan, Anthony; Milicevic, Denise; Lamplugh, Claire; Fenech, Pauline

    2008-02-01

    There remains a lack of consensus regarding the possibility that especially high levels of panic-related cognitions characterise panic disorder with agoraphobia. We administered the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire and the Anxious Thoughts and Tendencies Scale as well as measures of agoraphobic avoidance to patients diagnosed with panic disorder with agoraphobia (n=75) and without agoraphobia (n=26). Patients with panic disorder with agoraphobia did not score significantly higher on any of the cognitive variables than did panic disorder patients without agoraphobia. However, most of the cognitive variables showed small to moderate-strength correlations with self-report measures of agoraphobic avoidance. Our findings suggest that anxiety sensitivity, catastrophising of the consequences of panic and a general anxiety-prone cognitive style, although to some extent associated with agoraphobic avoidance, do not discriminate panic disorder with agoraphobia from panic disorder without agoraphobia.

  14. Outcome Studies in the Treatment of Panic Disorder: A Review.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; And Others

    1996-01-01

    Reviews outcome studies in the treatment of panic disorder without agoraphobia for adults. Presents evidence supporting the efficacy of psychopharmacological and cognitive-behavioral interventions. Addresses the need for standards of care in counseling persons with panic disorder. (RB)

  15. Anxiety and salivary cortisol in symptomatic and nonsymptomatic panic patients and healthy volunteers performing simulated public speaking.

    PubMed

    Garcia-Leal, Cybele; Parente, Alexandre C B V; Del-Ben, Cristina M; Guimarães, Francisco S; Moreira, Ayrton Custódio; Elias, Lucila Leico Kagohara; Graeff, Frederico G

    2005-02-28

    Anxiety and salivary cortisol were measured in subjects performing simulated public speaking (SPS), a procedure that has been neurobiologically related to panic disorder. The subjects were divided into three groups: 18 symptomatic panic patients, 16 nonsymptomatic, drug-treated panic patients, and 17 healthy controls. In the experimental session, subjective anxiety (Visual Analogue Mood Scale) and the total score of the Bodily Symptom Scale (BSS) were higher in symptomatic patients than in controls, with nonsymptomatic patients in between. Measures of cortisol taken at home showed that the level was higher at 9:00 h than at 23:00 h in every group, indicating a normal circadian regulation of the hypothalamic-pituitary-adrenal (HPA) axis in panic patients. Also in every group, the level of cortisol was high at the beginning of the experimental session and decreased after 70 min. This fall parallels the decrease in anxiety and BSS ratings, and appears to reflect habituation of initial, anticipatory anxiety. Preparation and performance of speech raised anxiety and BSS scores to the initial levels, but failed to increase cortisol measured over 60 min, starting at the end of the speech. Therefore, SPS does not seem to activate the HPA axis, as reported in panic attacks.

  16. A model on the financial panic

    NASA Astrophysics Data System (ADS)

    Kitamura, Toyoyuki

    2010-07-01

    The mechanism of the financial panic is clarified by the two band model in a simplified capitalist society from statistical mechanics. A financial panic occurs on an occasion of the supercooling process to avoid completing the financial (buy-sell) cycles under the circumstances: extremely high consumption causes enormous bubbles of buy-sell pairs of securities in financial markets, which form the configuration entropy (the Kauzmann entropy) and trigger a chain recession. As society cools down, the dynamical processes of financial panic are governed by universal features such as the Kauzmann entropy crisis and the drastic drop of the dynamical motions (the VTF law), which also cause further recession so that a chain recession occurs. And the financial markets eventually freeze.

  17. Simulating dynamical features of escape panic

    NASA Astrophysics Data System (ADS)

    Helbing, Dirk; Farkas, Illés; Vicsek, Tamás

    2000-09-01

    One of the most disastrous forms of collective human behaviour is the kind of crowd stampede induced by panic, often leading to fatalities as people are crushed or trampled. Sometimes this behaviour is triggered in life-threatening situations such as fires in crowded buildings; at other times, stampedes can arise during the rush for seats or seemingly without cause. Although engineers are finding ways to alleviate the scale of such disasters, their frequency seems to be increasing with the number and size of mass events. But systematic studies of panic behaviour and quantitative theories capable of predicting such crowd dynamics are rare. Here we use a model of pedestrian behaviour to investigate the mechanisms of (and preconditions for) panic and jamming by uncoordinated motion in crowds. Our simulations suggest practical ways to prevent dangerous crowd pressures. Moreover, we find an optimal strategy for escape from a smoke-filled room, involving a mixture of individualistic behaviour and collective `herding' instinct.

  18. Heart Attack

    MedlinePlus

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  19. Suicide as escape from psychotic panic.

    PubMed

    Goldblatt, Mark J; Ronningstam, Elsa; Schechter, Mark; Herbstman, Benjamin; Maltsberger, John T

    2016-01-01

    Suicides of patients in states of acute persecutory panic may be provoked by a subjective experience of helpless terror threatening imminent annihilation or dismemberment. These patients are literally scared to death and try to run away. They imagine suicide is survivable and desperately attempt to escape from imaginary enemies. These states of terror occur in a wide range of psychotic illnesses and are often associated with command hallucinations and delusions. In this article, the authors consider the subjective experience of persecutory panic and the suicide response as an attempt to flee from danger.

  20. Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative.

    PubMed

    Hamm, Alfons O; Richter, Jan; Pané-Farré, Christiane; Westphal, Dorte; Wittchen, Hans-Ulrich; Vossbeck-Elsebusch, Anna N; Gerlach, Alexander L; Gloster, Andrew T; Ströhle, Andreas; Lang, Thomas; Kircher, Tilo; Gerdes, Antje B M; Alpers, Georg W; Reif, Andreas; Deckert, Jürgen

    2016-03-01

    In the current review, we reconceptualize a categorical diagnosis-panic disorder and agoraphobia-in terms of two constructs within the domain "negative valence systems" suggested by the Research Domain Criteria initiative. Panic attacks are considered as abrupt and intense fear responses to acute threat arising from inside the body, while anxious apprehension refers to anxiety responses to potential harm and more distant or uncertain threat. Taking a dimensional view, panic disorder with agoraphobia is defined with the threat-imminence model stating that defensive responses are dynamically organized along the dimension of the proximity of the threat. We tested this model within a large group of patients with panic disorder and agoraphobia (N = 369 and N = 124 in a replication sample) and found evidence that panic attacks are indeed instances of circa strike defense. This component of the defensive reactivity was related to genetic modulators within the serotonergic system. In contrast, anxious apprehension-characterized by attentive freezing during postencounter defense-was related to general distress and depressive mood, as well as to genetic modulations within the hypothalamic-pituitary-adrenal (HPA) axis. Patients with a strong behavioral tendency for active and passive avoidance responded better to exposure treatment if the therapist guides the patient through the exposure exercises.

  1. Executive and modulatory neural circuits of defensive reactions: implications for panic disorder.

    PubMed

    Canteras, Newton S; Graeff, Frederico G

    2014-10-01

    The present review covers two independent approaches, a neuroanatomical and a pharmacological (focused on serotonergic transmission), which converge in highlighting the critical role of the hypothalamus and midbrain periaqueductal gray matter in the generation of panic attacks and in the mechanism of action of current antipanic medication. Accordingly, innate and learned fear responses to different threats (i.e., predator, aggressive members of the same species, interoceptive threats and painful stimuli) are processed by independent circuits involving corticolimbic regions (the amygdala, the hippocampus and the prefrontal and insular cortices) and downstream hypothalamic and brainstem circuits. As for the drug treatment, animal models of panic indicate that the drugs currently used for treating panic disorder should work by enhancing 5-HT inhibition of neural systems that command proximal defense in both the dorsal periaqueductal gray and in the medial hypothalamus. For the anticipatory anxiety, the reviewed evidence points to corticolimbic structures, such as the amygdala, the septo-hippocampus and the prefrontal cortex, as its main neural substrate, modulated by stimulation of 5-HT2C and 5-HT1A receptors.

  2. Behavioral, neuroendocrine and biochemical effects of different doses of 5-HTP in panic disorder.

    PubMed

    van Vliet, I M; Slaap, B R; Westenberg, H G; Den Boer, J A

    1996-05-01

    To investigate the role of serotonin (5-HT) in the pathophysiology of panic disorder (PD) a challenge test with L-5-hydroxytryptophan (5-HTP) was conducted. Seven patients suffering from PD and seven healthy controls received an i.v. challenge with 10 mg, 20 mg and 40 mg 5-HTP and placebo in random order on four different occasions. Before, during and until 2 h after 5-HTP administration anxious and depressive symptomatology was assessed. In addition, plasma levels of 5-HTP, cortisol, and 5-HIAA were measured at several timepoints. During and after infusion of placebo or any of the different dosages of 5-HTP, none of the patients or controls experienced a panic attack or showed an increase in anxiety or depressive symptoms. There was a dose-related increase in side effects, like nausea, dizziness and fatigue. Only infusion with 40 mg 5-HTP led to an increase in plasma cortisol in both patients and controls. The observed increase in plasma cortisol level was higher for patients compared to controls only at 30 min after infusion. In conclusion, stimulation of the serotonergic neuronal system by three different dosages of 5-HTP did not induce panic or anxiety in PD patients and healthy controls. The 5-HT hypersensitivity hypothesis of PD could not be confirmed in the present study.

  3. Failure of intravenous pentagastrin challenge to induce panic-like effects in rhesus monkeys.

    PubMed

    Rupniak, N M; Schaffer, L; Siegl, P; Iversen, S D

    1993-08-01

    We examined the ability of intravenous (i.v.) challenge with pentagastrin to induce behavioural and cardiovascular effects consistent with panic attack in conscious rhesus monkeys. For behavioural evaluation, 4 naive male rhesus monkeys familiar with minimal manual restraint necessary for drug administration received a rapid i.v. bolus of pentagastrin (4, 8 or 16 micrograms/kg) or water on four separate occasions according to a randomised cross-over design. Behaviour was rated by a blind observer continuously during, and for the first 5 min immediately following i.v. injections while the monkey sat on the handler's lap, and then for a further 25 min in an individual observation cage. In separate experiments, the ability of pentagastrin to alter cardiovascular parameters which may accompany panic or anxiety (elevated heart rate and blood pressure) was explored. For cardiovascular studies, 8 male or female rhesus monkeys with femoral artery catheters were chair restrained and received a bolus injection of pentagastrin (4, 8 or 16 micrograms/kg) or saline into the saphenous vein at 30 min intervals. Blood pressure and heart rate were monitored continuously using a Statham Gould pressure transducer. Pentagastrin induced no consistent behavioural or cardiovascular changes. Similar pilot studies using CCK4 also failed to reveal such effects. We conclude that CCK-induced panic-like effects may not be demonstrable following challenge with pentagastrin under laboratory conditions in rhesus monkeys.

  4. Frontoparietal Cortical Thinning in Respiratory-Type Panic Disorder: A Preliminary Report

    PubMed Central

    Yoon, Ho-Kyoung; Kang, June; Ham, Byung-Joo

    2016-01-01

    Objective Many evidences raise the possibility that the panic disorder (PD) patients with respiratory subtype (RS) may have characteristic structural abnormalities. We aimed to explore the structural differences between PD patients with and without the respiratory symptoms. Methods Patients with PD were recruited from the Department of Psychiatry at Korea University Anam Hospital. Respiratory subtype (RS) was diagnosed when at least 4 out of 5 of the following respiratory symptoms were present during the panic attack: fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and a choking sensation. We acquired high-resolution MRI scans and used FreeSurfer to obtain a measure of cortical thickness for each patient. Results Cluster based analysis revealed significantly decreased cortical thickness in the left hemisphere in the caudal-middle-frontal, superior frontal, and posterior parietal areas in the RS group. No significant difference was observed in any of the limbic areas. Conclusion Respiratory symptoms of panic disorder were associated with a reduction in cortical thickness in the left frontal and parietal areas. This finding leads to the assumption that the frontoparietal network is the crucial component in a larger cortical network underlying the perception of dyspnea in RS. PMID:26766957

  5. Evidence That the Periaqueductal Gray Matter Mediates the Facilitation of Panic-Like Reactions in Neonatally-Isolated Adult Rats

    PubMed Central

    Quintino-dos-Santos, Jeyce Willig; Müller, Cláudia Janaína Torres; Bernabé, Cristie Setúbal; Rosa, Caroline Azevedo; Tufik, Sérgio; Schenberg, Luiz Carlos

    2014-01-01

    Plenty of evidence suggests that childhood separation anxiety (CSA) predisposes the subject to adult-onset panic disorder (PD). As well, panic is frequently comorbid with both anxiety and depression. The brain mechanisms whereby CSA predisposes to PD are but completely unknown in spite of the increasing evidence that panic attacks are mediated at midbrain's dorsal periaqueductal gray matter (DPAG). Accordingly, here we examined whether the neonatal social isolation (NSI), a model of CSA, facilitates panic-like behaviors produced by electrical stimulations of DPAG of rats as adults. Eventual changes in anxiety and depression were also assessed in the elevated plus-maze (EPM) and forced-swimming test (FST) respectively. Male pups were subjected to 3-h daily isolations from post-natal day 2 (PN2) until weaning (PN21) allotting half of litters in individual boxes inside a sound-attenuated chamber (NSI, n = 26) whilst siblings (sham-isolated rats, SHAM, n = 27) and dam were moved to another box in a separate room. Non-handled controls (CTRL, n = 18) remained undisturbed with dams until weaning. As adults, rats were implanted with electrodes into the DPAG (PN60) and subjected to sessions of intracranial stimulation (PN65), EPM (PN66) and FST (PN67-PN68). Groups were compared by Fisher's exact test (stimulation sites), likelihood ratio chi-square tests (stimulus-response threshold curves) and Bonferroni's post hoc t-tests (EPM and FST), for P<0.05. Notably, DPAG-evoked panic-like responses of immobility, exophthalmus, trotting, galloping and jumping were markedly facilitated in NSI rats relative to both SHAM and CTRL groups. Conversely, anxiety and depression scores either did not change or were even reduced in neonatally-handled groups relative to CTRL, respectively. Data are the first behavioral evidence in animals that early-life separation stress produces the selective facilitation of panic-like behaviors in adulthood. Most importantly, results implicate

  6. Panic disorder, phobias, and generalized anxiety disorder.

    PubMed

    Craske, Michelle G; Waters, Allison M

    2005-01-01

    This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as well as specific to the etiology and maintenance of panic disorder, phobias, and generalized anxiety disorder. The relative contribution of broad risk factors to these disorders is discussed, including temperament, genetics, biological influences, cognition, and familial variables. In addition, the role that specific learning experiences play in relation to each disorder is reviewed. In an overarching hierarchical model, it is proposed that generalized anxiety disorder, and to some extent panic disorder, loads most heavily on broad underlying factors, whereas specific life history contributes most strongly to circumscribed phobias.

  7. Covariation bias in panic-prone individuals.

    PubMed

    Pauli, P; Montoya, P; Martz, G E

    1996-11-01

    Covariation estimates between fear-relevant (FR; emergency situations) or fear-irrelevant (FI; mushrooms and nudes) stimuli and an aversive outcome (electrical shock) were examined in 10 high-fear (panic-prone) and 10 low-fear respondents. When the relation between slide category and outcome was random (illusory correlation), only high-fear participants markedly overestimated the contingency between FR slides and shocks. However, when there was a high contingency of shocks following FR stimuli (83%) and a low contingency of shocks following FI stimuli (17%), the group difference vanished. Reversal of contingencies back to random induced a covariation bias for FR slides in high- and low-fear respondents. Results indicate that panic-prone respondents show a covariation bias for FR stimuli and that the experience of a high contingency between FR slides and aversive outcomes may foster such a covariation bias even in low-fear respondents.

  8. Lamotrigine administration in panic disorder with agoraphobia.

    PubMed

    Masdrakis, Vasilios G; Papadimitriou, George N; Oulis, Panagiotis

    2010-05-01

    Several anticonvulsants, although as yet not lamotrigine (LTG), have been found useful in the treatment of panic disorder with (PDA) or without agoraphobia. We administered LTG (200 mg/d) to 4 outpatients with PDA, as an augmentation therapy (3 patients with chronic and severe agoraphobia) or monotherapy (1 drug-naive patient with first-onset PDA) in a 14-week trial. The patient under LTG monotherapy improved significantly, whereas PDA symptoms in 2 of the other patients improved to some extent.

  9. Major depression in panic disorder patients with comorbid social phobia.

    PubMed

    Reiter, S R; Otto, M W; Pollack, M H; Rosenbaum, J F

    1991-07-01

    Rates of depression among panic disorder patients are particularly elevated in patients with comorbid social phobia. However, it is unclear whether this association is specific to social phobia, or whether any comorbid anxiety disorder increases the risk of depression. We assessed 100 panic disorder patients and found a significantly higher incidence of lifetime major depression for panic patients with comorbid social phobia or generalized anxiety disorder (GAD). Panic patients with comorbid social phobia had significantly higher scores on measures of dysfunctional attitudes and lower scores on measures of assertiveness; these variables may mediate the link between social phobia and depression in this population.

  10. Heart Rate Variability and Cardiovascular Reactivity in Panic Disorder

    DTIC Science & Technology

    1999-04-01

    heart rate reactivity to cold pressor , CO2 and mental arithmetic (Roth et aI., 1992) and orthostatic... heart rates in panic disorder are inconsistent. The decreased heart rate responses to commonly used stressors, such as cold pressor , may indicate that...cardiovascular activation and heart rate variability during naturalistic anxiety and panic. Specific hypotheses to be tested included: HyPOthesis

  11. Attack context: an important mediator of the relationship between psychological status and asthma outcomes

    PubMed Central

    Greaves, C; Eiser, C; Seamark, D; Halpin, D

    2002-01-01

    Background: The importance of psychosocial variables in asthma is increasingly recognised, although attempts to relate these to asthma outcomes often produce only weak relationships. This study aimed to identify whether such relationships might be obscured by the effects of recent asthma experience on psychological status. Methods: An adult community sample of 37 patients who had suffered a recent attack of asthma and 37 with stable asthma were given measures of panic fear and control confidence. The relationship with subsequent emergency service use was examined using two way ANOVA and correlational analyses. Covariate influences (psychiatric morbidity, age, sex, treatment level, asthma duration, social status) were considered. Results: Control confidence predicted emergency service use in different ways for recent attack and stable asthma patients. This interaction was highly significant (F(1,69) = 10.32, p<0.005) with high confidence relating to an increased risk of an attack in the recent attack group and low confidence relating to increased risk for the stable asthma group. There was also an interaction between panic fear and attack context (F(1,69) = 11.05, p<0.005) with low panic fear resulting in more attacks for recent attack cases. Conclusions: Attack context (having a recent attack) is an important mediator of psychological status. Strong cognitive/affective responses to attacks may motivate improved self-care and this represents a window of opportunity for self-care interventions. Weak cognitive/affective responses to attacks may reflect denial and require different intervention approaches. For those with recently stable asthma the relationships are qualitatively and quantitatively different, and the implications for intervention are also discussed. PMID:11867824

  12. Panic as a form of foreclosed experience.

    PubMed

    Schneider, John A

    2007-10-01

    Following a discussion of panic states and their relationship to psychosomatic illness and related disorders, the author presents an extended clinical vignette in which he initially viewed the patient's intense anxiety as a manifestation of repressed conflict and, accordingly, used verbal interpretations as the principal mode of intervention. After this approach did not prove effective, the analyst began to make use of nonverbal interventions consistent with his emerging understanding of the patient's distress as a manifestation of the foreclosure (de M'Uzan 2003) and relegation to the body of undreamable experience (Bion 1962).

  13. The Reliability and Validity of the Panic Disorder Self-Report: A New Diagnostic Screening Measure of Panic Disorder

    ERIC Educational Resources Information Center

    Newman, Michelle G.; Holmes, Marilyn; Zuellig, Andrea R.; Kachin, Kevin E.; Behar, Evelyn

    2006-01-01

    This study examined the Panic Disorder Self-Report (PDSR), a new self-report diagnostic measure of panic disorder based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994). PDSR diagnoses were compared with structured interview diagnoses of individuals with generalized anxiety…

  14. New segregation analysis of panic disorder

    SciTech Connect

    Vieland, V.J.; Fyer, A.J.; Chapman, T.

    1996-04-09

    We performed simple segregation analyses of panic disorder using 126 families of probands with DSM-III-R panic disorder who were ascertained for a family study of anxiety disorders at an anxiety disorders research clinic. We present parameter estimates for dominant, recessive, and arbitrary single major locus models without sex effects, as well as for a nongenetic transmission model, and compare these models to each other and to models obtained by other investigators. We rejected the nongenetic transmission model when comparing it to the recessive model. Consistent with some previous reports, we find comparable support for dominant and recessive models, and in both cases estimate nonzero phenocopy rates. The effect of restricting the analysis to families of probands without any lifetime history of comorbid major depression (MDD) was also examined. No notable differences in parameter estimates were found in that subsample, although the power of that analysis was low. Consistency between the findings in our sample and in another independently collected sample suggests the possibility of pooling such samples in the future in order to achieve the necessary power for more complex analyses. 32 refs., 4 tabs.

  15. Temperament, character traits, and alexithymia in patients with panic disorder

    PubMed Central

    Izci, Filiz; Gültekin, Bulent Kadri; Saglam, Sema; Koc, Merve Iris; Zincir, Selma Bozkurt; Atmaca, Murad

    2014-01-01

    Background The primary aim of the present study was to compare temperament and character traits and levels of alexithymia between patients with panic disorder and healthy controls. Methods Sixty patients with panic disorder admitted to the psychiatry clinic at Fırat University Hospital were enrolled in the study, along with 62 healthy age-matched and sex-matched controls. The Structured Clinical Interview for DSM-IV axis I (SCID-I), Temperament and Character Inventory (TCI), Toronto Alexithymia Scale (TAS-20), and Panic Agoraphobia Scale (PAS) were administered to all subjects. Results Within the temperament dimension, the mean subscale score for harm avoidance was significantly higher in patients with panic disorder than in controls. With respect to character traits, mean scores for self-directedness and cooperativeness were significantly lower than in healthy controls. Rates of alexithymia were 35% (n=21) and 11.3% (n=7) in patients with panic disorder and healthy controls, respectively. The difficulty identifying feelings subscale score was significantly higher in patients with panic disorder (P=0.03). A moderate positive correlation was identified between PAS and TAS scores (r=0.447, P<0.01). Moderately significant positive correlations were also noted for PAS and TCI subscale scores and scores for novelty seeking, harm avoidance, and self-transcendence. Conclusion In our study sample, patients with panic disorder and healthy controls differed in TCI parameters and rate of alexithymia. Larger prospective studies are required to assess for causal associations. PMID:24876780

  16. Panic-Focused Psychodynamic Psychotherapy in a Woman with Panic Disorder and Generalized Anxiety Disorder

    PubMed Central

    Sandberg, Larry; Busch, Fredric; Schneier, Franklin; Gerber, Andrew; Caligor, Eve; Milrod, Barbara

    2016-01-01

    Panic-focused psychodynamic psychotherapy (PFPP) is a 24-session, twice-weekly (12 weeks), manualized psychoanalytic psychotherapy with demonstrated preliminary efficacy for panic disorder (PD).1,2 Given the substantial morbidity and the health care utilization of the PD population,3,4 coupled with the sizable proportion of such patients who do not respond (or respond inadequately) to alternate treatments (cognitive-behavioral therapy [CBT] and drug therapy),5–7 PFPP may offer clinicians an additional tool for their therapeutic armamentarium. It may also facilitate a rapprochement between academic psychiatry and psychodynamic perspectives, and a reassessment of the role of psychodynamic therapy as part of the educational experience of residents in training—an experience that has diminished over two decades. PMID:23030215

  17. Quality of life and cost factors in panic disorder.

    PubMed

    Davidson, J R

    1996-01-01

    Quality of life encompasses domains of personal happiness, role fulfillment, and health status. Increasing attention has been paid to the relationship between quality of life and panic disorder, with accumulating evidence now available to suggest impairment in several domains among subjects with panic disorder. This review summarizes the results of community-based and treatment-seeking populations of subjects with panic disorder. Impaired personal happiness, restricted role functioning, and increased use of health services are all described. Evidence suggests that accurate diagnosis and effective treatment can significantly lessen health service utilization, resulting in substantial cost offset and also leading to increased work productivity and personal effectiveness.

  18. Anticipating Economic Market Crises Using Measures of Collective Panic.

    PubMed

    Harmon, Dion; Lagi, Marco; de Aguiar, Marcus A M; Chinellato, David D; Braha, Dan; Epstein, Irving R; Bar-Yam, Yaneer

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry--direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises.

  19. Anticipating Economic Market Crises Using Measures of Collective Panic

    PubMed Central

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry—direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises. PMID:26185988

  20. Agoraphobia Related to Unassertiveness in Panic Disorder.

    PubMed

    Levitan, Michelle Nigri; Simoes, Pedro; Sardinha, Aline G; Nardi, Antonio E

    2016-05-01

    Despite developments in panic disorder (PD) research, a significant percentage of patients do not benefit from conventional treatments. Interpersonal factors have been identified as potential predictors of treatment failures. We aimed to evaluate assertiveness in a sample of patients with PD and its implications for treatment. Forty-six symptomatic patients with PD and 46 college students responded to assessment scales regarding assertiveness and clinical data. Seventy-five percent of the patients had a secondary diagnosis of agoraphobia. We found that the PD group was characterized as nonassertive and slightly less assertive than control subjects. Furthermore, the deficit in the level of assertiveness correlated with the severity of the PD. The diagnosis of agoraphobia was correlated with unassertiveness (p < 0.05). Agoraphobia predisposes individuals to dependency and insecurity about their ability to overcome anxiogenic situations. These data demonstrate the importance of managing assertiveness in patients with PD accompanied by agoraphobia.

  1. Panic evacuation of single pedestrians and couples

    NASA Astrophysics Data System (ADS)

    Frank, G. A.; Dorso, C. O.

    2016-02-01

    Understanding the timing requirements for evacuation of people has focused primarily on independent pedestrians rather than pedestrians emotionally connected. However, the main statistical effects observed in crowds, the so-called “faster is slower”, “clever is not always better” and the “low visibility enhancement”, cannot explain the overall behavior of a crowd during an evacuation process when correlated pedestrians due to, for example feelings, are present. Our research addresses this issue and examines the statistical behavior of a mixture of individuals and couples during a (panic) escaping process. We found that the attractive feeling among couples plays an important role in the time delays during the evacuation of a single exit room.

  2. Does Fear Reactivity during Exposure Predict Panic Symptom Reduction?

    PubMed Central

    Meuret, Alicia E.; Seidel, Anke; Rosenfield, Benjamin; Hofmann, Stefan G.; Rosenfield, David

    2012-01-01

    Objective Fear reactivity during exposure is a commonly used indicator of learning and overall therapy outcome. The objective of this study was to assess the predictive value of fear reactivity during exposure using multimodal indicators and an advanced analytical design. We also investigated the degree to which treatment condition (cognitive training versus respiratory skill training) moderated fear reactivity and therapeutic outcome. Method Thirty-four patients with panic disorder and agoraphobia completed a total of 123 in-vivo exposure sessions, comprised of three weekly sessions and a fourth session 2 months following therapy completion. Sessions varied in length and phobic stimuli. Cardio-respiratory physiology (heart rate, PCO2, respiration rate) and experiential symptoms (panic symptoms and anxiety) were assessed repeatedly throughout exposure sessions, in addition to weekly assessments of panic cognitions, avoidance, and functioning. Results Panic symptomatology decreased substantially in both treatment conditions during therapy and follow-up. Significant cardio-respiratory and experiential reactivity was observed during all exposures, characterized by activation followed by reduction. Greater within-session activation of anxiety and panic symptoms was inversely related to improvement in panic symptoms severity, but neither physiological activation, nor within- or between-session reduction of either physiological or experiential variables was predictive of outcome. No moderating effects of treatment condition were found. Conclusions Fear activation and reduction during exposure are weak predictors of corrective learning and fear extinction. Clinical implications for exposure therapy and directions for future research are discussed. PMID:22486408

  3. The efficacy of milnacipran in panic disorder: an open trial.

    PubMed

    Blaya, Carolina; Seganfredo, Ana Carolina; Dornelles, Marina; Torres, Mariana; Paludo, Angela; Heldt, Elizeth; Manfro, Gisele G

    2007-05-01

    The aim of this study is to evaluate the efficacy of milnacipran in the acute treatment of patients with panic disorder. Thirty-one patients who met Diagnostic and statistical manual of mental disorders-IV criteria for panic disorder with or without agoraphobia were included in the study. Patients were initially treated with milnacipran 25 mg twice daily and then 50 mg twice daily until the 10th week. The treatment outcome and panic disorder severity were determined by the Panic Disorder Severity Scale, Panic Inventory, Clinical Global Impression and Hamilton Anxiety Scale, all of which were applied during every evaluation interview. Quality of life (WHOQOL-bref) was evaluated at baseline and at the end of the study. Missing data were handled by using the last observation carried forward for all participants who had taken at least one dose of study medication. Intention-to-treat was used in the analyses. Pharmacological treatment resulted in a clinically and statistically significant mean reduction in all severity measures. Remission (Clinical Global Impression < or = 2) was obtained in 58.1% of the sample. Regarding WHOQOL, we found a significant improvement (P<0.05) across treatment in all the domains studied. Although results may be influenced by the open design of this pilot study and by the small sample size, our findings suggest that milnacipran may be effective for the treatment of panic disorder and justify further research.

  4. Isolated sleep paralysis in African Americans with panic disorder.

    PubMed

    Paradis, C M; Friedman, S; Hatch, M

    1997-01-01

    Isolated sleep paralysis (ISP) was assessed in African Americans and Whites diagnosed with panic disorder and other anxiety disorders. Participants were recruited from an outpatient clinic where they were diagnosed with panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, social phobia, and simple phobia. Control groups of volunteers without a history of psychiatric disorder were included. All research participants completed a questionnaire to assess for ISP. Group differences were analysed through a series of chi-square analyses. The incidence of recurrent ISP was significantly higher in African Americans with panic disorder (59.6%) as compared with African Americans with other anxiety disorders (11.1%), African American control group participants (23%), Whites with panic disorder (7.5%), Whites with other anxiety disorders (0%), and White control group participants (6%). Recurrent ISP was found to be more common among African American participants, particularly for those with panic disorder. African Americans with panic disorder may experience recurrent ISP as a feature of their disorder.

  5. Heart Attack Recovery FAQs

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Heart Attack Recovery FAQs Updated:Sep 19,2016 Most people ... recovery. View an animation of a heart attack . Heart Attack Recovery Questions and Answers What treatments will I ...

  6. Anxiety sensitivity among Cambodian refugees with panic disorder: A factor analytic investigation.

    PubMed

    Hinton, Devon E; Pich, Vuth; Safren, Steven A; Pollack, Mark H; McNally, Richard J

    2006-01-01

    Among Cambodian refugees with panic disorder (N = 208), we performed two factor analyses, one with the ASI, another with an Augmented ASI (consisting of the 16-item ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). The principal component analysis of the ASI yielded a 3-factor solution (I, "Weak Heart Concerns"; II, "Social Concerns"; III, "Control Concerns"); the Augmented ASI, a 4-factor solution: I, "Wind Attack Concerns"; II, "Weak Heart Concerns"; III, "Social Concerns"; and IV, "Control Concerns." The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.

  7. “Nomophobia”: Impact of Cell Phone Use Interfering with Symptoms and Emotions of Individuals with Panic Disorder Compared with a Control Group

    PubMed Central

    King, Anna Lucia Spear; Valença, Alexandre Martins; Silva, Adriana Cardoso; Sancassiani, Federica; Machado, Sergio; Nardi, Antonio Egidio

    2014-01-01

    Panic disorder refers to the frequent and recurring acute attacks of anxiety. Objective: This study describes the routine use of mobiles phones (MPs) and investigates the appearance of possible emotional alterations or symptoms related to their use in patients with panic disorder (PD). Background: We compared patients with PD and agoraphobia being treated at the Panic and Respiration Laboratory of The Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil, to a control group of healthy volunteers. Methods: An MP-use questionnaire was administered to a consecutive sample of 50 patients and 70 controls. Results: People with PD showed significant increases in anxiety, tachycardia, respiratory alterations, trembling, perspiration, panic, fear and depression related to the lack of an MP compared to the control group. Conclusions: Both groups exhibited dependence on and were comforted by having an MP; however, people with PD and agoraphobia showed significantly more emotional alterations as well as intense physical and psychological symptoms when they were apart from or unable to use an MP compared to healthy volunteers. PMID:24669231

  8. Agoraphobia, panic disorder and generalized anxiety disorder: some implications of recent advances.

    PubMed

    Roth, M

    1984-01-01

    The nature of the relationship between 'panic disorder', agoraphobia and general anxiety disorder remains open. The aetiological theories which have tried to link them with the aid of biological and psychological concepts fail to take account of conflicting observations. 'Panic' attacks are not confined to agoraphobic and related disorders, being indistinguishable from the attacks of acute anxiety and phobic aversion manifest in a wide range of anxiety and affective disorders. There is continuity and discontinuity in the evolution of agoraphobia; those affected differ in respect of a range of premorbid features from patients with other disorders and control subjects. These variables include family history, life development, trait anxiety and other personality characteristics including introversion, neuroticism and probably emotional dependence on others. Not all the claims made on behalf of the efficacy of pharmacological treatment on the one hand and behavioural therapies on the other are substantiated. The success achieved by behavioural treatment appear to endure over some years. But the residual disabilities and defects that follow all forms of treatment and the problems posed by patient selection and high drop-out rates have received insufficient attention. Aetiological theories of agoraphobia and related conditions have been advanced along biomedical, psychological and psychodynamic lines. Some evidence supports each kind of theory. But none is wholly consistent with the findings regarding its phenomenology and evolution. Recent biological investigations have led to the formulation of hypotheses in relation to anticipatory and chronic anxiety in terms of changes in synaptic connections, enhancement of transmitter release as well as alterations in molecular configuration and regulation of gene expression. It would be premature to conclude that these findings can provide a unitary conceptual framework for the explanation of human anxiety disorders. The

  9. Metabolic decoupling in daily life in patients with panic disorder and agoraphobia.

    PubMed

    Pfaltz, Monique C; Kolodyazhniy, Vitaliy; Blechert, Jens; Margraf, Jürgen; Grossman, Paul; Wilhelm, Frank H

    2015-09-01

    Various studies have assessed autonomic and respiratory underpinnings of panic attacks, yet the psychophysiological functioning of panic disorder (PD) patients has rarely been examined under naturalistic conditions at times when acute attacks were not reported. We hypothesized that emotional activation in daily life causes physiologically demonstrable deviations from efficient metabolic regulation in PD patients. Metabolic coupling was estimated as within-individual correlations between heart rate (HR) and indices of metabolic activity, i.e., physical activity (measured by 3-axial accelerometry, Acc), and minute ventilation (Vm, measured by calibrated inductive plethysmography, as proxy for oxygen consumption). A total of 565 daytime hours were recorded in 19 PD patients and 20 healthy controls (HC). Pairwise cross-correlations of minute-by-minute averages of these metabolic indices were calculated for each participant and then correlated with several indices of self-reported anxiety. Ambulatory HR was elevated in PD (p = .05, d = 0.67). Patients showed reduced HR-Acc (p < .006, d = 0.97) and HR-Vm coupling (p < .009, d = 0.91). Combining Vm and Acc to predict HR showed the strongest group separation (p < .002, d = 1.07). Discriminant analyses, based on the combination of Vm and Acc to predict HR, classified 77% of all participants correctly. In PD, HR-Acc coupling was inversely related to trait anxiety sensitivity, as well as tonic and phasic daytime anxiety. The novel method that was used demonstrates that anxiety in PD may reduce efficient long-term metabolic coupling. Metabolic decoupling may serve as physiological characteristic of PD and might aid diagnostics for PD and other anxiety disorders. This measure deserves further study in research on health consequences of anxiety and psychosocial stress.

