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Multilevel Interdependencies and Constraints in Panic Disorder: Many Triggers, Few Responses

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Handbook of Systems and Complexity in Health

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Abstract

Panic disorder is unique among mental disorders because it is defined by an intermittent, dramatic, time-limited event—the panic attack. The apparent pervasive calm is periodically punctuated by moments of spontaneous terror, wreaking brief, autonomic and psychological havoc upon the individual. The “sting” of panic disorder afflicts almost 5 % of the population, 45 % of which rate the phenomenon as “serious” [1]. Not only does panic disorder lead to impaired sense of well-being and quality of life [2], but it often compromises work productivity and attendance [3]. In fact, 75 % of the economic cost of panic disorder is due to its effect on productivity. A recent estimate of the adjusted per capita cost for panic disorder found that panic disorder cost over $11,000 annually per person, more than other anxiety or mood disorders, alcoholism, or chronic somatization [4].

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References

  1. Kessler RC, Wang PS. Descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health. 2008;29:115–29.

    Article  PubMed  Google Scholar 

  2. Cramer V, Torgerson S, Kringlen E. Quality of life and anxiety disorders. J Nerv Ment Dis. 2005;193:196–202.

    Article  PubMed  Google Scholar 

  3. Andersch S, Hetta J. 15-year follow-up study of patients with panic disorder. Eur Psychiatry. 2003;18:401–8.

    Article  PubMed  Google Scholar 

  4. Batelaan N, Smit F, de Graaf R, et al. Economic costs of full-blown and subthreshold panic disorder. J Affect Disord. 2007;104:127–36.

    Article  PubMed  Google Scholar 

  5. Katerndahl DA. Intrapatient agreement on phenomenology of panic attacks. Psychol Rep. 1996;79(1):219–24.

    Article  PubMed  CAS  Google Scholar 

  6. Gurguis GNM, Cameron OG, Ericson WA, et al. Daily distribution of panic attacks. Compr Psychiatry. 1988;29(1):1–3.

    Article  PubMed  CAS  Google Scholar 

  7. deBeurs E, Chambliss DL, Goldstein AJ. Measurement of panic disorder by a modified panic diary. Depress Anxiety. 1997;6:133–9.

    Article  CAS  Google Scholar 

  8. Francis JL, Weisberg RB, Dyck IR, et al. Characteristics and course of panic disorder and panic disorder with agoraphobia in primary care patients. Prim Care Companion J Clin Psychiatry. 2007;9:173–9.

    Article  PubMed  Google Scholar 

  9. Batelaan NM, de Graaf R, Spijker J, et al. Course of panic attacks in individuals with panic disorder and subthreshold panic disorder. J Affect Disord. 2010;121:30–8.

    Article  PubMed  Google Scholar 

  10. Simon NM, Fischmann D. Implications of medical and psychiatric comorbidity with panic disorder. J Clin Psychiatry. 2005;66 Suppl 4:8–15.

    PubMed  Google Scholar 

  11. Noyes Jr R, Reich J, Christiansen J, et al. Outcome of panic disorder. Arch Gen Psychiatry. 1990;47:809–18.

    Article  PubMed  Google Scholar 

  12. Crowe RR, Goedken R, Samuelson S, et al. Genomewide survey of panic disorder. Am J Med Genet. 2001;105:105–9.

    Article  PubMed  CAS  Google Scholar 

  13. Knowles JA, Fyer AJ, Vieland VJ, et al. Results of a genome-wide genetic screen for panic disorder. Am J Med Genet. 1998;81:139–47.

    Article  PubMed  CAS  Google Scholar 

  14. Cameron OG, Lee MA, Curtis GC, et al. Endocrine and physiological changes during “spontaneous” panic attacks. Psychoneuroendocrinology. 1987;12(5):321–31.

    Article  PubMed  CAS  Google Scholar 

  15. Yeragani VK, Rao KAR. Nonlinear measures of QT interval series. Psychiatry Res. 2003;117:177–90.

    Article  PubMed  Google Scholar 

  16. Yeragani VK, Pohl R, Balon R, et al. Twenty-four-hour QT interval variability. Neuropsychobiology. 2002;46:1–6.

    Article  PubMed  Google Scholar 

  17. Yeragani VK, Pohl R, Jampala VC, et al. Increased QT variability in patients with panic disorder and depression. Psychiatry Res. 2000;93:225–35.

