Panic disorder is a condition characterized by repeated and unexpected panic attacks, fear that an attack will happen again (anticipatory fear), fear of potential physical, social and psychological consequences of the attack and the visible changes in behavior (eg avoiding situations or određnih undergoing numerous medical examinations).
A panic attack is a beginning, take a few minutes, rarely hours and has a spontaneous outburst završetak.To paroxysmal very intense fear, with no visible signs or cause, tends to have a recurrence and an emotional experience different from other anxiety disorders.
Panic disorder is often accompanied by agoraphobia. Agoraphobia is defined as the fear of a number of places or situations that can be avoided, and fear is the most common result of expectations that these situations occur panic attacks physical symptoms or fears. Agoraphobia is therefore the consequence of panic attacks and panic disturbances across complications.
Panic attacks can occur as early as ten years of age, which was found in 18% of adults with this problem.Most panic attacks in young adolescents is associated with some significant events, while older adolescents occurs unexpectedly. Some authors believe that the clinical presentation of panic disorder in the developmental period similar to that encountered in adult patients. I point out that adolescents and adults with panic are brought to the emergency medical service because of physical symptoms, which are not recognized as part of the panic disorder.
Not recognizing panic disorder in young people can be serious consequences for the psychosocial and cognitive development of young people. Practice has shown that prior to the arrival of a psychiatrist at least ten doctors are involved in the treatment of nearly 70% of panic patients. The process of searching for physical illness lasts for a long time, and then the patient is referred to, as it were, under the pressure of a psychiatrist, which bypasses all the time.
But this is often not the end of the problem, because often diagnoses fear neurosis, phobic neurosis, depressive reactions, etc.. As many as 95% of patients changed over shrink until the hold on again, and this fact has become a landmark in the accurate diagnosis of panic disorder.
In this population panic attacks are often characterized by the appearance of the following symptoms: palpitations, tremors, sweating, heat and cold waves over the body, nausea, abdominal pain, dizziness, and cognitive symptoms such as fear of losing control, fear of insanity and fear of deaths. About 40% of adolescents have during the worst panic attacks severe interference in the operation, and one in five adolescents with panic disorder seek professional help for their emotional and psychiatric problems.
Agoraphobia is prevalentnija the young in whom panic disorder started in previous years, and with them the common comorbidity with other anxiety and affective disorders. Agoraphobic avoidance behavior is a significant complication of panic disorder that requires vigorous treatment. It involves avoiding a number of places and situations caused by the fear of panic attacks in these places, and can greatly impoverish the life of a person.
Ethiopathogenesis panic disorder
Predisposing factors for the occurrence of panic disorder: anxiety sensitivity, negative affectivity, female gender, presence of depressive disorder, the presence of separation anxiety in early childhood and adolescence.
Precipitating factors for the occurrence of panic attacks include family conflicts and different stressful situations. As the previous depressive episode may be a predictor of early panic attacks and panic attacks prediktuje history of major depressive episode. Early onset of panic disorder is associated with a family, although the clinical picture of them does not have to be difficult.
The rate of panic disorder among relatives of the first generation was higher in patients with early-onset panic disorder.
The understanding of panic disorder has a significant role theory of separating the fears and perceptions psychodynamic model of panic disorder. Freud sepracionoj the anxiety gave special importance to the emerging panic disturbances across.
The first theory of fear-preobražanje libido into fear, at the same time, Freud's first theory of the fear of separation. Dealing with the fear of children, Freud opined that children experience fear in situations when separated from the mother, or when experiencing loss or feel loved. Separated from the mother, the children feel anxiety in the way as an older feel frustration libidinally invested implementation. The accumulated body tension is directly converted into fear.
Bowlby points out that changes in childhood, such as separation or threat of separation, which seem insignificant for parents can be traumatic for the child. Behavior bonding (attachment behavior) can persist for Boulbijevoj hypothesis throughout their lives. Failure of parental empathy in children with insecure attachment'''' included, constitutionally predisposed, leading to disordered internalization of soothing parental figure that would help a child in the modulation of intense feelings of fear. (Ainsworth, 1978).
Factors contributing to the maintenance of panic disorder are included in the conceptualization of cognitive disorders. Influential psychological models of anxiety disorders postulate that cognitive processes are essential for the maintenance of these disorders.