  10. [Group psychotherapy in patients with panic disorder and agoraphobia].

    PubMed

    Scheibe, G; Albus, M; Walther, A U; Schmauss, M

    1993-07-01

    The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.

  11. Pregnancy-Onset Panic Disorder: Incidence, Comorbidity and Associated Factors

    PubMed Central

    GÜLER, Özkan; KAYA, Veli; GEZGİNÇ, Kazım; KAYHAN, Fatih; ÇİÇEK, Erdinç; SÖNMEZ, Önder; UĞUZ, Faruk

    2015-01-01

    Introduction The present study aimed to investigate the incidence rate of pregnancy-onset panic disorder (POPD) among Turkish pregnant women using a diagnostic interview. Additionally, we examined whether the independent socio-demographic or clinical risk factors were associated with the risk of panic disorder in these women. Methods The study sample comprised 1475 consecutive pregnant women who presented to the obstetric outpatient clinics of two research centers. The rate of POPD in these participants was 1.3% (Group 1, n=20). The 20 women with POPD were compared with 250 pregnant women without pregnancy-onset depression or anxiety (Group 2; controls). Panic disorder and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders. Results The incidence rate of panic disorder was 1.3% (n=20). In group 1, 55% (n=11) of the women with POPD had an additional mood or anxiety disorder. In addition, the prevalence rate of any cluster C personality disorder, including avoidant, passive-aggressive and obsessive-compulsive personality disorders, were significantly greater in the group 1 women with POPD than the control pregnant women without a panic disorder (group 2). Conclusion The women with POPD were more likely than the controls to have a cluster C Axis II disorder and a history of a pre-existing anxiety or mood disorder.

  12. CRHR1 promoter hypomethylation: An epigenetic readout of panic disorder?

    PubMed

    Schartner, Christoph; Ziegler, Christiane; Schiele, Miriam A; Kollert, Leonie; Weber, Heike; Zwanzger, Peter; Arolt, Volker; Pauli, Paul; Deckert, Jürgen; Reif, Andreas; Domschke, Katharina

    2017-02-20

    The corticotropin releasing hormone receptor 1 (CRHR1) is crucially involved in the hypothalamic-pituitary-adrenal axis and thus a major regulator of the stress response. CRHR1 gene variation is associated with several mental disorders including anxiety disorders. Studies in rodents have demonstrated epigenetic regulation of CRHR1 gene expression to moderate response to stressful environment. In the present study, we investigated CRHR1 promoter methylation for the first time regarding its role in panic disorder applying a case-control approach (N=131 patients, N=131 controls). In an independent sample of healthy volunteers (N=255), CRHR1 methylation was additionally analyzed for association with the Beck Anxiety Inventory (BAI) score as a dimensional panic-related intermediate phenotype. The functional relevance of altered CRHR1 promoter methylation was investigated by means of luciferase-based reporter gene assays. In panic disorder patients, a significantly decreased CRHR1 methylation was discerned (p<0.001). Accordingly, healthy controls with high BAI scores showed significantly decreased CRHR1 methylation. Functional analyses revealed an increased gene expression in presence of unmethylated as compared to methylated pCpGl_CRHR1 reporter gene vectors. The present study identified a potential role of CRHR1 hypomethylation - conferring increased CRHR1 expression - in panic disorder and a related dimensional intermediate phenotype. This up-regulation of CRHR1 gene expression driven by de-methylation might constitute a link between the stress response and panic disorder risk.

  13. Opposing roles for cannabinoid receptor type-1 (CB₁) and transient receptor potential vanilloid type-1 channel (TRPV1) on the modulation of panic-like responses in rats.

    PubMed

    Casarotto, Plínio C; Terzian, Ana Luisa B; Aguiar, Daniele C; Zangrossi, Hélio; Guimarães, Francisco S; Wotjak, Carsten T; Moreira, Fabrício A

    2012-01-01

    The midbrain dorsal periaqueductal gray (dPAG) has an important role in orchestrating anxiety- and panic-related responses. Given the cellular and behavioral evidence suggesting opposite functions for cannabinoid type 1 receptor (CB₁) and transient receptor potential vanilloid type-1 channel (TRPV1), we hypothesized that they could differentially influence panic-like reactions induced by electrical stimulation of the dPAG. Drugs were injected locally and the expression of CB₁ and TRPV1 in this structure was assessed by immunofluorescence and confocal microscopy. The CB₁-selective agonist, ACEA (0.01, 0.05 and 0.5 pmol) increased the threshold for the induction of panic-like responses solely at the intermediary dose, an effect prevented by the CB₁-selective antagonist, AM251 (75 pmol). Panicolytic-like effects of ACEA at the higher dose were unmasked by pre-treatment with the TRPV1 antagonist capsazepine (0.1 nmol). Similarly to ACEA, capsazepine (1 and 10 nmol) raised the threshold for triggering panic-like reactions, an effect mimicked by another TRPV1 antagonist, SB366791 (1 nmol). Remarkably, the effects of both capsazepine and SB366791 were prevented by AM251 (75 pmol). These pharmacological data suggest that a common endogenous agonist may have opposite functions at a given synapse. Supporting this view, we observed that several neurons in the dPAG co-expressed CB₁ and TRPV1. Thus, the present work provides evidence that an endogenous substance, possibly anandamide, may exert both panicolytic and panicogenic effects via its actions at CB₁ receptors and TRPV1 channels, respectively. This tripartite set-point system might be exploited for the pharmacotherapy of panic attacks and anxiety-related disorders.

  14. The Influence of Hurricane Exposure and Anxiety Sensitivity on Panic Symptoms

    ERIC Educational Resources Information Center

    Hensley-Maloney, Lauren; Varela, R. Enrique

    2009-01-01

    Trauma exposure has been associated with panic symptoms in adult samples, but little is known about the relationship between trauma and panic in children. Anxiety sensitivity (AS), or the fear of anxiety-related bodily sensations, may help explain the relationship between trauma and panic. To examine relationships among trauma, anxiety…

  15. Cognitive-Behavioral Therapy of Panic Disorder with Secondary Major Depression: A Preliminary Investigation.

    ERIC Educational Resources Information Center

    Laberge, Benoit; And Others

    1993-01-01

    Investigated extent to which cognitive-behavioral therapy can be used successfully in treatment of secondary depressed panic patients. Findings from eight panic patients with major depression and seven panic patients without major depression showed that cognitive-behavioral therapy was significantly superior to information-based therapy in…

  16. Dynamic Modeling of the Economic Impacts of a Terrorist Attack using a Radiological Dispersion Device

    DTIC Science & Technology

    2009-03-01

    combined, the model uses historical examples of responses from the September 11 attacks, the Three Mile Island and Goiania , Brazil incidents, natural...radiological incidents is gathered from the Goiania , Brazil, Chernobyl, and Three Mile Island incidents. “The tragic radiological accident that occurred...treated for radiation burns, and 249 others were exposed to the cesium 137 radiation. Mass panic ensued across Goiania as the result of the incident

  17. The effects of extraverted temperament on agoraphobia in panic disorder.

    PubMed

    Rosellini, Anthony J; Lawrence, Amy E; Meyer, Joseph F; Brown, Timothy A

    2010-05-01

    Although situational avoidance is viewed as the most disabling aspect of panic disorder, few studies have evaluated how dimensions of neurotic (i.e., neuroticism, behavioral inhibition) and extraverted (i.e., extraversion, behavioral activation) temperament may influence the presence and severity of agoraphobia. Using logistic regression and structural equation modeling, we examined the unique effects of extraverted temperament on situational avoidance in a sample of 274 outpatients with a diagnosis of panic disorder with and without agoraphobia. Results showed low extraverted temperament (i.e., introversion) to be associated with both the presence and the severity of situational avoidance. Findings are discussed in regard to conceptualizations of conditioned avoidance, activity levels, sociability, and positive emotions within the context of panic disorder with agoraphobia.

  18. Virtual reality: a new tool for panic disorder therapy.

    PubMed

    Vincelli, Francesco; Riva, Giuseppe

    2002-05-01

    The use of a multicomponent cognitive-behavioral treatment strategy for panic disorder with agoraphobia is actually one of the preferred therapeutical approach for this disturbance. This method involves a mixture of cognitive and behavioral techniques which are intended to help patients identify and modify their dysfunctional anxiety-related thoughts, beliefs and behavior. Emphasis is placed on reversing the maintaining factors identified in the cognitive and behavioral patterns. The treatment protocol includes exposure to the feared situation, interoceptive exposure and cognitive restructuring. The paper presents a treatment protocol for panic disorder and agoraphobia, named experiential-cognitive therapy, that integrates the use of virtual reality in a multicomponent cognitive-behavioral treatment strategy. The goal of experiential-cognitive therapy is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms.

  19. Pericarditis - after heart attack

    MedlinePlus

    ... medlineplus.gov/ency/article/000166.htm Pericarditis - after heart attack To use the sharing features on this page, ... occur in the days or weeks following a heart attack . Causes Two types of pericarditis can occur after ...

  20. MAOA gene hypomethylation in panic disorder—reversibility of an epigenetic risk pattern by psychotherapy

    PubMed Central

    Ziegler, C; Richter, J; Mahr, M; Gajewska, A; Schiele, M A; Gehrmann, A; Schmidt, B; Lesch, K-P; Lang, T; Helbig-Lang, S; Pauli, P; Kircher, T; Reif, A; Rief, W; Vossbeck-Elsebusch, A N; Arolt, V; Wittchen, H-U; Hamm, A O; Deckert, J; Domschke, K

    2016-01-01

    Epigenetic signatures such as methylation of the monoamine oxidase A (MAOA) gene have been found to be altered in panic disorder (PD). Hypothesizing temporal plasticity of epigenetic processes as a mechanism of successful fear extinction, the present psychotherapy-epigenetic study for we believe the first time investigated MAOA methylation changes during the course of exposure-based cognitive behavioral therapy (CBT) in PD. MAOA methylation was compared between N=28 female Caucasian PD patients (discovery sample) and N=28 age- and sex-matched healthy controls via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells. MAOA methylation was furthermore analyzed at baseline (T0) and after a 6-week CBT (T1) in the discovery sample parallelized by a waiting time in healthy controls, as well as in an independent sample of female PD patients (N=20). Patients exhibited lower MAOA methylation than healthy controls (P<0.001), and baseline PD severity correlated negatively with MAOA methylation (P=0.01). In the discovery sample, MAOA methylation increased up to the level of healthy controls along with CBT response (number of panic attacks; T0–T1: +3.37±2.17%), while non-responders further decreased in methylation (−2.00±1.28% P=0.001). In the replication sample, increases in MAOA methylation correlated with agoraphobic symptom reduction after CBT (P=0.02–0.03). The present results support previous evidence for MAOA hypomethylation as a PD risk marker and suggest reversibility of MAOA hypomethylation as a potential epigenetic correlate of response to CBT. The emerging notion of epigenetic signatures as a mechanism of action of psychotherapeutic interventions may promote epigenetic patterns as biomarkers of lasting extinction effects. PMID:27045843

  1. Nine Going on Seventeen: Boundary Crises in the Cultural Map of Childhood/Adolescence.

    ERIC Educational Resources Information Center

    Mitchell, Claudia; Reid-Walsh, Jacqueline

    Boundary crises for girls moving into adolescence were studied by analyzing "Seventeen" magazine to contribute to the discourse around redefining childhood. The border between childhood and adolescence appears to be moving downward, and as the boundary goes down, the moral panic in society often goes up. To analyze "Seventeen,"…

  2. A Meta-Analysis of Treatments for Panic Disorder.

    ERIC Educational Resources Information Center

    Clum, George A.; And Others

    1993-01-01

    Used metanalysis to compare effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in sample and duration of illness were unrelated to effect size (ES). Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded most consistent ESs;…

  3. Anxiety Sensitivity in Children of Panic Disorder Patients

    ERIC Educational Resources Information Center

    van Beek, N.; Perna, G.; Schruers, K.; Muris, P.; Griez, E.

    2005-01-01

    Anxiety sensitivity (AS), which refers to the tendency to interpret anxiety-related bodily sensations as having potentially harmful somatic, psychological or social consequences, has been proposed as a vulnerability factor for the development of panic disorder (PD). The current study examined the anxiety sensitivity levels in children of parents…

  4. Adaptation of Panic-Related Psychopathology Measures to Russian

    ERIC Educational Resources Information Center

    Kotov, Roman; Schmidt, Norman B.; Zvolensky, Michael J.; Vinogradov, Alexander; Antipova, Anna V.

    2005-01-01

    The study reports results of adaptation of panic-related psychopathology measures to Russian, including the Anxiety Sensitivity Index (ASI), the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory for Agoraphobia (MIA). Psychometric properties (e.g., reliability, factor structure, endorsement) and external validity of the…

  5. Interoceptive Assessment and Exposure in Panic Disorder: A Descriptive Study

    ERIC Educational Resources Information Center

    Schmidt, Norman B.; Trakowski, Jack

    2004-01-01

    Cognitive behavioral treatment (CBT) protocols for panic disorder (PD) typically include some form of interoceptive exposure (IE)--repeated exposure to internal sensations. Despite the widespread clinical use of IE, there is a notable absence of empirical reports about the nature of interoceptive assessments and IE. The present study was designed…

  6. Untangling genetic networks of panic, phobia, fear and anxiety

    PubMed Central

    Villafuerte, Sandra; Burmeister, Margit

    2003-01-01

    As is the case for normal individual variation in anxiety levels, the conditions panic disorder, agoraphobia and other phobias have a significant genetic basis. Recent reports have started to untangle the genetic relationships between predispositions to anxiety and anxiety disorders. PMID:12914652

  7. A Man Develops Panic Disorder After a Car Accident

    PubMed Central

    Gentile, Julie P.; Morrison, Ann

    2004-01-01

    We will describe psychotherapy with a man who developed panic disorder after a motor vehicle accident. Early intervention, selection of therapeutic approach, important turning points in the therapy, the decision-making process of combining psychotherapy with medication, and successful psychiatric collaboration with the primary care physician are discussed. PMID:21191526

  8. A randomized, naturalistic, parallel-group study for the long-term treatment of panic disorder with clonazepam or paroxetine.

    PubMed

    Nardi, Antonio E; Freire, Rafael C; Mochcovitch, Marina D; Amrein, Roman; Levitan, Michelle N; King, Anna L; Valença, Alexandre M; Veras, André B; Paes, Flávia; Sardinha, Aline; Nascimento, Isabella; de-Melo-Neto, Valfrido L; Dias, Gisele P; E Silva, Adriana Cardoso de O; Soares-Filho, Gastão L; da Costa, Rafael T; Mezzasalma, Marco A; de Carvalho, Marcele R; de Cerqueira, Ana C; Hallak, Jaime E; Crippa, José A; Versiani, Marcio

    2012-02-01

    This long-term extension of an 8-week randomized, naturalistic study in patients with panic disorder with or without agoraphobia compared the efficacy and safety of clonazepam (n = 47) and paroxetine (n = 37) over a 3-year total treatment duration. Target doses for all patients were 2 mg/d clonazepam and 40 mg/d paroxetine (both taken at bedtime). This study reports data from the long-term period (34 months), following the initial 8-week treatment phase. Thus, total treatment duration was 36 months. Patients with a good primary outcome during acute treatment continued monotherapy with clonazepam or paroxetine, but patients with partial primary treatment success were switched to the combination therapy. At initiation of the long-term study, the mean doses of clonazepam and paroxetine were 1.9 (SD, 0.30) and 38.4 (SD, 3.74) mg/d, respectively. These doses were maintained until month 36 (clonazepam 1.9 [SD, 0.29] mg/d and paroxetine 38.2 [SD, 3.87] mg/d). Long-term treatment with clonazepam led to a small but significantly better Clinical Global Impression (CGI)-Improvement rating than treatment with paroxetine (mean difference: CGI-Severity scale -3.48 vs -3.24, respectively, P = 0.02; CGI-Improvement scale 1.06 vs 1.11, respectively, P = 0.04). Both treatments similarly reduced the number of panic attacks and severity of anxiety. Patients treated with clonazepam had significantly fewer adverse events than those treated with paroxetine (28.9% vs 70.6%, P < 0.001). The efficacy of clonazepam and paroxetine for the treatment of panic disorder was maintained over the long-term course. There was a significant advantage with clonazepam over paroxetine with respect to the frequency and nature of adverse events.

  9. Seven Deadliest Network Attacks

    SciTech Connect

    Prowell, Stacy J; Borkin, Michael; Kraus, Robert

    2010-05-01

    Do you need to keep up with the latest hacks, attacks, and exploits effecting networks? Then you need "Seven Deadliest Network Attacks". This book pinpoints the most dangerous hacks and exploits specific to networks, laying out the anatomy of these attacks including how to make your system more secure. You will discover the best ways to defend against these vicious hacks with step-by-step instruction and learn techniques to make your computer and network impenetrable. Attacks detailed in this book include: Denial of Service; War Dialing; Penetration 'Testing'; Protocol Tunneling; Spanning Tree Attacks; Man-in-the-Middle; and, Password Replay. Knowledge is power, find out about the most dominant attacks currently waging war on computers and networks globally. Discover the best ways to defend against these vicious attacks; step-by-step instruction shows you how. Institute countermeasures, don't be caught defenseless again, learn techniques to make your computer and network impenetrable.

  10. The RS685012 Polymorphism of ACCN2, the Human Ortholog of Murine Acid-Sensing Ion Channel (ASIC1) Gene, is Highly Represented in Patients with Panic Disorder.

    PubMed

    Gugliandolo, Agnese; Gangemi, Chiara; Caccamo, Daniela; Currò, Monica; Pandolfo, Gianluca; Quattrone, Diego; Crucitti, Manuela; Zoccali, Rocco Antonio; Bruno, Antonio; Muscatello, Maria Rosaria Anna

    2016-03-01

    Panic disorder (PD) is a disabling anxiety disorder that is characterized by unexpected, recurrent panic attacks, associated with fear of dying and worrying about possible future attacks or other behavioral changes as a consequence of the attacks. The acid-sensing ion channels (ASICs) are a family of proton-sensing channels expressed throughout the nervous system. Their activity is linked to a variety of behaviors including fear, anxiety, pain, depression, learning, and memory. The human analog of ASIC1a is the amiloride-sensitive cation channel 2 (ACCN2). Adenosine A2A receptors are suggested to play an important role in different brain circuits and pathways involved in anxiety reactions. In this work we aimed to evaluate the distribution of ACCN2 rs685012 and ADORA2A rs2298383 polymorphisms in PD patients compared with healthy subjects. We found no association between ADORA2A polymorphism and PD. Instead, the C mutated allele for ACCN2 rs685012 polymorphism was significantly more frequent in patients than in controls. On the contrary, the TT homozygous wild-type genotype and also the ACCN2 TT/ADORA2A CT diplotype were significantly more represented in controls. These results are suggestive for a role of ACCN2 rs685012 polymorphism in PD development in Caucasian people.

  11. Group II metabotropic glutamate receptor type 2 allosteric potentiators prevent sodium lactate-induced panic-like response in panic-vulnerable rats

    PubMed Central

    Johnson, Philip L; Fitz, Stephanie D; Engleman, Eric A; Svensson, Kjell A; Schkeryantz, Jeffrey M; Shekhar, Anantha

    2015-01-01

    Rats with chronic inhibition of GABA synthesis by infusion of l-allyglycine, a glutamic acid decarboxylase inhibitor, into their dorsomedial/perifornical hypothalamus are anxious and exhibit panic-like cardio-respiratory responses to treatment with intravenous (i.v.) sodium lactate (NaLac) infusions, in a manner similar to what occurs in patients with panic disorder. We previously showed that either NMDA receptor antagonists or metabotropic glutamate receptor type 2/3 receptor agonists can block such a NaLac response, suggesting that a glutamate mechanism is contributing to this panic-like state. Using this animal model of panic, we tested the efficacy of CBiPES and THIIC, which are selective group II metabotropic glutamate type 2 receptor allosteric potentiators (at 10–30mg/kg i.p.), in preventing NaLac-induced panic-like behavioral and cardiovascular responses. The positive control was alprazolam (3mg/kg i.p.), a clinically effective anti-panic benzodiazepine. As predicted, panic-prone rats given a NaLac challenge displayed NaLac-induced panic-like cardiovascular (i.e. tachycardia and hypertensive) responses and “anxiety” (i.e. decreased social interaction time) and “flight” (i.e. increased locomotion) -associated behaviors; however, systemic injection of the panic-prone rats with CBiPES, THIIC or alprazolam prior to the NaLac dose blocked all NaLac-induced panic-like behaviors and cardiovascular responses. These data suggested that in a rat animal model, selective group II metabotropic glutamate type 2 receptor allosteric potentiators show an anti-panic efficacy similar to alprazolam. PMID:22914798

  12. Life After a Heart Attack

    MedlinePlus

    ... from the NHLBI on Twitter. Life After a Heart Attack Many people survive heart attacks and live active, ... a few weeks. Anxiety and Depression After a Heart Attack After a heart attack, many people worry about ...

  13. What Is a Heart Attack?

    MedlinePlus

    ... from the NHLBI on Twitter. What Is a Heart Attack? Español A heart attack happens when the flow ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  14. Automatic associations and panic disorder: Trajectories of change over the course of treatment

    PubMed Central

    Teachman, Bethany A.; Marker, Craig D.; Smith-Janik, Shannan B.

    2008-01-01

    Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tests these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over the course of 12-week cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N=43) completed a measure of automatic panic associations (the Implicit Association Test, which reflects elements of the schema construct) every three weeks over the course of therapy, and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling indicated that automatic panic associations not only changed over the course of CBT for panic disorder, but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change. PMID:19045967

  15. Longitudinal course of panic disorder with and without agoraphobia using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

    PubMed

    Nay, William; Brown, Ruth; Roberson-Nay, Roxann

    2013-06-30

    Few naturalistic, longitudinal studies of panic disorder with and without agoraphobia (PD/PDA) exist, limiting our knowledge of the temporal rates of incidence, relapse, and chronicity, or the factors that predict category transition. Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1 (n=43,093) and wave 2 (n=34,653) were utilized to determine transitional rates, and predictors of category transitions, over a 3-year period. Analyses revealed very high 3-year remission rates for PD and PDA (75% and 67%, respectively), although relapse also was relatively frequent (PD=12%; PDA=21%). Logistic regression revealed previous history of panic attacks, generalized anxiety disorder/major depression (GAD/MDD), nicotine dependence, female sex, younger age, and major financial crises to be reliable predictors of incidence and relapse. The direction and magnitude of association of many predictor variables were similar for PD and PDA, with notable exceptions for social anxiety and romantic relationship factors. Clinicians should be aware of the relapsing-remitting nature of PD and PDA and, thus, take caution to not reduce or eliminate effective treatments prematurely. Similarly, the current study suggests clinicians pay particular attention to concurrent factors relevant to relapse in PD/PDA that may also be clinically addressed (e.g., co-morbid MDD/GAD and nicotine dependence).

  16. A genome-wide study of panic disorder suggests the amiloride-sensitive cation channel 1 as a candidate gene.

    PubMed

    Gregersen, Noomi; Dahl, Hans A; Buttenschøn, Henriette N; Nyegaard, Mette; Hedemand, Anne; Als, Thomas D; Wang, August G; Joensen, Sofus; Woldbye, David Pd; Koefoed, Pernille; Kristensen, Ann S; Kruse, Torben A; Børglum, Anders D; Mors, Ole

    2012-01-01

    Panic disorder (PD) is a mental disorder with recurrent panic attacks that occur spontaneously and are not associated to any particular object or situation. There is no consensus on what causes PD. However, it is recognized that PD is influenced by environmental factors, as well as genetic factors. Despite a significant hereditary component, genetic studies have only been modestly successful in identifying genes of importance for the development of PD. In this study, we conducted a genome-wide scan using microsatellite markers and PD patients and control individuals from the isolated population of the Faroe Islands. Subsequently, we conducted a fine mapping, which revealed the amiloride-sensitive cation channel 1 (ACCN1) located on chromosome 17q11.2-q12 as a potential candidate gene for PD. The further analyses of the ACCN1 gene using single-nucleotide polymorphisms (SNPs) revealed significant association with PD in an extended Faroese case-control sample. However, analyses of a larger independent Danish case-control sample yielded no substantial significant association. This suggests that the possible risk alleles associated in the isolated population are not those involved in the development of PD in a larger outbred population.

  17. Dorsal periaqueductal gray stimulation facilitates anxiety-, but not panic-related, defensive responses in rats tested in the elevated T-maze

    PubMed Central

    Camplesi, M.; de Bortoli, V.C.; de Paula Soares, V.; Nogueira, R.L.; Zangrossi, H.

    2012-01-01

    The escape response to electrical or chemical stimulation of the dorsal periaqueductal gray matter (DPAG) has been associated with panic attacks. In order to explore the validity of the DPAG stimulation model for the study of panic disorder, we determined if the aversive consequences of the electrical or chemical stimulation of this midbrain area can be detected subsequently in the elevated T-maze. This animal model, derived from the elevated plus-maze, permits the measurement in the same rat of a generalized anxiety- and a panic-related defensive response, i.e., inhibitory avoidance and escape, respectively. Facilitation of inhibitory avoidance, suggesting an anxiogenic effect, was detected in male Wistar rats (200-220 g) tested in the elevated T-maze 30 min after DPAG electrical stimulation (current generated by a sine-wave stimulator, frequency at 60 Hz) or after local microinjection of the GABAA receptor antagonist bicuculline (5 pmol). Previous electrical (5, 15, 30 min, or 24 h before testing) or chemical stimulation of this midbrain area did not affect escape performance in the elevated T-maze or locomotion in an open-field. No change in the two behavioral tasks measured by the elevated T-maze was observed after repetitive (3 trials) electrical stimulation of the DPAG. The results indicate that activation of the DPAG caused a short-lived, but selective, increase in defensive behaviors associated with generalized anxiety. PMID:22850873

  18. Internet Administration of Three Commonly Used Questionnaires in Panic Research: Equivalence to Paper Administration in Australian and Swedish Samples of People With Panic Disorder

    ERIC Educational Resources Information Center

    Austin, David W.; Carlbring, Per; Richards, Jeffrey C.; Andersson, Gerhard

    2006-01-01

    This study assessed the degree of equivalence between paper and Internet administration of three measures of panic and agoraphobia-related cognition and behavior: Body Sensations Questionnaire (BSQ), Agoraphobic Cognitions Questionnaire (ACQ), and Mobility Inventory (MI). Participants were 110 people with panic disorder who had registered for an…

  19. Traumatic tiger attack.

    PubMed

    Chum, Marvin; Ng, Wai Pui

    2011-11-01

    Attacks on humans by large cats are uncommon occurrences and thus the principles of managing such injuries are not well documented. The authors here report the case of an 11-year-old boy who was mauled by a privately owned tiger. The attack resulted in multiple cranial lacerations and fractures, dissection of the internal carotid artery, and persistent neurological deficits. This case outlines the multiple sources of injury and pathology that can result from such an attack. Discussion is focused on the pattern of injury seen in large feline attacks and the treatment approach.

  20. Mental, Emotional and Behavior Disorders in Children and Adolescents. Factsheet.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

    This factsheet describes the different mental, emotional, and behavior problems that can occur during childhood and adolescence. The incidence and symptoms of the following disorders are discussed: (1) anxiety disorders (including phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder);…

  1. Follow-up status of patients with angiographically normal coronary arteries and panic disorder

    SciTech Connect

    Beitman, B.D.; Kushner, M.G.; Basha, I.; Lamberti, J.; Mukerji, V.; Bartels, K. )

    1991-03-27

    Cardiology patients with normal coronary angiography demonstrate continuing and substantial social, health, and work disability. The authors hypothesized that the diagnosis of panic disorder would mark those for whom continuing disability is most likely. They interviewed 72 such patients at the time of their normal angiogram, and then again an average of 38 months later. Those with panic disorder (n=36) demonstrated significantly more disability at follow-up than did the other study patients. They conclude that those patients with normal angiograms who have panic disorder are more disabled than those who do not have panic disorder. Panic disorder in psychiatric samples has been shown to be highly treatable. Therefore, early identification and treatment of panic disorder in this group is likely to minimize the suffering associated with this condition.

  2. The genetic basis of panic and phobic anxiety disorders.

    PubMed

    Smoller, Jordan W; Gardner-Schuster, Erica; Covino, Jennifer

    2008-05-15

    Panic disorder and phobic anxiety disorders are common disorders that are often chronic and disabling. Genetic epidemiologic studies have documented that these disorders are familial and moderately heritable. Linkage studies have implicated several chromosomal regions that may harbor susceptibility genes; however, candidate gene association studies have not established a role for any specific loci to date. Increasing evidence from family and genetic studies suggests that genes underlying these disorders overlap and transcend diagnostic boundaries. Heritable forms of anxious temperament, anxiety-related personality traits and neuroimaging assays of fear circuitry may represent intermediate phenotypes that predispose to panic and phobic disorders. The identification of specific susceptibility variants will likely require much larger sample sizes and the integration of insights from genetic analyses of animal models and intermediate phenotypes.

  3. Occurrence of the Cys311 DRD2 variant in a pedigree multiply affected with panic disorder

    SciTech Connect

    Crawford, F.; Hoyne, J.; Diaz, P.

    1995-08-14

    Following the detection of the rare DRD2 codon 311 variant (Ser{yields}Cys) in an affected member from a large, multiply affected panic disorder family, we investigated the occurrence of this variant in other family members. The variant occurred in both affected and unaffected individuals. Further screening in panic disorder sib pairs unrelated to this family failed to detect the Cys311 variant. Our data suggests that this variant has no pathogenic role in panic disorder. 18 refs., 1 fig.

  4. Modeling physicians' prescribing decisions for patients with panic disorder.

    PubMed

    Freeman, J K; Barnes, J H; Summers, K H; Szeinbach, S L

    1993-01-01

    The authors asked general and family practitioners to rate the importance of several items relating to the prescribing of drug products for patients with panic disorder. Physicians preferred to use benzodiazepines alone and in combination with antidepressants for treatment, regardless of the presence or absence of phobic avoidance. Adverse drug events, efficacy, and patient characteristics were found to be important considerations when physicians prescribe medication. Educational and promotional strategies for pharmaceutical manufacturers and marketers are discussed.

  5. The Pathoplasty Relationship Between Anxiety Sensitivity and Panic Disorder

    DTIC Science & Technology

    2000-05-15

    ofevaluation. Clinical Psychology Review , 8, 77-100. Brickman, A. L., Yount, S. E., Blaney, N. T., Rothberg, S. T., and De-Nourt A. K. (1996...disorders. Journal ofAbnormal Psychology, 10lz 538-552. Reiss, S. (1987).. Theoretical perspectives on the fear ofanxiety. Clinical Psychology Review , 7...585-596. Reiss, S. (1991). Expectancy model offear, anxiety, and panic.. Clinical Psychology Review , lIt 141-153. Reiss, S. &. McNally, R. J.. (1985

  6. The making of a germ panic, then and now.

    PubMed Central

    Tomes, N

    2000-01-01

    Over the last 2 decades, a heightened interest in germs has been evident in many aspects of American popular culture, including news coverage, advertisements, and entertainment media. Although clearly a response to the AIDS epidemic and other recent disease outbreaks, current obsessions with germs have some striking parallels with a similar period of intense anxiety about disease germs that occurred between 1900 and 1940. A comparison of these 2 periods of germ "panic" suggests some of the long-term cultural trends that contributed to their making. Both germ panics reflected anxieties about societal incorporation, associated with expanding markets, transportation networks, and mass immigration. They were also shaped by new trends in public health education, journalism, advertising, and entertainment media. In comparison to the first germ panic, the current discourse about the "revenge of the superbugs" is considerably more pessimistic because of increasing worries about the environment, suspicions of governmental authority, and distrust of expert knowledge. Yet, as popular anxieties about infectious disease have increased, public health scientists have been attracting favorable coverage in their role as "medical detectives" on the trail of the "killer germ." PMID:10667179

  7. The making of a germ panic, then and now.

    PubMed

    Tomes, N

    2000-02-01

    Over the last 2 decades, a heightened interest in germs has been evident in many aspects of American popular culture, including news coverage, advertisements, and entertainment media. Although clearly a response to the AIDS epidemic and other recent disease outbreaks, current obsessions with germs have some striking parallels with a similar period of intense anxiety about disease germs that occurred between 1900 and 1940. A comparison of these 2 periods of germ "panic" suggests some of the long-term cultural trends that contributed to their making. Both germ panics reflected anxieties about societal incorporation, associated with expanding markets, transportation networks, and mass immigration. They were also shaped by new trends in public health education, journalism, advertising, and entertainment media. In comparison to the first germ panic, the current discourse about the "revenge of the superbugs" is considerably more pessimistic because of increasing worries about the environment, suspicions of governmental authority, and distrust of expert knowledge. Yet, as popular anxieties about infectious disease have increased, public health scientists have been attracting favorable coverage in their role as "medical detectives" on the trail of the "killer germ."

  8. Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.

    PubMed

    Schmidt, Norman B; Raines, Amanda M; Allan, Nicholas P; Zvolensky, Michael J

    2016-02-01

    Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers.

  9. Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic

    PubMed Central

    Schmidt, Norman B.; Raines, Amanda M.; Allan, Nicholas P.; Zvolensky, Michael J.

    2016-01-01

    Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. PMID:26752327

  10. Two cases of panic disorder treated with autogenic training and in vivo exposure without medication.

    PubMed

    Sakai, M; Takeichi, M

    1996-12-01

    The aim of this study was to use autogenic training in combination with in vivo exposure in the behavioral treatment of panic disorder without medication. Two cases of panic disorder with agoraphobic avoidance were presented. Case 1 was a 33 year old married female who exhibited mild panic symptoms, and case 2 was a 23 year old single male who had severe panic symptoms. Both subjects were successfully treated with the combination of these two techniques. Treatment effects were maintained for 9 years as a follow up in case 1, and for 4 years in case 2.