    Article  PubMed  CAS  Google Scholar 

  18. McCraty R, Atkinson M, Tomasino D, et al. Analysis of twenty-four hour heart rate variability in patients with panic disorder. Biol Psychiatry. 2001;56:131–50.

    Article  CAS  Google Scholar 

  19. Yeragani VK, Pohl R, Balon R, et al. Heart rate in panic disorder (letter). Acta Psychiatr Scand. 1991;83:79.

    Article  PubMed  CAS  Google Scholar 

  20. Aikens DE, Craske MG. Sleep-based heart period variability in panic disorder with and without nocturnal panic attacks. J Anxiety Disord. 2008;22:453–63.

    Article  Google Scholar 

  21. Yeragani VK, Balon R, Pohl R, et al. Decreased R-R variance in panic disorder patients. Acta Psychiatr Scand. 1990;81:554–9.

    Article  PubMed  CAS  Google Scholar 

  22. Melzig CA, Weike AI, Hamm AO, et al. Individual differences in fear-potentiated startle as a function of resting heart rate variability. Intl J Psychophysiol. 2009;71:109–17.

    Article  Google Scholar 

  23. Garakani A, Martinez JM, Aaronson CJ, et al. Effect of medication and psychotherapy on heart rate variability in panic disorder. Depress Anxiety. 2009;26:251–8.

    Article  PubMed  Google Scholar 

  24. Srinivasan K, Ashok MV, Vaz M, et al. Decreased chaos of heart rate time series in children of patients with panic disorder. Depress Anxiety. 2002;15:159–67.

    Article  PubMed  CAS  Google Scholar 

  25. Slaap BR, Boshuisen ML, van Roon AM, et al. Heart rate variability as predictor of nonresponse to mirtazapine in panic disorder. Intl Clin Psychopharmocol. 2002;17:69–74.

    Article  CAS  Google Scholar 

  26. Baker B, Khaykin Y, Devins G, et al. Correlates of therapeutic response in panic disorder presenting with palpitations. Can J Psychiatry. 2003;48:381–7.

    PubMed  Google Scholar 

  27. Middleton HC. Cardiovascular dystonia in recovered panic patients. J Affect Dis. 1990;19:229–36.

    Article  PubMed  CAS  Google Scholar 

  28. Craske MG, Lang AJ, Tsao JCI, et al. Reactivity to interoceptive cues in nocturnal panic. J Behav Ther Exp Psychiatry. 2001;32:173–90.

    Article  PubMed  CAS  Google Scholar 

  29. Katerndahl DA. Panic and prolapse. Meta-analysis. J Nerv Ment Dis. 1993;181(9):539–44.

    Article  PubMed  CAS  Google Scholar 

  30. Katerndahl DA, Vande Creek L. Hyperthyroidism and panic attacks. Psychosomatics. 1983;24(5):491–6.

    Article  PubMed  CAS  Google Scholar 

  31. Weilburg JB, Schachter S, Worth J, et al. EEG abnormalities in patients with atypical panic attacks. J Clin Psychiatry. 1995;56:358–62.

    PubMed  CAS  Google Scholar 

  32. Edlund MJ, McNamara E, Millman RP. Sleep apne and panic attacks. Compr Psychiatry. 1991;32(2):130–2.

    Article  PubMed  CAS  Google Scholar 

  33. Hayward C, Wilson KA, Lagle K, et al. Parent-reported predictors of adolescent panic attacks. J Am Acad Child Adolesc Psychiatry. 2004;43(5):613–20.

    Article  PubMed  Google Scholar 

  34. Albert U, Maina G, Bergesio C, et al. Nocturnal panic and recent life events. Depress Anxiety. 2005;22:52–8.

    Article  PubMed  Google Scholar 

  35. Venturello S, Barzega G, Maina G, et al. Premorbid conditions and precipitating events in early-onset panic disorder. Compr Psychiatry. 2002;43(1):28–36.

    Article  PubMed  Google Scholar 

  36. Dumas CA, Katerndahl DA, Burge SK. Familial patterns in patients with infrequent panic attacks. Arch Fam Med. 1995;4(10):863–7.