Three types of cognitive errors mediated the maintenance of anxiety disorders:
Errors attention
Errors in memory
Errors in interpretation
Among them, the panic disorder are the most specific errors in the interpretation of panic symptoms.People with panic disorder interpret bodily sensations, which are typical for panic disorder as threatening and menacing, and this interpretation by increasing the level of anxiety that result in panic attacks. Apart from fear of bodily symptoms and their interpretation as a sign of a serious physical illness which leads to the fear of death in patients with panic disorder are often the fear of falling and loss of consciousness (usually with symptoms of dizziness), fear of losing control and fear of madness. Catastrophic misrepresentation contributes to anxiety sensitivity, temperamental characteristics that predispose for the development of anxiety disorders. Anxiety sensitivity is the increased tendency to react fearfully to the emergence of anxiety symptoms and has a position of cognitive factors in the development of anxiety disorders in youth.
Consistent with the cognitive model of panic, that young and be able to experience physiological symptoms associated with panic requires a catastrophic cognitions. Negative cognitions and assumptions and interpretations of various physical symptom associated with panic significantly increase the likelihood of having a panic attack.
Contributes to the understanding of panic disorder and biological theory about the sympathetic overactivity and the role of genetic factors for cognitive behavioral inhibition. (Robinson, Kagan, 1992)
Share genetic factors in kogmitivnoj behavioral inhibition is about 50%. Kagan is hypothesized that inhibited children and young people tend to fear born with a lower threshold of stimulation of the amygdala and hypothalamic neurons. (Robinson, Kagan, 1992).
's Cognitive behavioral inhibition is characterized by the reaction of withdrawal in unfamiliar situations or among strangers, shyness and physical manifestations that are the result of increased sympathetic activity.The link between behavioral inhibition and anxiety disorders has been confirmed in a series of family studies. They show that children and parents with panic disorder and agoraphobia have a high degree of behavioral inhibition (Craske, 1997)
Any early occurrence of panic disorder, suggesting biological predispoziciju.Takođe, adverse experiences during childhood can have long-lasting effects on the central and serotonergic system and may determine predisposition to anxiety disorders. (Craske, 1997)
Treatment of panic disorder
Since the etiopathogenesis of panic disorder, a complex interplay of biological and psychological factors, the problem usually will not be able to solve through the prism of a single theoretical system and the theoretical approach, but we will have to resort to a combination of therapeutic modalities for the treatment, including pharmacotherapy, cognitive techniques -behavioral therapy and various modifications of psychoanalytic psychotherapy (psihoanalatičko counseling, brief psychodynamic).
Treatment of panic disorder is necessarily integrative, which again, includes a variety of therapeutic modalities in the different stages of the disease.
A panic attack is a beginning, take a few minutes, rarely hours and has a spontaneous outburst završetak.To paroxysmal very intense fear, with no visible signs or cause, tends to have a recurrence and an emotional experience different from other anxiety disorders.
Panic disorder is often accompanied by agoraphobia. Agoraphobia is defined as the fear of a number of places or situations that can be avoided, and fear is the most common result of expectations that these situations occur panic attacks physical symptoms or fears. Agoraphobia is therefore the consequence of panic attacks and panic disturbances across complications.
Panic attacks can occur as early as ten years of age, which was found in 18% of adults with this problem.Most panic attacks in young adolescents is associated with some significant events, while older adolescents occurs unexpectedly. Some authors believe that the clinical presentation of panic disorder in the developmental period similar to that encountered in adult patients. I point out that adolescents and adults with panic are brought to the emergency medical service because of physical symptoms, which are not recognized as part of the panic disorder.
Not recognizing panic disorder in young people can be serious consequences for the psychosocial and cognitive development of young people. Practice has shown that prior to the arrival of a psychiatrist at least ten doctors are involved in the treatment of nearly 70% of panic patients. The process of searching for physical illness lasts for a long time, and then the patient is referred to, as it were, under the pressure of a psychiatrist, which bypasses all the time.
But this is often not the end of the problem, because often diagnoses fear neurosis, phobic neurosis, depressive reactions, etc.. As many as 95% of patients changed over shrink until the hold on again, and this fact has become a landmark in the accurate diagnosis of panic disorder.
In this population panic attacks are often characterized by the appearance of the following symptoms: palpitations, tremors, sweating, heat and cold waves over the body, nausea, abdominal pain, dizziness, and cognitive symptoms such as fear of losing control, fear of insanity and fear of deaths. About 40% of adolescents have during the worst panic attacks severe interference in the operation, and one in five adolescents with panic disorder seek professional help for their emotional and psychiatric problems.
Agoraphobia is prevalentnija the young in whom panic disorder started in previous years, and with them the common comorbidity with other anxiety and affective disorders. Agoraphobic avoidance behavior is a significant complication of panic disorder that requires vigorous treatment. It involves avoiding a number of places and situations caused by the fear of panic attacks in these places, and can greatly impoverish the life of a person.