  11. Supply Chain Attack Framework and Attack Patterns

    DTIC Science & Technology

    2013-12-01

    Malware is embedded in a replacement server motherboard (e.g., in the flash memory) in order to alter server functionality from that intended. Attack...Slashdot: Dell Ships Infected Motherboards July 21, 2010(c/o Rick Dove) Threat: An adversary with access to hardware procurement, maintenance, or upgrade...control can embed malware in a critical component server motherboard . Vulnerabilities: The control processes and mechanisms for hardware

  12. Stroke following rottweiler attack.

    PubMed

    Miller, S J; Copass, M; Johansen, K; Winn, H R

    1993-02-01

    A previously healthy 50-year-old man suffered a major right cerebral infarction shortly after receiving head and neck bites in an attack by two rottweilers. Arteriography revealed occlusion of the right middle cerebral artery, an intimal flap and pseudoaneurysm in the high right internal carotid artery just proximal to the skull base, and an obstructed right vertebral artery. The powerful jaw mechanism of rottweilers and other large mastiff-type dogs makes their bites particularly destructive. The predilection of these animals for attacking the head and upper body makes occult crush injury to the extracranial cerebral vessels an important diagnostic consideration following such attacks.

  13. Signs of a Heart Attack

    MedlinePlus

    ... attack Heart Health and Stroke Signs of a heart attack Related information Make the Call. Don't Miss ... to top More information on Signs of a heart attack Read more from womenshealth.gov Make the Call, ...

  14. A fatal leopard attack.

    PubMed

    Hejna, Petr

    2010-05-01

    A rare case of a big cat fatal attack is presented. A male leopard that had escaped from its unlocked cage attacked a 26-year-old male zoo worker. The man sustained penetrating injuries to the neck with consequent external bleeding. The man died while being transported to the hospital as a result of the injuries sustained. The wounds discovered on the victim's body corresponded with the known methods of leopard attacks and with findings on the carcasses of animals killed by leopards in the wild. The conclusion of the medicolegal investigation was that the underlying cause of death was a bite wound to the neck which lacerated the left internal jugular vein, the two main branches of the left external carotid artery, and the cervical spine. The cause of death was massive external bleeding. Special attention is paid to the general pattern of injuries sustained from big cat attacks.

  15. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 ...

  16. New sensitivity analysis attack

    NASA Astrophysics Data System (ADS)

    El Choubassi, Maha; Moulin, Pierre

    2005-03-01

    The sensitivity analysis attacks by Kalker et al. constitute a known family of watermark removal attacks exploiting a vulnerability in some watermarking protocols: the attacker's unlimited access to the watermark detector. In this paper, a new attack on spread spectrum schemes is designed. We first examine one of Kalker's algorithms and prove its convergence using the law of large numbers, which gives more insight into the problem. Next, a new algorithm is presented and compared to existing ones. Various detection algorithms are considered including correlation detectors and normalized correlation detectors, as well as other, more complicated algorithms. Our algorithm is noniterative and requires at most n+1 operations, where n is the dimension of the signal. Moreover, the new approach directly estimates the watermark by exploiting the simple geometry of the detection boundary and the information leaked by the detector.

  17. Emerging Standards of Care for the Diagnosis and Treatment of Panic Disorder.

    ERIC Educational Resources Information Center

    Beamish, Patrica M.; Granello, Darcy Haag; Granello, Paul F.; McSteen, Patricia B.; Stone, David A.

    1997-01-01

    Proposes eight emerging standards of care, based on a literature review, for the diagnosis and treatment of panic disorder without agoraphobia in adults. The diagnostic criteria were particularly analyzed in terms of comorbid psychological disorders, medical disorders, and substances that mimic panic symptoms. Defines minimal professional conduct.…

  18. Virtual Reality Exposure in the Treatment of Panic Disorder with Agoraphobia: A Case Study

    ERIC Educational Resources Information Center

    Martin, Helena Villa; Botella, Cristina; Garcia-Palacios, Azucena; Osma, Jorge

    2007-01-01

    In this work we present a case example of the use of virtual reality exposure for the treatment of panic disorder with agoraphobia. The assessment protocol and procedure (including a baseline period) and the cognitive-behavioral treatment program are described. The clinical measures were categorized into target behaviors, panic and agoraphobia…

  19. Information processing biases and panic disorder: Relationships among cognitive and symptom measures

    PubMed Central

    Teachman, Bethany A.; Smith-Janik, Shannan B.; Saporito, Jena

    2007-01-01

    To test cognitive models of panic disorder, a range of information processing biases were examined among persons with panic disorder (N=43) and healthy control participants (N=38). Evidence for automatic associations in memory was assessed using the Implicit Association Test, interference effects related to attention biases were assessed using a modified supraliminal Stroop task, and interpretation biases were assessed using the Brief Body Sensations Interpretation Questionnaire. In addition, the relationship between information processing biases and clinical markers of panic (including affective, behavioral, and cognitive symptom measures) was investigated, along with the relationships among biases. Results indicated more threat biases among the panic (relative to control) group on each of the information processing measures, providing some of the first evidence for an implicit measure of panic associations. Further, structural equation modeling indicated that the information processing bias measures were each unique predictors of panic symptoms, but that the bias indicators did not relate to one another. These findings suggest that cognitive factors may independently predict panic symptoms, but not covary. Results are discussed in terms of their support for cognitive models of panic and the potential for automatic versus strategic processing differences across the tasks to explain the low relationships across the biases. PMID:17341415

  20. Acceptability of Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina

    2014-01-01

    Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program "Panic-Agoraphobia" has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients'…

  1. Fatal big cat attacks.

    PubMed

    Cohle, S D; Harlan, C W; Harlan, G

    1990-09-01

    Two cases of fatal attacks by large cats are presented. In the first case, a 30-year-old female zoo worker was attacked by a jaguar that had escaped its cage. In the second case, a 2-year-old girl was fatally injured by her father's pet leopard. The pattern of injuries in these cases is nearly identical to those of these cats' prey in the wild.

  2. Peritraumatic dissociation mediates the relationship between acute panic and chronic posttraumatic stress disorder.

    PubMed

    Bryant, Richard A; Brooks, Robert; Silove, Derrick; Creamer, Mark; O'Donnell, Meaghan; McFarlane, Alexander C

    2011-05-01

    Although peritraumatic dissociation predicts subsequent posttraumatic stress disorder (PTSD), little is understood about the mechanism of this relationship. This study examines the role of panic during trauma in the relationship between peritraumatic dissociation and subsequent PTSD. Randomized eligible admissions to 4 major trauma hospitals across Australia (n=244) were assessed during hospital admission and within one month of trauma exposure for panic, peritraumatic dissociation and PTSD symptoms, and subsequently re-assessed for PTSD three months after the initial assessment (n=208). Twenty (9.6%) patients met criteria for PTSD at 3-months post injury. Structural equation modeling supported the proposition that peritraumatic derealization (a subset of dissociation) mediated the effect of panic reactions during trauma and subsequent PTSD symptoms. The mediation model indicated that panic reactions are linked to severity of subsequent PTSD via derealization, indicating a significant indirect relationship. Whereas peritraumatic derealization is associated with chronic PTSD symptoms, this relationship is influenced by initial acute panic responses.

  3. DSM-III personality disorders in generalized anxiety, panic/agoraphobia, and obsessive-compulsive disorders.

    PubMed

    Mavissakalian, M R; Hamann, M S; Abou Haidar, S; de Groot, C M

    1993-01-01

    In an earlier report, we stated that personality profiles of patients with panic disorder/agoraphobia (n = 187) and obsessive-compulsive disorder ([ODC] n = 51) were similar, albeit more pronounced in OCD, suggesting that the link between panic disorder/agoraphobia and DSM-III personality disorders (PDs) or traits may be nonspecific. The present report extends the comparative study of DSM-III PDs/traits, as assessed by the Personality Diagnostic Questionnaire (PDQ), by adding a third diagnostic group of 39 patients with generalized anxiety disorder (GAD). The personality assessment of panic disorder/agoraphobia and GAD patients yielded virtually identical results on the PDQ and Eysenck Personality Inventory (EPI). Because GAD lacks the prominent panic, phobic, and obsessive-compulsive symptoms of other anxiety disorders, the present findings provide strong support for a nonspecific link between panic disorder/agoraphobia and DSM-III PDs/traits and for the presence of common personality characteristics in anxiety disorders.

  4. Affective comorbidity in panic disorder: is there a bipolar connection?

    PubMed

    Savino, M; Perugi, G; Simonini, E; Soriani, A; Cassano, G B; Akiskal, H S

    1993-07-01

    Although theoretical explanations for comorbidity in panic disorder (PD) abound in the literature, the complex clinical challenges of these patients have been neglected, especially where panic, obsessive-compulsive and 'soft' bipolar (e.g., hypomanic, cyclothymic and hyperthymic) conditions might co-exist. The aim of the present study has been to systematically explore the spectrum of intra-episodic and longitudinal comorbidity of 140 DSM-III-R PD patients--67.1% of whom concomitantly met the criteria for Agoraphobia--and who were consecutively admitted to the ambulatory service of the Psychiatric Clinic of the University of Pisa over a 2-year period. Comorbidity with strictly defined anxiety disorders--i.e., not explained as mere symptomatic extensions of PD--was relatively uncommon, and included Simple Phobia (10.7%), Social Phobia (6.4%), Generalized Anxiety Disorder (3.6%), and Obsessive-Compulsive Disorder (4.2%). Comorbidity with Major Depression--strictly limited to the melancholic subtype--occurred in 22.9%. Comorbidity with Bipolar Disorders included 2.1% with mania, 5% with hypomania, as well as 6.4% with cyclothymia, for a total of 13.5%; an additional 34.3% of PD patients met the criteria for hyperthymic temperament. We submit that such comorbid patterns are at the root of unwieldy clinical constructs like 'atypical depression' and 'borderline personality'. The relationship of panic disorder to other anxious-phobic and depressive states has been known for some time. Our data extend this relationship to soft bipolar disorders. Studies from other centers are needed to verify that the proposed new link is not merely due to referral bias to a tertiary university setting.

  5. Collaborative Attack vs. Collaborative Defense

    NASA Astrophysics Data System (ADS)

    Xu, Shouhuai

    We have witnessed many attacks in the cyberspace. However, most attacks are launched by individual attackers even though an attack may involve many compromised computers. In this paper, we envision what we believe to be the next generation cyber attacks — collaborative attacks. Collaborative attacks can be launched by multiple attackers (i.e., human attackers or criminal organizations), each of which may have some specialized expertise. This is possible because cyber attacks can become very sophisticated and specialization of attack expertise naturally becomes relevant. To counter collaborative attacks, we might need collaborative defense because each “chain” in a collaborative attack may be only adequately dealt with by a different defender. In order to understand collaborative attack and collaborative defense, we present a high-level abstracted framework for evaluating the effectiveness of collaborative defense against collaborative attacks. As a first step towards realizing and instantiating the framework, we explore a characterization of collaborative attacks and collaborative defense from the relevant perspectives.

  6. Quality of Smartphone Apps Related to Panic Disorder.

    PubMed

    Van Singer, Mathias; Chatton, Anne; Khazaal, Yasser

    2015-01-01

    Quality of smartphone apps related to panic: smartphone apps have a growing role in health care. This study assessed the quality of English-language apps for panic disorder (PD) and compared paid and free apps. Keywords related to PD were entered into the Google Play Store search engine. Apps were assessed using the following quality indicators: accountability, interactivity, self-help score (the potential of smartphone apps to help users in daily life), and evidence-based content quality. The Brief DISCERN score and the criteria of the "Health on the Net" label were also used as content quality indicators as well as the number of downloads. Of 247 apps identified, 52 met all inclusion criteria. The content quality and self-help scores of these PD apps were poor. None of the assessed indicators were associated with payment status or number of downloads. Multiple linear regressions showed that the Brief DISCERN score significantly predicted the content quality and self-help scores. Poor content quality and self-help scores of PD smartphone apps highlight the gap between their technological potential and the overall quality of available products.

  7. Quality of Smartphone Apps Related to Panic Disorder

    PubMed Central

    Van Singer, Mathias; Chatton, Anne; Khazaal, Yasser

    2015-01-01

    Quality of smartphone apps related to panic: smartphone apps have a growing role in health care. This study assessed the quality of English-language apps for panic disorder (PD) and compared paid and free apps. Keywords related to PD were entered into the Google Play Store search engine. Apps were assessed using the following quality indicators: accountability, interactivity, self-help score (the potential of smartphone apps to help users in daily life), and evidence-based content quality. The Brief DISCERN score and the criteria of the “Health on the Net” label were also used as content quality indicators as well as the number of downloads. Of 247 apps identified, 52 met all inclusion criteria. The content quality and self-help scores of these PD apps were poor. None of the assessed indicators were associated with payment status or number of downloads. Multiple linear regressions showed that the Brief DISCERN score significantly predicted the content quality and self-help scores. Poor content quality and self-help scores of PD smartphone apps highlight the gap between their technological potential and the overall quality of available products. PMID:26236242

  8. Are There Subtypes of Panic Disorder? An Interpersonal Perspective

    PubMed Central

    Zilcha-Mano, Sigal; McCarthy, Kevin S.; Dinger, Ulrike; Chambless, Dianne L.; Milrod, Barbara L.; Kunik, Lauren; Barber, Jacques P.

    2015-01-01

    Objective Panic disorder (PD) is associated with significant personal, social, and economic costs. However, little is known about specific interpersonal dysfunctions that characterize the PD population. The current study systematically examined these interpersonal dysfunctions. Method The present analyses included 194 patients with PD out of a sample of 201 who were randomized to cognitive-behavioral therapy, panic-focused psychodynamic psychotherapy, or applied relaxation training. Interpersonal dysfunction was measured using the Inventory of Interpersonal Problems–Circumplex (Horowitz, Alden, Wiggins, & Pincus, 2000). Results Individuals with PD reported greater levels of interpersonal distress than that of a normative cohort (especially when PD was accompanied by agoraphobia), but lower than that of a cohort of patients with major depression. There was no single interpersonal profile that characterized PD patients. Symptom-based clusters (with versus without agoraphobia) could not be discriminated on core or central interpersonal problems. Rather, as revealed by cluster analysis based on the pathoplasticity framework, there were two empirically derived interpersonal clusters among PD patients which were not accounted for by symptom severity and were opposite in nature: domineering-intrusive and nonassertive. The empirically derived interpersonal clusters appear to be of clinical utility in predicting alliance development throughout treatment: While the domineering-intrusive cluster did not show any changes in the alliance throughout treatment, the non-assertive cluster showed a process of significant strengthening of the alliance. Conclusions Empirically derived interpersonal clusters in PD provide clinically useful and non-redundant information about individuals with PD. PMID:26030762

  9. Developmental Risk Factors in Generalized Anxiety Disorder and Panic Disorder

    PubMed Central

    Newman, Michelle G.; Shin, Ki Eun; Zuellig, Andrea R.

    2016-01-01

    Background There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD). Goal This study investigated whether GAD and PD could be discriminated through differences in developmental etiological factors including childhood parental loss/separation, psychological disorders, and maternal and paternal attachment. Method Twenty people with adult generalized anxiety disorder (GAD), 20 with adult panic disorder (PD), 11 with adult comorbid GAD and PD, and 21 adult non-anxious controls completed diagnostic interviews to assess symptoms of mental disorders in adulthood and childhood. Participants also reported on parental attachment, loss, and separation. Results Childhood diagnoses of GAD and PD differentiated clinical groups from controls as well as from each other, suggesting greater likelihood for homotypic over heterotypic continuity. Compared to controls, specific phobia was associated with all three clinical groups, and childhood depression, social phobia, and PTSD were uniquely associated with adult GAD. Both maternal and paternal attachment also differentiated clinical groups from controls. However, higher levels of subscales reflecting maternal insecure avoidant attachment (e.g., no memory of early childhood experiences and balancing/forgiving current state of mind) emerged as more predictive of GAD relative to PD. There were no group differences in parental loss or separation. Conclusions These results support differentiation of GAD and PD based on developmental risk factors. Recommendations for future research and implications of the findings for understanding the etiology and symptomatology of GAD and PD are discussed. PMID:27466747

  10. Lack of association between the serotonin transporter promoter polymorphism (5-HTTLPR) and personality traits in asymptomatic patients with panic disorder.

    PubMed

    Wachleski, Cláudia; Blaya, Carolina; Salum, Giovanni Abrahão; Vargas, Verônica; Leistner-Segal, Sandra; Manfro, Gisele Gus

    2008-01-31

    The serotonin transporter promoter polymorphism (5-HTTLPR) has been investigated regarding its association with neuroticism, which, in its turn, is a personality dimension often found in patients with panic disorder (PD). It has been recently evidenced that the long 5-HTTLPR polymorphism has a genetic variation (Lg), which is related to its lower expression. The objective of this study was to assess the association between the 5-HTTLPR polymorphism in the triallelic system and the neurotic personality traits in patients in PD remission. Sixty-seven Caucasian patients with PD diagnosis according to the DSM-IV-TR assessed with the MINI (mini international neuropsychiatric interview) were included. The MMPI (Minnesota multiphasic personality inventory) was used to assess the personality. The remission of PD symptoms was defined as CGI (clinical global impression) panic attacks. The patients' genotypes were grouped according to the level of expression: low expression (SS, SLg and LgLg), intermediate expression (SLa, LgLa) and high expression (LaLa). There was no significant deviation from Hardy-Weinberg equilibrium (chi2=0.52, d.f.=1, p=0.471). According to the triallelic classification, the distribution of alleles in these patients was as follows: S 58 (43.3%), Lg 17 (12.7%) and La 59 (44.0%). There were no significant differences on the MMPI scales between different genotype classifications and allele analyses. Larger samples are necessary to exclude the less relevant genetic influences on these traits. In addition, other polymorphisms should be considered in the characterization of a heritable phenotype in the PD.

  11. Do Bartonella Infections Cause Agitation, Panic Disorder, and Treatment-Resistant Depression?

    PubMed Central

    Schaller, James L.; Burkland, Glenn A.; Langhoff, P.J.

    2007-01-01

    Introduction Bartonella is an emerging infection found in cities, suburbs, and rural locations. Routine national labs offer testing for only 2 species, but at least 9 have been discovered as human infections within the last 15 years. Some authors discuss Bartonella cases having atypical presentations, with serious morbidity considered uncharacteristic of more routine Bartonella infections. Some atypical findings include distortion of vision, abdominal pain, severe liver and spleen tissue abnormalities, thrombocytopenic purpura, bone infection, arthritis, abscesses, heart tissue and heart valve problems. While some articles discuss Bartonella as a cause of neurologic illnesses, psychiatric illnesses have received limited attention. Case reports usually do not focus on psychiatric symptoms and typically only as incidental comorbid findings. In this article, we discuss patients exhibiting new-onset agitation, panic attacks, and treatment-resistant depression, all of which may be attributed to Bartonella. Methods Three patients receiving care in an outpatient clinical setting developed acute onset personality changes and agitation, depression, and panic attacks. They were retrospectively examined for evidence of Bartonella infections. The medical and psychiatric treatment progress of each patient was tracked until both were significantly resolved and the Bartonella was cured. Results The patients generally seemed to require higher dosing of antidepressants, benzodiazepines, or antipsychotics in order to function normally. Doses were reduced following antibiotic treatment and as the presumed signs of Bartonella infection remitted. All patients improved significantly following treatment and returned to their previously healthy or near-normal baseline mental health status. Discussion New Bartonella species are emerging as human infections. Most do not have antibody or polymerase chain reaction (PCR) diagnostic testing at this time. Manual differential examinations are of

  12. Global panic reaction--a therapeutic approach to a world-wide economic crisis.

    PubMed

    Sperling, W; Biermann, T; Maler, J M

    2009-08-01

    Drastic losses on the stock markets within short periods have been the subject of numerous investigations in view of the fact that they are often irrational. In a recently published model we reported about the world-wide phenomenon of Global panic reaction (GPR) [Sperling W, Bleich S, Reulbach U. Black Monday on stock markets throughout the world - a new phenomenon of collective panic disorder? A psychiatric approach. Med Hypotheses 2008;71(6):972-4], which illustrate typical psychiatric symptoms of panic disorder. We now complete this model by a therapeutic approach for the patient. Therefore the identification of a therapeutic regime "step by step" was necessary.

  13. Low-dose imipramine for treatment of panic disorder during pregnancy: a retrospective chart review.

    PubMed

    Uguz, Faruk; Sahingoz, Mine; Gungor, Buket; Askin, Rustem

    2014-08-01

    Although imipramine is one of the antidepressants that could be effective in the treatment of panic disorder, data on its usage for this diagnosis in the pregnancy period are limited. This report presents the results of 16 pregnant women with panic disorder without comorbid diagnosis who underwent low-dose imipramine (10-40 mg/d) treatment. According to the Clinical Global Impression-Improvement Scale, 12 (75%) of 16 women responded to the treatment. The results suggest that low-dose imipramine may be useful for the treatment of panic disorder during pregnancy.

  14. Fatal crocodile attack.

    PubMed

    Chattopadhyay, Saurabh; Shee, Biplab; Sukul, Biswajit

    2013-11-01

    Attacks on human beings by various animals leading to varied types of injuries and even death in some cases are not uncommon. Crocodile attacks on humans have been reported from a number of countries across the globe. Deaths in such attacks are mostly due to mechanical injuries or drowning. Bites by the crocodiles often cause the limbs to be separated from the body. The present case refers to an incident of a fatal attack by a crocodile on a 35 years old female where only the mutilated head of the female was recovered. Multiple lacerated wounds over the face and scalp along with fracture of the cranial bones was detected on autopsy. Two distinct bite marks in the form of punched in holes were noted over the parietal and frontal bones. Injuries on the head with its traumatic amputation from the body were sufficient to cause death. However, the presence of other fatal injuries on the unrecovered body parts could not be ruled out.

  15. Word Attack Model.

    ERIC Educational Resources Information Center

    Follettie, Joseph F.

    A limited analysis of alternative approaches to phonemic-level word attack instruction is provided in this document. The instruction segment begins with training in letter-sound correspondences for which mastery of certain skills is assumed. Instruction ends with the decoding of novel items having a consonant-vowel-consonant construction. Contents…

  16. Functional neuroanatomy in panic disorder: Status quo of the research

    PubMed Central

    Sobanski, Thomas; Wagner, Gerd

    2017-01-01

    AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder. METHODS Panic disorder (PD) is a frequent psychiatric disease. Gorman et al (1989; 2000) proposed a comprehensive neuroanatomical model of PD, which suggested that fear- and anxiety-related responses are mediated by a so-called “fear network” which is centered in the amygdala and includes the hippocampus, thalamus, hypothalamus, periaqueductal gray region, locus coeruleus and other brainstem sites. We performed a systematic search by the electronic database PubMed. Thereby, the main focus was laid on recent neurofunctional, neurostructural, and neurochemical studies (from the period between January 2012 and April 2016). Within this frame, special attention was given to the emerging field of imaging genetics. RESULTS We noted that many neuroimaging studies have reinforced the role of the “fear network” regions in the pathophysiology of panic disorder. However, recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem, anterior and midcingulate cortex (ACC and MCC), insula, and lateral as well as medial parts of the prefrontal cortex. Interestingly, differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al (2000). Indeed, amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms, sample heterogeneity and size, as well as on limitations of neuroimaging techniques. Advanced neurochemical studies have substantiated the major role of serotonergic, noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD. However, alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable. A promising new research approach is “imaging genetics”. Imaging genetic studies are designed to evaluate the impact of genetic variations (polymorphisms) on

  17. The Developmental Course of Anxiety Symptoms during Adolescence: The TRAILS Study

    ERIC Educational Resources Information Center

    Van Oort, F. V. A.; Greaves-Lord, K.; Verhulst, F. C.; Ormel, J.; Huizink, A. C.

    2009-01-01

    Background: Little is known about the development of anxiety symptoms from late childhood to late adolescence. The present study determined developmental trajectories of symptoms of separation anxiety disorder (SAD), social phobia (SoPh), generalized anxiety disorder (GAD), panic disorder (PD), and obsessive-compulsive disorder (OCD) in a large…

  18. Maternal panic disorder: Infant prematurity and low birth weight.

    PubMed

    Warren, Susan L; Racu, Camellia; Gregg, Vanessa; Simmens, Samuel J

    2006-01-01

    The aim of this pilot research was to investigate whether infants of mothers with panic disorder (PD) would be at higher risk for prematurity and low birth weight (corrected for gestational age) than controls. Medical records were reviewed for 25 mothers with PD and 33 mothers without a lifetime history of anxiety disorders or other major psychopathology as determined by diagnostic interview. Mothers also completed questionnaires concerning demographic information and life stresses. Compared to controls, infants with PD mothers were not significantly more likely to be born prematurely or earlier than controls but did show smaller birth weight corrected for gestational age, even after accounting for possible confounding influences. Additional research is needed to confirm these preliminary findings. Studying PD mothers during pregnancy could provide insight concerning mechanisms for the development of low birth weight and psychopathology.

  19. The Effects of Extraverted Temperament on Agoraphobia in Panic Disorder

    PubMed Central

    Rosellini, Anthony J.; Lawrence, Amy E.; Meyer, Joseph F.; Brown, Timothy A.

    2010-01-01

    Although situational avoidance is viewed as the most disabling aspect of panic disorder (PD), few studies have evaluated how dimensions of neurotic (i.e., NT; neuroticism, behavioral inhibition) and extraverted (i.e. ET; extraversion, behavioral activation) temperament may influence the presence and severity of agoraphobia (AG). Using logistic regression and structural equation modeling, the present study examined the unique effects of ET on situational avoidance in a sample of 274 outpatients diagnosed with PD with and without AG. Results showed low ET (i.e., introversion) to be associated with both the presence and severity of situational avoidance. Findings are discussed in regard to conceptualizations of conditioned avoidance, activity levels, sociability, and positive emotions within the context of PD with AG. PMID:20455614

  20. Panic-like defensive behavior but not fear-induced antinociception is differently organized by dorsomedial and posterior hypothalamic nuclei of Rattus norvegicus (Rodentia, Muridae)

    PubMed Central

    Biagioni, A.F.; Silva, J.A.; Coimbra, N.C.

    2012-01-01

    The hypothalamus is a forebrain structure critically involved in the organization of defensive responses to aversive stimuli. Gamma-aminobutyric acid (GABA)ergic dysfunction in dorsomedial and posterior hypothalamic nuclei is implicated in the origin of panic-like defensive behavior, as well as in pain modulation. The present study was conducted to test the difference between these two hypothalamic nuclei regarding defensive and antinociceptive mechanisms. Thus, the GABAA antagonist bicuculline (40 ng/0.2 µL) or saline (0.9% NaCl) was microinjected into the dorsomedial or posterior hypothalamus in independent groups. Innate fear-induced responses characterized by defensive attention, defensive immobility and elaborate escape behavior were evoked by hypothalamic blockade of GABAA receptors. Fear-induced defensive behavior organized by the posterior hypothalamus was more intense than that organized by dorsomedial hypothalamic nuclei. Escape behavior elicited by GABAA receptor blockade in both the dorsomedial and posterior hypothalamus was followed by an increase in nociceptive threshold. Interestingly, there was no difference in the intensity or in the duration of fear-induced antinociception shown by each hypothalamic division presently investigated. The present study showed that GABAergic dysfunction in nuclei of both the dorsomedial and posterior hypothalamus elicit panic attack-like defensive responses followed by fear-induced antinociception, although the innate fear-induced behavior originates differently in the posterior hypothalamus in comparison to the activity of medial hypothalamic subdivisions. PMID:22437484

  1. Framing Samuel See: the discursive detritus of the moral panic over the "double epidemic" of methamphetamines and HIV among gay men.

    PubMed

    Gideonse, Theodore K

    2016-02-01

    After being arrested for violating a restraining order against his husband, on November 24, 2013, Yale professor Samuel See died while in lockup at the Union Avenue Detention Center in New Haven, Connecticut. The death received media attention around the world, with readers arguing online about whether See's death was caused by police misconduct, as his friends and colleagues charged in interviews and during a well-publicised march and protest. When an autopsy revealed that he had died from a methamphetamine-induced heart attack, online commentary changed dramatically, with See's many supporters rhetorically abandoning him and others describing him as a stereotype of the gay meth addict who deserved his fate. In this article, I argue that this shift in the interpretation and meaning of See's death can be traced to the discursive structures left by the moral panic about crystal meth in the United States (1996-2008), which comprised within it a secondary moral panic about crystal meth in the gay community and its connection to the spread of HIV and a possible super-strain (2005-2008).

  2. Panic-like defensive behavior but not fear-induced antinociception is differently organized by dorsomedial and posterior hypothalamic nuclei of Rattus norvegicus (Rodentia, Muridae).

    PubMed

    Biagioni, A F; Silva, J A; Coimbra, N C

    2012-04-01

    The hypothalamus is a forebrain structure critically involved in the organization of defensive responses to aversive stimuli. Gamma-aminobutyric acid (GABA)ergic dysfunction in dorsomedial and posterior hypothalamic nuclei is implicated in the origin of panic-like defensive behavior, as well as in pain modulation. The present study was conducted to test the difference between these two hypothalamic nuclei regarding defensive and antinociceptive mechanisms. Thus, the GABA(A) antagonist bicuculline (40 ng/0.2 µL) or saline (0.9% NaCl) was microinjected into the dorsomedial or posterior hypothalamus in independent groups. Innate fear-induced responses characterized by defensive attention, defensive immobility and elaborate escape behavior were evoked by hypothalamic blockade of GABA(A) receptors. Fear-induced defensive behavior organized by the posterior hypothalamus was more intense than that organized by dorsomedial hypothalamic nuclei. Escape behavior elicited by GABA(A) receptor blockade in both the dorsomedial and posterior hypothalamus was followed by an increase in nociceptive threshold. Interestingly, there was no difference in the intensity or in the duration of fear-induced antinociception shown by each hypothalamic division presently investigated. The present study showed that GABAergic dysfunction in nuclei of both the dorsomedial and posterior hypothalamus elicit panic attack-like defensive responses followed by fear-induced antinociception, although the innate fear-induced behavior originates differently in the posterior hypothalamus in comparison to the activity of medial hypothalamic subdivisions.

  3. Hypochondriasis Differs From Panic Disorder and Social Phobia: Specific Processes Identified Within Patient Groups.

    PubMed

    Höfling, Volkmar; Weck, Florian

    2017-03-01

    Studies of the comorbidity of hypochondriasis have indicated high rates of cooccurrence with other anxiety disorders. In this study, the contrast among hypochondriasis, panic disorder, and social phobia was investigated using specific processes drawing on cognitive-perceptual models of hypochondriasis. Affective, behavioral, cognitive, and perceptual processes specific to hypochondriasis were assessed with 130 diagnosed participants based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria (66 with hypochondriasis, 32 with panic disorder, and 32 with social phobia). All processes specific to hypochondriasis were more intense for patients with hypochondriasis in contrast to those with panic disorder or social phobia (0.61 < d < 2.67). No differences were found between those with hypochondriasis with comorbid disorders and those without comorbid disorders. Perceptual processes were shown to best discriminate between patients with hypochondriasis and those with panic disorder.

  4. Behavioral and neurophysiological evidence for altered processing of anxiety-related words in panic disorder.

    PubMed

    Pauli, P; Dengler, W; Wiedemann, G; Montoya, P; Flor, H; Birbaumer, N; Buchkremer, G

    1997-05-01

    Body-related and nonsomatic words were presented tachistoscopically to 15 panic patients and 15 healthy controls at each participant's threshold for correctly identifying 50% of neutral words. Behavioral (proportion of words correctly recognized) and electrocortical (event-related brain potentials [ERPs]) measures were registered. Panic patients recognized more body-related than nonsomatic words, and body-related as compared with nonsomatic words elicited, in these patients, significantly larger P300 amplitudes and enhanced positive slow waves (600 to 800 ms after stimulus presentation). In healthy controls, the number of correct recognized words and the ERPs were not differentially affected by the 2 word types. These results are grossly consistent with cognitive models of panic disorders, assuming that certain bodily sensation are perceived and processed in an affective manner that differentiates panic patients from healthy controls.

  5. Behavioral, Cognitive, and Pharmacological Treatments of Panic Disorder with Agoraphobia: Critique and Synthesis.

    ERIC Educational Resources Information Center

    Michelson, Larry K.; Marchione, Karen

    1991-01-01

    Examines theoretical, methodologic, and research issues as well as strengths, limitations, and possible interactions pertaining to behavioral, cognitive, and pharmacological treatments of panic disorder with agoraphobia. Compares attrition, outcome, and maintenance effects and presents composite indices of significant improvement, endstate…

  6. How to catch a parasite: Parasite Niche Modeler (PaNic) meets Fishbase

    USGS Publications Warehouse

    Strona, Giovanni; Lafferty, Kevin D.

    2012-01-01

    Parasite Niche Modeler (PaNic) is a free online software tool that suggests potential hosts for fish parasites. For a particular parasite species from the major helminth groups (Acanthocephala, Cestoda, Monogenea, Nematoda, Trematoda), PaNic takes data from known hosts (maximum body length, growth rate, life span, age at first maturity, trophic level, phylogeny, and biogeography) and hypothesizes similar fish species that might serve as hosts to that parasite. Users can give varying weights to host attributes and create custom models. In addition to suggesting plausible hosts (with varying degrees of confidence), the models indicate known host species that appear to be outliers in comparison to other known hosts. These unique features make PaNic an innovative tool for addressing both theoretical and applied questions in fish parasitology. PaNic can be accessed at .

  7. Heart Attack Symptoms in Women

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Heart Attack Symptoms in Women Updated:Jan 10,2017 Heart Attack Signs in Women Uncomfortable pressure, squeezing, fullness or ...

  8. An Attack Surface Metric

    DTIC Science & Technology

    2005-07-01

    Introduction Measurement of security, both qualitatively and quantitatively, has been a long standing challenge to the research community , and is of...our approach to related work in Section 2. We introduce the entry point and exit point framework in Section 3. We present the definitions of...ignores the specific system configuration that gave rise to the vulnerability, and it does not capture a system’s future attackability. Our approach

  9. When women attack.

    PubMed

    McLaughlin, Bryan; Davis, Catasha; Coppini, David; Kim, Young Mie; Knisely, Sandra; McLeod, Douglas

    2015-01-01

    The common assumption that female candidates on the campaign trail should not go on the attack, because such tactics contradict gender stereotypes, has not received consistent support. We argue that in some circumstances gender stereotypes will favor female politicians going negative. To test this proposition, this study examines how gender cues affect voter reactions to negative ads in the context of a political sex scandal, a context that should prime gender stereotypes that favor females. Using an online experiment involving a national sample of U.S. adults (N = 599), we manipulate the gender and partisan affiliation of a politician who attacks a male opponent caught in a sex scandal involving sexually suggestive texting to a female intern. Results show that in the context of a sex scandal, a female candidate going on the attack is evaluated more positively than a male. Moreover, while female participants viewed the female sponsor more favorably, sponsor gender had no effect on male participants. Partisanship also influenced candidate evaluations: the Democratic female candidate was evaluated more favorably than her Republican female counterpart.