    Article  PubMed  CAS  Google Scholar 

  37. Katerndahl DA, Realini JP. Family characteristics of subjects with panic attacks. Fam Med. 1997;29(8):563–7.

    PubMed  CAS  Google Scholar 

  38. Fone D, Dunstan F, Lloyd K, et al. Does social cohesion modify the association between area income deprivation and mental health? Int J Epidemiol. 2007;36:338–45.

    Article  PubMed  Google Scholar 

  39. Katerndahl DA. Community effects on mental health outcomes in subjects with and without panic attacks: results from a population-based study in San Antonio. Texas Prim Care Companion J Clin Psychiatry. 2007;9:429–32.

    Article  Google Scholar 

  40. Katerndahl DA. Community correlates of outcomes in subjects with panic attacks. Depress Anxiety. 2001;13(4):194–7.

    Article  PubMed  CAS  Google Scholar 

  41. Goodwin RD, Hamilton SP. Early-onset fearful panic attack as a predictor of severe psychopathology. Psychiatry Res. 2002;109:71–9.

    Article  PubMed  Google Scholar 

  42. Katerndahl DA, Larme AC, Palmer RF, et al. Reflections on DSM classification and its utility in primary care: case studies in “Mental Disorders”. Prim Care Companion J Clin Psychiatry. 2005;7(3):91–9.

    Article  PubMed  Google Scholar 

  43. Ampollini P, Machesi C, Signifredi R, et al. Temperament and personality features in patients with major depression, panic disorder and mixed conditions. J Affect Disord. 1999;52:203–7.

    Article  PubMed  CAS  Google Scholar 

  44. Goodwin RD, Fergusson DM, Horwood LJ. Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood. Psychol Med. 2005;35:881–90.

    Article  PubMed  Google Scholar 

  45. Biederman J, Petty CR, Hirshfeld-Becker DR, et al. Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression. Psychiatry Res. 2007;153:245–52.

    Article  PubMed  Google Scholar 

  46. Plehn K, Peterson RA. Anxiety sensitivity as a predictor of the development of panic symptoms, panic attacks, and panic disorder. Anxiety Disord. 2002;16:455–74.

    Article  Google Scholar 

  47. Kutz A, Marshall E, Bernstein A, et al. Evaluating emotional sensitivity and tolerance factors in the prediction of panic-relevant responding to a biological challenge. J Anxiety Disord. 2010;24(1):16–22.

    Article  PubMed  Google Scholar 

  48. Schmidt NB, Bates MJ. Evaluation of a pathoplastic relationship between anxiety sensitivity and panic disorder. Anxiety Stress Coping. 2003;16(1):17–30.

    Article  Google Scholar 

  49. Bandelow B, Spath C, Tichauer GA, et al. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with panic disorder. Compr Psychiatry. 2002;43(4):269–78.

    Article  PubMed  Google Scholar 

  50. Tschacher W. Dynamics of psychosocial crises. J Nerv Ment Dis. 1996;184(3):172–9.

    Article  PubMed  CAS  Google Scholar 

  51. Ovid’ko IA. Order and chaos in thoughts, feelings, and actions. Psychol Rep. 1999;84(1):87–106.

    Article  PubMed  Google Scholar 

  52. Goldberger AL. Fractal variability versus pathologic periodicity. Perspect Biol Med. 1997;40:543.

    PubMed  CAS  Google Scholar 

  53. Han DH, Renshaw PF, Dager SR, et al. Altered cingulated white matter connectivity in panic disorder patients. J Psychiatr Res. 2008;42:399–407.

    Article  PubMed  Google Scholar 

  54. Heath RA. Complexity and mental health. In: Holt TA, editor. Complexity for clinicians. Abingdon: Radcliffe; 2004.

    Google Scholar 

  55. Rao RKA, Yeragani VK. Decreased chaos and increased nonlinearity of heart rate time series in patients with panic disorder. Auton Neurosci. 2001;88:99–108.

    Article  PubMed  CAS  Google Scholar 

  56. Bob P, Kukleta M, Riecansky I, et al. Chaotic EEG patterns during recall of stressful memory related to panic attack. Physiol Res. 2006;55 suppl 1:S113–9.

    PubMed  Google Scholar 

  57. Katerndahl DA, Ferrer RL, Best RG, et al. Dynamic patterns in mood among newly-diagnosed patients with major depressive episode, panic disorder, and normal controls. Prim Care Companion J Clin Psychiatry. 2007;9(3):183–7.

