Nonclinical panickers: A critical review
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Subthreshold or mild panic disorder affects a sizeable population segment.
“Early intervention in subthreshold or mild panic disorder is of public interest because it affects a sizeable population segment, 1,2”
From Early intervention in panic: Pragmatic randomised controlled trial (2010) · cites this paper as [1]
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“Norton et al. (1992) discuss a similar issue with regard to assessing panic attacks, given above and indicated the approximate frequency (never, arguing that the provision of a vignette substantially reduced once, two to five times, more than five times).”
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“We followed the method of McNally, Hornig, Hoffman, and Han (1999) and Norton, Cox, and Malan (1992) of categorizing individuals based on a history of spontaneous panic.”
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“Many people experience panic attacks without necessarily developing panic disorder (i.e., nonclinical panic attacks; Norton et al., 1992).”
BackgroundDimensions of Anxiety Sensitivity and Their Relationship to Nonclinical Panic
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“The prevalence of NCP in this sample (11.5%) closely resembles the prevalence rates typically observed in structured interview assessments of NCP and is substantially lower than the prevalence rates that are usually obtained in studies using questionnaire assessment ( Norton et al., 1992 ).”
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Self-citationCandidate genes for panic disorder: insight from human and mouse genetic studies
Gratacòs, M., Sahún, I., Gallego, X., Amador‐Arjona, A., Estivill, X., & Dierssen, M. (2007) · Genes Brain & Behavior · doi:10.1111/j.1601-183x.2007.00318.x · Cited by 33 · see citing works
“Anxiety sensitivity scores (ASI) distinguish between individuals with and without a lifetime history of panic attacks (for review, see Norton et al. 1992; Taylor 1999), and between individuals experiencing panic attacks and those with panic disorder (Cox et al. 1991).”
BackgroundSelf-rated importance of religion predicts one-year outcome of patients with panic disorder
Bowen, R., Baetz, M., & D’Arcy, C. (2006) · Depression and Anxiety · doi:10.1002/da.20157 · Cited by 33 · see citing works
“Nonclinical panic attacks are even more common, as much as 14% of the population or higher, depending on the method of ascertainment [Norton et al., 1992].”
Mathyssek, C. M., Olino, T. M., Verhulst, F. C., & van Oort, F. V. A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0051564 · Cited by 33 · see citing works
“They are considered to be amongst the most debilitating psychiatric conditions [2] and are associated with high level of mental health treatment seeking [3].”
BackgroundMarshall-Berenz, E. C., Vujanovic, A. A., & Zvolensky, M. J. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.09.001 · Cited by 31 · see citing works
Anxiety sensitivity as a predictor of panic disorder symptoms: a prospective 3-year study
Jurin, T., & Biglbauer, S. (2018) · Anxiety Stress & Coping · doi:10.1080/10615806.2018.1453745 · Cited by 30 · see citing works
Nonclinical Panic Attacks in Adolescents: Prevalence, Symptomatology, and Associated Features
King, N. J., Ollendick, T. H., Mattis, S. G., Yang, B., & Tonge, B. J. (1996) · Behaviour Change · doi:10.1017/s0813483900004940 · Cited by 29 · see citing works
“Next, based on extant empirical findings and theory, we included measures of anxiety, depression, and fear (Barlow, 1988; King et al., 1993; Macaulay & Kleinknecht, 1989; Norton et al., 1992).”
BackgroundMethodResultCognitive-Behavior Therapy and the Longitudinal Course of Panic Disorder
Otto, M. W., & Whittal, M. L. (1995) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(18)30024-8 · Cited by 29 · see citing works
Ataques de nervios: culturally bound and distinct from panic attacks?
