Research
Panic
Anxiety Education
Management Services
Evaluation of Effectiveness of Panic Anxiety
Management Program
Jasmine Arthur-Jones and Associate
Professor Dr Julian Hafner
INTRODUCTION
The Panic Anxiety Management Workshop is for people with an
Anxiety Disorder and their carers. It was designed by people who
have recovered from an Anxiety Disorder. The Sub components of the
Workshop are
- Information relating to Anxiety Disorders: symptoms,
panic/anxiety attacks, dissociation, causes, secondary
conditions eg depression, Agoraphobia, drug issues, alcohol
abuse;
- Meditation: how, why, where and when plus a practical session;
- Cognitive: teaching participants how to work with their
thinking, how to work with dissociation, panic attacks, and the
major Anxiety Disorder fears
- The Working Through Process to Recovery: varying factors
associated with recovery process; and
- Self Issues: dealing with 'Who am I'.
This Workshop was conducted over a 2 day period, usually the
weekend.
This paper presents the results of a 18 month study conducted by the
Panic Anxiety Disorder Association in conjunction with Associate
Professor Dr Julian Hafner, Dibden Research Unit, Glenside Campus,
South Australia Mental Health Services, Adelaide. The emphasis will
be on presenting the comparative results obtained from people
diagnosed with an Anxiety Disorder attending the 2 day Panic Anxiety
Management Workshops held in Queensland, Western Australia and
Northern Territory. Recovery rates are obtained via comparison of
initial contact data obtained from participants i.e. when they
attended the weekend Workshop and Follow Up data i.e 3 months after
attending the weekend Workshop.
Assessments were also made of the effectiveness of the Panic Anxiety
Management Workshop by the individual participants Data is also
compiled from participant's opinion of the effectiveness of other
therapy modalities available for people diagnosed with an Anxiety
Disorder.
METHOD
The Panic/Anxiety Disorder Questionnaire (Appendix 1) and
Therapy/Workshop Assessment Questionnaire (Appendix 2) were designed
by Bronwyn Fox (Panic Anxiety Disorder Association) and Associate
Professor Dr Julian Hafner. The Fear Questionnaire usually given to
Anxiety Disorder patients was discounted as appropriate for this
study by Bronwyn Fox after consultation with Dr Hafner. A previous
pilot study conducted by Dr Hafner/B.Fox which incorporated the Fear
Questionnaire was questioned by participants as to it's accurate
measurement of their Anxiety Disorder. Preference was given by the
clients to the Symptom Questionnaire. The Panic/Anxiety Disorder
Questionnaire also included primary personal data such as
participant's name, sex, age, and Anxiety Disorder diagnosis.
Questions 37 through 41 of the Panic/Anxiety Disorder Questionnaire
relate to Descriptors of a panic attack as shown from previous
studies undertaken by Bronwyn Fox. These Descriptors, although not
found in current literature regarding Panic Attacks, are identified
by people actually having Panic Attacks as descriptive of their
experience. The Therapy/Workshop Assessment Questionnaire obtained
data such as participant's name, gender, age, marital status,
therapies previously tried and their rate of effectiveness,
effectiveness of the Panic/Anxiety Management Workshop they had just
attended, what they had learnt from the Workshop,and personal
suggestions or comments about the course. Panic Anxiety Management
Workshops were held every three (3) months initially, then every 4
months thereafter in Queensland, Western Australia and Northern
Territory over a period of 18 months. Those people attending the
Workshop were given a choice as to whether they wished to
participate in the study, therefore total attendance figures far
exceed the study participant figures. On the first day of the Panic
Anxiety Management Workshop, people in attendance were given the
Panic/Anxiety Disorder Questionnaire and on the following day the
Therapy/Workshop Assessment Questionnaire. Those people diagnosed
with an Anxiety Disorder wishing to participate in the Effectiveness
study returned their filled in Questionnaires on the final day of
the Workshop. These completed Questionnaires/ Assessments were given
to Dr Julian Hafner for analysis. Three (3) months after the initial
contact, the Panic/Anxiety Disorder Questionnaire was sent to those
participating in the study to be filled in and returned to Dr Hafner
as Follow Up data. Comparison of degree of severity of Panic/Anxiety
Disorder symptoms from initial contact to the 3 month Follow Up
indicate the recovery rate of Anxiety Disorder participants. The
data is compiled from a total of 16 Workshops.
