Cognitive Behaviour Therapy
Volume 37, Issue 2, 2008, Pages 101-116

The panic attack - Posttraumatic stress disorder model: Applicability to orthostatic panic among Cambodian refugees (Article)

Hinton D.E.* , Hofmann S.G. , Pitman R.K. , Pollack M.H. , Barlow D.H.
  • a Southeast Asian Clinic, Arbour Counseling Services, Lowell, MA, United States, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States, Department of Psychology, Harvard Medical School, Cambridge, MA, United States
  • b Department of Psychology, Harvard Medical School, Cambridge, MA, United States
  • c Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States, Department of Psychology, Harvard Medical School, Cambridge, MA, United States
  • d Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States, Department of Psychology, Harvard Medical School, Cambridge, MA, United States
  • e Center for Anxiety and Related Disorders, Boston University, Boston, MA, United States

Abstract

This article examines the ability of the panic attack-posttraumatic stress disorder (PTSD) model to predict how panic attacks are generated and how panic attacks worsen PTSD. The article does so by determining the validity of the panic attack-PTSD model in respect to one type of panic attack among traumatized Cambodian refugees: orthostatic panic (OP) attacks (i.e. panic attacks generated by moving from lying or sitting to standing). Among Cambodian refugees attending a psychiatric clinic, the authors conducted two studies to explore the validity of the panic attack-PTSD model as applied to OP patients (i.e. patients with at least one episode of OP in the previous month). In Study 1, the panic attack-PTSD model accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious-depressive distress (Symptom Checklist-90-R subscales), and OP severity significantly mediated the effect of anxious-depressive distress on Clinician-Administered PTSD Scale severity. In Study 2, as predicted by the panic attack-PTSD model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a cognitive behavioural therapy study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity.

Author Keywords

Stress disorder Posttraumatic Panic disorder Flashbacks Orthostatic intolerance Panic attack Catastrophic cognitions Cambodian refugees

Index Keywords

Models, Psychological depression Panic Disorder refugee regression analysis anxiety disorder Cambodia cognitive defect human comorbidity Refugees middle aged validation process controlled study cognitive therapy orthostatic stress panic dizziness United States Symptom Checklist 90 Humans Severity of Illness Index Asian Americans male female prediction Reproducibility of Results prevalence Article major clinical study adult posttraumatic stress disorder Stress Disorders, Post-Traumatic disease severity accuracy statistical model clinical effectiveness
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-46049106532&doi=10.1080%2f16506070801969062&partnerID=40&md5=c9cad65d490e27fb891d5d72fb83ba03
DOI: 10.1080/16506070801969062
ISSN: 16506073
Cited by: 49
Original Language: English