  10. Antiretroviral Therapy Use, Medication Adherence, and Viral Suppression among PLWHA with Panic Symptoms

    PubMed Central

    Sam, Tanyka S; Hutton, Heidi E; Lau, Bryan; McCaul, Mary E; Keruly, Jeanne; Moore, Richard; Chander, Geetanjali

    2015-01-01

    Panic symptoms are prevalent among PLWHAs, yet few studies have examined their relationship with HIV outcomes. Using data from an observational cohort study in Baltimore, MD, we examined the association between panic symptoms and ART use, medication adherence, and viral suppression. Data were analyzed using GEE and adjusted for age, sex, race/ethnicity, cocaine and/or heroin use, clinic enrollment time, alcohol use, and depressive symptoms. Between June 2010 and September 2012, 1195 individuals participated in 2080 audio computer assisted interviews; 9.9% (n=118) of individuals endorsed current panic symptoms. In multivariate analysis, panic symptoms were associated with decreased ART use (IRR 0.94; p = 0.05). Panic symptoms were neither associated with medication adherence nor viral suppression. These findings were independent of depressive symptoms and substance use. Panic symptoms are under-recognized in primary care settings and present an important barrier to ART use. Further studies investigating the reasons for this association are needed. PMID:25903506

  11. The Deakin/Graeff hypothesis: focus on serotonergic inhibition of panic

    PubMed Central

    Paul, Evan D.; Johnson, Philip L.; Shekhar, Anantha; Lowry, Christopher A.

    2014-01-01

    The Deakin/Graeff hypothesis proposes that different subpopulations of serotonergic neurons through topographically organized projections to forebrain and brainstem structures modulate the response to acute and chronic stressors, and that dysfunction of these neurons increases vulnerability to affective and anxiety disorders, including Panic Disorder. We outline evidence supporting the existence of a serotonergic system originally discussed by Deakin/Graeff that is implicated in the inhibition of panic-like behavioral and physiological responses. Evidence supporting this panic inhibition system comes from the following observations: 1) serotonergic neurons located in the ‘ventrolateral dorsal raphe nucleus (DRVL) as well as the ventrolateral periaqueductal gray (VLPAG) inhibit dorsal periaqueductal gray-elicited panic-like responses; 2) chronic, but not acute, antidepressant treatment potentiates serotonin’s panicolytic effect; 3) contextual fear activates a central nucleus of the amygdala-DRVL/VLPAG circuit implicated in mediating freezing and inhibiting panic-like escape behaviors; 4) DRVL/VLPAG serotonergic neurons are central chemoreceptors and modulate the behavioral and cardiorespiratory response to panicogenic agents such as sodium lactate and CO2. Implications of the panic inhibition system are discussed. PMID:24661986

  12. Correlates of DSM-III personality disorder in panic disorder and agoraphobia.

    PubMed

    Mavissakalian, M; Hamann, M S

    1988-01-01

    One hundred eighty-seven patients meeting DSM-III criteria for panic disorder (n = 26) or agoraphobia with panic (n = 161) were assessed with the Personality Diagnostic Questionnaire (PDQ), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated our earlier findings of a preponderance of dependent, avoidant, and histrionic features and the finding that patients exhibiting a greater number of personality traits were also significantly more symptomatic. Patients with the diagnosis of panic disorder did not differ on any personality disorder variables from patients with the diagnosis of agoraphobia with panic. Furthermore, none of the specific symptom dimensions, i.e., panic, anxiety, or agoraphobia, was selected as a unique predictor of any personality variables in the regression analyses. Rather, the most important correlates of personality disorder in these patients consisted of general factors such as dysphoric mood, social phobia, or interpersonal sensitivity, and Eysenck's neuroticism dimension. The results are discussed in light of recent findings suggesting a nonspecific link between panic disorder or agoraphobia and personality disorder.

  13. Connexions between the dorsomedial division of the ventromedial hypothalamus and the dorsal periaqueductal grey matter are critical in the elaboration of hypothalamically mediated panic-like behaviour.

    PubMed

    Ullah, Farhad; Dos Anjos-Garcia, Tayllon; Mendes-Gomes, Joyce; Elias-Filho, Daoud Hibrahim; Falconi-Sobrinho, Luiz Luciano; Freitas, Renato Leonardo de; Khan, Asmat Ullah; Oliveira, Ricardo de; Coimbra, Norberto Cysne

    2017-02-15

    The electrical and chemical stimulation of the dorsal periaqueductal grey matter (dPAG) elicits panic-like explosive escape behaviour. Although neurons of the ventromedial hypothalamus (VMH) seem to organise oriented escape behaviour, when stimulated with excitatory amino acids at higher doses, non-oriented/explosive escape reactions can also be displayed. The aim of this work was to examine the importance of reciprocal projections between the VMH and the dPAG for the organisation of this panic-like behaviour. The chemical stimulation of the VMH with 9nmol of N-methyl-d-aspartic acid (NMDA) elicited oriented and non-oriented escape behaviours. The pretreatment of the dPAG with a non-selective blocker of synaptic contacts, cobalt chloride (CoCl2), followed by stimulation of the dorsomedial part of the ventromedial hypothalamus (dmVMH) with 9nmol of NMDA, abolished the non-oriented/explosive escape and freezing responses elicited by the stimulation of the dmVMH. Nonetheless, the rats still showed oriented escape to the burrow. On the other hand, when the blockade of the dmVMH with CoCl2 was followed by stimulation of the dPAG with 6nmol of NMDA, no effect was observed either on the non-oriented/explosive escape or on the freezing behaviour organised by the dPAG. Furthermore, Fos protein-labelled neurons were observed in the dPAG after the stimulation of the dmVMH with 9nmol of NMDA. Additionally, when the anterograde neurotracer biotinylated dextran amine (BDA) was deposited in the dmVMH subsequent stimulation of the dmVMH produced BDA-labelled neural fibres with terminal boutons surrounding Fos-labelled neurons in the dPAG, suggesting synaptic contacts between dmVMH and dPAG neurons for eliciting panic-like behavioural responses. The current data suggest that the dPAG is the key structure that organises non-oriented/explosive escape reactions associated with panic attack-like behaviours.

  14. Replacement Attack: A New Zero Text Watermarking Attack

    NASA Astrophysics Data System (ADS)

    Bashardoost, Morteza; Mohd Rahim, Mohd Shafry; Saba, Tanzila; Rehman, Amjad

    2017-03-01

    The main objective of zero watermarking methods that are suggested for the authentication of textual properties is to increase the fragility of produced watermarks against tampering attacks. On the other hand, zero watermarking attacks intend to alter the contents of document without changing the watermark. In this paper, the Replacement attack is proposed, which focuses on maintaining the location of the words in the document. The proposed text watermarking attack is specifically effective on watermarking approaches that exploit words' transition in the document. The evaluation outcomes prove that tested word-based method are unable to detect the existence of replacement attack in the document. Moreover, the comparison results show that the size of Replacement attack is estimated less accurate than other common types of zero text watermarking attacks.

  15. Modeling Partial Attacks with Alloy

    NASA Astrophysics Data System (ADS)

    Lin, Amerson; Bond, Mike; Clulow, Jolyon

    The automated and formal analysis of cryptographic primitives, security protocols and Application Programming Interfaces (APIs) up to date has been focused on discovering attacks that completely break the security of a system. However, there are attacks that do not immediately break a system but weaken the security sufficiently for the adversary. We term these attacks partial attacks and present the first methodology for the modeling and automated analysis of this genre of attacks by describing two approaches. The first approach reasons about entropy and was used to simulate and verify an attack on the ECB|ECB|OFB triple-mode DES block-cipher. The second approach reasons about possibility sets and was used to simulate and verify an attack on the personal identification number (PIN) derivation algorithm used in the IBM 4758 Common Cryptographic Architecture.

  16. Improving Attack Graph Visualization through Data Reduction and Attack Grouping

    SciTech Connect

    John Homer; Ashok Varikuti; Xinming Ou; Miles A. McQueen

    2008-09-01

    Various tools exist to analyze enterprise network systems and to produce attack graphs detailing how attackers might penetrate into the system. These attack graphs, however, are often complex and difficult to comprehend fully, and a human user may find it problematic to reach appropriate configuration decisions. This paper presents methodologies that can 1) automatically identify portions of an attack graph that do not help a user to understand the core security problems and so can be trimmed, and 2) automatically group similar attack steps as virtual nodes in a model of the network topology, to immediately increase the understandability of the data. We believe both methods are important steps toward improving visualization of attack graphs to make them more useful in configuration management for large enterprise networks. We implemented our methods using one of the existing attack-graph toolkits. Initial experimentation shows that the proposed approaches can 1) significantly reduce the complexity of attack graphs by trimming a large portion of the graph that is not needed for a user to understand the security problem, and 2) significantly increase the accessibility and understandability of the data presented in the attack graph by clearly showing, within a generated visualization of the network topology, the number and type of potential attacks to which each host is exposed.

  17. DNS Rebinding Attacks

    DTIC Science & Technology

    2009-09-01

    action [From 2] The same origin policy is also called Single Origin or Same Site Policy. It was originally released with Netscape Navigator 2.0 and...success Netscape 8.2.1 Windows XP / SP2 success Opera 9.0.2 Windows 2000 / SP4 success Table 6. Satoh’s attack results using Adobe Flash Player...dns/dns-rebinding.pdf. Retrieved May 2009. [4] D. Dean, E. W. Felten, and D. S. Wallach “Java Security: From HotJava to Netscape and Beyond

  18. How Is a Heart Attack Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is a Heart Attack Treated? Early treatment for a heart attack can ... or years after the procedure. Other Treatments for Heart Attack Other treatments for heart attack include: Medicines Medical ...

  19. How Is a Heart Attack Diagnosed?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is a Heart Attack Diagnosed? Your doctor will diagnose a heart attack ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  20. Homotypic versus Heterotypic Continuity of Anxiety Symptoms in Young Adolescents: Evidence for Distinctions between DSM-IV Subtypes

    ERIC Educational Resources Information Center

    Ferdinand, Robert F.; Dieleman, Gwen; Ormel, Johan; Verhulst, Frank C.

    2007-01-01

    Objective: To investigate homotypic and heterotypic longitudinal patterns of symptoms of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), social phobia (SoPh), panic disorder (PD), and obsessive compulsive disorder (OCD) in young adolescents from the Dutch general population. Method: 2,067 individuals (51.4% girls) from a…

  1. Student Support in E-Learning Courses in Higher Education--Insights from a Metasynthesis "A Pedagogy of Panic Attacks"

    ERIC Educational Resources Information Center

    Minnaar, A.

    2011-01-01

    E-learning includes the use of the internet for accessing learning materials, interacting with learning content and with instructors and students to obtain support during the learning process in order to gain knowledge and personal meaning and to grow. It occurs when students have electronic access to resources and where they are in regular online…

  2. Phobias

    MedlinePlus

    ... nervous and have a panic attack. What's a Panic Attack Like? Panic attacks can be really scary and may make someone ... sweat, and breathe quickly. Some people who have panic attacks might have chest pains, feel dizzy, or feel ...

  3. Psychological vulnerabilities in patients with major depression vs panic disorder.

    PubMed

    Cox, B J; Enns, M W; Walker, J R; Kjernisted, K; Pidlubny, S R

    2001-05-01

    The tripartite model (Clark & Watson, 1991: Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336) posits that anxiety and depression share nonspecific features of neuroticism but that somatic arousal appears unique to anxiety, and low positive affect appears unique to depression. The present study controlled for these higher-order effects and evaluated the relative contributions of four, specific lower-order vulnerabilities (anxiety sensitivity, rumination, self-criticism, self-oriented perfectionism). Participants were 38 depressed patients and 38 patients with panic disorder matched as closely as possible for age and gender, and all were diagnosed using the same structured interview by an experienced clinician. Results from hierarchical logistic regression analysis were consistent with predictions from the tripartite model in that only the unique features of arousal and positive affectivity differentiated the two diagnostic groups. At a lower-order level, only anxiety sensitivity (and its facet of fear of physical symptoms) and a ruminative response style demonstrated incremental predictive ability. The discussion focuses on the relationships among these higher-order and lower-order variables, and their potential importance for understanding specific manifestations of psychopathology.

  4. Differential attentional bias in generalized anxiety disorder and panic disorder

    PubMed Central

    Chen, Jing; Wang, Zhiyan; Wu, Yan; Cai, Yiyun; Shen, Yifeng; Wang, Liwei; Shi, Shenxun

    2013-01-01

    Background Cognitive theorists relate anxiety disorders to the way in which emotional information is processed. The existing research suggests that patients with anxiety disorders tend to allocate their attention toward threat-related information selectively, and this may differ among different types of anxious subjects. The aim of this study was to explore attentional bias in patients with generalized anxiety disorder (GAD) and panic disorder (PD) using the emotional Stroop task and compare the differences between them. Methods Forty-two patients with GAD, 34 patients with PD, and 46 healthy controls performed the emotional Stroop task with four word types, ie, GAD-related words, PD-related words, neutral words, and positive words. Results Patients with GAD and those with PD were slower than healthy controls to respond to all stimuli. Patients with GAD had longer response latencies in color-naming both PD-relevant words and GAD relevant words. Patients with PD had longer response latencies only in color-naming PD-related words, similar to healthy controls. Conclusion Patients with GAD and those with PD had a different pattern of attentional bias, and there was insufficient evidence to support the existence of specific attentional bias in patients with PD. PMID:23326197

  5. Gender differences in brain serotonin transporter availability in panic disorder.

    PubMed

    Maron, Eduard; Tõru, Innar; Hirvonen, Jussi; Tuominen, Lauri; Lumme, Ville; Vasar, Veiko; Shlik, Jakov; Nutt, David J; Helin, Semi; Någren, Kjell; Tiihonen, Jari; Hietala, Jarmo

    2011-07-01

    The role of the serotonin (5-HT) system in the neurobiology and treatment of panic disorder (PD) remains unproven. Previously we detected lower brain 5-HT transporter (SERT) availability in PD, but the findings were preliminary and mainly limited to female patients. The aim of this study was to assess non-displaceable brain SERT binding potential (BP (ND)) in male and female patients with PD. The SERT BP (ND) was measured in groups of patients with PD (five males and six females) and matched healthy control subjects (12 males and 12 females) using positron emission tomography (PET) and [¹¹C]MADAM tracer. SERT BP (ND) were significantly higher in 13 of 20 studied brain regions, including several cortical and raphe areas, but lower in the hippocampus in males with PD as compared with healthy males. No significant differences in SERT BP (ND) were observed between female patients and controls. The results suggest gender-dependent regional differences in brain SERT availability and converge with previous PET findings of reduced 5-HT(1A) receptor binding in similar brain areas in PD. Distinctive functioning of the 5-HT system in males and females may underlie certain gender-dependent differences in expressions of PD.

  6. Novel Psychological Formulation and Treatment of "Tic Attacks" in Tourette Syndrome.

    PubMed

    Robinson, Sally; Hedderly, Tammy

    2016-01-01

    onset and maintenance of tic attacks. These cases provide support for the view that tic attacks are triggered and maintained by psychological factors, thereby challenging the view that tic attacks merely reflect extended bouts of tics. As such, we propose that the movements seen in tic attacks may resemble a combination of tics and functional neurological movements, with tic attacks reflecting episodes of panic and anxiety for individuals with TS.

  7. Copeptin - A potential endocrine surrogate marker of CCK-4-induced panic symptoms?

    PubMed

    Demiralay, Cüneyt; Agorastos, Agorastos; Yassouridis, Alexander; Jahn, Holger; Wiedemann, Klaus; Kellner, Michael

    2017-02-01

    Intravenous cholecystokinin-tetrapeptide (CCK-4) administration reliably and dose-dependently provokes panic anxiety in man, accompanied by adrenocorticotropic hormone (ACTH) and cortisol release. Preclinical findings suggest that behavioral and endocrine effects of CCK-4 are mediated via corticotropin-releasing hormone (CRH) release. Anxiogenic stimulation of the central CCK-receptors in man was shown to increase as well vasopressin (AVP), which acts synergistically with CRH as pituitary-adrenocortical axis stimulator during stress. Copeptin (CoP), the C-terminal part of pre-pro-AVP, is released in an equimolar ratio to AVP. It is more stable in the circulation and easier to determine than AVP and it was found to closely mirror the production of AVP. So far, CoP secretion has not been characterized during panic provocation. In 30 healthy male human subjects, we repeatedly measured CoP in plasma during a panic challenge and studied its correlation to Acute Panic Inventory (API) ratings and plasma ACTH and cortisol. CoP levels correlated positively with the increase in API ratings (r=0.41, p=0.03), while ACTH or cortisol did not (r=0.08, p=0.68 and r=0.12, p=0.53, respectively). CoP levels correlated also positively with ACTH (r=0.48, p=0.009) and cortisol (r=0.48, p=0.01) concentrations throughout the CCK-4 challenge. As expected, we found a positive correlation between plasma ACTH and cortisol levels (r=0.57, p=0.001). A vasopressinergic activation during CCK-4 induced panic was demonstrated, which was correlated positively to panic symptoms and pituitary-adrenocortical release. Our findings suggest a role of CoP as a potential surrogate marker of CCK-4 panic symptoms. Further studies are needed to replicate our results and to further clarify the role of CoP as a stress-sensitive hormone in different panic paradigms as well as in panic patients.

  8. The relationships among separation anxiety disorder, adult attachment style and agoraphobia in patients with panic disorder.

    PubMed

    Pini, Stefano; Abelli, Marianna; Troisi, Alfonso; Siracusano, Alberto; Cassano, Giovanni B; Shear, Katherine M; Baldwin, David

    2014-12-01

    Epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. It is unclear whether the presence of adult separation anxiety disorder (ASAD) is a manifestation of anxious attachment, or a form of agoraphobia, or a specific condition with clinically significant consequences. We conducted a study to examine these questions. A sample of 141 adult outpatients with panic disorder participated in the study. Participants completed standardized measures of separation anxiety, attachment style, agoraphobia, panic disorder severity and quality of life. Patients with ASAD (49.5% of our sample) had greater panic symptom severity and more impairment in quality of life than those without separation anxiety. We found a greater rate of symptoms suggestive of anxious attachment among panic patients with ASAD compared to those without ASAD. However, the relationship between ASAD and attachment style is not strong, and adult ASAD occurs in some patients who report secure attachment style. Similarly, there is little evidence for the idea that separation anxiety disorder is a form of agoraphobia. Factor analysis shows clear differentiation of agoraphobic and separation anxiety symptoms. Our data corroborate the notion that ASAD is a distinct condition associated with impairment in quality of life and needs to be better recognized and treated in patients with panic disorder.

  9. Anxiolytic therapy with alprazolam increases muscle sympathetic activity in patients with panic disorders.

    PubMed

    Béchir, Markus; Schwegler, Kyrill; Chenevard, Rémy; Binggeli, Christian; Caduff, Christian; Büchi, Stefan; Buddeberg, Claus; Lüscher, Thomas F; Noll, Georg

    2007-07-31

    Anxiolytic therapy with the benzodiazepine alprazolam is an established therapy in patients with panic disorder. Normally, panic-like anxiety and its concomitant physical symptoms quickly disappear under such treatment. Therefore we investigated whether there is a difference in sympathetic nervous system in patients with panic disorder compared to healthy controls. Three groups of subjects were included: ten patients with panic disorder, who received alprazolam and 20 healthy control subjects who were given either alprazolam (n=10) or matching placebo (n=10). Muscle sympathetic nerve activity (MSNA) and heart rate did not differ at baseline but significantly increased both in patients and healthy controls after intake of alprazolam (1 mg). However, in both groups both MSNA and heart rate were significantly elevated when compared to both baseline and the placebo control group. This study demonstrates (1) that anxiolytic therapy with alprazolam increases muscle sympathetic nerve activity and heart rate not only in patients with panic disorder but also in healthy controls and (2) that a significant difference in sympathetic nervous system activity between patients and controls, at baseline and during the therapy with alprazolam could not be demonstrated.

  10. CO2 exposure as translational cross-species experimental model for panic

    PubMed Central

    Leibold, N K; van den Hove, D L A; Viechtbauer, W; Buchanan, G F; Goossens, L; Lange, I; Knuts, I; Lesch, K P; Steinbusch, H W M; Schruers, K R J

    2016-01-01

    The current diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders are being challenged by the heterogeneity and the symptom overlap of psychiatric disorders. Therefore, a framework toward a more etiology-based classification has been initiated by the US National Institute of Mental Health, the research domain criteria project. The basic neurobiology of human psychiatric disorders is often studied in rodent models. However, the differences in outcome measurements hamper the translation of knowledge. Here, we aimed to present a translational panic model by using the same stimulus and by quantitatively comparing the same outcome measurements in rodents, healthy human subjects and panic disorder patients within one large project. We measured the behavioral–emotional and bodily response to CO2 exposure in all three samples, allowing for a reliable cross-species comparison. We show that CO2 exposure causes a robust fear response in terms of behavior in mice and panic symptom ratings in healthy volunteers and panic disorder patients. To improve comparability, we next assessed the respiratory and cardiovascular response to CO2, demonstrating corresponding respiratory and cardiovascular effects across both species. This project bridges the gap between basic and human research to improve the translation of knowledge between these disciplines. This will allow significant progress in unraveling the etiological basis of panic disorder and will be highly beneficial for refining the diagnostic categories as well as treatment strategies. PMID:27598969

  11. Reported early separation anxiety symptoms in patients with panic and generalised anxiety disorders.

    PubMed

    Silove, D; Manicavasagar, V; O'Connell, D; Blaszczynski, A

    1993-09-01

    Attachment theory has proposed that early separation anxiety is a risk factor for adult anxiety disorder, with the recent focus being particularly on panic disorder. The results of empirical studies examining this link are, however, contradictory, possibly because of inconsistencies across studies in measuring memories of early separation anxiety. In the present study, a psychometrically sound measure, the Separation Anxiety Symptom Inventory (SASI) was used to compare memories of such early symptoms in panic disorder (including those with mild phobic-avoidance), generalised anxiety disorder and control subjects. Anxiety patients as a group returned higher SASI scores (p < 0.001) with a non-significant trend for panic disorder patients to score higher than those with generalised anxiety. These results suggest that early separation anxiety may be a harbinger of adult anxiety and that risk of panic disorder may be higher in the most severely affected youngsters. As a risk factor, early separation anxiety does not however appear to be uniquely related to adult panic disorder.

  12. Sulfate attack expansion mechanisms

    SciTech Connect

    Müllauer, Wolfram Beddoe, Robin E.; Heinz, Detlef

    2013-10-15

    A specially constructed stress cell was used to measure the stress generated in thin-walled Portland cement mortar cylinders caused by external sulfate attack. The effects of sulfate concentration of the storage solution and C{sub 3}A content of the cement were studied. Changes in mineralogical composition and pore size distribution were investigated by X-ray diffraction and mercury intrusion porosimetry, respectively. Damage is due to the formation of ettringite in small pores (10–50 nm) which generates stresses up to 8 MPa exceeding the tensile strength of the binder matrix. Higher sulfate concentrations and C{sub 3}A contents result in higher stresses. The results can be understood in terms of the effect of crystal surface energy and size on supersaturation and crystal growth pressure.

  13. Dog pack attack: hunting humans.

    PubMed

    Avis, S P

    1999-09-01

    Dog bite-related fatalities, although unusual, accounted for 304 deaths in the United States between 1979 and 1996 and 6 fatalities in Canada between 1994 and 1996. Fatal dog pack attacks and attacks involving human predation are less common. The following describes a dog pack attack on a family of four involving 2 fatalities with predation of the victims. Factors previously identified that contribute to pack attacks and predation, including prior group hunting, social feeding, territorial defense, lack of human interaction, and prey stimuli, are discussed.

  14. Worry, worry attacks, and PTSD among Cambodian refugees: a path analysis investigation.

    PubMed

    Hinton, Devon E; Nickerson, Angela; Bryant, Richard A

    2011-06-01

    Among traumatized Cambodian refugees, this article investigates worry (e.g., the types of current life concerns) and how worry worsens posttraumatic stress disorder (PTSD). To explore how worry worsens PTSD, we examine a path model of worry to see whether certain key variables (e.g., worry-induced somatic arousal and worry-induced trauma recall) mediate the relationship between worry and PTSD. Survey data were collected from March 2010 until May 2010 in a convenience sample of 201 adult Cambodian refugees attending a psychiatric clinic in Massachusetts, USA. We found that worry was common in this group (65%), that worry was often about current life concerns (e.g., lacking financial resources, children not attending school, health concerns, concerns about relatives in Cambodia), and that worry often induced panic attacks: in the entire sample, 41% (83/201) of the patients had "worry attacks" (i.e., worry episodes that resulted in a panic episode) in the last month. "Worry attacks" were highly associated with PTSD presence. In the entire sample, generalized anxiety disorder was also very prevalent, and was also highly associated with PTSD. Path analysis revealed that the effect of worry on PTSD severity was mediated by worry-induced somatic arousal, worry-induced catastrophic cognitions, worry-induced trauma recall, inability to stop worry, and irritability. The final model accounted for 75% of the variance in PTSD severity among patients with worry. The public health and treatment implications of the study's findings that worry may have a potent impact on PTSD severity in severely traumatized populations are discussed: worry and daily concerns are key areas of intervention for these worry-hypersensitive (and hence daily-stressor-hypersensitive) populations.

  15. Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes

    ERIC Educational Resources Information Center

    Arch, Joanna J.; Craske, Michelle G.

    2011-01-01

    In this paper, we present a client with panic disorder and agoraphobia who relapses following a full course of cognitive behavioral therapy (CBT). To frame the client's treatment, the major components of CBT for panic disorder with or without agoraphobia (PD/A) are reviewed. Likely reasons for the treatment's failure and strategies for improving…

  16. Internet Cognitive Behavioural Therapy for Panic Disorder: Does the Inclusion of Stress Management Information Improve End-State Functioning?

    ERIC Educational Resources Information Center

    Richards, Jeffrey C.; Klein, Britt; Austin, David W.

    2006-01-01

    Previous research has established Internet-based cognitive behavioural therapy (CBT) for panic disorder (PD) as effective in reducing panic severity and frequency. There is evidence, however, that such programs are less effective at improving overall end-state functioning, defined by a PD clinician severity rating of [less than or equal to] 2 and…

  17. Cognitive Behavioral Treatment of Panic Disorder and Agoraphobia in a Multiethnic Urban Outpatient Clinic: Initial Presentation and Treatment Outcome

    ERIC Educational Resources Information Center

    Friedman, Steven; Braunstein, Jeffrey W.; Halpern, Beth

    2006-01-01

    Few studies examine the effectiveness of panic control treatment across diverse ethnic groups. In this paper we present data on 40 patients (African American, n = 24; Caucasian, n = 16) with panic disorder and comorbid agoraphobia who presented at an anxiety disorder clinic in an inner-city area. On initial assessment both groups were similar on…

  18. Feeling Anxious: A Twin Study of Panic/Somatic Ratings, Anxiety Sensitivity and Heartbeat Perception in Children

    ERIC Educational Resources Information Center

    Eley, Thalia C.; Gregory, Alice M.; Clark, David M.; Ehlers, Anke

    2007-01-01

    Background: Little is known about mechanisms of genetic influence on panic, particularly in childhood. Cognitive theories of panic disorder highlight threatening interpretations of physical sensations, and increased awareness of such sensations. Specifically, anxiety sensitivity (AS) and heartbeat perception (HBP) have been associated with panic…

  19. Translating Empirically Supported Strategies into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder

    ERIC Educational Resources Information Center

    Smits, Jasper A. J.; Powers, Mark B.; Berry, Angela C.; Otto, Michael W.

    2007-01-01

    Many patients suffering from panic disorder do not receive adequate care. Advances in the conceptualization and treatment of panic disorder encourage innovative strategies for targeting core fears (fears of anxiety sensations) that underlie this disorder. In this article, we discuss the use of exercise as a potential strategy for therapeutic…

  20. Posttraumatic stress disorder in Manhattan, New York City, after the September 11th terrorist attacks.

    PubMed

    Galea, Sandro; Resnick, Heidi; Ahern, Jennifer; Gold, Joel; Bucuvalas, Michael; Kilpatrick, Dean; Stuber, Jennifer; Vlahov, David

    2002-09-01

    Estimates of acute mental health symptoms in the general population after disasters are scarce. We assessed the prevalence and correlates of acute posttraumatic stress disorder (PTSD) in residents of Manhattan 5-8 weeks after the terrorist attacks of September 11, 2001. We used random-digit dialing to contact a representative sample of adults living in Manhattan below 110th Street. Participants were interviewed about prior life events, personal characteristics, exposure to the events of September 11th, and psychological symptoms after the attack. Among 988 eligible adults, 19.3% reported symptoms consistent with PTSD at some point in their life, and 8.8% reported symptoms consistent with a diagnosis of current (within the past 30 days) PTSD. Overall, 57.8% of respondents reported at least one PTSD symptom in the past month. The most common past-month symptoms were intrusive memories (27.4%) and insomnia (24.5%). Predictors of current PTSD in a multivariable model were residence below Canal Street, low social support, life stressors 12 months prior to September 11th, perievent panic attack, losing possessions in the attacks, and involvement in the rescue efforts. These findings can help guide resource planning for future disasters in densely populated urban areas.

  1. Subjective and neurovegetative changes in healthy volunteers and panic patients performing simulated public speaking.

    PubMed

    Parente, Alexandre C B V; Garcia-Leal, Cybele; Del-Ben, Cristina M; Guimarães, Francisco S; Graeff, Frederico G

    2005-12-01

    Drug-free symptomatic panic patients, drug-treated nonsymptomatic patients and healthy controls were submitted to simulated public speaking. Subjective anxiety, cognitive impairment and discomfort measured by the visual analog mood scale as well as skin conductance level were higher in symptomatic patients than in controls at the beginning of the experimental session, nonsymptomatic patients lying in between. Subjective sedation, spontaneous fluctuations of skin conductance, heart rate and blood pressure were similar in the three groups. Preparation and performance of speech decreased sedation while increasing anxiety, cognitive impairment, level and fluctuations of skin conductance, heart rate and blood pressure. Anxiety, cognitive impairment and conductance level were less increased in symptomatic patients than in controls. Electrodermal activity, but not cardiovascular measures of sympathetic arousal correlated with anticipatory anxiety. Chronic treatment with serotonin uptake inhibitors attenuated the differences between panic patients and controls, supporting the participation of serotonin in panic disorder.

  2. What fMRI can tell as about panic disorder: bridging the gap between neurobiology and psychotherapy.

    PubMed

    Grambal, Aleš; Hluštík, Petr; Praško, Ján

    2015-01-01

    Fifty years ago, when the effect of antidepressants on panic disorder was described, a significant progress in understanding this anxiety disorder has been made. Theoretical mechanisms and models of fear and panic disorder were proposed and tested in animal models and humans. With growing possibilities of non-invasive neuroimaging techniques, there is an increasing amount of information on the panic disorder. Unfortunately, a number of circumstances lead to inconsistent findings and its interpretations. In our review, we focused on functional MRI in panic disorder, limitations of current studies, possible interpretations and proposals for future direction. In our opinion, the current findings support the neuroanatomical model of panic disorder at the level of group data analysis. But at the same time, the results suggest significant inter-individual differences across the patients, which may be related to each patient's individual history, woven into their neural network and affecting the individual symptoms and response to therapy.

  3. Serum biomarkers predictive of depressive episodes in panic disorder.

    PubMed

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome.

  4. Scenario Graphs and Attack Graphs

    DTIC Science & Technology

    2004-04-14

    46 6.1 Vulnerability Analysis of a Network . . . . . . . . . . . . . . . . . . . . . . . . . 53 6.2 Sandia Red Team Attack Graph...asymptotic bound. The test machine was a 1Ghz Pentium III with 1GB of RAM, running Red Hat Linux 7.3. Figure 4.1(a) plots running time of the implemen...host scanning tools network information vulnerability Attack Graph network Red

  5. Association of a polyadenylation polymorphism in the serotonin transporter and panic disorder

    PubMed Central

    Gyawali, Sandeep; Subaran, Ryan; Weissman, Myrna M.; Hershkowitz, Dylan; McKenna, Morgan C.; Talari, Ardesheer; Fyer, Abby J.; Wickramaratne, Priya; Adams, Phillip B.; Hodge, Susan E.; Schmidt, Carl J.; Bannon, Michael J.; Glatt, Charles E.

    2010-01-01

    Background Genetic markers in the serotonin transporter are associated with panic disorder. The associated polymorphisms do not include the serotonin transporter-linked polymorphic region and display no obvious functional attributes. A common polymorphism (rs3813034) occurs in one of the two reported polyadenylation signals for the serotonin transporter and is in linkage disequilibrium with the panic disorder-associated markers. If functional, rs3813034 may be the risk factor that explains the association of the serotonin transporter and panic disorder. Methods Quantitative PCR on human brain samples (n=65) and lymphoblast cultures (n=71) was used to test rs3813034 for effects on expression of the polyadenylation forms of the serotonin transporter. rs3813034 was also tested for association in a sample of panic disorder cases (n=307) and a control sample (n=542) that has similar population structure. Results The balance of the two polyadenylation forms of the serotonin transporter is associated with rs3813034 in brain (P<0.001) and lymphoblasts (P<0.001). The balance of the polyadenylation forms is also associated with gender in brain only (P<0.05). Association testing of rs3813034 in panic disorder identified a significant association (P=0.0068) with a relative risk of 1.56 and 1.81 for the heterozygous and homozygous variant genotypes respectively. Conclusions rs3813034 is a functional polymorphism in the serotonin transporter that alters the balance of the two polyadenylation forms of the serotonin transporter. rs3813034 is a putative risk factor for panic disorder and other behavioral disorders that involve dysregulation of serotonergic neurotransmission. PMID:19969287

  6. Gout attacks and lunar cycle.

    PubMed

    Mikulecký, M; Rovenský, J

    2000-07-01

    The aim was to search for periodical fluctuations in daily occurrence of gout attacks during the synodic lunar cycle. 126 gout attacks were recorded between 1972 and 1994 at known calendar dates. The synodic plexogram, displaying the number of attacks for each day of the cycle, was processed by cosinor regression. A pronounced cycling was found, with highest peaks under the new and full moon (syzygigies). Thus, the maximal occurrence of attacks coincides with the peaking lunisolar tidal effect. Similar relation of attacks to synodic moon was seen in bronchial asthma of children, and a reciprocal one in paroxysmal tachyarrhythmia. Differing pathogenetic backgrounds of these diseases substantiate the observed differences in their putative reactions on the changing cosmogeophysical environment.

  7. Can You Recognize a Heart Attack? Quiz

    MedlinePlus

    ... Heart Attack? Updated:Sep 16,2016 Begin the quiz Heart Attack • Home • About Heart Attacks Acute Coronary ... in Women “Can you recognize a heart attack?” Quiz • Understand Your Risks to Prevent a Heart Attack ...

  8. Computerized measurement of anticipated anxiety from eating increasing portions of food in adolescents with and without anorexia nervosa: Pilot studies.