    Article  PubMed  Google Scholar 

  58. Combs A, Winkler M, Daley C. Chaotic systems analysis of rhythms in feeling states. Psychol Rec. 1994;44:359–68.

    Google Scholar 

  59. Gustafson JP, Meyer M. Non-linear model of dynamics. Psychodyn Pract. 2004;10(4):doi:10.1080/14753630412331313703.

    Google Scholar 

  60. Katerndahl DA, Wang C. Dynamic covariation of symptoms of anxiety and depression among newly-diagnosed patients with major depressive episode, panic disorder, and controls. Nonlinear Dynamics Psychol Life Sci. 2007;11(3):349–65.

    PubMed  Google Scholar 

  61. Saloma C, Perez GJ, Tapang G, et al. Self-organized queuing and scale-free behavior in real escape panic. Proc Natl Acad Sci USA. 2003;100(21):11947–52.

    Article  PubMed  CAS  Google Scholar 

  62. Katerndahl DA. Power laws in covariability of anxiety and depression among newly diagnosed patients with major depressive episode, panic disorder and controls. J Eval Clin Pract. 2009;15:565–70.

    Article  PubMed  Google Scholar 

  63. Schmidt NB, Lerew DR, Joiner Jr TE. Prospective evaluation of the etiology of anxiety sensitivity. Behav Res Ther. 2000;38:1083–95.

    Article  PubMed  CAS  Google Scholar 

  64. Acs N, Banhidy F, Horvath-Puho E, et al. Maternal panic disorder and congenital abnormalities: a population-based case-control study. Birth Defects Res A Clin Mol Teratol. 2006;76:253–61.

    Article  PubMed  CAS  Google Scholar 

  65. Bakker A, Spinhoven P, Van Balkom AJLM, et al. Relevance of assessment of cognitions during panic attacks in the treatment of panic disorder. Psychother Psychosom. 2002;271:158–61.

    Article  Google Scholar 

  66. Grillon C, Lissek S, Rabin S, et al. Increased anxiety during anticipation of unpredictable but not predictable aversive stimuli as a psychophysiologic marker of panic disorder. Am J Psychiatry. 2008;165:898–904.

    Article  PubMed  Google Scholar 

  67. Katerndahl DA. Symptom severity and perceptions in subjects with panic attacks. Arch Fam Med. 2000;9(10):1028–35.

    Article  PubMed  CAS  Google Scholar 

  68. Kessler H, Roth J, Von Wietersheim J, et al. Emotion recognition patterns in patients with panic disorder. Depress Anxiety. 2007;24:223–6.

    Article  PubMed  Google Scholar 

  69. Neidhardt E, Florin I. Memory bias for panic-related material in patients with panic disorder. Psychopathology. 1999;32:260–6.

    Article  PubMed  CAS  Google Scholar 

  70. Lim SL, Kim JH. Cognitive processing of emotional information in depression, panic, and somatoform disorder. J Abnorm Psychol. 2005;114(1):50–61.

    Article  PubMed  Google Scholar 

  71. Sheehan D, Carr DB, Fishman SM, et al. Lactate infusion in anxiety research. J Clin Psychiatry. 1985;46:158–65.

    PubMed  CAS  Google Scholar 

  72. Frohlich ED, Tarazi RC, Duston HP. Hyperdynamic beta adrenergic circulatory state. Arch Intern Med. 1969;123:1–7.

    Article  PubMed  CAS  Google Scholar 

  73. Charney DS, Woods SW, Goodman WK, et al. Serotonin function in anxiety. Psychopharmacologia. 1987;92:14–24.

    Article  CAS  Google Scholar 

  74. Gorman JM, Askanazi J, Liebowitz MR, et al. Response to hyperventilation in a group of patients with panic disorder. Am J Psychiatry. 1984;141:857–61.

    PubMed  CAS  Google Scholar 

  75. Perna G, Barbini B, Cocchi S, et al. 35% CO2 challenge in panic and mood disorders. J Affect Disord. 1995;33:189–94.

    Article  PubMed  CAS  Google Scholar 

  76. Tinitigan R, Ali F, Tinitigan M, et al. Prevalence, comorbidity, and outcomes of chemical Intolerance in primary Care Settings. Fam Med. 2011;43(Suppl 1). http://www.stfm.org/fmsup/napcrg/fmconferencesupplement.cfm?confid=135.

