F. Dudley McGlynn
Todd A. Smitherman
Jacinda C. Hammel
Panic attacks are sudden periods of extreme biological and cognitive fearfulness that typically peak within 10 minutes then gradually subside. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised text (DSM-IV-TR; American Psychiatric Association [APA], 2000), the symptoms of panic attacks include at least four of the following: tachycardia or palpitations, sweating, trembling/shaking, shortness of breath or smothering, sensations of choking, chest pain or discomfort, nausea or stomach distress, feeling dizzy or faint, derealization or depersonalization, fear of losing control or of going crazy, fear of dying, numbing or tingling sensations, and chills or hot flushes. Panic disorder (PD), in turn, is characterized by presence of recurring, unexpected panic attacks. Formally the attacks must be accompanied by a month or longer of continuing concern about having additional attacks, by worry about implications of such attacks or their consequences, or by an adaptively significant change in behavior as a result of the attacks.
The core feature of agoraphobia is anxiety about being in places or situations from which escape might be difficult, impossible, or embarrassing, or in which help might not be available, in the event of panic. Thus,