ABSTRACT
The essence of panic disorder is a ‘crescendo of fear’ (ICD-10; World Health Organization 1992) occurring unexpectedly. Many anxiety sufferers, such as clients with generalised anxiety disorder, suffer from periods of heightened anxiety, but the distinguishing feature of panic attacks is that symptoms reach a peak within ten minutes of experiencing the first symptoms (see CBT Pocketbook, Appendix A, which directly accesses each of the symptom criteria for the condition in DSM-IV-TR [American Psychiatric Association 2000]). Although panic attacks are a necessary feature of panic disorder, panic attacks are not on their own enough to make the diagnosis. Panic attacks may happen in the context of specific situations such as social or specific phobias which are different from panic disorder. Panic disorder is classified by the DSM-IV-TR (American Psychiatric Association 2000) as recurrent, unpredictable panic attacks followed by at least a month of persistent concern about having another panic attack, worry about the consequences of the panic attacks or a significant behavioural change related to the attacks. In DSM-IV-TR agoraphobia is construed as an attempt to avoid situations in which panic attacks may occur rather than as a separate diagnosable condition. Without a reliable diagnosis of panic disorder, clients with other anxiety disorders can be inappropriately treated with a panic disorder protocol.