Keough, M. E., Timpano, K. R., & Schmidt, N. B. (2008) · Depression and Anxiety · doi:10.1002/da.20498 · Cited by 27 · see citing works
Nonclinical panic attacks in late adolescence prevalence and associated psychopathology
Mattis, S. G., & Ollendick, T. H. (2002) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(01)00085-8 · Cited by 27 · see citing works
Anxiety sensitivity and its relationship to spontaneous and cued panic attacks in college students
Asmundson, G. J. G., & Norton, G. R. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90072-3 · Cited by 27 · see citing works
Self-citationMeasures for Panic Disorder and Agoraphobia
Antony, M. (2002) · Kluwer Academic Publishers eBooks · doi:10.1007/0-306-47628-2_10 · Cited by 26 · see citing works
“For example, the PAQ and PAQ-R have been used extensively to identify individuals in nonclinical samples who experience panic attacks ( Norton, Cox; & Malan, 1992; Norton, Pidlubny, & Norton, 1999) and to study the features of panic attacks in clinical samples (e.g., Cox, Endler, & Swinson, 1995; Cox, Swinson, Endler,…”
MethodBunaciu, L., Feldner, M. T., Blumenthal, H., Babson, K. A., Schmidt, N. B., & Sachs‐Ericsson, N. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.10.001 · Cited by 25 · see citing works
Substance Use and Non-Clinical Panic Attacks in a Young Adult Sample
Deacon, B. J., & Valentiner, D. P. (2000) · Journal of Substance Abuse · doi:10.1016/s0899-3289(99)00017-6 · Cited by 25 · see citing works
“Similarly, panic disorder often begins in young adulthood, but many adolescents report having experienced a panic attack (Norton et al., 1992).”
BackgroundInfluentialBernstein, A., Zvolensky, M. J., Sachs‐Ericsson, N., Schmidt, N. B., & Bonn‐Miller, M. O. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2006.01.002 · Cited by 24 · see citing works
“For example, panic attacks do not always lead to more severe forms of psychopathology, indicating that they should not be equated with psychiatric disorders [18-20].”
BackgroundIsyanov, E. V., & Calamari, J. E. (2004) · Anxiety Stress & Coping · doi:10.1080/0003379042000221421 · Cited by 24 · see citing works
Anxiety sensitivity: stability in prospective research
Maltby, N., Mayers, M., Allen, G. J., & Tolin, D. F. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.08.003 · Cited by 24 · see citing works
Hearld, K. R., Henna Budhwani, P., & Chavez‐Yenter, D. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.11.041 · Cited by 22 · see citing works
Consistencies between recalled panic and lactate‐induced panic
Goetz, R. R., Klein, D. F., & Gorman, J. M. (1994) · Anxiety · doi:10.1002/anxi.3070010108 · Cited by 22 · see citing works
Early intervention in panic: randomized controlled trial and cost-effectiveness analysis
Meulenbeek, P. A. M., Willemse, G., Smit, F., van Balkom, A. V., Spinhoven, P., & Cuijpers, P. (2008) · Trials · doi:10.1186/1745-6215-9-67 · Cited by 24 · see citing works
“A substantial proportion of the population suffers from subthreshold PD [8-10].”
The phenomenology of the first panic attack in clinical and community-based samples
Pané‐Farré, C. A., Stender, J. P., Fenske, K., Deckert, J., Reif, A., John, U., Schmidt, C. O., Schulz, A., Lang�, T., Alpers, G. W., et al. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.05.009 · Cited by 20 · see citing works
“These data support earlier findings from Roy-Byrne et al. (1999) who found that panic disorder patients do not improve from primary care setting and that primary care physicians have to be supported by delivering evidence based short-term treatments (Roy-Byrne, Wagner, & Schraufnagel, 2005).”
ResultMarshall, E. C., Zvolensky, M. J., Sachs‐Ericsson, N., Schmidt, N. B., & Bernstein, A. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.10.016 · Cited by 20 · see citing works
Uncued and cued emotions and associated distress in a college sample
Craske, M. G., Brown, T. A., Meadows, E. A., & Barlow, D. H. (1995) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)00036-0 · Cited by 19 · see citing works
Nonclinical panicker personality: Profile and discriminative ability
Richman, H., & Nelson-Gray, R. (1994) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)90021-3 · Cited by 19 · see citing works
Familial aggregation of panic in nonclinical panickers
Brown, T. A. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90116-3 · Cited by 17 · see citing works
Physical symptoms associated with worry in a nonclinical population
Freeston, M. H., Dugas, M. J., Letarte, H., Rhéaume, J., Blais, F. C., & Ladouceur, R. (1996) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(96)00017-5 · Cited by 17 · see citing works
Pané‐Farré, C. A., Fenske, K., Stender, J. P., Meyer, C., John, U., Rumpf, H., Hapke, U., & Hamm, A. O. (2013) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2013.06.008 · Cited by 16 · see citing works
Wie erleben Achtjährige Panikanfälle?
