Paths to panic disorder/agoraphobia: an exploratory analysis from age 3 to 21 in an unselected birth cohort.

OBJECTIVE: To evaluate childhood temperamental traits and early illness experiences in the etiology of adult panic disorder with agoraphobia. METHOD: Evaluated temperamental and illness experience factors, at ages 3 through 18, as predictors of panic and agoraphobia at ages 18 or 21 in an unselected sample (N = 992). Analyses were conducted with classification trees. RESULTS: Experience with respiratory ill health predicted panic/agoraphobia relative to other anxiety disorders and healthy controls. Also, temperamental emotional reactivity at age 3 predicted panic/agoraphobia in males but did not predict other anxiety disorders, compared with healthy controls. Furthermore, temperament and ill health interacted with gender. CONCLUSIONS: Results are discussed in terms of cognitive theories of fear of physical symptoms and biological models of respiratory disturbance for panic/agoraphobia.

Reactivity to interoceptive cues in nocturnal panic.

In this study, patients with panic disorder (PD) who suffered nocturnal panic (NP) attacks were compared with PD patients who never experienced NP attacks and healthy controls. Three tasks were chosen to evaluate attention to cardiac cues, reactivity to induction of respiratory cues, and reactivity to relaxation cues. Relative to healthy controls, PD groups reported more fear of all three tasks and showed more physiological arousal in response to the hyperventilation task. The only task on which the two PD groups differed was the relaxation task, where nocturnal panickers were significantly more distressed. These findings are consistent with the notion that nocturnal panickers are fearful of states involving a diminution of conscious awareness or vigilance.

The effects of cognitive-behavior therapy for panic disorder on comorbid conditions.

In a replication and extension of prior research (Brown, Antony, & Barlow, 1995) examining the impact of treatment on additional diagnoses, our study investigated the effects of cognitive-behavioral treatment for panic disorder on frequency and severity of comorbid conditions in 33 principal panic disorder patients. Patients were diagnosed using the Anxiety Disorders Interview Schedule-Revised (ADIS-R; Di Nardo & Barlow, 1988) and assigned severity ratings indicating degree of distress and/or impairment for both principal panic disorder and comorbid conditions. A high rate of comorbidity (63.6%) was found at pretreatment. Following cognitive-behavioral treatment, there was a significant reduction in the number of patients with at least one additional diagnosis (p < .01); the greatest declines were found in comorbid social phobia and generalized anxiety disorder. Severity ratings also declined significantly from pre- to posttreatment for comorbid social phobia, generalized anxiety disorder, and posttraumatic stress disorder (p < .01) and were marginally significant for depression. There was a trend for comorbidity to reduce likelihood of achieving high improvement in panic at posttreatment. Implications of these findings for classification and treatment mechanisms are discussed.

Informational and symbolic content of over-the-counter drug advertising on television.

The informational and symbolic content of 150 over-the-counter drug commercials on television are empirically analyzed in this study. Results on the informational content suggest that over-the-counter drug ads tend to focus on the concern of what the drug will do for the consumer, rather than on the reasons why the drug should be ingested. Accordingly, advertising strategy is centered on consumer awareness of the product as the primary goal. Educational commitment, however, did not seem to be blended into the promotional efforts for over-the-counter drugs. Findings on the symbolic content of over-the-counter drug ads reveal that drug images have been distorted. Performance of most drugs has been portrayed to be simple resolutions to relieve the symptom. Moreover, a casual attitude toward drug usage is encouraged in the commercials, while time lapse of drug effects is overlooked.