    PubMed

    Kissileff, H R; Brunstrom, J M; Tesser, R; Bellace, D; Berthod, S; Thornton, J C; Halmi, K

    2016-02-01

    Dieting and excessive fear of eating coexist in vulnerable individuals, which may progress to anorexia nervosa [AN], but there is no objective measure of this fear. Therefore, we adapted a computer program that was previously developed to measure the satiating effects of foods in order to explore the potential of food to induce anxiety and fear of eating in adolescent girls. Twenty four adolescents (AN) and ten healthy controls without eating disorders rated pictures of different types of foods in varying sized portions as too large or too small and rated the expected anxiety of five different portions (20-320 kcal). Two low energy dense (potatoes and rice) and two high energy dense (pizza and M&Ms) foods were used. The regression coefficient of line lengths (0-100 mm) marked from "No anxiety" to "this would give me a panic attack", regressed from portions shown, was the measure of "expected anxiety" for a given food. The maximum tolerated portion size [kcal] (MTPS), computed by method of constant stimulus from portions shown, was significantly smaller for high energy dense foods, whereas the expected anxiety response was greater, for all foods, for patients compared to controls. For both groups, expected anxiety responses were steeper, and maximum tolerated portion sizes were larger, for low, than high, energy dense foods. Both maximum tolerated portion size and expected anxiety response were significantly predicted by severity of illness for the patients. Those who had larger maximum tolerated portion sizes had smaller anticipated anxiety to increasing portion sizes. Visual size had a greater influence than energy content for these responses. This method could be used to quantify the anxiety inducing potential of foods and for studies with neuro-imaging and phenotypic clarifications.

  9. WILD PIG ATTACKS ON HUMANS

    SciTech Connect

    Mayer, J.

    2013-04-12

    Attacks on humans by wild pigs (Sus scrofa) have been documented since ancient times. However, studies characterizing these incidents are lacking. In an effort to better understand this phenomenon, information was collected from 412 wild pig attacks on humans. Similar to studies of large predator attacks on humans, data came from a variety of sources. The various attacks compiled occurred in seven zoogeographic realms. Most attacks occurred within the species native range, and specifically in rural areas. The occurrence was highest during the winter months and daylight hours. Most happened under non-hunting circumstances and appeared to be unprovoked. Wounded animals were the chief cause of these attacks in hunting situations. The animals involved were typically solitary, male and large in size. The fate of the wild pigs involved in these attacks varied depending upon the circumstances, however, most escaped uninjured. Most human victims were adult males traveling on foot and alone. The most frequent outcome for these victims was physical contact/mauling. The severity of resulting injuries ranged from minor to fatal. Most of the mauled victims had injuries to only one part of their bodies, with legs/feet being the most frequent body part injured. Injuries were primarily in the form of lacerations and punctures. Fatalities were typically due to blood loss. In some cases, serious infections or toxemia resulted from the injuries. Other species (i.e., pets and livestock) were also accompanying some of the humans during these attacks. The fates of these animals varied from escaping uninjured to being killed. Frequency data on both non-hunting and hunting incidents of wild pig attacks on humans at the Savannah River Site, South Carolina, showed quantitatively that such incidents are rare.

  10. Allergens might trigger migraine attacks.

    PubMed

    Bektas, Hesna; Karabulut, Hayriye; Doganay, Beyza; Acar, Baran

    2017-03-01

    Migraine is a common primary headache disorder. The mechanisms underlying the onset of a migraine attack are not completely understood. Environmental changes and a number of other factors could induce migraine attacks. The aim of this study was to investigate the relationship between the frequency of migraine attacks and allergens. Migraine patients without aura, and healthy individuals similar in age and gender without a history of headache and allergy were prospectively included in the study. The duration of migraine, the frequency of migraine attacks, the medication history, and the symptoms during attacks were questioned. Migraine disability assessment score (MIDAS) and visual analog scale (VAS) scores were obtained. Allergen extracts including dust, fungi, insect, animal epithelium, pollens, and food allergens were applied for allergy tests. 49 migraine patients and 49 healthy individuals were enrolled in the study. There was no significant difference in terms of age and gender. The median migraine disease duration, the number of attacks in a month, and the duration of attacks were, respectively, 5.5 years (1-44), 4 (1-10) day/month, and 24 (4-72) h. The mean MIDAS grade was 2.45 ± 0.14 (1-4), and mean VAS score was 7.89 ± 0.27 (4-10). The positivity of allergy tests was 55.1 % (27/49) in the migraine group and 32.7 % (16/49) in the control group (p < 0.05). The allergy tests were positive for house dust, red birch, hazel tree, olive tree, nettle, and wheat. The frequency of migraine attacks was higher in allergy-test-positive patients than in negative ones in the migraine group (p = 0.001). The migraine patients who had frequent attacks should be examined for allergies.

  11. Screening for Generalized Anxiety Disorder Symptoms in the Wake of Terrorist Attacks: A Study in Primary Care

    PubMed Central

    Ghafoori, Bita; Neria, Yuval; Gameroff, Marc J.; Olfson, Mark; Lantigua, Rafael; Shea, Steven; Weissman, Myrna M.

    2013-01-01

    Little is known about the mental health impact of terrorism beyond posttraumatic stress disorder (PTSD) and depression. The associations between exposure to the September 11, 2001 (9/11) attacks in New York City and generalized anxiety disorder (GAD) symptoms were examined in a sample of 929 primary care patients. After controlling for PTSD, depression, panic and substance use disorders, and pre-9/11 trauma, patients who screened positive (vs. negative) for GAD symptoms were roughly twice as likely to report having a loved one at the 9/11 disaster site, twice as likely to know someone who was killed by the attacks, and twice as likely to know someone who was involved with the rescue/recovery efforts after the disaster. Implications for treatment and future research are discussed. PMID:19475656

  12. Adolescent development

    MedlinePlus

    Development - adolescent; Growth and development - adolescent ... During adolescence, children develop the ability to: Understand abstract ideas. These include grasping higher math concepts, and developing moral ...

  13. High Angle of Attack Aerodynamics

    DTIC Science & Technology

    1979-01-01

    HIGH ANGLE OF ATTACK IN A VERY LOW TURBULENCE LEVEL AIR STREAM by B.L.Hunt and P.C.Dexter 17 WIND AND WATER TUNNEL INVESTIGATIONS OF THE INTERACTION OF...FIGURE 1. TYPICAL FIGffTER FOREBODY LENGTHS It baa been convincingly shown in small-scale wind tunnel and water tunnel experiments that the apfro...attack taken during a water tunnel test. jn asymmetric vor~ox pattern io clearly ubewn. LOW ANGLE OF ATTACKC HIGH ANGLE OF ATTACK (SYMMETRIC

  14. Understand Your Risk of Heart Attack

    MedlinePlus

    ... Aneurysm More Understand Your Risks to Prevent a Heart Attack Updated:Sep 16,2016 Knowledge is power, so ... medication. This content was last reviewed June 2016. Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ...

  15. Lifestyle Changes for Heart Attack Prevention

    MedlinePlus

    ... from the NHLBI on Twitter. How Can a Heart Attack Be Prevented? Lowering your risk factors for coronary ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  16. Pentagastrin-induced hemoconcentration in healthy volunteers and patients with panic disorder: effect of pretreatment with ethinyl estradiol.

    PubMed

    Le Melledo, Jean Michel; Perez-Parada, Jorge; Morrow, Jarret; Bellavance, Francois; Lara, Nathalie; Jahandar, Farideh; Granger, Robert; Tait, Glendon; McManus, Karen

    2011-01-01

    Panic disorder has been associated with both an increased risk of coronary events as well as an increased risk of stroke. Hemoconcentration, with both a decrease in plasma volume and an increase in plasma viscosity, is a possible contributor to the risk of acute ischemic events. Our objectives were to demonstrate the process of hemoconcentration in response to induced panic symptoms and to assess the effect of pretreatment with ethinyl estradiol on panic-induced hemoconcentration. Fifteen male patients with panic disorder and 10 male healthy volunteers were included in a double-blind cross-over placebo-controlled design consisting of two injections of pentagastrin following randomized pretreatment with placebo and ethinyl estradiol. Plasma levels of hematocrit and hemoglobin were assessed at baseline and post-injections, and used to calculate an indirect estimation of the change in plasma volume. Pentagastrin-induced panic symptoms were associated with a mean decrease in plasma volume of 4.8% in the placebo pretreatment condition. Pretreatment with ethinyl estradiol attenuated this effect. The acute hemoconcentration observed in relation to pentagastrin-induced panic symptoms may be relevant to the increased risk of stroke and acute coronary events found in patients with panic disorder.

  17. Reproductive rights under attack.

    PubMed

    Mcdonald, K

    1995-01-01

    Women's groups, politicians, nongovernmental organizations, funding groups, and donor countries must all be lobbied with the message that sexual and reproductive health issues are inextricably linked to women in development, education, and future economic strength of nations worldwide. In the Beijing Nongovernmental Organization (NGO) Forum the draft Plan of Action had 35% of its language bracketed and subject to negotiation in Beijing. The previous International Conference on Population and Development (ICPD) in Cairo had only 15% of its language bracketed. Much of the language bracketed for Beijing had already been fully agreed upon before the Cairo conference. The bracketed language was in the health and human rights sections, and most of the language pertained to sexual and reproductive health. The increase in controversy is due to an opposition better organized in Beijing than it had been in Cairo, due to the opposition's failure to recognize the implications of the Cairo declarations on women, men, and children, and due to the opposition's general intolerance of sexual and reproductive issues. The major factor, however, was the linking of women's rights with sexual and reproductive health issues. Family planners joined with women's rights groups, which had always promoted women's control over their bodies as the cornerstone of equality. This connection was interpreted as a threat to the social order by conservative societies. NGO participants included 1400 people representing 170 countries. The NGO anti-abortion contingent was well-funded, well-organized, and large. Lobbying was conducted in an effort to convince people to oppose any language pertaining to gender, sexual and reproductive health, and adolescent rights. Anti-abortion lobbyists also rifled through documents of pro-choice participants. In Canada and the United States anti-abortion groups are lobbying hard to overturn the Cairo Plan of Action and to expand their efforts internationally among

  18. Cognitive-Behavioral Therapy for Comorbid Generalized Anxiety Disorder and Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Labrecque, Joane; Dugas, Michel J.; Marchand, Andre; Letarte, Andree

    2006-01-01

    The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with…

  19. Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

    The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were…

  20. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  1. Parental Bonds in Children at High and Low Familial Risk for Panic Disorder

    ERIC Educational Resources Information Center

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H.; Flament, Martine F.; Bradwejn, Jacques

    2013-01-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n =…

  2. Causes and Management of Treatment-Resistant Panic Disorder and Agoraphobia: A Survey of Expert Therapists

    ERIC Educational Resources Information Center

    Sanderson, William C.; Bruce, Timothy J.

    2007-01-01

    Cognitive behavior therapy (CBT) is recognized as an effective psychological treatment for panic disorder (PD). Despite its efficacy, some clients do not respond optimally to this treatment. Unfortunately, literatures on the prediction, prevention, and management of suboptimal response are not well developed. Considering this lack of empirical…

  3. Preliminary Evidence for Cognitive Mediation during Cognitive-Behavioral Therapy of Panic Disorder

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2007-01-01

    Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus…

  4. Sensation-Focused Intensive Treatment for Panic Disorder with Moderate to Severe Agoraphobia

    ERIC Educational Resources Information Center

    Morissette, Sandra Baker; Spiegel, David A.; Heinrichs, Nina

    2005-01-01

    The current article presents a detailed description of an intensive treatment program for panic disorder with moderate to severe levels of agoraphobia (PDA), called Sensation-Focused Intensive Treatment (SFIT). Although the efficacy of traditional CBT treatment programs has been well established for the treatment of PDA, patients with moderate to…

  5. Impact of Cognitive-Behavioral Treatment on Quality of Life in Panic Disorder Patients.

    ERIC Educational Resources Information Center

    Telch, Michael J.; And Others

    1995-01-01

    Patients (n=156) meeting criteria for panic disorder with agoraphobia were randomly assigned to group cognitive-behavioral treatment (CBT) or a delayed-treatment control. Compared with the control group, CBT-treated patients showed significant reductions in impairment that were maintained at follow-up. Anxiety and phobic avoidance were…

  6. Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

    ERIC Educational Resources Information Center

    Deacon, Brett

    2007-01-01

    Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…

  7. Catastrophic Misinterpretations as a Predictor of Symptom Change during Treatment for Panic Disorder

    ERIC Educational Resources Information Center

    Teachman, Bethany A.; Marker, Craig D.; Clerkin, Elise M.

    2010-01-01

    Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related…

  8. Face-Emotion Processing in Offspring at Risk for Panic Disorder.

    ERIC Educational Resources Information Center

    Pine, Daniel S.; Klein, Rachel G.; Mannuzza, Salvatore; Moulton, John L., III; Lissek, Shmuel; Guardino, Mary; Woldehawariat, Girma

    2005-01-01

    Objective: Panic disorder (PD) has been linked to perturbed processing of threats. This study tested the hypotheses that offspring of parents with PD and offspring with anxiety disorders display relatively greater sensitivity and attention allocation to fear provocation. Method: Offspring of adults with PD, major depressive disorder (MDD), or no…

  9. Touching Practice and Physical Education: Deconstruction of a Contemporary Moral Panic

    ERIC Educational Resources Information Center

    Fletcher, Simon

    2013-01-01

    This paper explores the insecurities and discursive moral panics elicited by the discussion of intergenerational touch in education, and their subsequent manifestation in "classroom panopticism". In a number of contexts, public hysteria has grown around the interaction between adult and child, and whether this interaction stays within…

  10. Respiratory and Cognitive Mediators of Treatment Change in Panic Disorder: Evidence for Intervention Specificity

    ERIC Educational Resources Information Center

    Meuret, Alicia E.; Rosenfield, David; Seidel, Anke; Bhaskara, Lavanya; Hofmann, Stefan G.

    2010-01-01

    Objective: There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this…

  11. After the Moral Panic? Reframing the Debate about Child Safety Online

    ERIC Educational Resources Information Center

    Facer, Keri

    2012-01-01

    This paper examines the initial "moral panic" surrounding children's access to the Internet at the end of the last century by analysing more than 900 media articles and key government documents from 1997 to 2001. It explores the ambiguous settlements that this produced in adult-child relations and children's access to the Internet. The…

  12. Genetic attack on neural cryptography

    SciTech Connect

    Ruttor, Andreas; Kinzel, Wolfgang; Naeh, Rivka; Kanter, Ido

    2006-03-15

    Different scaling properties for the complexity of bidirectional synchronization and unidirectional learning are essential for the security of neural cryptography. Incrementing the synaptic depth of the networks increases the synchronization time only polynomially, but the success of the geometric attack is reduced exponentially and it clearly fails in the limit of infinite synaptic depth. This method is improved by adding a genetic algorithm, which selects the fittest neural networks. The probability of a successful genetic attack is calculated for different model parameters using numerical simulations. The results show that scaling laws observed in the case of other attacks hold for the improved algorithm, too. The number of networks needed for an effective attack grows exponentially with increasing synaptic depth. In addition, finite-size effects caused by Hebbian and anti-Hebbian learning are analyzed. These learning rules converge to the random walk rule if the synaptic depth is small compared to the square root of the system size.

  13. Joint Direct Attack Munition (JDAM)

    DTIC Science & Technology

    2013-12-01

    2005 FEB 2005 Selective Availability Anti- Spoofing Module (SAASM)/ GPS Anti-Jam Production Award N/A MAR 2005 SEP 2005 MAR 2005 Change Explanations...Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-503 Joint Direct Attack Munition (JDAM) As of FY 2015 President’s Budget...2013 to 00-00-2013 4. TITLE AND SUBTITLE Joint Direct Attack Munition (JDAM) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  14. Implementation of an Intensive Treatment Protocol for Adolescents with Panic Disorder and Agoraphobia

    ERIC Educational Resources Information Center

    Angelosante, Aleta G.; Pincus, Donna B.; Whitton, Sarah W.; Cheron, Daniel; Pian, Jessica

    2009-01-01

    New and innovative ways of implementing cognitive-behavioral therapy (CBT) are required to address the varied needs of youth with anxiety disorders. Brief treatment formats may be useful in assisting teens to return to healthy functioning quickly and can make treatment more accessible for those who may not have local access to providers of CBT.…

  15. Panic disorder cases in Japanese-Brazilians in Japan: their ethnic and cultural confusion.

    PubMed

    Tsuji, K; Miyasaka, L S; Otsuka, K; Honda, G; Kato, S; Abe, Y

    2001-04-01

    The comparatively high salaries made in Japan are attractive to many Japanese-Brazilians. The number of individuals from this ethnic group being treated in Japanese mental hospitals has increased. We hypothesized that Japanese-Brazilian patients with panic disorders adjusted better to Japanese society and culture than those with other mental disorders. The subjects in the present study are 40 Japanese-Brazilian patients undergoing treatment at the Department of Psychiatry at Jichi Medical School, Japan, from May 1990 to September 1998. Patients were divided into a panic disorder group, a schizophrenic group, a mood disorder group and a neurosis group. Demographic data (Japanese language ability, duration of residence in Japan etc.) were collected. A comparison was made among the four groups. Patients in the panic disorder group showed a significant tendency to be fluent speakers of Japanese. Patients in the panic disorder group also had been in Japan for a significantly longer period of time than those in the other three groups. Japanese ability and length of residence in Japan rule out exacerbating factors due to a foreign living environment. Panic disorder patients usually have resolved the problems inherent in living and working in a foreign country. In general, Japanese-Brazilians are more comfortable both financially and socially in Japan than other foreign laborers because of their cultural and family background. The emotional conflict experienced by such patients may result from concern over whether to live in Brazil or Japan in the future. Their ethnic and cultural identity may be confused, fluctuating between identifying with Brazil and with Japan, and this may cause vague feelings of anxiety.

  16. Adolescent Images of Adolescence.

    ERIC Educational Resources Information Center

    Falchikov, Nancy

    1989-01-01

    Examined extent to which Scottish adolescents (N=40) were influenced by negative images of adolescence present in the culture, investigating self-images by means of Q sort. Eleven factors emerged from analysis, six of which met criterion that distinguishes common factors. Little evidence was found to suggest that adolescents were influenced by…

  17. Impact of the September 11th Terrorist Attacks on Teenagers' Mental Health

    ERIC Educational Resources Information Center

    Gould, Madelyn S.; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie; Lubell, Keri; Provenzano, Danielle

    2004-01-01

    The impact of the September 11th terrorist attacks on adolescents' mental health is reported. Two successive cohorts of students in 6 New York state high schools, identified from health courses, completed an in-school self-report baseline assessment of hopelessness, impairment, and help-seeking behavior. One year later, these students completed a…

  18. Analytical Characterization of Internet Security Attacks

    ERIC Educational Resources Information Center

    Sellke, Sarah H.

    2010-01-01

    Internet security attacks have drawn significant attention due to their enormously adverse impact. These attacks includes Malware (Viruses, Worms, Trojan Horse), Denial of Service, Packet Sniffer, and Password Attacks. There is an increasing need to provide adequate defense mechanisms against these attacks. My thesis proposal deals with analytical…

  19. Eyespots divert attacks by fish.

    PubMed

    Kjernsmo, Karin; Merilaita, Sami

    2013-09-07

    Eyespots (colour patterns consisting of concentric rings) are found in a wide range of animal taxa and are often assumed to have an anti-predator function. Previous experiments have found strong evidence for an intimidating effect of eyespots against passerine birds. Some eyespots have been suggested to increase prey survival by diverting attacks towards less vital body parts or a direction that would facilitate escape. While eyespots in aquatic environments are widespread, their function is extremely understudied. Therefore, we investigated the protective function of eyespots against attacking fish. We used artificial prey and predator-naive three-spined sticklebacks (Gasterosteus aculeatus) as predators to test both the diversion (deflection) and the intimidation hypothesis. Interestingly, our results showed that eyespots smaller than the fish' own eye very effectively draw the attacks of the fish towards them. Furthermore, our experiment also showed that this was not due to the conspicuousness of the eyespot, because attack latency did not differ between prey items with and without eyespots. We found little support for an intimidating effect by larger eyespots. Even though also other markings might misdirect attacks, we can conclude that the misdirecting function may have played an important role in the evolution of eyespots in aquatic environments.

  20. Eyespots divert attacks by fish

    PubMed Central

    Kjernsmo, Karin; Merilaita, Sami

    2013-01-01

    Eyespots (colour patterns consisting of concentric rings) are found in a wide range of animal taxa and are often assumed to have an anti-predator function. Previous experiments have found strong evidence for an intimidating effect of eyespots against passerine birds. Some eyespots have been suggested to increase prey survival by diverting attacks towards less vital body parts or a direction that would facilitate escape. While eyespots in aquatic environments are widespread, their function is extremely understudied. Therefore, we investigated the protective function of eyespots against attacking fish. We used artificial prey and predator-naive three-spined sticklebacks (Gasterosteus aculeatus) as predators to test both the diversion (deflection) and the intimidation hypothesis. Interestingly, our results showed that eyespots smaller than the fish’ own eye very effectively draw the attacks of the fish towards them. Furthermore, our experiment also showed that this was not due to the conspicuousness of the eyespot, because attack latency did not differ between prey items with and without eyespots. We found little support for an intimidating effect by larger eyespots. Even though also other markings might misdirect attacks, we can conclude that the misdirecting function may have played an important role in the evolution of eyespots in aquatic environments. PMID:23864602

  1. Retrospective reports of parenting in depressed adults with and without comorbid panic disorder and social anxiety disorder.

    PubMed

    Torpey, Dana C; Olino, Thomas M; Klein, Daniel N

    2007-09-01

    Previous research has examined the role of parenting in the development of depression and anxiety disorders using retrospective reports of parenting behaviors. However, most studies have not considered comorbidity; the few that have did not differentially examine individual anxiety disorders and yielded inconsistent results. The present study compared retrospective parenting reports given by depressed individuals with no comorbid anxiety disorder, comorbid panic disorder, and comorbid social anxiety disorder. Results indicated that depressed men with panic disorder reported significantly greater maternal and nonsignificantly greater paternal protectiveness than depressed men without panic disorder but not than depressed women with and without panic disorder. No differences were found for the retrospective parenting reports given by depressed participants with or without social anxiety disorder. This work highlights the importance of examining specific anxiety disorders rather than grouping all depressed patients with any anxiety disorder together, as well as examining males and females separately when investigating the influence of parental behavior.

  2. A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders.

    PubMed

    Gratacòs, M; Nadal, M; Martín-Santos, R; Pujana, M A; Gago, J; Peral, B; Armengol, L; Ponsa, I; Miró, R; Bulbena, A; Estivill, X

    2001-08-10

    Anxiety disorders are complex and common psychiatric illnesses associated with considerable morbidity and social cost. We have studied the molecular basis of the cooccurrence of panic and phobic disorders with joint laxity. We have identified an interstitial duplication of human chromosome 15q24-26 (named DUP25), which is significantly associated with panic/agoraphobia/social phobia/joint laxity in families, and with panic disorder in nonfamilial cases. Mosaicism, different forms of DUP25 within the same family, and absence of segregation of 15q24-26 markers with DUP25 and the psychiatric phenotypes suggest a non-Mendelian mechanism of disease-causing mutation. We propose that DUP25, which is present in 7% control subjects, is a susceptibility factor for a clinical phenotype that includes panic and phobic disorders and joint laxity.

  3. Censorship: Heading Off the Attack.

    ERIC Educational Resources Information Center

    Donelson, Ken

    1987-01-01

    The author discusses censorship in the field of adolescent literature. He gives a brief history of censorship and discusses why it is increasing. He suggests how practitioners can counter censorship and how to deal with protesters. (CH)

  4. Signs of an asthma attack

    MedlinePlus

    ... call 911 if your child has any of these symptoms. This includes teachers, babysitters, and others who take care of your ... Durrani SR, Busse WW. Management of asthma in adolescents and adults. In: Adkinson ...

  5. Hyperventilation in Panic Disorder and Asthma: Empirical Evidence and Clinical Strategies

    PubMed Central

    Meuret, Alicia E.; Ritz, Thomas

    2010-01-01

    Sustained or spontaneous hyperventilation has been associated with a variety of physical symptoms and has been linked to a number of organic illnesses and mental disorders. Theories of panic disorder hold that hyperventilation either produces feared symptoms of hypocapnia or protects against feared suffocation symptoms of hypercapnia. Although the evidence for both theories is inconclusive, findings from observational, experimental, and therapeutic studies suggest an important role of low carbon dioxide (CO2) levels in this disorder. Similarly, hypocapnia and associated hyperpnia are linked to bronchoconstriction, symptom exacerbation, and lower quality of life in patients with asthma. Raising CO2 levels by means of therapeutic capnometry has proven beneficial effects in both disorders, and the reversing of hyperventilation has emerged as a potent mediator for reductions in panic symptom severity and treatment success. PMID:20685222

  6. An experimental study of the "faster-is-slower" effect using mice under panic

    NASA Astrophysics Data System (ADS)

    Lin, Peng; Ma, Jian; Liu, Tianyang; Ran, Tong; Si, Youliang; Li, Tao

    2016-06-01

    A number of crowd accidents in last decades have attracted the interests of scientists in the study of self-organized behavior of crowd under extreme conditions. The faster-is-slower effect is one of the most referenced behaviors in pedestrian dynamics. However, this behavior has not been experimentally verified yet. A series of experiments with mice under panic were conducted in a bi-dimensional space. The mice were trained to be familiar with the way of escape. A varying number of joss sticks were used to produce different levels of stimulus to drive the mice to escape. The evacuation process was video-recorded for further analysis. The experiment found that the escape times significantly increased with the levels of stimulus due to the stronger competition of selfish mice in panic condition. The faster-is-slower effect was experimentally verified. The probability distributions of time intervals showed a power law and the burst sizes exhibited an exponential behavior.

  7. The brain decade in debate: II. Panic or anxiety? From animal models to a neurobiological basis.

    PubMed

    Andreatini, R; Blanchard, C; Blanchard, R; Brandão, M L; Carobrez, A P; Griebel, G; Guimarães, F S; Handley, S L; Jenck, F; Leite, J R; Rodgers, J; Schenberg, L C; Da Cunha, C; Graeff, F G

    2001-02-01

    This article is a transcription of an electronic symposium sponsored by the Brazilian Society of Neuroscience and Behavior (SBNeC). Invited researchers from the European Union, North America and Brazil discussed two issues on anxiety, namely whether panic is a very intense anxiety or something else, and what aspects of clinical anxiety are reproduced by animal models. Concerning the first issue, most participants agreed that generalized anxiety and panic disorder are different on the basis of clinical manifestations, drug response and animal models. Also, underlying brain structures, neurotransmitter modulation and hormonal changes seem to involve important differences. It is also common knowledge that existing animal models generate different types of fear/anxiety. A challenge for future research is to establish a good correlation between animal models and nosological classification.

  8. Is early separation anxiety a specific precursor of panic disorder-agoraphobia? A community study.

    PubMed

    Silove, D; Harris, M; Morgan, A; Boyce, P; Manicavasagar, V; Hadzi-Pavlovic, D; Wilhelm, K

    1995-03-01

    The present study aimed to examine memories of early separation anxiety symptoms in a community sample of women at heightened risk to neurotic disorder. The chief finding was that subjects with a lifetime history of panic disorder-agoraphobia (PD-Ag) returned statistically higher scores on a retrospective measure of early separation anxiety compared to subjects with either generalized anxiety or other phobic disorders, a result which was not accounted for by differences in neuroticism or General Health Questionnaire scores. Although limited by its retrospective design and the problem of co-morbidity in subclassifying the anxiety disorders, the present study does provide added support for the hypothesis--endorsed by DSM-III-R--that there is a developmental link between early separation anxiety and panic disorder.

  9. Treatment of internet addiction in patient with panic disorder and obsessive compulsive disorder: a case report.

    PubMed

    Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear

    2015-01-01

    Problematic Internet use is a worldwide social issue and it can be found in any age, social, educational, or economic range. In some countries like China and South Korea internet addiction (IA) is considered a public health condition and this governments support research, education and treatment. Internet addiction has been associated with others psychiatric disorders. Panic disorder (PD) and Obsessive Compulsive Disorder (OCD) are anxiety disorders that involve a lot of damages in patient's life. We report a treatment of a patient with Panic Disorder and Obsessive Compulsive Disorder and internet addition involving pharmacotherapy and Cognitive Behavioral Therapy (CBT). The Cognitive Behavioral Therapy was conducted 1 time per week during 10 weeks and results suggest that the treatment was an effective treatment for the anxiety and for the internet addiction.

  10. Evaluation of Word Attack Skills.

    ERIC Educational Resources Information Center

    Follettie, Joseph F.

    A framework for more apt and sensitive evaluation of generalized word attack skill--the heart of oral reading skill--is presented. The paper envisions the design and development of oral reading instruction as bounded by a fully-specified evaluation scheme. (Author)

  11. Mitigating Higher Ed Cyber Attacks

    ERIC Educational Resources Information Center

    Rogers, Gary; Ashford, Tina

    2015-01-01

    In this presentation we will discuss the many and varied cyber attacks that have recently occurred in the higher ed community. We will discuss the perpetrators, the victims, the impact and how these institutions have evolved to meet this threat. Mitigation techniques and defense strategies will be covered as will a discussion of effective security…

  12. Sex Differences in Internalizing Problems During Adolescence in Autism Spectrum Disorder.

    PubMed

    Oswald, Tasha M; Winter-Messiers, Mary Ann; Gibson, Brandon; Schmidt, Alexandra M; Herr, Cynthia M; Solomon, Marjorie

    2016-02-01

    We hypothesized that the double hit conferred by sex and diagnosis increases the risk for internalizing disorders in adolescent females with autism spectrum disorder (ASD). In a sample of 32 adolescents with ASD and 32 controls, we examined the effects of sex, diagnostic factors, and developmental stages on depression and anxiety. A 3-way interaction revealed that females with ASD exhibited greater depressive symptoms than males with ASD and female controls particularly during early adolescence; therefore, females with ASD might have a unique combination of genetic, hormonal, and psychosocial vulnerabilities that heighten their risk for depression during early adolescence. Additionally, the ASD group reported high levels of separation anxiety and panic in late adolescence, possibly indicating atypical development of independence.

  13. A new paradigm (Westphal-Paradigm) to study the neural correlates of panic disorder with agoraphobia.

    PubMed

    Wittmann, A; Schlagenhauf, F; John, T; Guhn, A; Rehbein, H; Siegmund, A; Stoy, M; Held, D; Schulz, I; Fehm, L; Fydrich, T; Heinz, A; Bruhn, H; Ströhle, A

    2011-04-01

    Agoraphobia (with and without panic disorder) is a highly prevalent and disabling anxiety disorder. Its neural complexity can be characterized by specific cues in fMRI studies. Therefore, we developed a fMRI paradigm with agoraphobia-specific stimuli. Pictures of potential agoraphobic situations were generated. Twenty-six patients, suffering from panic disorder and agoraphobia, and 22 healthy controls rated the pictures with respect to arousal, valence, and agoraphobia-related anxiety. The 96 pictures, which discriminated best between groups were chosen, split into two parallel sets and supplemented with matched neutral pictures from the International Affective Picture System. Reliability, criterion, and construct validity of the picture set were determined in a second sample (44 patients, 28 controls). The resulting event-related "Westphal-Paradigm" with cued and uncued pictures was tested in a fMRI pilot study with 16 patients. Internal consistency of the sets was very high; parallelism was given. Positive correlations of picture ratings with Mobility Inventory and Hamilton anxiety scores support construct validity. FMRI data revealed activations in areas associated with the fear circuit including amygdala, insula, and hippocampal areas. Psychometric properties of the Westphal-Paradigm meet necessary quality requirements for further scientific use. The paradigm reliably produces behavioral and fMRI patterns in response to agoraphobia-specific stimuli. To our knowledge, it is the first fMRI paradigm with these properties. This paradigm can be used to further characterize the functional neuroanatomy of panic disorder and agoraphobia and might be useful to contribute data to the differentiation of panic disorder and agoraphobia as related, but conceptually different clinical disorders.

  14. A Novel Animal Model for Panic Disorder: Attempted Reproduction of the Fear of Fear

    DTIC Science & Technology

    1999-11-04

    stimulation on the social interaction of rats. Social interaction is thought to be a measure of anxiety in rats, wi th decreased social interaction ...reflecting anxiety and increased social interaction representing an anxiolytic effect (Fi le , 1980). The effect of bicuculline at baseline and...following treatment with two anti -panic agents (imipramine and c1onazepam) was assessed. Sicuculline decreased social activity in the social interaction

  15. PANIC (PtSi Astronomical Near-Infrared Camera) in South Africa and its astronomical applications

    NASA Astrophysics Data System (ADS)

    Tanabe, Toshihiko; Nishida, Shinji; Nakada, Yoshikazu; Matsumoto, Shigeru; Onaka, Takashi; Sekiguchi, Kazuhiro; Ono, Tomoko; Glass, Ian S.; Carter, David B.

    1996-06-01

    A large-format PtSi array (effectively 1040 by 520 pixels) has been incorporated into an astronomical infrared camera (named PANIC: PtSi astronomical near-infrared camera) intended for wide-field survey work using the 0.75-m telescope at Sutherland and the 0.4-m one at Capetown. Here we briefly describe our camera and its astronomical applications.

  16. Comparison of the DSM-5 and ICD-10: panic and other anxiety disorders.

    PubMed

    Bandelow, Borwin

    2017-02-08

    Anxiety disorders are the most prevalent mental disorders and are associated with substantial healthcare costs and a high burden of disease. In this article, changes in the new Diagnostic and Statistical Manual for Mental Disorders (the DSM-5) with respect to panic disorder/agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and selective mutism are compared with the International Classification of Diseases (ICD-10) system.

  17. Terrorism and Resilience: Adolescents' and Teachers' Responses to September 11, 2001

    ERIC Educational Resources Information Center

    Noppe, Illene C.; Noppe, Lloyd D.; Bartell, Denise

    2006-01-01

    This study examined the impact of terrorism on adolescents, who may be resolving developmental issues regarding their vulnerability to death. Approximately 4 months after the September 11th attacks, a survey was given to 973 Upper Midwest adolescents and teachers. Quantitative analyses indicated that adolescents (especially girls) were frightened…

  18. Reactivity to 35% carbon dioxide in bulimia nervosa and panic disorder.

    PubMed

    Woznica, Andrea; Vickers, Kristin; Koerner, Naomi; Fracalanza, Katie

    2015-08-30

    The inhalation of 35% carbon dioxide (CO₂) induces panic and anxiety in people with panic disorder (PD) and in people with various other psychiatric disorders. The anxiogenic effect of CO₂ in people with eating disorders has received sparse attention despite the fact that PD and bulimia nervosa (BN) have several common psychological and neurobiological features. This study compared CO₂-reactivity across three groups of participants: females with BN, females with PD, and female controls without known risk factors for enhanced CO₂-reactivity (e.g., social anxiety disorder, first degree relatives with PD). Reactivity was measured by self-reported ratings of panic symptomatology and subjective anxiety, analyzed as both continuous variables (change from room-air to CO₂) and dichotomous variables (positive versus negative responses to CO₂). Analyses of each outcome measure demonstrated that CO₂-reactivity was similar across the BN and PD groups, and reactivity within each of these two groups was significantly stronger than that in the control group. This is the first study to demonstrate CO₂-hyperreactivity in individuals with BN, supporting the hypothesis that reactivity to this biological paradigm is not specific to PD. Further research would benefit from examining transdiagnostic mechanisms in CO₂-hyperreactivity, such as anxiety sensitivity, which may account for this study's results.