Federer, M., Schneider, S., Margraf, J., & Herrle, J. (2000) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026//0084-5345.29.3.195 · Cited by 15 · see citing works
Nonclinical panic and suicidality: Prevalence and psychopathology
Woodruff‐Borden, J., Stanley, M. A., Lister, S. C., & Tabacchi, M. R. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00092-7 · Cited by 15 · see citing works
Prenoveau, J. M., Forsyth, J. P., Kelly, M. M., & Barrios, V. (2006) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.03.004 · Cited by 14 · see citing works
The phenomenology of non-clinical panic in older adults in comparison to younger adults
Depp, C. A., Woodruff‐Borden, J., Meeks, S., Gretarsdottir, E., & DeKryger, N. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.04.007 · Cited by 11 · see citing works
Infrequent panic: physiological and subjective reactions to hyperventilation
Whittal, M. L., Goetsch, V. L., & Suchday, S. (1994) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)90009-4 · Cited by 11 · see citing works
A Study of Panic Attacks in University Students of Iran
Nazemi, H., Kleinknecht, R. A., Dinnel, D. L., Lonner, W. J., Nazemi, S., Shamlo, S., & Sobhan, A. (2003) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1023577024280 · Cited by 11 · see citing works
“Although similar to previous findings ( Norton et al., 1986, 1992 ), it is important to recognize that these are second hand and retrospective reports and therefore especially vulnerable to inaccuracy of recall.”
BackgroundResultPanic Disorder and Agoraphobia
Bouman, T. K., & Emmelkamp, P. M. G. (1996) · Springer eBooks · doi:10.1007/978-1-4899-1528-3_2 · Cited by 11 · see citing works
Hyperventilation and panic attacks in general hospital patients
Spinhoven, P., Onstein, E. J., Sterk, P. J., & Haen-Versteijnen, D. L. (1993) · General Hospital Psychiatry · doi:10.1016/0163-8343(93)90117-7 · Cited by 10 · see citing works
Cox, B. J., Endler, N. S., & Norton, G. R. (1994) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(94)90061-2 · Cited by 9 · see citing works
Self-citationCritical analysis of the DSM III-R classification of panic disorder: A survey of current opinions
Norton, G. R., Cox, B. J., & Schwartz, M. A. J. (1992) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(92)90014-x · Cited by 9 · see citing works
Self-citationCuestionario de pánico y agorafobia (CPA) : características de los ataques de pánico no clínicos
Sandín, B., Chorot, P., Valiente, R. M., Sánchez-Arribas, C., & Germán, M. Á. S. (2004) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.vol.9.num.2.2004.3974 · Cited by 7 · see citing works
“Algunos aspectos que parecen influir en las diferencias en las tasas obtenidas son la mayor o menor especificación de lo que es un AP en las instruc- ciones iniciales, y los requerimientos de 4 síntomas y/o el carácter inesperado de los AP (Norton et al, 1992).”
BackgroundInfluentialOlatunji, B. O., Feldner, M. T., Karekla, M., & Forsyth, J. P. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.02.008 · Cited by 7 · see citing works
Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance
Geyer, R. B., Magee, J. C., & Clerkin, E. M. (2022) · Anxiety Stress & Coping · doi:10.1080/10615806.2022.2146102 · Cited by 6 · see citing works
“Panic attacks are experienced across a range of different anxiety disorders, including panic, social anxiety, and generalized anxiety disorders (Brown et al., 2016; Tull et al., 2009; Versella et al., 2016), and are also seen in nonclinical populations (Norton et al., 1992).”
BackgroundSmits, J. A. J., Kauffman, B. Y., Lee-Furman, E., Zvolensky, M. J., Otto, M. W., Piper, M. E., Powers, M. B., & Rosenfield, D. (2016) · Contemporary Clinical Trials · doi:10.1016/j.cct.2016.03.011 · Cited by 4 · see citing works
“Panic attacks are common (7–10% of the general population regularly experience panic attacks; [32]) and co-occur with smoking at rates that exceed those found in the general non-psychiatric population [2,8,9,17,18,25,35].”
