Archival ReportDo Unexpected Panic Attacks Occur Spontaneously?
Section snippets
Participants
Forty-three patients with PD with or without agoraphobia were recruited through advertisements to participate in a treatment study (24). Patients' mean age was 41.6 years (range 23–61). The majority were Caucasians (81.8%), 9.1% were Hispanic, and 9.1% were Asian. Patients met the following inclusion criteria: DSM-IV principal diagnosis of PD and age 18 to 65, with the following exclusion criteria: no evidence of an organic mental disorder, suicidality, schizophrenia, alcohol or drug abuse or
Panic Attack Self-Reports
The median length of the 13 PAs was 8 minutes (range = 1–30, M = 10.6). 38.4% of the PAs occurred when the patient was alone, 23.1% in the presence of friends, and 38.5% with family. One PA occurred during sleep. 69.2% of PAs were reported as unexpected. Among the expected attacks, two occurred at home (no trigger listed), one “on the freeway,” and one “during an argument with friend.” With the exception of driving, none of the situations were previously listed by the patients as PA triggers.
Discussion
Using a novel analysis to detect points of significant change in continuous physiological time series, we found that the hour preceding the onset of naturally occurring panic attacks was marked by significant cardiorespiratory instability. These changes were largely absent in the control periods. The physiological instabilities occurred in repeated bouts often initiated by HR accelerations. The period surrounding panic onset was dominated by respiratory changes. Before panic onset, VT decreased
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