Characteristics of panic attack subtypes: Assessment of spontaneous panic, situational panic, sleep panic, and limited symptom attacks
Open accessAbstract
We report the analyses of daily journal descriptions of 790 self-defined panic attacks from 59 patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks. The DSM-III-R specified symptoms occurred with frequencies ranging from choking (17% of attacks) to palpitations (63% of attacks). The mean weekly panic attack severity correlated significantly with the number of symptoms per attack, but not their weekly frequency. Within a given person, situational and spontaneous panic attacks did not significantly differ over a number of characteristics, including severity, duration, frequency per week, diurnal distribution, and the number of symptoms per attack. Limited symptom attacks were less severe, but were otherwise similar to panic attacks. Also, panic attacks during sleep were less frequent than panic attacks in the awake state, but did not significantly differ on other descriptive characteristics. These data support the validity of the symptoms specified for panic attacks by DSM-III-R. They also suggest that within an individual, panic attacks of various subtypes may be descriptively similar, despite the differing contexts in which they arise. In addition, these data question the diagnostic significance of the limited symptom attack-panic attack distinction.
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Dissociation may be more a consequence than a cause, related to high arousal during trauma.
“Dissociation may be more of a consequence than a cause, related to high levels of arousal during trauma (Krystal, Woods, Hill, & Charney, 1991; Marmar et al., 1997).”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Krystal, Woods, Hill, & Charney, 1991
The Symptoms of Self-Defined Panic Attacks section records feelings of unreality during panic attacks, but does not discuss dissociation as a consequence rather than a cause of trauma-related arousal. The Discussion addresses similarities among panic-attack subtypes, not that proposed relationship. Searches for dissociation, trauma, and arousal found no passage addressing the claim; page numbers were unavailable in our copy. (LLM, conf=0.76)
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- Authors
- Krystal, J. H., Woods, S. W., Hill, C. L., & Charney, D. S.
- Affiliations
- Veterans Health Administration (US)
- Yale University (US)
- Corresponding author
- Krystal, John H.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 1991-11
- Volume
- 32
- Issue
- 6
- Pages
- 474-480
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2014275487
- Cited by
- 73
- References
- 16
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Comprehensive Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Institutes of Health (1k08mh000579-01)
- National Center for PTSD, U.S. Department of Veterans Affairs
- National Institute of Mental Health (MH 40840, 30929, MH-00579, MH30929)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- panic attacks, panic disorder, agoraphobia, symptom frequency, diurnal distribution, choking, palpitations
- MeSH terms
- Adult, Agoraphobia, Arousal, Female, Humans, Male, Panic, Psychiatric Status Rating Scales, Psychometrics, Sleep Wake Disorders, Sleep Stages, Social Environment, Wakefulness, Panic Disorder
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