Ethiopathogenesis panic disorder
Predisposing factors for the occurrence of panic disorder: anxiety sensitivity, negative affectivity, female gender, presence of depressive disorder, the presence of separation anxiety in early childhood and adolescence.
Precipitating factors for the occurrence of panic attacks include family conflicts and different stressful situations. As the previous depressive episode may be a predictor of early panic attacks and panic attacks prediktuje history of major depressive episode. Early onset of panic disorder is associated with a family, although the clinical picture of them does not have to be difficult.
The rate of panic disorder among relatives of the first generation was higher in patients with early-onset panic disorder.
The understanding of panic disorder has a significant role theory of separating the fears and perceptions psychodynamic model of panic disorder. Freud sepracionoj the anxiety gave special importance to the emerging panic disturbances across.
The first theory of fear-preobražanje libido into fear, at the same time, Freud's first theory of the fear of separation. Dealing with the fear of children, Freud opined that children experience fear in situations when separated from the mother, or when experiencing loss or feel loved. Separated from the mother, the children feel anxiety in the way as an older feel frustration libidinally invested implementation. The accumulated body tension is directly converted into fear.
Bowlby points out that changes in childhood, such as separation or threat of separation, which seem insignificant for parents can be traumatic for the child. Behavior bonding (attachment behavior) can persist for Boulbijevoj hypothesis throughout their lives. Failure of parental empathy in children with insecure attachment'''' included, constitutionally predisposed, leading to disordered internalization of soothing parental figure that would help a child in the modulation of intense feelings of fear. (Ainsworth, 1978).
Factors contributing to the maintenance of panic disorder are included in the conceptualization of cognitive disorders. Influential psychological models of anxiety disorders postulate that cognitive processes are essential for the maintenance of these disorders.
Three types of cognitive errors mediated the maintenance of anxiety disorders:
Errors attention
Errors in memory
Errors in interpretation
Among them, the panic disorder are the most specific errors in the interpretation of panic symptoms.People with panic disorder interpret bodily sensations, which are typical for panic disorder as threatening and menacing, and this interpretation by increasing the level of anxiety that result in panic attacks. Apart from fear of bodily symptoms and their interpretation as a sign of a serious physical illness which leads to the fear of death in patients with panic disorder are often the fear of falling and loss of consciousness (usually with symptoms of dizziness), fear of losing control and fear of madness. Catastrophic misrepresentation contributes to anxiety sensitivity, temperamental characteristics that predispose for the development of anxiety disorders. Anxiety sensitivity is the increased tendency to react fearfully to the emergence of anxiety symptoms and has a position of cognitive factors in the development of anxiety disorders in youth.
Consistent with the cognitive model of panic, that young and be able to experience physiological symptoms associated with panic requires a catastrophic cognitions. Negative cognitions and assumptions and interpretations of various physical symptom associated with panic significantly increase the likelihood of having a panic attack.
Contributes to the understanding of panic disorder and biological theory about the sympathetic overactivity and the role of genetic factors for cognitive behavioral inhibition. (Robinson, Kagan, 1992)
Share genetic factors in kogmitivnoj behavioral inhibition is about 50%. Kagan is hypothesized that inhibited children and young people tend to fear born with a lower threshold of stimulation of the amygdala and hypothalamic neurons. (Robinson, Kagan, 1992).
's Cognitive behavioral inhibition is characterized by the reaction of withdrawal in unfamiliar situations or among strangers, shyness and physical manifestations that are the result of increased sympathetic activity.The link between behavioral inhibition and anxiety disorders has been confirmed in a series of family studies. They show that children and parents with panic disorder and agoraphobia have a high degree of behavioral inhibition (Craske, 1997)
Any early occurrence of panic disorder, suggesting biological predispoziciju.Takođe, adverse experiences during childhood can have long-lasting effects on the central and serotonergic system and may determine predisposition to anxiety disorders. (Craske, 1997)
Treatment of panic disorder
Since the etiopathogenesis of panic disorder, a complex interplay of biological and psychological factors, the problem usually will not be able to solve through the prism of a single theoretical system and the theoretical approach, but we will have to resort to a combination of therapeutic modalities for the treatment, including pharmacotherapy, cognitive techniques -behavioral therapy and various modifications of psychoanalytic psychotherapy (psihoanalatičko counseling, brief psychodynamic).
Treatment of panic disorder is necessarily integrative, which again, includes a variety of therapeutic modalities in the different stages of the disease.
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