  19. Feedback of End-tidal pCO2 as a Therapeutic Approach for Panic Disorder

    PubMed Central

    Meuret, Alicia E.; Wilhelm, Frank H.; Ritz, Thomas; Roth, Walton T.

    2009-01-01

    Background Given growing evidence that respiratory dysregulation is a central feature of panic disorder (PD) interventions for panic that specifically target respiratory functions could prove clinically useful and scientifically informative. We tested the effectiveness of a new, brief, capnometry-assisted breathing therapy (BRT) on clinical and respiratory measures in PD. Methods Thirty-seven participants with PD with or without agoraphobia were randomly assigned to BRT or to a delayed-treatment control group. Clinical status, respiration rate, and end-tidal pCO2 were assessed at baseline, posttreatment, 2-month and 12-month follow-up. Respiratory measures were also assessed during homework exercises using a portable capnometer as a feedback device. Results Significant improvements (in PD severity, agoraphobic avoidance, anxiety sensitivity, disability, and respiratory measures) were seen in treated but not untreated patients, with moderate to large effect sizes. Improvements were maintained at follow-up. Treatment compliance was high for session attendance and homework exercises; dropouts were few. Conclusions The data provide preliminary evidence that raising end-tidal pCO2 by means of capnometry feedback is therapeutically beneficial for panic patients. Replication and extension will be needed to verify this new treatment’s efficacy and determine its mechanisms. PMID:17681544

  20. The Neuroanatomical Basis of Panic Disorder and Social Phobia in Schizophrenia: A Voxel Based Morphometric Study

    PubMed Central

    Picado, Marisol; Carmona, Susanna; Hoekzema, Elseline; Pailhez, Guillem; Bergé, Daniel; Mané, Anna; Fauquet, Jordi; Hilferty, Joseph; Moreno, Ana; Cortizo, Romina; Vilarroya, Oscar; Bulbena, Antoni

    2015-01-01

    Objective It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions. PMID:25774979

  1. An integrated cognitive model of panic disorder: the role of positive and negative cognitions.

    PubMed

    Casey, Leanne M; Oei, Tian P S; Newcombe, Peter A

    2004-09-01

    One reason for the neglect of the role of positive factors in cognitive-behavioural therapy (CBT) may relate to a failure to develop cognitive models that integrate positive and negative cognitions. Bandura [Psychol. Rev. 84 (1977) 191; Anxiety Res. 1 (1988) 77] proposed that self-efficacy beliefs mediate a range of emotional and behavioural outcomes. However, in panic disorder, cognitively based research to date has largely focused on catastrophic misinterpretation of bodily sensations. Although a number of studies support each of the predictions associated with the account of panic disorder that is based on the role of negative cognitions, a review of the literature indicated that a cognitively based explanation of the disorder may be considerably strengthened by inclusion of positive cognitions that emphasize control or coping. Evidence to support an Integrated Cognitive Model (ICM) of panic disorder was examined and the theoretical implications of this model were discussed in terms of both schema change and compensatory skills accounts of change processes in CBT.

  2. Panic disorder in African-Americans: symptomatology and isolated sleep paralysis.

    PubMed

    Friedman, Steven; Paradis, Cheryl

    2002-06-01

    While attention has been paid to the study of panic disorder (PD) with or without agoraphobia among Caucasians, surprisingly little empirical research within the United States has looked at the phenomenology of PD among minority groups. In this paper we present data we have collected and review other research on the phenomenology, social supports, and coping behavior among African-Americans with panic disorder. Our studies indicate that, in comparison to Caucasians, African-Americans with PD reported more intense fears of dying or going crazy, as well as higher levels of numbing and tingling in their extremities. African-Americans reported higher rates of comorbid post traumatic disorder and more depression. African-Americans also used somewhat different coping strategies (such as religiosity and counting one's blessings), less self-blame, and were somewhat more dissatisfied with social supports. The incidence of isolated sleep paralysis was, as per previous reports, higher in African-Americans. These findings, results of other research, and the implications for assessment and treatment are discussed within a semantic network analysis of panic (Hinton and Hinton 2002, this issue).

  3. Childhood history of anxiety in adults with panic disorder: association with anxiety sensitivity and comorbidity.

    PubMed

    Otto, M W; Pollack, M H; Rosenbaum, J F; Sachs, G S; Asher, R H

    1994-01-01

    Converging lines of evidence indicate a nonspecific link between childhood anxiety disorders and adult panic disorder. Anxiety sensitivity, defined as the fear of anxiety symptoms, was hypothesized to be a potential mediating variable in this link. This study examined the association among childhood history of anxiety disorders, current anxiety symptoms, and anxiety sensitivity in a sample of 100 patients with panic disorder undergoing treatment. Fifty-five percent of the patients had histories of one or more childhood anxiety disorders. Despite the heterogeneity of symptoms and treatment interventions among these patients, a childhood history of anxiety was associated with comorbid anxiety conditions, agoraphobic avoidance, and anxiety sensitivity scores. Anxiety sensitivity was itself a significant predictor of current severity of illness, but a childhood history of anxiety was not. These findings are consistent with the hypothesis that having an anxiety disorder during childhood is linked with patterns of anxiety and phobic avoidance in adulthood, including the level of anxiety sensitivity in patients with panic disorder.

  4. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder.

    PubMed

    Ströhle, Andreas; Stoy, Meline; Graetz, Barbara; Scheel, Michael; Wittmann, André; Gallinat, Jürgen; Lang, Undine E; Dimeo, Fernando; Hellweg, Rainer

    2010-04-01

    The neurotrophin brain-derived neurotrophic factor (BDNF) has been implicated in depression and anxiety. Antidepressants and exercise increase BDNF expression, and both have an antidepressant and anxiolytic activity. To further characterize the association of anxiety, BDNF and exercise, we studied panic disorder patients (n=12) and individually matched healthy control subjects (n=12) in a standardized exercise paradigm. Serum samples for BDNF analyses were taken before and after 30min of exercise (70 VO(2max)) or quiet rest. The two conditions were separated by 1 week and the order was randomized. Non-parametric statistical analyses were performed. There was a negative correlation of BDNF concentrations and subjective arousal at baseline (r=-0.42, p=0.006). Compared to healthy control subjects, patients with panic disorder had significantly reduced BDNF concentrations at baseline and 30min of exercise significantly increased BDNF concentrations only in these patients. Our results suggest that acute exercise ameliorates reduced BDNF concentrations in panic disorder patients and raise the question whether this is also found after long-term exercise training and if it is related to the therapeutic outcome.

  5. Virtual reality assisted cognitive behavioral therapy for the treatment of Panic Disorders with Agoraphobia.

    PubMed

    Vincelli, F; Choi, H; Molinari, E; Wiederhold, B K; Bouchard, S; Riva, G

    2002-01-01

    The chapter describes the characteristics of the Experiential-Cognitive Therapy (ECT) protocol for Panic Disorder and Agoraphobia. The goal of ECT is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms. This is possible in an average of eight sessions of treatment plus an assessment phase and booster sessions, through the integration of Virtual Experience and traditional cognitive-behavioral techniques. We decided to employ the techniques included in the cognitive-behavioral approach because they showed high levels of efficacy. Through virtual environments we can gradually expose the patient to feared situation: virtual reality consent to re-create in our clinical office a real experiential world. The patient faces the feared stimuli in a context that is nearer to reality than imagination. For ECT we developed the Virtual Environments for Panic Disorders--VEPD--virtual reality system. VEPD is a 4-zone virtual environment developed using the Superscape VRT 5.6 toolkit. The four zones reproduce different potentially fearful situations--an elevator, a supermarket, a subway ride, and large square. In each zone the characteristics of the anxiety-related experience are defined by the therapist through a setup menu.

  6. Attack Vulnerability of Network Controllability

    PubMed Central

    2016-01-01

    Controllability of complex networks has attracted much attention, and understanding the robustness of network controllability against potential attacks and failures is of practical significance. In this paper, we systematically investigate the attack vulnerability of network controllability for the canonical model networks as well as the real-world networks subject to attacks on nodes and edges. The attack strategies are selected based on degree and betweenness centralities calculated for either the initial network or the current network during the removal, among which random failure is as a comparison. It is found that the node-based strategies are often more harmful to the network controllability than the edge-based ones, and so are the recalculated strategies than their counterparts. The Barabási-Albert scale-free model, which has a highly biased structure, proves to be the most vulnerable of the tested model networks. In contrast, the Erdős-Rényi random model, which lacks structural bias, exhibits much better robustness to both node-based and edge-based attacks. We also survey the control robustness of 25 real-world networks, and the numerical results show that most real networks are control robust to random node failures, which has not been observed in the model networks. And the recalculated betweenness-based strategy is the most efficient way to harm the controllability of real-world networks. Besides, we find that the edge degree is not a good quantity to measure the importance of an edge in terms of network controllability. PMID:27588941

  7. Crony Attack: Strategic Attack’s Silver Bullet

    DTIC Science & Technology

    2006-11-01

    by distributing a large amount of private goods to the selectorate—the cronies—can be termed kleptocracies . Many govern- ments do indeed resemble...where the high-private goods kleptocracy is a good model. Furthermore, while not an example of crony attack to affect policy change (as opposed to...information about those nearest to the leader. The relationships part is only the start. Kleptocracies , like orga- nized crime leaders, are clever

  8. The effect of asymmetric attack on trim angle of attack

    NASA Technical Reports Server (NTRS)

    Kruse, R. L.

    1983-01-01

    Ballistic range tests were conducted to determine the effect of an asymmetrically ablated heat shield on the trim angle of attack of an entry vehicle. The tests, which were in support of Project Galileo, were conducted in atmospheric air at Mach numbers from 0.7 to 2.0. For the results for the configuration that was tested, the deduced trim angle varied between 13 deg and 21 deg.

  9. Plasma anti-serotonin and serotonin anti-idiotypic antibodies are elevated in panic disorder.

    PubMed

    Coplan, J D; Tamir, H; Calaprice, D; DeJesus, M; de la Nuez, M; Pine, D; Papp, L A; Klein, D F; Gorman, J M

    1999-04-01

    The psychoneuroimmunology of panic disorder is relatively unexplored. Alterations within brain stress systems that secondarily influence the immune system have been documented. A recent report indicated elevations of serotonin (5-HT) and ganglioside antibodies in patients with primary fibromyalgia, a condition with documented associations with panic disorder. In line with our interest in dysregulated 5-HT systems in panic disorder (PD), we wished to assess if antibodies directed at the 5-HT system were elevated in patients with PD in comparison to healthy volunteers. Sixty-three patients with panic disorder and 26 healthy volunteers were diagnosed by the SCID. Employing ELISA, we measured anti-5-HT and 5-HT anti-idiotypic antibodies (which are directed at 5-HT receptors). To include all subjects in one experiment, three different batches were run during the ELISA. Plasma serotonin anti-idiotypic antibodies: there was a significant group effect [patients > controls (p = .007)] and batch effect but no interaction. The mean effect size for the three batches was .76. Following Z-score transformation of each separate batch and then combining all scores, patients demonstrated significantly elevated levels of plasma serotonin anti-idiotypic antibodies. Neither sex nor age as covariates affected the significance of the results. There was a strong correlation between anti-serotonin antibody and serotonin anti-idiotypic antibody measures. Plasma anti-serotonin antibodies: there was a significant diagnosis effect [patients > controls (p = .037)]. Mean effect size for the three batches was .52. Upon Z-score transformation, there was a diagnosis effect with antibody elevations in patients. Covaried for sex and age, the result falls below significance to trend levels. The data raise the possibility that psychoimmune dysfunction, specifically related to the 5-HT system, may be present in PD. Potential interruption of 5-HT neurotransmission through autoimmune mechanisms may be of

  10. Psychiatric comorbidity in adolescent electronic and conventional cigarette use.

    PubMed

    Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet

    2016-02-01

    The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use.

  11. Zika Attacks Nerves, Muscles, Other Tissues

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_164010.html Zika Attacks Nerves, Muscles, Other Tissues Monkey study may ... 2017 (HealthDay News) -- Scientists have learned where the Zika virus attacks the body in monkeys. In their ...

  12. Beware Heart Attack Risk from Shoveling Snow

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_163566.html Beware Heart Attack Risk From Shoveling Snow Canadian study finds cases ... why men are more likely to suffer a heart attack after a heavy snowfall, researchers report. In a ...

  13. Being active after a heart attack (image)

    MedlinePlus

    ... best activity when you start exercising after a heart attack. Start slowly, and increase the amount of time ... best activity when you start exercising after a heart attack. Start slowly, and increase the amount of time ...

  14. Network Attack Reference Data Set

    DTIC Science & Technology

    2004-12-01

    services they offer. When the attacker attempts to access system services in order to determine which are available, the scan is called a “ portscan ”. Network...Scans The following portscans were crafted using simPortScan.cc (Appendix B.2). Filename: scan V TCP fast seq small.tcp Source: Crafted...Stealthy Portscans . Journal of Computer Security, 10, 105–136. 6. Yegneswaran, V., Barford, P., and Ullrich, J. (2003). Internet Intrusions: Global

  15. Biomechanics of knife stab attacks.

    PubMed

    Chadwick, E K; Nicol, A C; Lane, J V; Gray, T G

    1999-10-25

    Equipment, materials and methods for the measurement of the biomechanical parameters governing knife stab attacks have been developed and data have been presented that are relevant to the improvement of standards for the testing of stab-resistant materials. A six-camera Vicon motion analysis system was used to measure velocity, and derive energy and momentum during the approach phase of the attack and a specially developed force-measuring knife was used to measure three-dimensional forces and torque during the impact phase. The body segments associated with the knife were modelled as a series of rigid segments: trunk, upper arm, forearm and hand. The velocities of these segments, together with knowledge of the mass distribution from biomechanical tables, allowed the calculation of the individual segment energy and momentum values. The instrumented knife measured four components of load: axial force (along the length of the blade), cutting force (parallel to the breadth of the blade), lateral force (across the blade) and torque (twisting action) using foil strain gauges. Twenty volunteers were asked to stab a target with near maximal effort. Three styles of stab were used: a short thrust forward, a horizontal style sweep around the body and an overhand stab. These styles were chosen based on reported incidents, providing more realistic data than had previously existed. The 95th percentile values for axial force and energy were 1885 N and 69 J, respectively. The ability of current test methods to reproduce the mechanical parameters measured in human stab attacks has been assessed. It was found that current test methods could reproduce the range of energy and force values measured in the human stab attacks, although the simulation was not accurate in some respects. Non-axial force and torque values were also found to be significant in the human tests, but these are not reproduced in the standard mechanical tests.

  16. Anxiety Distorders: Types, Diagnosis and Treatment | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Sometimes symptoms may last longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or ... also have a strong physical reaction during a panic attack. It may feel like having a heart attack. ...

  17. Terror attacks influence driving behavior in Israel

    PubMed Central

    Stecklov, Guy; Goldstein, Joshua R.

    2004-01-01

    Terror attacks in Israel produce a temporary lull in light accidents followed by a 35% spike in fatal accidents on Israeli roads 3 days after the attack. Our results are based on time-series analysis of Israeli traffic flows, accidents, and terror attacks from January 2001 through June 2002. Whereas prior studies have focused on subjective reports of posttraumatic stress, our study shows a population-level behavioral response to violent terror attacks. PMID:15448203

  18. Flashbulb memories of Paris attacks

    PubMed Central

    El Haj, Mohamad; Gandolphe, Marie-Charlotte; Wawrziczny, Emilie; Antoine, Pascal

    2016-01-01

    Abstract Rationale: Flashbulb memories are detailed and vivid memories of attributes of the reception context of surprising and emotionally arousing public events. Patient concerns and diagnosis: This paper offers a fine-grained view of flashbulb memories in a patient with mild Alzheimer's disease (AD). Interventions: The patient underwent a directed interview about the 13 November 2015 attacks in Paris. Outcomes: Unlike her memory about the date and month of the attacks, the patient provided accurate information about the year, time and places they occurred. The patient also provided accurate information about how she first became aware of the attacks, where she was, with whom, what she was doing, and what time it was when she learned about them. As for the affective characteristics of these memories, she tended to have high ratings of vividness and rehearsal. Negative emotional states and great surprise and novelty were also reported. Lessons: By assessing the impact of flashbulb memories in this patient with AD, this paper offers a unique view into how such memories may trigger a considerable recall of context as well much subjective reliving. PMID:27861395

  19. The Reverse Statistical Disclosure Attack

    NASA Astrophysics Data System (ADS)

    Mallesh, Nayantara; Wright, Matthew

    Statistical disclosure is a well-studied technique that an attacker can use to uncover relations between users in mix-based anonymity systems. Prior work has focused on finding the receivers to whom a given targeted user sends. In this paper, we investigate the effectiveness of statistical disclosure in finding all of a users' contacts, including those from whom she receives messages. To this end, we propose a new attack called the Reverse Statistical Disclosure Attack (RSDA). RSDA uses observations of all users sending patterns to estimate both the targeted user's sending pattern and her receiving pattern. The estimated patterns are combined to find a set of the targeted user's most likely contacts. We study the performance of RSDA in simulation using different mix network configurations and also study the effectiveness of cover traffic as a countermeasure. Our results show that that RSDA outperforms the traditional SDA in finding the user's contacts, particularly as the amounts of user traffic and cover traffic rise.

  20. Review of Existing Wormhole Attack Discovery Techniques

    DTIC Science & Technology

    2006-08-01

    Review of Existing Wormhole Attack Discovery Techniques Maria Alexandrovna Gorlatova The scientific or...DATES COVERED - 4. TITLE AND SUBTITLE Review of Existing Wormhole Attack Discovery Techniques 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Review of Existing Wormhole Attack

  1. On Mitigating Distributed Denial of Service Attacks

    ERIC Educational Resources Information Center

    Gao, Zhiqiang

    2006-01-01

    Denial of service (DoS) attacks and distributed denial of service (DDoS) attacks are probably the most ferocious threats in the Internet, resulting in tremendous economic and social implications/impacts on our daily lives that are increasingly depending on the well-being of the Internet. How to mitigate these attacks effectively and efficiently…

  2. Cyberprints: Identifying Cyber Attackers by Feature Analysis

    ERIC Educational Resources Information Center

    Blakely, Benjamin A.

    2012-01-01

    The problem of attributing cyber attacks is one of increasing importance. Without a solid method of demonstrating the origin of a cyber attack, any attempts to deter would-be cyber attackers are wasted. Existing methods of attribution make unfounded assumptions about the environment in which they will operate: omniscience (the ability to gather,…

  3. Hypermethylation of FOXP3 Promoter and Premature Aging of the Immune System in Female Patients with Panic Disorder?

    PubMed Central

    Prelog, Martina; Hilligardt, Deborah; Schmidt, Christian A.; Przybylski, Grzegorz K.; Leierer, Johannes; Almanzar, Giovanni; El Hajj, Nady; Lesch, Klaus-Peter; Arolt, Volker; Zwanzger, Peter; Haaf, Thomas; Domschke, Katharina

    2016-01-01

    Immunological abnormalities associated with pathological conditions, such as higher infection rates, inflammatory diseases, cancer or cardiovascular events are common in patients with panic disorder. In the present study, T cell receptor excision circles (TRECs), Forkhead-Box-Protein P3 gene (FOXP3) methylation of regulatory T cells (Tregs) and relative telomere lengths (RTLs) were investigated in a total and subsamples of 131 patients with panic disorder as compared to 131 age- and sex-matched healthy controls in order to test for a potential dysfunction and premature aging of the immune system in anxiety disorders. Significantly lower TRECs (p = 0.004) as well as significant hypermethylation of the FOXP3 promoter region (p = 0.005) were observed in female (but not in male) patients with panic disorder as compared to healthy controls. No difference in relative telomere length was discerned between patients and controls, but significantly shorter telomeres in females, smokers and older persons within the patient group. The presently observed reduced TRECs in panic disorder patients and FOXP3 hypermethylation in female patients with panic disorder potentially reflect impaired thymus and immunosuppressive Treg function, which might partly account for the known increased morbidity and mortality of anxiety disorders conferred by e.g. cancer and cardiovascular disorders. PMID:27362416

  4. Panic disorder and health-related quality of life: the predictive roles of anxiety sensitivity and trait anxiety.

    PubMed

    Kang, Eun-Ho; Kim, Borah; Choe, Ah Young; Lee, Jun-Yeob; Choi, Tai Kiu; Lee, Sang-Hyuk

    2015-01-30

    Panic disorder (PD) is a very common anxiety disorder and is often a chronic disabling condition. However, little is known about the factors that predict health-related quality of life (HRQOL) other than sociodemographic factors and illness-related symptomatology that explain HRQOL in only small to modest degrees. This study explored whether anxiety-related individual traits including anxiety sensitivity and trait anxiety can predict independently HRQOL in panic patients. Patients with panic disorder with or without agoraphobia (N=230) who met the diagnostic criteria in the Structured Clinical Interview for DSM-IV were recruited. Stepwise regression analysis was performed to determine the factors that predict HRQOL in panic disorder. HRQOL was assessed by the 36-item Short-Form Health Survey (SF-36). Anxiety sensitivity was an independent predictor of bodily pain and social functioning whereas trait anxiety independently predicted all of the eight domains of the SF-36. Our data suggests that the assessment of symptomatology as well as individual anxiety-related trait should be included in the evaluation of HRQOL in panic patients.

  5. Mechanisms of change in cognitive behavioral therapy for panic disorder: the unique effects of self-efficacy and anxiety sensitivity.

    PubMed

    Gallagher, Matthew W; Payne, Laura A; White, Kamila S; Shear, Katherine M; Woods, Scott W; Gorman, Jack M; Barlow, David H

    2013-11-01

    The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment.

  6. Worry, Worry Attacks, and PTSD among Cambodian Refugees: A Path Analysis Investigation

    PubMed Central

    Hinton, Devon E.; Nickerson, Angela; Bryant, Richard A.

    2011-01-01

    Among traumatized Cambodian refugees, this article investigates worry (e.g., the types of current life concerns) and how worry worsens posttraumatic stress disorder (PTSD). To explore how worry worsens PTSD, we examine a path model of worry to see whether certain key variables (e.g., worry-induced somatic arousal and worry-induced trauma recall) mediate the relationship between worry and PTSD. Survey data were collected from March 2010 until May 2010 in a convenience sample of 201 adult Cambodian refugees attending a psychiatric clinic in Massachusetts, USA. We found that worry was common in this group (65%), that worry was often about current life concerns (e.g., lacking financial resources, children not attending school, health concerns, concerns about relatives in Cambodia), and that worry often induced panic attacks: in the entire sample, 41% (83/201) of the patients had “worry attacks” (i.e., worry episodes that resulted in a panic episode) in the last month. “Worry attacks” were highly associated with PTSD presence. In the entire sample, generalized anxiety disorder was also very prevalent, and was also highly associated with PTSD. Path analysis revealed that the effect of worry on PTSD severity was mediated by worry-induced somatic arousal, worry-induced catastrophic cognitions, worry-induced trauma recall, inability to stop worry, and irritability. The final model accounted for 75% of the variance in PTSD severity among patients with worry. The public health and treatment implications of the study’s findings that worry may have a potent impact on PTSD severity in severely traumatized populations are discussed: worry and daily concerns are key areas of intervention for these worry-hypersensitive (and hence daily-stressor-hypersensitive) populations. PMID:21663803

  7. Lightweight Distance Bounding Protocol against Relay Attacks

    NASA Astrophysics Data System (ADS)

    Kim, Jin Seok; Cho, Kookrae; Yum, Dae Hyun; Hong, Sung Je; Lee, Pil Joong

    Traditional authentication protocols are based on cryptographic techniques to achieve identity verification. Distance bounding protocols are an enhanced type of authentication protocol built upon both signal traversal time measurement and cryptographic techniques to accomplish distance verification as well as identity verification. A distance bounding protocol is usually designed to defend against the relay attack and the distance fraud attack. As there are applications to which the distance fraud attack is not a serious threat, we propose a streamlined distance bounding protocol that focuses on the relay attack. The proposed protocol is more efficient than previous protocols and has a low false acceptance rate under the relay attack.

  8. A Pilot Study of Sensation-Focused Intensive Treatment for Panic Disorder with Moderate to Severe Agoraphobia: Preliminary Outcome and Benchmarking Data

    ERIC Educational Resources Information Center

    Bitran, Stella; Morissette, Sandra B.; Spiegel, David A.; Barlow, David H.

    2008-01-01

    This report presents results of a treatment for panic disorder with moderate to severe agoraphobia (PDA-MS) called sensation-focused intensive treatment (SFIT). SFIT is an 8-day intensive treatment that combines features of cognitive-behavioral treatment for panic disorder, such as interoceptive exposure and cognitive restructuring with ungraded…

  9. Effectiveness of Cognitive-Behavioral Treatment for Panic Disorder Versus Treatment as Usual in a Managed Care Setting: 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Addis, Michael E.; Hatgis, Christina; Cardemil, Esteban; Jacob, Karen; Krasnow, Aaron D.; Mansfield, Abigail

    2006-01-01

    Eighty clients meeting criteria for panic disorder and receiving either panic control therapy (PCT; M. G. Craske, E. Meadows, & D. H. Barlow, 1994) or treatment as usual (TAU) in a managed care setting were assessed 1 and 2 years following acute treatment. PCT was provided by therapists with little or no previous exposure to cognitive-behavioral…

  10. Black Monday on stock markets throughout the world - a new phenomenon of collective panic disorder? A psychiatric approach.

    PubMed

    Sperling, Wolfgang; Bleich, Stefan; Reulbach, Udo

    2008-12-01

    Drastic losses on the stock markets within short periods have been the subject of numerous investigations in view of the fact that they are often irrational. Stock exchanges around the world suffered dramatic losses on Monday 21 January 2008, and again recently on Monday 17 March 2008. Regardless of cultural affiliation, public reporting of the global collapse in stock prices on Monday was striking in its almost unified mood of panic, anxiety and general fear of further partially arbitrary trading losses. These partly irrational mechanisms of an international financial crisis seem to fulfil several criteria of typical panic disorders according to classification systems like ICD-10 or DSM-IV. The new phenomenon affects international stock markets in the sense of a global panic disorder (GPD).

  11. Neuroticism moderates the effect of maximum smoking level on lifetime panic disorder: a test using an epidemiologically defined national sample of smokers.

    PubMed

    Zvolensky, Michael J; Sachs-Ericsson, Natalie; Feldner, Matthew T; Schmidt, Norman B; Bowman, Carrie J

    2006-03-30

    The present study evaluated a moderational model of neuroticism on the relation between smoking level and panic disorder using data from the National Comorbidity Survey. Participants (n=924) included current regular smokers, as defined by a report of smoking regularly during the past month. Findings indicated that a generalized tendency to experience negative affect (neuroticism) moderated the effects of maximum smoking frequency (i.e., number of cigarettes smoked per day during the period when smoking the most) on lifetime history of panic disorder even after controlling for drug dependence, alcohol dependence, major depression, dysthymia, and gender. These effects were specific to panic disorder, as no such moderational effects were apparent for other anxiety disorders. Results are discussed in relation to refining recent panic-smoking conceptual models and elucidating different pathways to panic-related problems.

  12. Peritraumatic fear, helplessness and horror and peritraumatic dissociation: do physical and cognitive symptoms of panic mediate the relationship between the two?

    PubMed

    Fikretoglu, Deniz; Brunet, Alain; Best, Suzanne R; Metzler, Thomas J; Delucchi, Kevin; Weiss, Daniel S; Fagan, Jeffrey; Liberman, Akiva; Marmar, Charles R

    2007-01-01

    The goal of this study was to examine whether panic mediates the relationship between fear, helplessness, and horror (PTSD criterion A2) and dissociation at the time of trauma. The study sample included 709 police officers and 317 peer-nominated civilians who had been exposed to a variety of critical incidents. Participants filled out measures of critical incident exposure, PTSD criterion A2, panic, and dissociation. Results indicate that together, physical and cognitive symptoms of panic completely mediate the relationship between criterion A2 and dissociation in civilians, and partially mediate that relationship in police. These results provide support for the idea that panic mediates the relationship between fear, helplessness, and horror (criterion A2) and dissociation at the time of trauma. The results also raise the possibility, however, that the mediational role of panic may be further moderated by additional variables.

  13. Linkage analysis of alternative anxiety phenotypes in multiply affected panic disorder families

    PubMed Central

    Fyer, Abby J.; Costa, Ramiro; Haghighi, Fatemeh; Logue, Mark W.; Knowles, James A.; Weissman, Myrna M.; Hodge, Susan E.; Hamilton, Steven P.

    2013-01-01

    Background The choice of phenotype definitions for genetic studies of panic and phobic disorders is complicated by family, twin and neurobiological data indicating both distinct and shared risk factors as well as heterogeneity within categories. We previously reported a genome scan in 120 multiplex panic disorder (PD) families using a phenotype that closely adhered to the DSM IV PD definition. Here we extend this work by conducting exploratory linkage analyses in this same pedigree set using ten additional literature- based panic and phobia-related phenotypes that take into account aspects of these hypothesized complexities. Methods Multiply affected families (> 2 individuals with PD) were recruited from clinical and non-clinical sources, evaluated by clinician administered semi-structured interview and subsequent blind consensus best estimate procedure. Each phenotype was analyzed under dominant and recessive models using parametric 2-point (homogeneity and heterogeneity), multipoint, and non-parametric methods. Empirically based permutations were used to estimate model specific and global (across all phenotypes) p-values. Results The highest score was a 2-point lod (4.27, global p < 0.08) on chromosome 13 (D13S793, 76cM) for the phenotype “specific or social phobia” under a recessive model and conditions of homogeneity. There was minimal support for linkage to any of the remaining nine phenotypes. Conclusions Though interpretation of findings is limited by sample size and the large number of phenotypes and models analyzed these data suggest a region on chromosome 13 as a potential site for further exploration in relation to risk for specific and social phobias. PMID:22525237

  14. Sexual obsessions and suicidal behaviors in patients with mood disorders, panic disorder and schizophrenia

    PubMed Central

    2012-01-01

    Background The topic of sexual obsessions as a psychiatric symptom has not been well investigated. The aim of this study was twofold: 1) to explore the presence of sexual obsessions in patients with mood disorders (n=156), panic disorder (n=54) and schizophrenia (n=79), with respect to non-psychiatric subjects (n=100); 2) to investigate the relationship between sexual obsessions and suicidal behaviors, taking into account socio-demographic variables ad mental disorders. Methods 289 psychiatric patients with mood disorders, panic disorder or schizophrenia, were recruited at the Italian University departments of psychiatry along with 100 non-psychiatric subjects, who presented for a routine eye exam at the ophthalmology department of the same Universities. The assessments included: the Structured Clinical Interview for DSM-IV-TR, the Brief Psychiatric Rating Scale (BPRS), the Obsessive-Compulsive Spectrum Self-Report (OBS-SR), for sexual obsession, and the Mood Spectrum-Self Report lifetime version (MOODS-SR). Suicidality was assessed by means of 6 items of the MOODS-SR. Results Sexual obsessions were more frequent in schizophrenia (54.4%), followed by mood disorders (35.9%). Among schizophrenia patients, males reported more sexual obsessions than females (P<0.01). Subjects who were more likely to report suicidal behaviors (suicidal ideation, plans and attempts) were female (adjusted OR=1.99), patients with mental disorders, specifically mood disorders (adjusted OR=11.5), schizophrenia (adjusted OR=3.7) or panic disorder (adjusted OR=2.9), and subjects who reported lifetime sexual obsessions (adjusted OR= 3.6). Sexual obsessions remained independently associated with all aspects of suicidal behaviors. Age, education, marital and employment status were not related to suicidal behaviors. Conclusions Special attention should be given to investigate and establish effective strategies of treatment for sexual obsessions, especially those with comorbid mood disorders or

  15. Joint Direct Attack Munition (JDAM)

    DTIC Science & Technology

    2015-12-01

    Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-503 Joint Direct Attack Munition (JDAM) As of FY 2017 President’s Budget Defense Acquisition...RDT&E - Research, Development, Test, and Evaluation SAR - Selected Acquisition Report SCP - Service Cost Position TBD - To Be Determined TY - Then Year...N/A Feb 2005 Feb 2005 Feb 2005 Selective Availability Anti-Spoofing Module (SAASM)/GPS Anti-Jam Production Award N/A Mar 2005 Mar 2005 Mar 2005

  16. Warning Signs of Heart Attack, Stroke and Cardiac Arrest

    MedlinePlus

    ... a Heart Attack WARNING SIGNS OF HEART ATTACK, STROKE & CARDIAC ARREST HEART ATTACK WARNING SIGNS CHEST DISCOMFORT ... nausea or lightheadedness. Learn more about heart attack STROKE WARNING SIGNS Spot a stroke F.A.S.T.: - ...

  17. What Are the Symptoms of a Heart Attack?

    MedlinePlus

    ... on Twitter. What Are the Symptoms of a Heart Attack? Not all heart attacks begin with the sudden, ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  18. Coronary Artery Dissection: Not Just a Heart Attack

    MedlinePlus

    ... Aneurysm More Coronary Artery Dissection: Not Just a Heart Attack Updated:Oct 4,2016 Sometimes a heart attack ... Disease Go Red For Women Types of aneurysms Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ...