RESULTS
A total of 310 people with an Anxiety Disorder participated in
the Effectiveness study. Figure 1 shows the age distribution, with a
mean age 41.6 years (SD=12.4, range=12 - 76). Gender distribution is
264 (or 73.1%) female and 97 (or 26.9%) male. Percentile
distribution of marital status of participants is shown is as
follows: single 17.7%; married 65.2%; divorced 8.1%; separated 3.3%;
and widowed 5.7%. State of origin distribution of participants was
Western Australia 109 (or 30.1%); Queensland 203 (or 56.1%); and
Northern Territory 50 (or 13.8%). Percentile distribution of primary
Anxiety Disorder diagnosis of Effectiveness Study participants are
shown in Figure 1.
Table 1. Percentile distribution
of Anxiety Disorder disgnosis of Evaluation participants.
|
Anxiety Disorder Diagnosis |
Percent of Evaluation participants |
| Panic Disorder |
50.6% |
| Generalised Anxiety Disorder |
42.3% |
| Obsessive Compulsive Disorder |
5.5% |
| Post Traumatic Stress Disorder |
10% |
| Social Phobia (Anxiety) |
14.2% |
| Specific Phobia |
8.1% |
| Other (Agoraphobia etc) |
7.4% |
Primary Anxiety Disorder diagnoses are specified in DSM IV.
Comparison
of severity of Anxiety Disorder symptoms
Initial are shown in Table 2.
Table 2. Symptoms experienced by
Evaluation participants - Initial contact
| Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Heart Palpitations |
21.9% |
25.8% |
22.3% |
20.6% |
9.4% |
| Missed heartbeats |
48.7% |
23.9% |
14.2% |
11% |
2.3% |
| Chest pain |
34.5% |
28.1% |
17.1% |
12.6% |
7.7% |
| Shortness of breath |
27.4% |
17.7% |
20.3% |
20% |
14.5% |
| Difficulty breathing |
32.9% |
14.5% |
17.1% |
20% |
15.5% |
| Choking sensations |
56.5% |
12.6% |
11.9% |
10.6% |
8.4% |
| Nausea |
35.8% |
21.3% |
18.7% |
16.5% |
7.7% |
| Burning sensation in stomach |
50% |
16.8% |
16.5% |
10% |
6.8% |
| Shaking/ trembling |
25.8% |
18.4% |
21.6% |
17.7% |
16.5% |
| Pins and needles |
38.4% |
25.5% |
15.8% |
15.5% |
4.8% |
| Diarrhea |
53.5% |
21.3% |
12.6% |
8.1% |
4.5% |
| Vomiting |
78.7% |
11.9% |
3.2% |
3.9% |
2.3% |
| Hot flashes |
32.6% |
24.2% |
19% |
13.2% |
11% |
| Cold flashes |
65.2% |
15.2% |
9.7% |
5.8% |
4.2% |
| Night sweats |
57.7% |
16.8% |
12.3% |
7.1% |
6.1% |
| Headaches |
26.5% |
24.2% |
21% |
17.1% |
11.3% |
| Neckaches |
26.5% |
15.5% |
20.3% |
21.3% |
16.5% |
| Lower back pain |
40.6% |
19% |
15.8% |
17.4% |
7.1% |
| Pelvic pain |
71.6% |
9.7% |
9.7% |
6.8% |
2.3% |
| Numbness in hands/feet |
50% |
20.6% |
14.8% |
8.7% |
5.8% |
| Loss of appetite |
51.6% |
18.1% |
10.6% |
13.2% |
6.5% |
| Extreme exhaustion |
17.4% |
18.4% |
19% |
21.9% |
23.2% |
| Loss of concentration |
11.9% |
17.4% |
19.7% |
30.6% |
20.3% |
| Temporary paralysis |
78.4% |
9.7% |
7.1% |
3.2% |
1.6% |
| Feeling faint |
27.1% |
24.8% |
20% |
16.1% |
11.9% |
| Feeling dizzy |
22.8% |
23.1% |
24.8% |
17.9% |