BackgroundTalkovsky, A. M., & Norton, P. J. (2015) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.29.2.123 · Cited by 3 · see citing works
“For instance, G. Norton, Cox, and Malan (1992) report that average of 16.2% of individuals (range: 6.2%–29.9”
BackgroundInfluentialPanic Disorder and Agoraphobia
Teachman, B. A., Beltzer, M., & Werntz, A. J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108140416.017 · Cited by 3 · see citing works
A 28-Year-Old Woman With Panic Disorder
Gorman, J. M. (2001) · JAMA · doi:10.1001/jama.286.4.450 · Cited by 3 · see citing works
The Development of Anxiety Symptoms in Adolescents
Mathyssek, C. M. (2014) · EUR Research Repository (Erasmus University Rotterdam) · Cited by 3 · see citing works
Emmelkamp, P. M. G., & van Oppen, P. (1994) · Springer eBooks · doi:10.1007/978-1-4757-0345-0_14 · Cited by 3 · see citing works
Untroubled Pullers: An Examination of Nonclinical Hair-Pulling
Flannery, M. K., Falkenstein, M. J., Boyd, M., & Haaga, D. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100821 · Cited by 2 · see citing works
Analisis Eskalasi Panic Attack And Anxiety Disorder Terhadap Kesehatan Mental Remaja
Kurniawan, D., Mu'arifah, N. E. I., & Ma’shum, A. R. (2022) · Busyro Jurnal Dakwah dan Komunikasi Islam · doi:10.55352/kpi.v3i2.236 · Cited by 2 · see citing works
Tobacco Use and Panic Psychopathology: Current Status and Future Directions
Zvolensky, M. J., Leyro, T. M., Bernstein, A., Feldner, M. T., Yartz, A. R., Babson, K. A., & Bonn‐Miller, M. O. (2007) · Springer eBooks · doi:10.1007/978-0-387-74753-8_1 · Cited by 1 · see citing works
“Thus, panic attacks are a relatively common psychological experience and many people experience panic attacks without necessarily developing panic disorder (i.e., nonclinical panic attacks; Norton, Cox, & Malan, 1992 ).”
BackgroundWright, J. H. (1997) · Cited by 1 · see citing works
Emmelkamp, P. M. G., & van Oppen, P. (2001) · Springer eBooks · doi:10.1007/978-1-4419-8497-5_14 · Cited by 1 · see citing works
Valentiner, D. P., & Jones, D. (2025) · Springer eBooks · doi:10.1007/978-1-0716-4362-4_8 · Cited by 1 · see citing works
Avoiding Treatment Failures in Panic Disorder
Latin, H. M., McHugh, R. K., & Otto, M. W. (2009) · Springer eBooks · doi:10.1007/978-1-4419-0612-0_7 · Cited by 1 · see citing works
Welch, S. S., Craske, M., Stein, M. B., Harrison-Read, P., & Roy‐Byrne, P. (2008) · Cambridge University Press eBooks · doi:10.1017/cbo9780511544392.034 · Cited by 1 · see citing works
Moore, M. C. (2001) · ThinkTech (Texas Tech University) · Cited by 1 · see citing works
Panic Disorder without Agoraphobia
National Cancer Institute (2020) · Definitions · doi:10.32388/ckyzgx · Cited by 1 · see citing works
Ranslow, E. (2004) · DigitalCommons (California Polytechnic State University)
Panic Disorder, Trait Anxiety, and Risk Drinking in Pregnant and Non-Pregnant Women
Meshberg‐Cohen, S. (2006) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/ytyp-h017
- Authors
- Norton, G. R., Cox, B. J., & Malan, J.
- Affiliations
- York University (CA)
- The University of Winnipeg (CA)
- ORCID
- Cox, Brian J.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 1992-01
- Volume
- 12
- Issue
- 2
- Pages
- 121-139
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2164483219
- Cited by
- 115
- References
- 66
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2020: 1 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 5 · 2013: 1 · 2012: 2
- FWCI
- 9.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- panic attacks, prevalence, psychophysiological responses, depression, anxiety
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