  77. Katerndahl DA, Realini JP. Relationship between substance abuse and panic attacks. Addict Behav. 1999;24(5):731–6.

    Article  PubMed  CAS  Google Scholar 

  78. Maron E, Hettema JM, Shlik J. Advances in molecular genetics of panic disorder. Mol Psychiatry. 2010;15(7):681–701.

    Article  PubMed  CAS  Google Scholar 

  79. Erhardt A, Lucae S, Kern N, et al. Association of polymorphisms in the angiotensin-converting enzyme gene with syndromal panic attacks. Mol Psychiatry. 2008;13(3):242–3.

    Article  PubMed  CAS  Google Scholar 

  80. Unschuld PG, Ising M, Erhardt A, et al. Polymorphisms in the galanin gene are associated with symptom-severity in female patients suffering from panic disorder. J Affect Disord. 2008;105:177–84.

    Article  PubMed  CAS  Google Scholar 

  81. Okamura N, Hashimoto K, Iyo M, et al. Gender-specific association of a functional coding polymorphism in the Neuropeptide S receptor gene with panic disorder but not with schizophrenia or attention-deficit/hyperactivity disorder. Biol Psychiatry. 2007;31(7):1444–8.

    CAS  Google Scholar 

  82. Ishii T, Akiyoshi J, Hanada H, et al. Association between the obestatin and BDNF gene polymorphism and panic disorder. Psychiatr Genet. 2009;19(3):159.

    Article  PubMed  Google Scholar 

  83. Erhardt A, Lucae S, Unschuld PG, et al. Association of polymorphisms in P2RX7 and CaMKKb with anxiety disorders. J Affect Disord. 2007;101:159–68.

    Article  PubMed  CAS  Google Scholar 

  84. Maron E, Shlik J. Serotonin function in panic disorder. Neuropsychopharmacology. 2006;31(1):1–11.

    PubMed  CAS  Google Scholar 

  85. Maron E, Nikopensius T, Koks S, et al. Association study of 90 candidate gene polymorphisms in panic disorder. Psychiatr Genet. 2005;15(1):17–24.

    Article  PubMed  Google Scholar 

  86. Hamilton SP, Slager SL, deLeon AB, et al. Evidence for genetic linkage between a polymorphism in the Adenosine 2A receptor and panic disorder. Neuropsychopharmacology. 2004;29(3):558–65.

    Article  PubMed  CAS  Google Scholar 

  87. Ho HP, Westberg L, Annerbrink K, et al. Association between a functional polymorphism in the progesterone receptor gene and panic disorder in women. Psychoneuroendocrinology. 2004;29(9):1138–41.

    Article  PubMed  CAS  Google Scholar 

  88. Roy-Byrne PP, Uhde TW. Exogenous factors in panic disorder. J Clin Psychiatry. 1988;49:56–61.

    PubMed  CAS  Google Scholar 

  89. Van der Does AJW, Antony MM, Ehlers A, et al. Heartbeat perception in panic disorder. Behav Res Ther. 2000;38:47–62.

    Article  Google Scholar 

  90. Craske MG, Poulton R, Tsao JCI, et al. Paths to panic disorder/agoraphobia. J Am Acad Child Adolesc Psychiatry. 2001;40(5):556–63.

    Article  PubMed  CAS  Google Scholar 

  91. Fava M, Anderson K, Rosenbaum JF. “Anger attacks”: possible variants of panic and major depressive disorders. Am J Psychiatry. 1990;147:867–70.

    PubMed  CAS  Google Scholar 

  92. Mavissakalian MR, Guo S. Early detection of relapse in panic disorder. Acta Psychiatr Scand. 2004;110:393–9.

    Article  PubMed  CAS  Google Scholar 

  93. Jacobs WJ, Nadel L. First panic attack. Can J Exp Psychol. 1999;53(1):92–107.

    Article  PubMed  CAS  Google Scholar 

  94. Casey LM, Oei TPS, Newcombe PA. Integrated cognitive model of panic disorder. Clin Psychol Rev. 2004;24:529–55.

    Article  PubMed  Google Scholar 

  95. Bouchard S, Gauthier J, Nouwen A, et al. Temporal relationship between dysfunctional beliefs, self-efficacy and panic apprehension in the treatment of panic disorder and agoraphobia. J Behav Ther Exp Psychiatry. 2007;38:275–92.

