Cognitive and Biological Models of Panic: Toward an Integration: M. Katherine Shear
The delineation of panic disorder as a specific diagnostic category is one of the innovations in DSM-III, the current psychiatric diagnostic system (American Psychiatric Association, 1980). Patients who are diagnosed as having this disorder have recurrent unexpected episodes of panic, defined as sudden onset of intense fear associated with somatic symptoms such as chest pain, heart palpitations, shortness of breath, dizziness, tingling sensations, hot or cold flashes or faintness. Panic episodes are accompanied by varying degrees of nonpanic anxiety and phobic avoidance. The clinical psychopathology of panic disorder is determined by both panic and its consequences. Neurobiological studies (Brier, Charney, & Heninger, 1985; Rainey & Nesse, 1985) family studies (Harris, Noyes, Crowe, Chaudhry, 1983; Surman, Sheehan, Fuller, Gallo, 1983; Torgersen, 1983) and treatment studies (Barlow, Cohen, Waddell, Vermilyea, Klosko, Blanchard, DiNardo, 1984; Klein, 1964, 1982; Rohs & Noyes, 1978; Sheehan, Ballenger, & Jacobsen, 1980; Zitrin, Klein, & Woerner, 1980) support the diagnostic validity of the panic disorder category.