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An Analysis of Uncued Panic Attacks in Panic Disorder - Part2

RESULTS

Primary Statistical Data

Panic Disorder participants consisted of 9 males and 26 females. Analysis of panic attack experiences of each subgroup showed an insignificant difference in subjective experiences, therefore results of panic attack analysis are not skewed by gender differences. Other Anxiety Disorder participants consisted of 9 males and 27 females. Once again, analysis of subjective anxiety experiences of each subgroup showed an insignificant difference in subjective experiences, therefore results of anxiety analysis are not skewed by gender differences. Normal adults consisted of 15 males and 8 females.
Mean age of Panic Disorder participants was 37 years with a SD=12 years. Mean age of other Anxiety Disorder participants was 45 years with a SD=11 years. Mean age of normal adults was 48 years.
Mean age for experiencing first panic attack for Panic Disorder participants was 26 years SD=9 years. Mean age for experiencing first limited symptom (anxiety) attack for other Anxiety Disorder participants was 33 years SD=11 years.
Mean length of time (years) experiencing ongoing panic attacks for Panic Disorder participants was 10 years. Mean length of time (years) experiencing ongoing limited symptoms(anxiety) attacks for other Anxiety Disorder participants was 9 years.
Distribution of life/traumatic experiences that preceded the first panic attack or limited symptom attack are shown below in Table 1. Many participants reported more than one life event occurring previous to the first panic or anxiety attack eg. a death in the family and a major trauma.

Table 1. Life events that preceded first panic or anxiety attack.

Life event that preceded first panic or anxiety attack	Panic Disorder participants	Other Anxiety Disorder participants
Death in the family	25%	0%
Divorce	11%	0%
Pregnancy	3%	6%
Childbirth	11%	0%
Financial	17%	14%
Job loss	11%	0%
Unemployed	8%	6%
Car accident	8%	0%
Major illness	14%	14%
Major trauma	36%	28%
Near death experience	8%	0%
Drugs	28%	17%
Meditation	3%	0%
Depression	10%	0%
No cause	36%	28%
Other	36%	17%

The results of the child trauma survey are displayed in Table 2, comparing Panic Disorder, other Anxiety Disorder and normal participants. The results of the survey correspond to those achieved in similar studies(8). The survey was undertaken to see the link of childhood trauma and dissociative experiences. High scores for childhood trauma and dissociation were obtained for panic disorder participants(16).

 

Table 2. Childhood trauma in Panic Disorder, Other Anxiety Disorder, Normal

Childhood Trauma items	Panic Disorder Participants	Other Anxiety Disorder Participants	Normal Participants
Parental violence	33%	13%	21%
Verbal abuse	45%	13%	34%
Violence in home	37%	26%	13%
Left alone	31%	12%	21%
Unwanted/ neglected	59%	39%	25%
Sexual abuse	12%	12%	4%
Sexual trauma	31%	13%	13%
Blamed	45%	40%	25%
Insulted/ called names	53%	33%	29%
Hit or beaten	39%	26%	13%
Physically mistreated	54%	39%	21%

Fear Response Analysis

It is commonly thought that the panic attack is actually a peak of fear and that the overwhelming energy rush/movement is adrenalin related. Discussions with large numbers of Panic Disorder sufferers indicates that this is not the case and that the 'energy' experienced is subjectively felt as being other than adrenal energy. Table 3 summarises the results investigating fear response triggering within a panic attack and limited symptom (anxiety) attack.

Table 3. Results of investigation into panic/ anxiety attacks as a fear response.

Investigation into whether 'energy' felt with panic/anxiety attacks is a fear response (adrenal energy)	Panic Disorder Participants	Other Anxiety Disorder Participants
Experience 'energy' when relatively "calm" eg. watching TV/relaxation	78%	28%
'Energy' occurs while going to sleep	69%	22%
'Energy' wakes from sleep at night	86%	19%
Find it difficult to link 'energy' to adrenalin rush	71%	14%
After 'energy' subsides I feel intense fear	75%	11%
After 'energy' subsides I feel intense fatigue	78%	17%
After 'energy' subsides I feel calm or peaceful	19%	6%
Experience 'energy' as I begin meditation/relaxation	44%	14%
Panic attacks have previously disappeared previously without treatment	69%	19%

Compared with other Anxiety Disorder participants, a high proportion of Panic Disorder participants report that they find it difficult to link the 'energy' movement of a panic attack with an adrenalin rush (71% vs 14%, P< 0.001). Also, Panic Disorder participants experience the 'energy' movement of a panic attack when relatively calm in a much higher proportion than Anxiety Disorder participants for a limited symptom (anxiety) attack (78% vs 28%, P<0.002). Referring to sleep panic attacks, the results concur with the study by Thomas W.Udhe(4) on the occurrence of sleep panic attacks. Panic Disorder participants report that the 'energy' of a panic attack occurs while going to sleep (69% vs 22%[other Anxiety Disorder for limited symptom attack], P<0.005) and that the 'energy' of a panic attack actually wakes them from sleep at night (89% vs 19% [other Anxiety Disorder for limited symptom attack], P<0.001).
Investigating further into the fear response triggering within the panic attack, Panic Disorder participants actually feel intense fear after the 'energy' of a panic attack subsides (75% vs 11%, P<0.001) and also experience intense fatigue or exhaustion after the 'energy' of a panic attack subsides (78% vs 17%, P<0.001).
The above results are significant discriminators between the adrenal and anxiety response within the limited symptom (anxiety) attack and that of the panic attack. Also, the experience of the panic attack 'energy' waking them from sleep at night.

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