    Article  PubMed  Google Scholar 

  96. Wiedemann G, Pauli P, Dengler W. A priori expectancy bias in patients with panic disorder. Anxiety Disord. 2001;15:401–12.

    Article  CAS  Google Scholar 

  97. Morrison AP, Wells A. Comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behav Res Ther. 2003;41:251–6.

    Article  PubMed  Google Scholar 

  98. Goldberg C. Cognitive processes in panic disorder. Psychol Rep. 2001;88:139–59.

    Article  PubMed  CAS  Google Scholar 

  99. Poloni C, Riquier F, Zimmermann G, et al. Perceptual defense in anxiety disorders. Percept Mot Skills. 2003;97:971–8.

    Article  PubMed  Google Scholar 

  100. Holt PE, Andrews G. Provocation of panic. Behav Res Ther. 1989;27(3):253–61.

    Article  PubMed  CAS  Google Scholar 

  101. Salkovskis PM, Clark DM, Hackmann A, et al. Experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behav Res Ther. 1999;37:559–74.

    Article  PubMed  CAS  Google Scholar 

  102. Katerndahl DA. Illness attitudes and coping process in subjects with panic attacks. J Nerv Ment Dis. 1999;187(9):561–5.

    Article  PubMed  CAS  Google Scholar 

  103. Berksun OE. Panic disorder and memory. Eur Psychiatry. 1999;14(1):54–6.

    Article  PubMed  CAS  Google Scholar 

  104. Day SJ, Holmes EA, Hackmann A. Occurrence of imagery and its link with early memories in agoraphobia. Memory. 2004;12(4):416–27.

    Article  PubMed  Google Scholar 

  105. Ludewig S, Paulus MP, Ludewig K, et al. Decision-making strategies by panic disorder subjects are more sensitive to errors. J Affect Disord. 2003;76:183–9.

    Article  PubMed  Google Scholar 

  106. Tinitigan R, Katerndahl DA, Miller CS. Relationship of chemical intolerance and childhood abuse to the onset of panic attacks. Fam Med. 2010;42(Suppl 2). http://www.stfm.org/fmsup/napcrg/fmconferencesupplement.cfm?confid=133.

  107. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV-TR). 4th ed. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  108. Katerndahl DA. The sequence of panic symptoms. J Fam Pract. 1988;26(1):49–52.

    PubMed  CAS  Google Scholar 

  109. Hedley LM, Hoffart A, Dammen T, et al. Relationship between cognitions and panic attack intensity. Acta Psychiatr Scand. 2000;102:300–2.

    Article  PubMed  CAS  Google Scholar 

  110. Moynihan JE, Gevirtz RN. Respiratory and cognitive subtypes of panic. Behav Modif. 2001;25(4):555–83.

    Article  PubMed  CAS  Google Scholar 

  111. Katerndahl DA, Gabel LL, Monk JS. Comparative symptomatology of phobic and nonphobic panic attacks. Fam Pract Res J. 1986;6(2):106–13.

    PubMed  CAS  Google Scholar 

  112. Norton GR, Norton PJ, Walker JR, et al. Comparison of people with and without nocturnal panic attacks. J Behav Ther Exp Psychiatry. 1999;30:37–44.

    Article  PubMed  CAS  Google Scholar 

  113. Craske MG, Lang AJ, Mystkowski JL, et al. Does nocturnal panic represent a more severe form of panic disorder? J Nerv Ment Dis. 2002;190:611–8.

    Article  PubMed  Google Scholar 

  114. Merritt-Davis O, Balon R. Nocturnal panic. Depress Anxiety. 2003;18:221–7.

    Article  PubMed  Google Scholar 

  115. Katerndahl DA. Panic attacks and panic disorder. J Fam Pract. 1996;43(3):275–82.

    PubMed  CAS  Google Scholar 

  116. Katerndahl DA. Factors associated with persons with panic attacks seeking medical care. Fam Med. 1990;22(6):462–6.

    PubMed  CAS  Google Scholar 

  117. Van den Hout MA, de Jong P, Zandbergen J, et al. Waning of panic sensations during prolonged hyperventilation. Behav Res Ther. 1990;28(5):445–8.