11.4% |
Table 2. Dissociative symptoms
experienced by Evaluation participants - Initial contact
Dissociative
Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Feeling detached from body |
58.3% |
16.3% |
8.8% |
10.4% |
6.2% |
| Feel as if floating |
60.9% |
15% |
10.4% |
8.1% |
5.5% |
| Feel surroundings not seem real |
35.5% |
20.5% |
16.6% |
15.3% |
12.1% |
| Surroundings as through a mist |
62.5% |
11.4% |
14.3% |
7.5% |
4.2% |
| Visual distortions/ objects moving |
59.9% |
18.2% |
8.5% |
9.1% |
4.2% |
| Falling into a void |
64.2% |
14.3% |
6.2% |
9.1% |
6.2% |
| Oversensitivity to colours |
72.6% |
13% |
7.2% |
6.2% |
1% |
| Eyes burning |
55.7% |
19.5% |
13% |
8.5% |
3.3% |
| Oversensitive hearing |
43.6% |
16.9% |
16.3% |
15.6% |
7.5% |
Table 2. Panic attack descriptors
experienced by Evaluation participants - Initial contact
| Panic Attack Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Electric current move through body |
59.6% |
13.7% |
11.1% |
8.5% |
7.2% |
| Intense energy flow thru body |
44.6% |
16.3% |
16.3% |
12.7% |
10.1% |
| Intense heat/ burning thru body |
60.6% |
15% |
9.4% |
9.4% |
5.5% |
| Wave-like energy thru body |
57.7% |
14.7% |
10.4% |
9.4% |
7.8% |
| Hot prickly sensation thru body |
58.3% |
14.3% |
12.4% |
8.8% |
6.2% |
Table 2. Anxiety Disorder major
fears experienced by Evaluation participants - Initial contact
| AnxietyDisorder Major
Fears |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Feeling having a heart attack |
36.5% |
17.9% |
10.1% |
16.9% |
18.6% |
| Feeling going to die |
36.8% |
12.4% |
9.8% |
17.9% |
23.1% |
| Feeling going insane |
29% |
15% |
11.1% |
18.9% |
26.1% |
| Feeling losing control |
14.3% |
8.8% |
17.6% |
21.5% |
37.8% |
| Feeling passing out |
35.5% |
16% |
13% |
13.4% |
22.1% |
| Feeling attack of diarrhea |
65.5% |
13.7% |
10.7% |
4.2% |
5.9% |
| Feeling going to vomit |
69.1% |
11.7% |
7.2% |
6.2% |
5.9% |
| Feeling will hurt self or someone |
54.1% |
14.3% |
7.5% |
12.1% |
12.1% |
Follow up are shown in Table 3.
Table 3. Symptoms experienced by
Evaluation participants - Follow up contact
| Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Heart Palpitations |
34.1% |
39.6% |
14% |
9.1% |
3% |
| Missed heartbeats |
57.3% |
28.7% |
9.1% |
4.3% |
0.6% |
| Chest pain |
53% |
24.4% |
14.6% |
6.1% |
1.8% |
| Shortness of breath |
32.3% |
23.2% |
23.2% |
15.2% |
6.1% |
| Difficulty breathing |
39.6% |
19.5% |
20.1% |
14.6% |
6.1% |
| Choking sensations |
59.8% |
15.9% |
11% |
9.8% |
3.7% |
| Nausea |
39.8% |
28.7% |
12.2% |
14% |
5.5% |
| Burning sensation in stomach |
53% |
14.6% |
18.9% |
10.4% |
3% |
| Shaking/ trembling |
27.4% |
32.9% |
15.2% |
16.5% |
7.9% |
| Pins and needles |
45.7% |
30.5% |
17.1% |
4.9% |
1.8% |
| Diarrhea |
54.3% |
23.2% |
16.5% |
3.7% |
2.4% |
| Vomiting |
80.5% |
7.9% |
6.7% |
3.7% |
1.2% |
| Hot flashes |