  19. OREXIN 1 AND 2 RECEPTOR INVOLVEMENT IN CO2-INDUCED PANIC-ASSOCIATED BEHAVIOR AND AUTONOMIC RESPONSES

    PubMed Central

    Johnson, Philip L.; Federici, Lauren M.; Fitz, Stephanie D.; Renger, John J.; Shireman, Brock; Winrow, Christopher J.; Bonaventure, Pascal; Shekhar, Anantha

    2016-01-01

    Background The neuropeptides orexin A and B play a role in reward and feeding and are critical for arousal. However, it was not initially appreciated that most prepro-orexin synthesizing neurons are almost exclusively concentrated in the perifornical hypothalamus, which when stimulated elicits panic-associated behavior and cardiovascular responses in rodents and self-reported “panic attacks” and “fear of dying” in humans. More recent studies support a role for the orexin system in coordinating an integrative stress response. For instance, orexin neurons are highly reactive to anxiogenic stimuli, are hyperactive in anxiety pathology, and have strong projections to anxiety and panic-associated circuitry. Although the two cognate orexin receptors are colocalized in many brain regions, the orexin 2 receptor (OX2R) most robustly maps to the histaminergic wake-promoting region, while the orexin 1 receptor (OX1R) distribution is more exclusive and dense in anxiety and panic circuitry regions, such as the locus ceruleus. Overall, this suggests that OX1Rs play a critical role in mobilizing anxiety and panic responses. Methods Here, we used a CO2-panic provocation model to screen a dual OX1/2R antagonist (DORA-12) to globally inhibit orexin activity, then a highly selective OX1R antagonist (SORA1, Compound 56) or OX2R antagonist (SORA2, JnJ10397049) to assess OX1R and OX2R involvement. Results All compounds except the SORA2 attenuated CO2-induced anxiety-like behaviors, and all but the SORA2 and DORA attenuated CO2-induced cardiovascular responses. Conclusions SORA1s may represent a novel method of treating anxiety disorders, with no apparent sedative effects that were present with a benzodiazepine. PMID:26332431

  20. Internet cognitive–behavioural treatment for panic disorder: randomised controlled trial and evidence of effectiveness in primary care

    PubMed Central

    Newby, Jill M.; Mackenzie, Anna; Smith, Jessica; Boulton, Matthew; Loughnan, Siobhan A.; Andrews, Gavin

    2016-01-01

    Background Internet cognitive–behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown. Aims To determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder. Method Study 1 (efficacy): Randomised controlled trial comparing active iCBT (n=27) and waiting list control participants (n=36) on measures of panic severity and comorbid symptoms. Study 2 (effectiveness): 330 primary care patients completed the iCBT programme under the supervision of primary care practitioners. Results iCBT was significantly more effective than waiting list control in reducing panic (g=0.97, 95% CI 0.34 to 1.61), distress (g=0.92, 95% CI 0.28 to 1.55), disability (g=0.81, 95% CI 0.19 to 1.44) and depression (g=0.79, 95% CI 0.17 to 1.41), and gains were maintained at 3 months post-treatment (iCBT group). iCBT remained effective in primary care, but lower completion rates were found (56.1% in study 2 v. 63% in study 1). Adherence appeared to be related to therapist contact. Conclusions The five-lesson Panic Program has utility for treating panic disorder, which translates to primary care. Adherence may be enhanced with therapist contact. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703768

  1. Quality of Life in Patients with Coronary Artery Disease and Panic Disorder: A Comparative Study

    PubMed Central

    Srivastava, Shruti; Shekhar, Skand; Bhatia, Manjeet Singh; Dwivedi, Shridhar

    2017-01-01

    Objectives The quality of life (QOL) of patients with coronary artery disease (CAD) is known to be impaired. Non-cardiac chest pain referrals are often under-diagnosed and untreated, and there are hardly any studies comparing the QOL of CAD and panic disorder related (non-cardiac) chest pain referrals (PDRC). Methods We assessed the psychiatric morbidity and QOL of patients newly diagnosed with CAD (n = 40) at baseline and six weeks post-treatment and compared their QOL with patients with PDRC (n = 40) and age- and gender-matched healthy controls (n = 57). Psychiatric morbidity in the CAD group was assessed using the General Health Questionnaire (GHQ12) item, Hamilton Anxiety Scores (HAM-A), and Hamilton Depression Scores (HAMD). QOL measures were determined by the World Health Organization QOL questionnaire (brief) and Seattle Angina Questionnaire. The CAD group was treated with anti-ischemic drugs (nitrates, betablockers), antiplatelet drugs (acetylsalicylsalicylic acid), anticoagulants (low molecular weight heparin, clopidogrel), and managed for risk factors. The PDRC group was treated with selective serotonin reuptake inhibitors and anxiolytics. Results Patients with panic disorder had a worse QOL than those with CAD and healthy controls in the physical domain and psychological domain (PDRC vs. CAD vs. healthy controls, p < 0.001). In the CAD group, smoking was associated with change in angina stability (p = 0.049) whereas other tobacco products were associated with change in angina frequency (p = 0.044). Psychiatric morbidity was present in 40.0% of patients with CAD. In the PDRC group, a significant correlation of HAM-A scores was noted in the physical (p = 0.000), psychological (p = 0.001), social (p = 0.006), and environment (p = 0.001) domains of QOL. Patients with panic disorder had a significant improvement in anxiety scores after treatment compared to baseline (HAM-A scores difference 21.0 [16.5−25.6]; p < 0.001). Conclusions Patients in the PDRC

  2. Electroconvulsive therapy in a physically restrained man with comorbid major depression, severe agoraphobia with panic disorder, and histrionic personality disorder.

    PubMed

    Rapinesi, Chiara; Serata, Daniele; Del Casale, Antonio; Kotzalidis, Giorgio D; Romano, Silvia; Milioni, Mara; Capezzuto, Silvia; Carbonetti, Paolo; Angeletti, Gloria; Fensore, Claudio; Tatarelli, Roberto; Girardi, Paolo

    2012-03-01

    A 36-year-old man with comorbid panic disorder with agoraphobia, major depression, and histrionic personality disorder since age 21 was resistant to combined drug and psychotherapy treatment. His conditions had progressively worsened with time, causing him to withdraw socially and to simultaneously require continuous physical restraint, which further worsened his functioning. He spent almost 3 consecutive years in restraint, until he consented to receive bilateral ECT treatment. He improved after 13 sessions in all areas (social and role functioning, and panic, depressive, and histrionic symptoms) and is well 3 months later with a lithium-atypical antipsychotic combination.

  3. Migraine attacks the Basal Ganglia

    PubMed Central

    2011-01-01

    Background With time, episodes of migraine headache afflict patients with increased frequency, longer duration and more intense pain. While episodic migraine may be defined as 1-14 attacks per month, there are no clear-cut phases defined, and those patients with low frequency may progress to high frequency episodic migraine and the latter may progress into chronic daily headache (> 15 attacks per month). The pathophysiology of this progression is completely unknown. Attempting to unravel this phenomenon, we used high field (human) brain imaging to compare functional responses, functional connectivity and brain morphology in patients whose migraine episodes did not progress (LF) to a matched (gender, age, age of onset and type of medication) group of patients whose migraine episodes progressed (HF). Results In comparison to LF patients, responses to pain in HF patients were significantly lower in the caudate, putamen and pallidum. Paradoxically, associated with these lower responses in HF patients, gray matter volume of the right and left caudate nuclei were significantly larger than in the LF patients. Functional connectivity analysis revealed additional differences between the two groups in regard to response to pain. Conclusions Supported by current understanding of basal ganglia role in pain processing, the findings suggest a significant role of the basal ganglia in the pathophysiology of the episodic migraine. PMID:21936901

  4. Shoulder injuries from attacking motion

    NASA Astrophysics Data System (ADS)

    Yanagi, Shigeru; Nishimura, Tetsu; Itoh, Masaru; Wada, Yuhei; Watanabe, Naoki

    1997-03-01

    Sports injuries have bothered professional players. Although many medical doctors try to treat injured players, to prevent sports injuries is more important. Hence, it is required to clear a kinematic mechanism of the sport injuries. A shoulder of volleyball attacker or baseball pitcher is often inured by playing motion. The injuries are mainly caused at the end of long head tendon, which is located in the upper side of scapula. Generally, a muscle and tendon have enough strength against tensile force, however, it seems that they are sometimes defeated by the lateral force. It is imagined that the effect of the lateral force has a possibility of injuring the tendon. If we find the influence of the lateral force on the injured portion, the mechanism of injuries must be cleared. In our research, volleyball attacking motion is taken by high speed video cameras. We analyze the motion as links system and obtain an acceleration of an arm and a shoulder from video image data. The generated force at a shoulder joint is calculated and resolved into the lateral and longitudinal forces. Our final goal is to discuss a possibility that the lateral force causes the injuries.

  5. Percolation of localized attack on complex networks

    NASA Astrophysics Data System (ADS)

    Shao, Shuai; Huang, Xuqing; Stanley, H. Eugene; Havlin, Shlomo

    2015-02-01

    The robustness of complex networks against node failure and malicious attack has been of interest for decades, while most of the research has focused on random attack or hub-targeted attack. In many real-world scenarios, however, attacks are neither random nor hub-targeted, but localized, where a group of neighboring nodes in a network are attacked and fail. In this paper we develop a percolation framework to analytically and numerically study the robustness of complex networks against such localized attack. In particular, we investigate this robustness in Erdős-Rényi networks, random-regular networks, and scale-free networks. Our results provide insight into how to better protect networks, enhance cybersecurity, and facilitate the design of more robust infrastructures.

  6. Diagnosis and management of generalized anxiety disorder and panic disorder in adults.

    PubMed

    Locke, Amy B; Kirst, Nell; Shultz, Cameron G

    2015-05-01

    Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient's quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses and misdiagnosis of GAD and PD are high, with symptoms often ascribed to physical causes. Diagnosing GAD and PD requires a broad differential and caution to identify confounding variables and comorbid conditions. Screening and monitoring tools can be used to help make the diagnosis and monitor response to therapy. The GAD-7 and the Severity Measure for Panic Disorder are free diagnostic tools. Successful outcomes may require a combination of treatment modalities tailored to the individual patient. Treatment often includes medications such as selective serotonin reuptake inhibitors and/or psychotherapy, both of which are highly effective. Among psychotherapeutic treatments, cognitive behavior therapy has been studied widely and has an extensive evidence base. Benzodiazepines are effective in reducing anxiety symptoms, but their use is limited by risk of abuse and adverse effect profiles. Physical activity can reduce symptoms of GAD and PD. A number of complementary and alternative treatments are often used; however, evidence is limited for most. Several common botanicals and supplements can potentiate serotonin syndrome when used in combination with antidepressants. Medication should be continued for 12 months before tapering to prevent relapse.

  7. Memory performance in panic disorder patients after chronic use of clomipramine.

    PubMed

    de Carvalho, Stefania Caldeira; Marcourakis, Tania; Artes, Rinaldo; Gorenstein, Clarice

    2002-09-01

    This study investigated the chronic use (6.3 +/- 0.5 years; mean +/- SEM) of therapeutic doses of clomipramine (57.0 +/- 8.0 mg/day) by outpatients with panic disorder/agoraphobia who were currently in remission to assess impairment of memory and psychomotor functions. In addition, the association between test performance and serum levels of clomipramine (CMI) and its active metabolite desmethylclomipramine (DCMI) was also assessed. Patients and healthy volunteers matched for sex, age and educational level were submitted to rating scales and to memory and psychomotor tests. There was no significant difference between groups regarding any variable, except for metamemory. Significant associations were found between (i) longer-term clomipramine treatment and poorer performance in the implicit test and (ii) higher serum levels of clomipramine or desmethylclomipramine, or both (CMI + DCMI) and lower performance in central executive tests and metamemory. The results showed that low doses of CMI chronically administered to panic patients are associated with diminished metamemory and impaired priming and working memory. Further investigations are needed to confirm these results and to determine whether the chronic use of higher therapeutic doses of tricyclic antidepressants is associated with more intense deleterious effects on memory and psychomotor functions.

  8. A usability assessment on a virtual reality system for panic disorder treatment

    NASA Astrophysics Data System (ADS)

    Lee, Jaelin; Kawai, Takashi; Yoshida, Nahoko; Izawa, Shuhei; Nomura, Shinobu; Eames, Douglas; Kaiya, Hisanobu

    2008-02-01

    The authors have developed a virtual reality exposure system that reflects the Japanese culture and environment. Concretely, the system focuses on the subway environment, which is the environment most patients receiving treatment for panic disorder at hospitals in Tokyo, Japan tend to avoid. The system is PC based and features realistic video images and highly interactive functionality. In particular, the system enables instant transformation of the virtual space and allows situations to be freely customized according to the condition and symptoms expressed by each patient. Positive results achieved in therapy assessments aimed at patients with panic disorder accompanying agoraphobia indicate the possibility of indoor treatment. Full utilization of the functionality available requires that the interactive functions be easily operable. Accordingly, there appears to be a need for usability testing aimed at determining whether or not a therapist can operate the system naturally while focusing fully on treatment. In this paper, the configuration of the virtual reality exposure system focusing on the subway environment is outlined. Further, the results of usability tests aimed at assessing how naturally it can be operated while focusing fully on treatment are described.

  9. Optimal layout design of obstacles for panic evacuation using differential evolution

    NASA Astrophysics Data System (ADS)

    Zhao, Yongxiang; Li, Meifang; Lu, Xin; Tian, Lijun; Yu, Zhiyong; Huang, Kai; Wang, Yana; Li, Ting

    2017-01-01

    To improve the pedestrian outflow in panic situations by suitably placing an obstacle in front of the exit, it is vital to understand the physical mechanism behind the evacuation efficiency enhancement. In this paper, a robust differential evolution is firstly employed to optimize the geometrical parameters of different shaped obstacles in order to achieve an optimal evacuation efficiency. Moreover, it is found that all the geometrical parameters of obstacles could markedly influence the evacuation efficiency of pedestrians, and the best way for achieving an optimal pedestrian outflow is to slightly shift the obstacle from the center of the exit which is consistent with findings of extant literature. Most importantly, by analyzing the profiles of density, velocity and specific flow, as well as the spatial distribution of crowd pressure, we have proven that placing an obstacle in panic situations does not reduce or absorb the pressure in the region of exit, on the contrary, promotes the pressure to a much higher level, hence the physical mechanism behind the evacuation efficiency enhancement is not a pressure decrease in the region of exit, but a significant reduction of high density region by effective separation in space which finally causes the increasing of escape speed and evacuation outflow. Finally, it is clearly demonstrated that the panel-like obstacle is considerably more robust and stable than the pillar-like obstacle to guarantee the enhancement of evacuation efficiency under different initial pedestrian distributions, different initial crowd densities as well as different desired velocities.

  10. Anxiety Sensitivity, the Menstrual Cycle, and Panic Disorder: A Putative Neuroendocrine and Psychological Interaction

    PubMed Central

    Nillni, Yael I.; Toufexis, Donna J.; Rohan, Kelly J.

    2011-01-01

    The 2:1 female-to-male sex difference in the prevalence of Panic Disorder (PD) suggests that there is a sex-specific vulnerability involved in the etiology and/or maintenance of this disorder. The purpose of this paper is to present a new conceptual model, which emphasizes the interaction between a cognitive vulnerability for PD, anxiety sensitivity, and the effects of progesterone and its metabolite, allopregnanolone, on behavioral and physiological responses to stress during the premenstrual phase. This interaction is proposed to be a potential sex-specific pathway that may initiate and/or maintain panic and anxiety symptoms in women. This review paper presents preliminary evidence from both the human and animal literatures to support this new model. Specific topics reviewed include: psychopathology related to the menstrual cycle, anxiety sensitivity and its relationship to the menstrual cycle, PMS, and PMDD, anxiety-modulating effects of progesterone and its neuroactive metabolite, allopregnanolone, and how results from the neuroendocrine literature relate to psychopathology or symptoms associated with the menstrual cycle. PMID:21855828

  11. Differences in Affective Temperaments in Anxiety Disorders: Comparison of Panic Disorder and Obsessive Compulsive Disorder

    PubMed Central

    FISTIKÇI, Nurhan; HACIOĞLU, Münevver; EREK, Şakire; TABO, Abdülkadir; ERTEN, Evrim; GÜLER, Ayşegül Selcen; KALKAN, Murat; SAATÇİOĞLU, Ömer

    2013-01-01

    Introduction In this study, probable differences in affective temperament among anxiety disorders were investigated via a comparison of panic disorder (PD) and obsessive-compulsive disorder (OCD). Method 44 patients with OCD and 42 patients with PD, who were admitted to Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery outpatient clinics with complaints of OCD and PD and were diagnosed according to DSM IV criteria, were consecutively included in the study after informed consent was taken. A sociodemographic form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory, Panic and Agoraphobia Scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the temperament evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were given to the patients. PD and OCD patients were compared in terms of affective temperament characteristics. Results Mean age, educational status and gender distribution of OCD and PD patients were similar (p>0.05). Dominant depressive temperament was more prominent in OCD group than in PD group (p=0.021). Hyperthymic temperament scores were higher in PD group than in OCD group (p=0.002). Dominant hyperthymic temperament was not encountered in either group. Conclusion Dominant depressive temperament was more prominent in OCD group whereas hyperthymic temperament scores were higher in PD group. These findings should be evaluated in studies with larger sample sizes.

  12. Combined paroxetine and clonazepam treatment strategies compared to paroxetine monotherapy for panic disorder.

    PubMed

    Pollack, Mark H; Simon, Naomi M; Worthington, John J; Doyle, Alicia L; Peters, Patricia; Toshkov, Fany; Otto, Michael W

    2003-09-01

    Despite the widespread application of combined selective serotonin reuptake inhibitors (SSRI) and benzodiazepine treatment for panic disorder, there has been relatively little systematic assessment of the safety and efficacy of this therapeutic strategy. Although the limited number of studies to date suggest a more rapid onset of benefit with combined treatment, this study is the first to address the critical question of whether continued combined treatment confers superior efficacy. This study is a randomized, double-blind, three-arm study in patients with panic disorder (n = 60), comparing the efficacy and safety of paroxetine and placebo (PP), paroxetine coadministered with clonazepam followed by a tapered benzodiazepine discontinuation phase (PC-D), and ongoing combination treatment (PC-M). All treatment groups demonstrated significant improvement by endpoint. There was a significant advantage for the combined treatment groups early in treatment but, subsequently, outcome in all three groups was similar. A trend towards greater achievement of endpoint remission status for the PC-D group was attenuated when variability in baseline severity was considered. The results of this study should be interpreted in the context of a relatively moderate sample size and higher rates of early dropout. Combined treatment with paroxetine and clonazepam resulted in more rapid response than with the SSRI alone, but there was no differential benefit beyond the initial few weeks of therapy. Initiating combined treatment followed by benzodiazepine taper after a few weeks may provide early benefit while avoiding the potential adverse consequences of long-term combination therapy.

  13. Cement composition and sulfate attack

    SciTech Connect

    Shanahan, Natalya; Zayed, Abla . E-mail: zayed@eng.usf.edu

    2007-04-15

    Four cements were used to address the effect of tricalcium silicate content of cement on external sulfate attack in sodium sulfate solution. The selected cements had similar fineness and Bogue-calculated tricalcium aluminate content but variable tricalcium silicates. Durability was assessed using linear expansion and compressive strength. Phases associated with deterioration were examined using scanning electron microscopy and X-ray diffraction. Mineralogical phase content of the as-received cements was studied by X-ray diffraction using two methods: internal standard and Rietveld analysis. The results indicate that phase content of cements determined by X-ray mineralogical analysis correlates better with the mortar performance in sulfate environment than Bogue content. Additionally, it was found that in cements containing triclacium aluminate only in the cubic form, the observed deterioration is affected by tricalcium silicate content. Morphological similarities between hydration products of high tricalcium aluminate and high tricalcium silicate cements exposed to sodium sulfate environment were also observed.

  14. Detecting Denial of Service Attacks in Tor

    NASA Astrophysics Data System (ADS)

    Danner, Norman; Krizanc, Danny; Liberatore, Marc

    Tor is currently one of the more popular systems for anonymizing near real-time communications on the Internet. Recently, Borisov et al. proposed a denial of service based attack on Tor (and related systems) that significantly increases the probability of compromising the anonymity provided. In this paper, we propose an algorithm for detecting such attacks and examine the effectiveness of the obvious approach to evading such detection. We implement a simplified version of the detection algorithm and study whether the attack may be in progress on the current Tor network. Our preliminary measurements indicate that the attack was probably not implemented during the period we observed the network.

  15. Cougar attacks on humans: a case report.

    PubMed

    McKee, Denise

    2003-01-01

    Cougar attacks on humans are increasing. Presented is a case report of a nonfatal 2-year-old male cougar attack on an 8-year-old girl in British Columbia. Discussions of wound management, rabies postexposure prophylaxis (RPEP), and the possible psychologic ramifications of such an attack are presented. Also reviewed are recommendations on actions that may be helpful in preventing an attack following a sudden encounter with a cougar. Humans must learn to coexist with cougars, which present a small but real threat to people.

  16. Depression and anxiety among patients with somatoform disorders, panic disorder, and other depressive/anxiety disorders in Taiwan.

    PubMed

    Huang, Wei-Lieh; Chen, Tzu-Ting; Chen, I-Ming; Ma, Huei-Mei; Lee, Ming-Tzu; Liao, Shih-Cheng; Gau, Shur-Fen

    2016-07-30

    The aim of this study is to compare the severity of depression and anxiety in individuals with somatoform disorders, panic disorder, other depressive/anxiety disorders, and healthy controls in a Han Chinese population. According to the DSM-IV-TR-based diagnostic interviews, we recruited 152 subjects with somatoform disorders (SG), 56 with panic disorder (PG), 85 with other depressive/anxiety disorders (OG), and 179 without any psychiatric disorder (NG). The four groups reported on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) for depressive and anxiety symptoms, respectively. Correlation analysis and multivariate regression analysis were used to determine the effects of demographic factors and psychiatric diagnoses on depressive and anxiety symptoms separately. BDI-II scores were not significantly different in SG, PG, and OG but were higher than NG. SG and PG had the highest BAI scores, whereas NG had the lowest. Multiple linear regression analyses revealed that the associated factors for BDI-II were gender, residential location, somatoform disorders, panic disorder, major depressive disorder (MDD), and generalized anxiety disorder, whereas BAI was significantly associated with somatoform disorders, panic disorder, and MDD. Our results strongly suggest the inclusion of clinical assessment of depressive and anxious symptoms in patients with somatoform disorders.

  17. Mechanism of Change in Cognitive-Behavioral Treatment of Panic Disorder: Evidence for the Fear of Fear Mediational Hypothesis

    ERIC Educational Resources Information Center

    Smits, Jasper A. J.; Powers, Mark B.; Cho, Yongrae; Telch, Michael J.

    2004-01-01

    Numerous clinical trials have demonstrated the efficacy of cognitive-behavioral treatment (CBT) for panic disorder. However, studies investigating the mechanisms responsible for improvement with CBT are lacking. The authors used regression analyses outlined by R. M. Baron and D. A. Kenny (1986) to test whether a reduction in fear of fear (FOF)…

  18. Cognitive-Behavioral Treatment for Panic Disorder with Agoraphobia: A Randomized, Controlled Trial and Cost-Effectiveness Analysis

    ERIC Educational Resources Information Center

    Roberge, Pasquale; Marchand, Andre; Reinharz, Daniel; Savard, Pierre

    2008-01-01

    A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement…

  19. Physical, Mental, and Social Catastrophic Cognitions as Prognostic Factors in Cognitive-Behavioral and Pharmacological Treatments for Panic Disorder

    ERIC Educational Resources Information Center

    Hicks, Thomas V.; Leitenberg, Harold; Barlow, David H.; Gorman, Jack M.; Shear, Katherine M.; Woods, Scott W.

    2005-01-01

    The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes…

  20. Popular Culture and Moral Panics about "Children at Risk": Revisiting the Sexualisation-of-Young-Girls Debate

    ERIC Educational Resources Information Center

    Tsaliki, Liza

    2015-01-01

    In an attempt to resist moral panics over children's media consumption, and especially girls' consumption of hyper-sexualised popular media, this paper aims to offer a more positive account of popular culture and young children's, especially girls', engagement with it. By adopting a historical approach to modern childhood and the moral panics…

  1. The Effects of Aggression on Symptom Severity and Treatment Response in a Trial of Cognitive Behavioral Therapy for Panic Disorder

    PubMed Central

    Cassiello-Robbins, Clair; Conklin, Laren R.; Anakwenze, Ujunwa; Gorman, Jack M.; Woods, Scott W.; Shear, M. Katherine; Barlow, David H.

    2015-01-01

    Background Previous research suggests that patients with panic disorder exhibit higher levels of aggression than patients with other anxiety disorders. This aggression is associated with more severe symptomatology and interpersonal problems. However, few studies have examined whether higher levels of aggression are associated with a worse treatment response in this population. Methods The present study sought to examine the association of aggression with panic disorder symptom severity in a sample of 379 patients who participated in a trial examining long-term strategies for the treatment of panic disorder. Results We found that aggression was significantly associated with higher baseline levels of panic disorder symptoms, anxiety, depression, and functional impairment. Further, we found that patients higher in aggression did not achieve the same level of improvement in general anxiety symptoms during treatment compared to patients lower in aggression, even when controlling for baseline anxiety symptom severity. Conclusion These results suggest that more research is needed concerning patients with anxiety disorders with higher aggression, as they may be a group in need of additional treatment considerations. PMID:25987198

  2. Effects of ayahuasca on psychometric measures of anxiety, panic-like and hopelessness in Santo Daime members.

    PubMed

    Santos, R G; Landeira-Fernandez, J; Strassman, R J; Motta, V; Cruz, A P M

    2007-07-25

    The use of the hallucinogenic brew ayahuasca, obtained from infusing the shredded stalk of the malpighiaceous plant Banisteriopsis caapi with the leaves of other plants such as Psychotria viridis, is growing in urban centers of Europe, South and North America in the last several decades. Despite this diffusion, little is known about its effects on emotional states. The present study investigated the effects of ayahuasca on psychometric measures of anxiety, panic-like and hopelessness in members of the Santo Daime, an ayahuasca-using religion. Standard questionnaires were used to evaluate state-anxiety (STAI-state), trait-anxiety (STAI-trait), panic-like (ASI-R) and hopelessness (BHS) in participants that ingested ayahuasca for at least 10 consecutive years. The study was done in the Santo Daime church, where the questionnaires were administered 1h after the ingestion of the brew, in a double-blind, placebo-controlled procedure. While under the acute effects of ayahuasca, participants scored lower on the scales for panic and hopelessness related states. Ayahuasca ingestion did not modify state- or trait-anxiety. The results are discussed in terms of the possible use of ayahuasca in alleviating signs of hopelessness and panic-like related symptoms.

  3. A crucible for murder: the social context of violent children and adolescents.

    PubMed

    Twemlow, Stuart W

    2003-07-01

    The author describes aspects of social context that are of importance in the genesis of murderous violence in children and adolescents. Case presentations illustrate the effects of family attachment pathology, differing outcomes in destructive children, and the copycat phenomenon. The author concludes by summarizing the continuum of responses of children and adolescents to various forms of threat: real attack, unconscious threat, kindled threat, suppressed threat, bully-victim-bystander sadomasochistic ritual attack, and peer-group-validated threat.

  4. The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

    PubMed Central

    Wood, Cristina Mae; Ruíz-Rodríguez, Paloma; Tomás-Tomás, Patricia; Gracia-Gracia, Irene; Dongil-Collado, Esperanza; Iruarrizaga, M. Iciar

    2016-01-01

    Introduction Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. Method We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. Results The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). Conclusion Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes. PMID:27525977

  5. Anxiety During Pregnancy and Postpartum

    MedlinePlus

    ... the sufferer feels very nervous and has recurring panic attacks. During a panic attack, she may experience shortness of breath, chest pain, ... palpitations, and numbness and tingling in the extremities. Panic attacks seem to go in waves, but it is ...

  6. British used Congreve Rockets to Attack Napoleon

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Sir William Congreve developed a rocket with a range of about 9,000 feet. The incendiary rocket used black powder, an iron case, and a 16-foot guide stick. In 1806, British used Congreve rockets to attack Napoleon's headquarters in France. In 1807, Congreve directed a rocket attack against Copenhagen.

  7. 47 CFR 76.1612 - Personal attack.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Personal attack. 76.1612 Section 76.1612 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1612 Personal attack. (a) When, during origination cablecasting...

  8. Preventive attack in the 1990s

    SciTech Connect

    Prebeck, S.R.

    1993-05-28

    The decline of the Soviet Union upset the world`s balance of power and opened the door to third world proliferation since the superpowers no longer have tight control over their client-states. This increase in proliferation raised the issue of how the United States (US) should respond to a third world nation that is acquiring nuclear weapons. Should the United States depend on preventive attacks to stop the proliferation of nuclear weapons. This is not a new issue. Proliferation and preventive war have both been issues since the end of World War II. The United States considered a preventive attack against the Soviet Union in the postwar years. The Soviet Union considered preventive attacks against the People`s Republic of China in 1969. Israel conducted a preventive attack in 1981 against the Osiraq nuclear reactor in Iraq. Preventive attacks are politically untenable and are not militarily possible. Without perfect political conditions, it is unacceptable for the only remaining superpower to attack a second-rate power. It is militarily impossible for the United States to guarantee the removal of all nuclear weapons in a single preventive attack. This study concludes that the United States should not depend on preventive attacks to stop proliferation of nuclear weapons.

  9. The cost of attack in competing networks.

    PubMed

    Podobnik, B; Horvatic, D; Lipic, T; Perc, M; Buldú, J M; Stanley, H E

    2015-11-06

    Real-world attacks can be interpreted as the result of competitive interactions between networks, ranging from predator-prey networks to networks of countries under economic sanctions. Although the purpose of an attack is to damage a target network, it also curtails the ability of the attacker, which must choose the duration and magnitude of an attack to avoid negative impacts on its own functioning. Nevertheless, despite the large number of studies on interconnected networks, the consequences of initiating an attack have never been studied. Here, we address this issue by introducing a model of network competition where a resilient network is willing to partially weaken its own resilience in order to more severely damage a less resilient competitor. The attacking network can take over the competitor's nodes after their long inactivity. However, owing to a feedback mechanism the takeovers weaken the resilience of the attacking network. We define a conservation law that relates the feedback mechanism to the resilience dynamics for two competing networks. Within this formalism, we determine the cost and optimal duration of an attack, allowing a network to evaluate the risk of initiating hostilities.

  10. The cost of attack in competing networks

    PubMed Central

    Podobnik, B.

    2015-01-01

    Real-world attacks can be interpreted as the result of competitive interactions between networks, ranging from predator–prey networks to networks of countries under economic sanctions. Although the purpose of an attack is to damage a target network, it also curtails the ability of the attacker, which must choose the duration and magnitude of an attack to avoid negative impacts on its own functioning. Nevertheless, despite the large number of studies on interconnected networks, the consequences of initiating an attack have never been studied. Here, we address this issue by introducing a model of network competition where a resilient network is willing to partially weaken its own resilience in order to more severely damage a less resilient competitor. The attacking network can take over the competitor's nodes after their long inactivity. However, owing to a feedback mechanism the takeovers weaken the resilience of the attacking network. We define a conservation law that relates the feedback mechanism to the resilience dynamics for two competing networks. Within this formalism, we determine the cost and optimal duration of an attack, allowing a network to evaluate the risk of initiating hostilities. PMID:26490628

  11. A Typology of Retaliation Strategies against Social Aggression among Adolescent Girls

    ERIC Educational Resources Information Center

    Kozlowski, Karen Phelan; Warber, Kathleen M.

    2010-01-01

    Girls respond to peer attacks of indirect social aggression in various ways. This study explores when and how victims retaliate against their aggressors. Qualitative interviews with 15 adolescent girls ages 10-16 suggest that victims of social aggression are likely to retaliate when their aggressors communicate the following: identity attacks,…

  12. Panic disorder

    MedlinePlus

    ... while on this medicine. Talk therapy (cognitive-behavioral therapy, or CBT) helps you understand your behaviors and how to change them. During therapy you will learn how to: Understand and control ...

  13. Rages and refusals. Managing the many faces of adolescent anxiety.

    PubMed Central

    Garland, E. J.

    2001-01-01

    OBJECTIVE: To provide family physicians with a practical approach to recognition, assessment, and treatment of adolescent anxiety disorders complicated by avoidance or oppositional behaviour. QUALITY OF EVIDENCE: Current literature was searched via MEDLINE using the MeSH headings Anxiety and Anxiety Disorders, focusing on epidemiology, clinical presentations in adolescence, and both pharmacologic and nonpharmacologic treatment. In addition, internationally accepted diagnostic criteria, current practice guidelines, and recent textbooks by recognized experts were reviewed. Research evidence and consensus recommendations were integrated with a practical approach developed in a provincial mood and anxiety disorders clinic. MAIN FINDINGS: Anxiety disorders are common in adolescents, with estimated prevalence of at least 10%. Substance abuse and avoiding school are common complications, and irritability with behavioural and rage problems can interfere with effective management. Current controlled research is examining the effectiveness of serotonergic medications known to benefit panic disorder, social phobia, and generalized anxiety in adults. While cognitive and behavioural treatments are effective for some child and adolescent anxiety disorders, they can be difficult to administer, and a supportive and psychoeducational approach could be as effective for those who refuse to go to school. CONCLUSION: Family physicians' awareness of the role of anxiety in adolescent school avoidance and in intense, oppositional emotional reactions at home can lead to more specific assessment and therapeutic intervention. Practical management strategies are recommended. PMID:11398717

  14. Terrorist Attacks Escalate in Frequency and Fatalities Preceding Highly Lethal Attacks

    PubMed Central

    Martens, Andy; Sainudiin, Raazesh; Sibley, Chris G.; Schimel, Jeff; Webber, David

    2014-01-01

    Highly lethal terrorist attacks, which we define as those killing 21 or more people, account for 50% of the total number of people killed in all terrorist attacks combined, yet comprise only 3.5% of terrorist attacks. Given the disproportionate influence of these incidents, uncovering systematic patterns in attacks that precede and anticipate these highly lethal attacks may be of value for understanding attacks that exact a heavy toll on life. Here we examined whether the activity of terrorist groups escalates–both in the number of people killed per attack and in the frequency of attacks–leading up to highly lethal attacks. Analyses of terrorist attacks drawn from a state-of-the-art international terrorism database (The Global Terrorism Database) showed evidence for both types of escalation leading up to highly lethal attacks, though complexities to the patterns emerged as well. These patterns of escalation do not emerge among terrorist groups that never commit a highly lethal attack. PMID:24755753

  15. Parental bonds in children at high and low familial risk for panic disorder.

    PubMed

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H; Flament, Martine F; Bradwejn, Jacques

    2013-04-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n = 71) and children of parents with no psychiatric history (n = 80) participated in the study. Results indicate that high risk children do not perceive their parents as being more protective and less caring than low risk controls. The optimal bonding type (high care, low protection) was the most frequently reported parenting style across groups. The constraining type of maternal bonding (high care, high protection) was less frequently reported by high risk children (p < 0.05). Overall, these data suggest that parental PD does not compromise the parent-child bonds in never-ill offspring.

  16. Obstacle Optimization for Panic Flow - Reducing the Tangential Momentum Increases the Escape Speed

    PubMed Central

    Jiang, Li; Li, Jingyu; Shen, Chao; Yang, Sicong; Han, Zhangang

    2014-01-01

    A disastrous form of pedestrian behavior is a stampede occurring in an event involving a large crowd in a panic situation. To deal with such stampedes, the possibility to increase the outflow by suitably placing a pillar or some other shaped obstacles in front of the exit has been demonstrated. We present a social force based genetic algorithm to optimize the best design of architectural entities to deal with large crowds. Unlike existing literature, our simulation results indicate that appropriately placing two pillars on both sides but not in front of the door can maximize the escape efficiency. Human experiments using 80 participants correspond well with the simulations. We observed a peculiar property named tangential momentum, the escape speed and the tangential momentum are found to be negatively correlated. The idea to reduce the tangential momentum has practical implications in crowd architectural design. PMID:25531676

  17. Insomnia Symptoms Following Treatment for Comorbid Panic Disorder With Agoraphobia and Generalized Anxiety Disorder.

    PubMed

    Cousineau, Héloïse; Marchand, André; Bouchard, Stéphane; Bélanger, Claude; Gosselin, Patrick; Langlois, Frédéric; Labrecque, Joane; Dugas, Michel J; Belleville, Geneviève

    2016-04-01

    Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD.