    Article  PubMed  Google Scholar 

  118. Kenardy J, Taylor CB. Expected versus unexpected panic attacks. J Anxiety Disord. 1999;13(4):435–45.

    Article  PubMed  CAS  Google Scholar 

  119. Katerndahl DA. Factors influencing care seeking for a self-defined worst panic attack. Psychiatr Serv. 2002;53(4):464–70.

    Article  PubMed  Google Scholar 

  120. Katerndahl DA. Predictors of the development of phobic avoidance. J Clin Psychiatry. 2000;61(8):618–23.

    Article  PubMed  CAS  Google Scholar 

  121. Realini JP, Katerndahl DA. Factors affecting the threshold for seeking care: the Panic Attack Care-Seeking Threshold (PACT) Study. J Am Board Fam Pract. 1993;6(3):215–23.

    PubMed  CAS  Google Scholar 

  122. Rogler LH, Cortes DE. Help-seeking pathways. Am J Psychiatry. 1993;150:554–61.

    PubMed  CAS  Google Scholar 

  123. Katerndahl DA, Realini JP. Where do panic attack sufferers seek care? J Fam Pract. 1995;40(3):237–43.

    PubMed  CAS  Google Scholar 

  124. Katerndahl DA. Power law relationships between health care utilization and symptom assessment among people with panic attacks. J Eval Clin Pract. 2010;16:421–6.

    PubMed  Google Scholar 

  125. Goodwin R, Anderson RM. Use of the Behavioral Model of Health Care use to identify correlates of use of treatment for panic attacks in the community. Soc Psychiatry Psychiatr Epidemiol. 2002;37:212–9.

    Article  PubMed  Google Scholar 

  126. Katerndahl DA, Parchman ML. Understanding ambulatory care use by people with panic attacks: testing the behavioral model for vulnerable populations. J Nerv Ment Dis. 2002;190(8):554–7.

    Article  PubMed  Google Scholar 

  127. Kessler RC, Olfson M, Berglund PA. Patterns and predictors of treatment contact after first onset of psychiatric disorders. Am J Psychiatry. 1998;155:62–9.

    PubMed  CAS  Google Scholar 

  128. Katerndahl D. Initial care seeking for panic attacks. Psychiatr Serv. 2003;54(8):1168.

    Article  PubMed  Google Scholar 

  129. Katerndahl DA. Explaining health care utilization for panic attacks using cusp catastrophe modeling. Nonlinear Dynamics Psychol Life Sci. 2008;12(4):409–24.

    PubMed  Google Scholar 

  130. Katerndahl DA, Realini JP. Use of health care services by persons with panic symptoms. Psychiatr Serv. 1997;48(8):1027–32.

    PubMed  CAS  Google Scholar 

  131. Katerndahl DA. Panic is panic: homogeneity of the panic attack experience. Fam Pract Res J. 1990;9(2):147–55.

    PubMed  CAS  Google Scholar 

  132. Zane MD. Contextual approach to panic. In: Baker R, editor. Panic disorder: theory, research and therapy. Oxford: Wiley; 1989.

    Google Scholar 

  133. Iglesias A, Iglesias A. Awake-alert hypnosis in the treatment of panic disorder. Am J Clin Hypn. 2005;47:249–57.

    Article  PubMed  Google Scholar 

  134. Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry. 1995;152:1084–6.

    PubMed  CAS  Google Scholar 

  135. Baillie AJ, Rapee RM. Predicting who benefits from psychoeducation and self help for panic attacks. Behav Res Ther. 2004;42:513–27.

    Article  PubMed  Google Scholar 

  136. Barlow JH, Ellard DR, Hainsworth JM, et al. Review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders. Acta Psychiatr Scand. 2005;111:272–85.

    Article  PubMed  CAS  Google Scholar 

  137. Strohle A, Feller C, Onken M, et al. Acute antipanic activity of aerobic exercise. Am J Psychiatry. 2005;162:1376–8.

    Article  Google Scholar 

  138. Lambert RA, Harvey I, Poland F. Pragmatic, unblended randomized controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care. J Affect Disord. 2007;99:63–71.

    Article  PubMed  Google Scholar 

  139. Kiropoulos LA, Klein B, Austin DW, et al. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? J Anxiety Disord. 2008;22:1273–84.