43.9% |
23.8% |
15.9% |
11% |
5.5% |
| Cold flashes |
65.2% |
19.5% |
9.8% |
4.3% |
1.2% |
| Night sweats |
68.3% |
14% |
12.2% |
3.7% |
1.8% |
| Headaches |
28% |
34.1% |
15.9% |
14.6% |
7.3% |
| Neckaches |
28.7% |
26.7% |
20.7% |
14.6% |
9.1% |
| Lower back pain |
45.1% |
16.5% |
17.1% |
13.4% |
7.9% |
| Pelvic pain |
71.3% |
15.2% |
6.7% |
5.5% |
1.2% |
| Numbness in hands/feet |
55.5% |
26.2% |
8.5% |
8.5% |
1.2% |
| Loss of appetite |
60.4% |
18.9% |
9.1% |
8.5% |
3% |
| Extreme exhaustion |
23.8% |
23.2% |
20.7% |
20.7% |
11.6% |
| Loss of concentration |
15.2% |
26.2% |
21.3% |
23.2% |
14% |
| Temporary paralysis |
83.5% |
5.5% |
4.9% |
3% |
3% |
| Feeling faint |
39% |
27.4% |
14% |
11.6% |
7.9% |
| Feeling dizzy |
32.3% |
34.1% |
14% |
12.8% |
6.7% |
Table 3. Dissociative symptoms
experienced by Evaluation participants - Follow up contact
Dissociative
Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Feeling detached from body |
63.2% |
20.2% |
4.9% |
7.4% |
4.3% |
| Feel as if floating |
63.4% |
21.3% |
8.5% |
6.1% |
0.6% |
| Feel surroundings not seem real |
42.1% |
29.9% |
11.6% |
12.8% |
3.7% |
| Surroundings as through a mist |
62.2% |
22% |
8.5% |
5.5% |
1.8% |
| Visual distortions/ objects moving |
65.9% |
23.2% |
6.7% |
3.7% |
0.6% |
| Falling into a void |
67.7% |
17.7% |
4.9% |
7.3% |
2.4% |
| Oversensitivity to colours |
69.5% |
17.7% |
9.1% |
2.4% |
1.2% |
| Eyes burning |
57.3% |
25.6% |
9.8% |
4.9% |
2.4% |
| Oversensitive hearing |
47% |
18.9% |
17.7% |
12.2% |
4.3% |
Table 3. Panic attack descriptors
experienced by Evaluation participants - Follow up contact
| Panic Attack Symptoms |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Electric current move through body |
64% |
14.6% |
11% |
9.1% |
1.2% |
| Intense energy flow thru body |
58.5% |
19.5% |
12.2% |
7.3% |
2.4% |
| Intense heat/ burning thru body |
63.4% |
20.1% |
11% |
4.3% |
1.2% |
| Wave-like energy thru body |
64% |
14% |
13.4% |
7.9% |
0.6% |
| Hot prickly sensation thru body |
62.2% |
15.2% |
14% |
6.7% |
1.8% |
Table 3. Anxiety Disorder major
fears experienced by Evaluation participants - Follow up contact
| AnxietyDisorder Major
Fears |
No problem |
Slightly Troublesome |
Fairly Troublesome |
Very Troublesome |
Almost Unbearable |
| Feeling having a heart attack |
50.6% |
23.2% |
11% |
8.5% |
6.7% |
| Feeling going to die |
53% |
15.2% |
11.6% |
8.5% |
11.6% |
| Feeling going insane |
44.5% |
14.6% |
13.4% |
8.5% |
18.9% |
| Feeling losing control |
26.8% |
22.6% |
12.2% |
17.1% |
21.3% |
| Feeling passing out |
47.6% |
17.7% |
9.1% |
15.2% |
10.4% |
| Feeling attack of diarrhea |
76.2% |
13.4% |
4.3% |
3% |
3% |
| Feeling going to vomit |
74.4% |
8.5% |
6.7% |
5.5% |
4.9% |
| Feeling will hurt self or someone |
62.8% |
16.5% |
6.1% |
10.4% |
4.3% |
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