  18. Obstacle optimization for panic flow--reducing the tangential momentum increases the escape speed.

    PubMed

    Jiang, Li; Li, Jingyu; Shen, Chao; Yang, Sicong; Han, Zhangang

    2014-01-01

    A disastrous form of pedestrian behavior is a stampede occurring in an event involving a large crowd in a panic situation. To deal with such stampedes, the possibility to increase the outflow by suitably placing a pillar or some other shaped obstacles in front of the exit has been demonstrated. We present a social force based genetic algorithm to optimize the best design of architectural entities to deal with large crowds. Unlike existing literature, our simulation results indicate that appropriately placing two pillars on both sides but not in front of the door can maximize the escape efficiency. Human experiments using 80 participants correspond well with the simulations. We observed a peculiar property named tangential momentum, the escape speed and the tangential momentum are found to be negatively correlated. The idea to reduce the tangential momentum has practical implications in crowd architectural design.

  19. Body image in social anxiety disorder, obsessive-compulsive disorder, and panic disorder.

    PubMed

    Aderka, Idan M; Gutner, Cassidy A; Lazarov, Amit; Hermesh, Haggai; Hofmann, Stefan G; Marom, Sofi

    2014-01-01

    Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive-compulsive disorder (OCD; n=22), social anxiety disorder (SAD; n=25), and panic disorder (PD; n=21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.

  20. Enhanced anger superiority effect in generalized anxiety disorder and panic disorder.

    PubMed

    Ashwin, Chris; Holas, Pawel; Broadhurst, Shanna; Kokoszka, Andrzej; Georgiou, George A; Fox, Elaine

    2012-03-01

    People are typically faster and more accurate to detect angry compared to happy faces, which is known as the anger superiority effect. Many cognitive models of anxiety suggest anxiety disorders involve attentional biases towards threat, although the nature of these biases remains unclear. The present study used a Face-in-the-Crowd task to investigate the anger superiority effect in a control group and patients diagnosed with either generalized anxiety disorder (GAD) or panic disorder (PD). The main finding was that both anxiety groups showed an enhanced anger superiority effect compared to controls, which is consistent with key theories of anxiety. Furthermore, both anxiety groups showed a differential pattern of enhanced bias towards threat depending on the crowd in the displays. The different attentional bias patterns between the GAD and PD groups may be related to the diverse symptoms in these disorders. These findings have implications for the diagnosis and treatment of anxiety.

  1. [Clinical, neurophysiological and psychological characteristics of neurosis in patients with panic disorders].

    PubMed

    Tuter, N V

    2008-01-01

    Forty-eight patients with panic disorders (PD), aged 31,5 years, 17 men, 31 women, were studied. The results were analyzed in comparison to a control group which comprised 16 healthy people, 6 men, 10 women, mean age 29,5 years. A traditional clinical approach, including somatic, neurologic and psychiatric examination, was used in the study. Also, a neurophysiological study using compression and spectral analyses, EEG, cognitive evoked potentials, skin evoked potentials, was conducted. A psychological examination included assessment of personality traits (Cattell's test), MMPI personality profile, mechanisms of psychological defense, the "Life style index" and Sondy test. A decrease of - and -rhythms was found that implied the reduction of activation processes. The psychological data mirror as common signs characteristic of all PD, as well as psychological features characteristic of neurotic disorders. The results obtained confirm the heterogeneity of PD in nosological aspect that demands using differential approach to the problems of their diagnostics and treatment.

  2. Effects of chronic corticosterone and imipramine administration on panic and anxiety-related responses.

    PubMed

    Diniz, L; Dos Reis, B B; de Castro, G M; Medalha, C C; Viana, M B

    2011-10-01

    It is known that chronic high levels of corticosterone (CORT) enhance aversive responses such as avoidance and contextual freezing. In contrast, chronic CORT does not alter defensive behavior induced by the exposure to a predator odor. Since different defense-related responses have been associated with specific anxiety disorders found in clinical settings, the observation that chronic CORT alters some defensive behaviors but not others might be relevant to the understanding of the neurobiology of anxiety. In the present study, we investigated the effects of chronic CORT administration (through surgical implantation of a 21-day release 200 mg pellet) on avoidance acquisition and escape expression by male Wistar rats (200 g in weight at the beginning of the experiments, N = 6-10/group) tested in the elevated T-maze (ETM). These defensive behaviors have been associated with generalized anxiety and panic disorder, respectively. Since the tricyclic antidepressant imipramine is successfully used to treat both conditions, the effects of combined treatment with chronic imipramine (15 mg, ip) and CORT were also investigated. Results showed that chronic CORT facilitated avoidance performance, an anxiogenic-like effect (P < 0.05), without changing escape responses. Imipramine significantly reversed the anxiogenic effect of CORT (P < 0.05), although the drug did not exhibit anxiolytic effects by itself. Confirming previous observations, imipramine inhibited escape responses, a panicolytic-like effect. Unlike chronic CORT, imipramine also decreased locomotor activity in an open field. These data suggest that chronic CORT specifically altered ETM avoidance, a fact that should be relevant to a better understanding of the physiopathology of generalized anxiety and panic disorder.

  3. Preliminary optical design of PANIC, a wide-field infrared camera for CAHA

    NASA Astrophysics Data System (ADS)

    Cárdenas, M. C.; Rodríguez Gómez, J.; Lenzen, R.; Sánchez-Blanco, E.

    2008-07-01

    In this paper, we present the preliminary optical design of PANIC (PAnoramic Near Infrared camera for Calar Alto), a wide-field infrared imager for the Calar Alto 2.2 m telescope. The camera optical design is a folded single optical train that images the sky onto the focal plane with a plate scale of 0.45 arcsec per 18 μm pixel. A mosaic of four Hawaii 2RG of 2k x 2k made by Teledyne is used as detector and will give a field of view of 31.9 arcmin x 31.9 arcmin. This cryogenic instrument has been optimized for the Y, J, H and K bands. Special care has been taken in the selection of the standard IR materials used for the optics in order to maximize the instrument throughput and to include the z band. The main challenges of this design are: to produce a well defined internal pupil which allows reducing the thermal background by a cryogenic pupil stop; the correction of off-axis aberrations due to the large field available; the correction of chromatic aberration because of the wide spectral coverage; and the capability of introduction of narrow band filters (~1%) in the system minimizing the degradation in the filter passband without a collimated stage in the camera. We show the optomechanical error budget and compensation strategy that allows our as built design to met the performances from an optical point of view. Finally, we demonstrate the flexibility of the design showing the performances of PANIC at the CAHA 3.5m telescope.

  4. The side effects burden of extended imipramine treatment of panic disorder.

    PubMed

    Mavissakalian, M R; Perel, J M

    2000-10-01

    In a recent study, the authors gauged the net effectiveness of imipramine to be 53%; that is, of 110 patients having panic disorder with agoraphobia who started a course of imipramine at a fixed, targeted, weight-adjusted dose of 2.25 mg x kg(-1) x day(-1), 59 adhered to the regimen and showed a marked and stable response. The present study investigated in detail the side effects burden of imipramine treatment in the same sample using hierarchical linear modeling in a short-term perspective, based on data at baseline (N = 110) and at weeks 1, 2, 4, 6, and 8 (N = 77) of treatment, and a long-term perspective, based on data at baseline and at weeks 8, 16 (N = 66), and 24 (N = 59). Deviations from the general pattern were explored by considering only severe side effects or only completers of treatment to better gauge the clinical significance of the findings. The results revealed that of 15 complaints systematically elicited using a side effects inventory, only 3--dry mouth, sweating, and constipation--continued as a substantial burden at the end of 6 months of treatment. On most other items, the initial increase was followed by a decrease to lower than baseline at the end of treatment. In the case of nausea, vomiting, increased energy, headache, and sexual disorders, the complaints were at their worst before treatment started and improved over the course of treatment. A sustained heart rate elevation between 10 and 15 beats per minute was found, but there were no significant effects on blood pressure or weight. The discussion underscores the need for more methodologically improved comparative studies with selective serotonin reuptake inhibitors in the treatment of panic disorder.

  5. Situational awareness of a coordinated cyber attack

    NASA Astrophysics Data System (ADS)

    Sudit, Moises; Stotz, Adam; Holender, Michael

    2005-03-01

    As technology continues to advance, services and capabilities become computerized, and an ever increasing amount of business is conducted electronically the threat of cyber attacks gets compounded by the complexity of such attacks and the criticality of the information which must be secured. A new age of virtual warfare has dawned in which seconds can differentiate between the protection of vital information and/or services and a malicious attacker attaining their goal. In this paper we present a novel approach in the real-time detection of multistage coordinated cyber attacks and the promising initial testing results we have obtained. We introduce INFERD (INformation Fusion Engine for Real-time Decision-making), an adaptable information fusion engine which performs fusion at levels zero, one, and two to provide real-time situational assessment and its application to the cyber domain in the ECCARS (Event Correlation for Cyber Attack Recognition System) system. The advantages to our approach are fourfold: (1) The complexity of the attacks which we consider, (2) the level of abstraction in which the analyst interacts with the attack scenarios, (3) the speed at which the information fusion is presented and performed, and (4) our disregard for ad-hoc rules or a priori parameters.

  6. Adaptive cyber-attack modeling system

    NASA Astrophysics Data System (ADS)

    Gonsalves, Paul G.; Dougherty, Edward T.

    2006-05-01

    The pervasiveness of software and networked information systems is evident across a broad spectrum of business and government sectors. Such reliance provides an ample opportunity not only for the nefarious exploits of lone wolf computer hackers, but for more systematic software attacks from organized entities. Much effort and focus has been placed on preventing and ameliorating network and OS attacks, a concomitant emphasis is required to address protection of mission critical software. Typical software protection technique and methodology evaluation and verification and validation (V&V) involves the use of a team of subject matter experts (SMEs) to mimic potential attackers or hackers. This manpower intensive, time-consuming, and potentially cost-prohibitive approach is not amenable to performing the necessary multiple non-subjective analyses required to support quantifying software protection levels. To facilitate the evaluation and V&V of software protection solutions, we have designed and developed a prototype adaptive cyber attack modeling system. Our approach integrates an off-line mechanism for rapid construction of Bayesian belief network (BN) attack models with an on-line model instantiation, adaptation and knowledge acquisition scheme. Off-line model construction is supported via a knowledge elicitation approach for identifying key domain requirements and a process for translating these requirements into a library of BN-based cyber-attack models. On-line attack modeling and knowledge acquisition is supported via BN evidence propagation and model parameter learning.

  7. Protecting complex infrastructures against multiple strategic attackers

    NASA Astrophysics Data System (ADS)

    Hausken, Kjell

    2011-01-01

    Infrastructures are analysed subject to defence by a strategic defender and attack by multiple strategic attackers. A framework is developed where each agent determines how much to invest in defending versus attacking each of multiple targets. A target can have economic, human and symbolic values, which generally vary across agents. Investment expenditure functions for each agent can be linear in the investment effort, concave, convex, logistic, can increase incrementally, or can be subject to budget constraints. Contest success functions (e.g., ratio and difference forms) determine the probability of a successful attack on each target, dependent on the relative investments of the defender and attackers on each target, and on characteristics of the contest. Targets can be in parallel, in series, interlinked, interdependent or independent. The defender minimises the expected damage plus the defence expenditures. Each attacker maximises the expected damage minus the attack expenditures. The number of free choice variables equals the number of agents times the number of targets, or lower if there are budget constraints. Each agent is interested in how his investments vary across the targets, and the impact on his utilities. Alternative optimisation programmes are discussed, together with repeated games, dynamic games and incomplete information. An example is provided for illustration.

  8. Smart Grid Integrity Attacks: Characterizations and Countermeasures

    SciTech Connect

    Annarita Giani; Eilyan Bitar; Miles McQueen; Pramod Khargonekar; Kameshwar Poolla

    2011-10-01

    Real power injections at loads and generators, and real power flows on selected lines in a transmission network are monitored, transmitted over a SCADA network to the system operator, and used in state estimation algorithms to make dispatch, re-balance and other energy management system [EMS] decisions. Coordinated cyber attacks of power meter readings can be arranged to be undetectable by any bad data detection algorithm. These unobservable attacks present a serious threat to grid operations. Of particular interest are sparse attacks that involve the compromise of a modest number of meter readings. An efficient algorithm to find all unobservable attacks [under standard DC load flow approximations] involving the compromise of exactly two power injection meters and an arbitrary number of power meters on lines is presented. This requires O(n2m) flops for a power system with n buses and m line meters. If all lines are metered, there exist canonical forms that characterize all 3, 4, and 5-sparse unobservable attacks. These can be quickly detected in power systems using standard graph algorithms. Known secure phase measurement units [PMUs] can be used as countermeasures against an arbitrary collection of cyber attacks. Finding the minimum number of necessary PMUs is NP-hard. It is shown that p + 1 PMUs at carefully chosen buses are sufficient to neutralize a collection of p cyber attacks.

  9. The Contribution of Personal and Exposure Characteristics to the Adjustment of Adolescents Following War

    ERIC Educational Resources Information Center

    Lavi, T.; Green, O.; Dekel, R.

    2013-01-01

    The study examined the unique contribution of both personal characteristics and several types of exposure variables to the adjustment of Israeli adolescents following the Second Lebanon War. Two thousand three hundred and fourteen adolescents, who lived in areas that were the target of multiple missile attacks, completed self-report questionnaires…

  10. Heart Attack or Sudden Cardiac Arrest: How Are They Different?

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Heart Attack or Sudden Cardiac Arrest: How Are They Different? ... to heart disease and stroke. Start exploring today ! Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ...

  11. Who Is at Risk for a Heart Attack?

    MedlinePlus

    ... on Twitter. Who Is at Risk for a Heart Attack? Certain risk factors make it more likely that ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  12. When You Visit Your Doctor After a Heart Attack

    MedlinePlus

    ... inbox ! When You Visit Your Doctor - After a Heart Attack After a Heart Attack Questions to Discuss with Your Doctor: Have you ... body? Did you have this pain before your heart attack? What brings it on? How frequently do you ...

  13. After Cancer, Higher Risk of Severe Heart Attack

    MedlinePlus

    ... this type of heart attack, called ST-elevation myocardial infarction (STEMI). One in 10 had a history of ... that cancer survivors had a higher rate of heart attack, not all of those attacks proved fatal. In ...

  14. Women's Heart Disease: Heart Attack Symptoms

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  15. Evaluation of the Single Keybit Template Attack

    DTIC Science & Technology

    2011-03-01

    27 v Page 3.5 Measures of Performance...17 MOP Measures of Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 x...include en- cryption standards, leakage models, correlation, classification theory, previous tem- plate attacks and measures of performance. 2.1

  16. On localization attacks against cloud infrastructure

    NASA Astrophysics Data System (ADS)

    Ge, Linqiang; Yu, Wei; Sistani, Mohammad Ali

    2013-05-01

    One of the key characteristics of cloud computing is the device and location independence that enables the user to access systems regardless of their location. Because cloud computing is heavily based on sharing resource, it is vulnerable to cyber attacks. In this paper, we investigate a localization attack that enables the adversary to leverage central processing unit (CPU) resources to localize the physical location of server used by victims. By increasing and reducing CPU usage through the malicious virtual machine (VM), the response time from the victim VM will increase and decrease correspondingly. In this way, by embedding the probing signal into the CPU usage and correlating the same pattern in the response time from the victim VM, the adversary can find the location of victim VM. To determine attack accuracy, we investigate features in both the time and frequency domains. We conduct both theoretical and experimental study to demonstrate the effectiveness of such an attack.

  17. Identifying and Analyzing Web Server Attacks

    SciTech Connect

    Seifert, Christian; Endicott-Popovsky, Barbara E.; Frincke, Deborah A.; Komisarczuk, Peter; Muschevici, Radu; Welch, Ian D.

    2008-08-29

    Abstract: Client honeypots can be used to identify malicious web servers that attack web browsers and push malware to client machines. Merely recording network traffic is insufficient to perform comprehensive forensic analyses of such attacks. Custom tools are required to access and analyze network protocol data. Moreover, specialized methods are required to perform a behavioral analysis of an attack, which helps determine exactly what transpired on the attacked system. This paper proposes a record/replay mechanism that enables forensic investigators to extract application data from recorded network streams and allows applications to interact with this data in order to conduct behavioral analyses. Implementations for the HTTP and DNS protocols are presented and their utility in network forensic investigations is demonstrated.

  18. Recovery of infrastructure networks after localised attacks.

    PubMed

    Hu, Fuyu; Yeung, Chi Ho; Yang, Saini; Wang, Weiping; Zeng, An

    2016-04-14

    The stability of infrastructure network is always a critical issue studied by researchers in different fields. A lot of works have been devoted to reveal the robustness of the infrastructure networks against random and malicious attacks. However, real attack scenarios such as earthquakes and typhoons are instead localised attacks which are investigated only recently. Unlike previous studies, we examine in this paper the resilience of infrastructure networks by focusing on the recovery process from localised attacks. We introduce various preferential repair strategies and found that they facilitate and improve network recovery compared to that of random repairs, especially when population size is uneven at different locations. Moreover, our strategic repair methods show similar effectiveness as the greedy repair. The validations are conducted on simulated networks, and on real networks with real disasters. Our method is meaningful in practice as it can largely enhance network resilience and contribute to network risk reduction.

  19. Recovery of infrastructure networks after localised attacks

    PubMed Central

    Hu, Fuyu; Yeung, Chi Ho; Yang, Saini; Wang, Weiping; Zeng, An

    2016-01-01

    The stability of infrastructure network is always a critical issue studied by researchers in different fields. A lot of works have been devoted to reveal the robustness of the infrastructure networks against random and malicious attacks. However, real attack scenarios such as earthquakes and typhoons are instead localised attacks which are investigated only recently. Unlike previous studies, we examine in this paper the resilience of infrastructure networks by focusing on the recovery process from localised attacks. We introduce various preferential repair strategies and found that they facilitate and improve network recovery compared to that of random repairs, especially when population size is uneven at different locations. Moreover, our strategic repair methods show similar effectiveness as the greedy repair. The validations are conducted on simulated networks, and on real networks with real disasters. Our method is meaningful in practice as it can largely enhance network resilience and contribute to network risk reduction. PMID:27075559

  20. Study Shows How Zika Attacks Infant Brain

    MedlinePlus

    ... gov/news/fullstory_162514.html Study Shows How Zika Attacks Infant Brain Virus can copy itself thousands ... New research paints a chilling portrait of how Zika ravages the infant brain. Scientists from the U.S. ...

  1. Diabetes - preventing heart attack and stroke

    MedlinePlus

    Diabetes complications - heart; Coronary artery disease - diabetes; CAD - diabetes; Cerebrovascular disease - diabetes ... People with diabetes have a higher chance of having heart attacks and strokes. Smoking and having high blood pressure and high ...

  2. Cyber Security Audit and Attack Detection Toolkit

    SciTech Connect

    Peterson, Dale

    2012-05-31

    This goal of this project was to develop cyber security audit and attack detection tools for industrial control systems (ICS). Digital Bond developed and released a tool named Bandolier that audits ICS components commonly used in the energy sector against an optimal security configuration. The Portaledge Project developed a capability for the PI Historian, the most widely used Historian in the energy sector, to aggregate security events and detect cyber attacks.

  3. Heart Attack - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Arabic) النوبة القلبية - العربية Bilingual PDF Health Information Translations Bosnian (Bosanski) Heart Attack Srčani udar - Bosanski (Bosnian) Bilingual PDF Health Information Translations Chinese - Simplified (简体中文) Heart Attack 心脏病发作 - 简体中文 (Chinese - ...

  4. The role of symptom induction in the treatment of panic and anxiety. Identifiable domains, conditional properties, and treatment targets.

    PubMed

    Rudd, M D; Joiner, T

    1998-01-01

    Although the importance of affectively charged material in the treatment of panic and anxiety has been emphasized and implicitly viewed as essential for effective therapeutic change, a general framework for organizing, understanding, implementing, and evaluating symptom induction techniques has yet to be offered. This article offers a framework for organizing symptoms induction techniques, categorizing treatment targets, and, accordingly, assessing therapeutic change in the treatment of panic and anxiety. Symptom induction techniques are examined in three exposure domains: physiological, cognitive, and situational/circumstantial; treatment targets fall into five categories: (a) poor symptom tolerance and resultant hypersensitivity and hypervigilance, (b) avoidance of internal and external triggers, (c) the emergence of specific catastrophic thoughts and related misinterpretations, (d) diminished adaptive coping skills, and (e) a reduction in general self-efficacy. Additionally, a distinction is proposed between conditional and unconditional properties of symptom induction, with an emphasis on the potential deleterious role conditional properties play during the course of treatment.

  5. Therapist effects and the outcome-alliance correlation in cognitive behavioral therapy for panic disorder with agoraphobia.

    PubMed

    Huppert, Jonathan D; Kivity, Yogev; Barlow, David H; Gorman, Jack M; Shear, M Katherine; Woods, Scott W

    2014-01-01

    Although the alliance-outcome correlation is well established, no published studies to date have separated between therapists' and patients' contributions while controlling for early symptom change. In this study, we examined therapist effects in two trials of CBT for panic disorder with agoraphobia (PDA) and the impact of therapists' and patients' contribution to the alliance on outcome and attrition in one trial. Alliance ratings were obtained from patients and therapists early and late in treatment (n = 133). Data were analyzed using multi-level modeling controlling for early symptom change. No therapist effects were found. The patients' contribution to the alliance predicted outcome (in both panic severity and anxiety sensitivity) and attrition. The therapists' contribution to the alliance predicted attrition but not outcome. Results suggest that the patient's contribution to the alliance plays an important role in CBT for PDA and that including common factors into research on CBT may help elucidate treatment processes.

  6. Defense mechanisms after brief cognitive-behavior group therapy for panic disorder: one-year follow-up.

    PubMed

    Heldt, Elizeth; Blaya, Carolina; Kipper, Leticia; Salum, Giovanni A; Otto, Michael W; Manfro, Gisele G

    2007-06-01

    Changes in defense mechanisms have been shown in long-term psychodynamic treatment. The aim of this study was to examine the changes that occurred after brief cognitive-behavior group therapy in the defense style of panic disorder patients that had failed to respond to pharmacotherapy. Forty-seven patients participated in the study and severity of panic disorder was evaluated by Clinical Global Impression. Defense mechanisms were evaluated by the Defense Style Questionnaire. Patients decreased the use of maladaptive defenses after cognitive-behavior group therapy, and the change in immature defenses was maintained at 1-year follow-up evaluation (p = 0.022). These modifications were associated with reduction of symptoms (F = 0.359; p = 0.047). These findings are consistent with the hypothesis that defense styles are malleable in short-term treatment and are, at least partially, symptom-state dependent.

  7. Severe attacks by dogs: characteristics of the dogs, the victims, and the attack settings.

    PubMed

    Wright, J C

    1985-01-01

    Sixteen incidents involving dog bites fitting the description "severe" were identified among 5,711 dog bite incidents reported to health departments in five South Carolina counties (population 750,912 in 1980) between July 1, 1979, and June 30, 1982. A "severe" attack was defined as one in which the dog "repeatedly bit or vigorously shook its victim, and the victim or the person intervening had extreme difficulty terminating the attack." Information from health department records was clarified by interviews with animal control officers, health and police officials, and persons with firsthand knowledge of the events. Investigation disclosed that the dogs involved in the 16 severe attacks were reproductively intact males. The median age of the dogs was 3 years. A majority of the attacks were by American Staffordshire terriers, St. Bernards, and cocker spaniels. Ten of the dogs had been aggressive toward people or other dogs before the incident that was investigated. Ten of the 16 victims of severe attacks were 10 years of age or younger; the median age of all 16 victims was 8 years. Twelve of the victims either were members of the family that owned the attacking dog or had had contact with the dog before the attack. Eleven of the victims were bitten on the head, neck, or shoulders. In 88 percent of the cases, the attacks took place in the owner's yard or home, or in the adjoining yard. In 10 of the 16 incidents, members of the victims' families witnessed the attacks. The characteristics of these attacks, only one of which proved fatal, were similar in many respects to those that have been reported for other dog bite incidents that resulted in fatalities. On the basis of this study, the author estimates that a risk of 2 fatalities per 1,000 reported dog bites may exist nationwide. Suggestions made for the prevention of severe attacks focus on changing the behavior of both potential canine attackers and potential victims.

  8. Avoiding Panic and Keeping the Ports Open in a Chemical and Biological Threat Environment. A Literature Review

    DTIC Science & Technology

    2005-06-01

    rare.8 As Quarantelli views the evidence, the belief that people panic, tend of freeze up in shock , or become anti-social during disasters are...their own. Acute Stress Disorder/ Shock : Acute Stress Disorder (ASD), often popularly referred to as “ shock ,” represents another potential category of...of the paper. The principal maladaptive behaviors to worry about during the impact phase are shock , sociogenic illness, and stigmatization. In

  9. Adolescent Pregnancy.

    PubMed

    Leftwich, Heidi K; Alves, Marcus Vinicius Ortega

    2017-04-01

    Adolescent pregnancy, although on the decline, represents a significant public health concern. Often adolescents present late to prenatal care, either from lack of knowledge, fear of consequences, limited access, stigma, or all of the above. Although multifaceted, there are many risks both to mother and child that are increased in adolescent pregnancy. Many are unintended and are at risk for repeat adolescent pregnancy, especially within the first 2 years. Risks include but are not limited to: low birth weight, preterm delivery, stillbirth, and preeclampsia, as well as feelings of social isolation, delayed or neglected educational goals, and maternal depression.

  10. Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity Among Patients With Panic Disorder: A Preliminary Study.

    PubMed

    Ural, Cenk; Belli, Hasan; Akbudak, Mahir; Tabo, Abdulkadir

    2015-01-01

    This study assessed childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with panic disorder (PD). A total of 92 psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital, were involved in the study. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire, Panic and Agoraphobia Scale, Panic Disorder Severity Scale, and Childhood Trauma Questionnaire. Of the patients with PD, 18 (19%) had a comorbid dissociative disorder diagnosis on screening with the SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified, dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (p < .05). All of the childhood trauma subscales used were correlated with the severity of symptoms of dissociation and PD. Among all of the subscales, the strongest relationship was with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms at admission should not lead the clinician to overlook the underlying dissociative process and associated traumatic experiences among these patients.

  11. Histone Modifications in a Mouse Model of Early Adversities and Panic Disorder: Role for Asic1 and Neurodevelopmental Genes

    PubMed Central

    Cittaro, Davide; Lampis, Valentina; Luchetti, Alessandra; Coccurello, Roberto; Guffanti, Alessandro; Felsani, Armando; Moles, Anna; Stupka, Elia; D’ Amato, Francesca R.; Battaglia, Marco

    2016-01-01

    Hyperventilation following transient, CO2-induced acidosis is ubiquitous in mammals and heritable. In humans, respiratory and emotional hypersensitivity to CO2 marks separation anxiety and panic disorders, and is enhanced by early-life adversities. Mice exposed to the repeated cross-fostering paradigm (RCF) of interference with maternal environment show heightened separation anxiety and hyperventilation to 6% CO2-enriched air. Gene-environment interactions affect CO2 hypersensitivity in both humans and mice. We therefore hypothesised that epigenetic modifications and increased expression of genes involved in pH-detection could explain these relationships. Medullae oblongata of RCF- and normally-reared female outbred mice were assessed by ChIP-seq for H3Ac, H3K4me3, H3K27me3 histone modifications, and by SAGE for differential gene expression. Integration of multiple experiments by network analysis revealed an active component of 148 genes pointing to the mTOR signalling pathway and nociception. Among these genes, Asic1 showed heightened mRNA expression, coherent with RCF-mice’s respiratory hypersensitivity to CO2 and altered nociception. Functional enrichment and mRNA transcript analyses yielded a consistent picture of enhancement for several genes affecting chemoception, neurodevelopment, and emotionality. Particularly, results with Asic1 support recent human findings with panic and CO2 responses, and provide new perspectives on how early adversities and genes interplay to affect key components of panic and related disorders. PMID:27121911

  12. Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.

    PubMed

    Feldman, Jonathan M; Matte, Lynne; Interian, Alejandro; Lehrer, Paul M; Lu, Shou-En; Scheckner, Bari; Steinberg, Dara M; Oken, Tanya; Kotay, Anu; Sinha, Sumita; Shim, Chang

    2016-12-01

    Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improvements in PD severity were mediated by anxiety sensitivity in CBPT and by depression in MRT, although earlier levels of these mediators did not predict subsequent improvements. Attrition was high (40%) in both groups, albeit comparable to CBT studies targeting anxiety in Latinos. Additional strategies are needed to improve retention in this high-risk population. Both CBPT and MRT may be efficacious interventions for comorbid asthma-PD, and CBPT may offer additional benefits for improving medication adherence.

  13. Histone Modifications in a Mouse Model of Early Adversities and Panic Disorder: Role for Asic1 and Neurodevelopmental Genes.

    PubMed

    Cittaro, Davide; Lampis, Valentina; Luchetti, Alessandra; Coccurello, Roberto; Guffanti, Alessandro; Felsani, Armando; Moles, Anna; Stupka, Elia; D' Amato, Francesca R; Battaglia, Marco

    2016-04-28

    Hyperventilation following transient, CO2-induced acidosis is ubiquitous in mammals and heritable. In humans, respiratory and emotional hypersensitivity to CO2 marks separation anxiety and panic disorders, and is enhanced by early-life adversities. Mice exposed to the repeated cross-fostering paradigm (RCF) of interference with maternal environment show heightened separation anxiety and hyperventilation to 6% CO2-enriched air. Gene-environment interactions affect CO2 hypersensitivity in both humans and mice. We therefore hypothesised that epigenetic modifications and increased expression of genes involved in pH-detection could explain these relationships. Medullae oblongata of RCF- and normally-reared female outbred mice were assessed by ChIP-seq for H3Ac, H3K4me3, H3K27me3 histone modifications, and by SAGE for differential gene expression. Integration of multiple experiments by network analysis revealed an active component of 148 genes pointing to the mTOR signalling pathway and nociception. Among these genes, Asic1 showed heightened mRNA expression, coherent with RCF-mice's respiratory hypersensitivity to CO2 and altered nociception. Functional enrichment and mRNA transcript analyses yielded a consistent picture of enhancement for several genes affecting chemoception, neurodevelopment, and emotionality. Particularly, results with Asic1 support recent human findings with panic and CO2 responses, and provide new perspectives on how early adversities and genes interplay to affect key components of panic and related disorders.

  14. Adolescent care

    PubMed Central

    Gilbert, Andrée; Maheux, Brigitte; Frappier, Jean-Yves; Haley, Nancy

    2006-01-01

    OBJECTIVE To investigate how often family physicians see adolescents with mental health problems and how they manage these problems. DESIGN Mailed survey completed anonymously. SETTING Province of Quebec. PARTICIPANTS All 358 French-speaking family physicians who practise primarily in local community health centres (CLSCs), including physicians working in CLSC youth clinics, and 749 French-speaking practitioners randomly selected from private practice. MAIN OUTCOME MEASURES Frequency with which physicians saw adolescents with mental health problems, such as depression, suicidal thoughts, behavioural disorders, substance abuse, attempted suicide, or suicide, during the last year or since they started practice. RESULTS Response rate was 70%. Most physicians reported having seen adolescents with mental health problems during the last year. About 10% of practitioners not working in youth clinics reported seeing adolescents with these disorders at least weekly. Anxiety was the most frequently seen problem. A greater proportion of physicians working in youth clinics reported often seeing adolescents for all the mental health problems examined in this study. Between 8% and 33% of general practitioners not working in youth clinics said they had not seen any adolescents with depression, behavioural disorders, or substance abuse. More than 80% of physicians had seen adolescents who had attempted suicide, and close to 30% had had adolescent patients who committed suicide. CONCLUSION Family physicians play a role in adolescent mental health care. The prevalence of mental health problems seems higher among adolescents who attend youth clinics. Given the high prevalence of these problems during adolescence, we suggest on the basis of our results that screening for these disorders in primary care could be improved. PMID:17279202

  15. Adolescent Literacy

    ERIC Educational Resources Information Center

    Ippolito, Jacy, Ed.; Steele, Jennifer L., Ed.; Samson, Jennifer F., Ed.

    2012-01-01

    "Adolescent Literacy" initially appeared as a special issue of the "Harvard Educational Review". It explores key issues and debates in the adolescent literacy crisis, the popular use of cognitive strategies, and disciplinary and content-area literacy. Also examined are alternative forms of literacy, afterschool interventions, new instruction…

  16. Adolescent Abuse.

    ERIC Educational Resources Information Center

    Foreman, Susan; Seligman, Linda

    1983-01-01

    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  17. Adolescent Loneliness.

    ERIC Educational Resources Information Center

    Goldenberg, Sheila

    Research has suggested that the incidence of loneliness peaks at adolescence and decreases with age. Changes in the determinants of loneliness during adolescence were investigated for grade 8, grade 11, and university students. Subjects (N=410) completed a written questionnaire which included ten items from the UCLA Loneliness Scale, the…

  18. Adolescent Turmoil.

    ERIC Educational Resources Information Center

    Offer, Daniel

    1982-01-01

    Examines recent empirical evidence to test theories postulated in separate works by G. Stanley Hall and Anna Freud that adolescents must experience psychological turbulence in the transition to adulthood. Concludes that turmoil is no longer a necessary condition of adolescence and that those who do experience it need psychiatric attention.…

  19. Know the Warning Signs of a Heart Attack

    MedlinePlus

    ... No. 22 Know the Warning Signs of a Heart Attack What is a heart attack? Aheart attack happens when the blood vessels that ... hurting your heart muscle. Another name for a heart attack is myocardial infarction, or MI. If you have ...

  20. A Game Theoretic Approach to Cyber Attack Prediction

    SciTech Connect

    Peng Liu

    2005-11-28

    The area investigated by this project is cyber attack prediction. With a focus on correlation-based prediction, current attack prediction methodologies overlook the strategic nature of cyber attack-defense scenarios. As a result, current cyber attack prediction methodologies are very limited in predicting strategic behaviors of attackers in enforcing nontrivial cyber attacks such as DDoS attacks, and may result in low accuracy in correlation-based predictions. This project develops a game theoretic framework for cyber attack prediction, where an automatic game-theory-based attack prediction method is proposed. Being able to quantitatively predict the likelihood of (sequences of) attack actions, our attack prediction methodology can predict fine-grained strategic behaviors of attackers and may greatly improve the accuracy of correlation-based prediction. To our best knowledge, this project develops the first comprehensive framework for incentive-based modeling and inference of attack intent, objectives, and strategies; and this project develops the first method that can predict fine-grained strategic behaviors of attackers. The significance of this research and the benefit to the public can be demonstrated to certain extent by (a) the severe threat of cyber attacks to the critical infrastructures of the nation, including many infrastructures overseen by the Department of Energy, (b) the importance of cyber security to critical infrastructure protection, and (c) the importance of cyber attack prediction to achieving cyber security.