    Article  PubMed  Google Scholar 

  140. Marks IM, Kenwright M, McDonough M, et al. Saving clinicians’ time by delegating routine aspects of therapy to a computer. Psychol Med. 2004;34:9–18.

    Article  PubMed  CAS  Google Scholar 

  141. Shandley K, Austin DW, Klein B, et al. Therapist-assisted, internet-based treatment for panic disorder. J Med Internet Res. 2008;10(2):e14.

    Article  PubMed  Google Scholar 

  142. Huppert JD, Schultz LT, Foa EB, et al. Differential response to placebo among patients with social phobia, panic disorder, and obsessive-compulsive disorder. Am J Psychiatry. 2004;161:1485–7.

    Article  PubMed  Google Scholar 

  143. Budman SH, Gurman AS. Time-sensitive model of brief therapy. In: Budman SH, Hoyt MF, Friedman S, editors. The first session in brief therapy. New York: Guilford; 1992.

    Google Scholar 

  144. Deacon B. Two-day, intensive cognitive-behavioral therapy for panic disorder. Behav Modif. 2007;31:595–615.

    Article  PubMed  Google Scholar 

  145. Wittchen HU. Met and unmet need for interventions in community cases with anxiety disorders. In: Andrews G, Henderson S, editors. Unmet need in psychiatry. Cambridge: Cambridge University Press; 2000.

    Google Scholar 

  146. Greenhalgh T, Hurwitz B. Why study narrative? Br Med J. 1999;318:48–50.

    Article  CAS  Google Scholar 

  147. Garfinkel A, Spano ML, Ditto WL, et al. Controlling cardiac chaos. Science. 1992;257:1230–5.

    Article  PubMed  CAS  Google Scholar 

  148. Christini D, Collins J, Linsay P. Experimental control of high dimensional chaos. Phys Rev E. 1996;54:4824–7.

    Article  CAS  Google Scholar 

  149. Regalado A. Gentle scheme for unleashing chaos. Science. 1995;268:1848.

    Article  PubMed  CAS  Google Scholar 

  150. Miller WL, Crabtree BF, McDaniel R, et al. Understanding change in primary care practice using complexity theory. J Fam Pract. 1998;46:369–76.

    PubMed  CAS  Google Scholar 

  151. Sharp DM, Power KG, Swanson V. Comparison of the efficacy and acceptability of group versus individual cognitive behavior therapy in the treatment of panic disorder and agoraphobia in primary care. Clin Psychol Psychother. 2004;11(2):73–82.

    Article  Google Scholar 

  152. Bakker A, Spinhoven P, van der Does AJW, et al. Locus of control orientation in panic disorder and the differential effects of treatment. Psychother Psychosom. 2002;71:85–9.

    Article  PubMed  Google Scholar 

  153. Morel B, Ramanujam R. Through the looking glass. Organ Sci. 1999;10(3):278–93.

    Article  PubMed  CAS  Google Scholar 

  154. Smethurst DP, Williams HC. Are hospital waiting lists self-regulating? Nature. 2001;410:652–3.

    Article  PubMed  CAS  Google Scholar 

  155. Viney LL, Clarke AM, Benjamin YN. General systems approach to the patient, hospital staff, family, and community. Behav Sci. 1986;31:239–53.

    Article  PubMed  CAS  Google Scholar 

  156. Ahn AC, Tewari M, Poon CS, et al. Clinical applications of a systems approach. PLoS Med. 2006;3(7):e209.

    Article  PubMed  Google Scholar 

  157. Carlson JM, Doyle J. Highly optimized tolerance. Phys Rev E. 1999;60:1412–27.

    Article  CAS  Google Scholar 

  158. Zeeman EC. Mathematical model for conflicting judgments caused by stress, applied to possible misestimations of speed caused by alcohol. Br J Math Stat Psychol. 1976;29:19–31.

    Article  PubMed  CAS  Google Scholar 

  159. Furukawa TA, Watanabe N, Churchill R. Psychotherapy plus antidepressant for panic disorder with or without agoraphobia. Br J Psychiatry. 2006;188(4):305–12.

    Article  PubMed  Google Scholar 

  160. Furukawa TA, Watanabe N, Omori IM, et al. Can pill placebo augment cognitive-behavior therapy for panic disorder? BMC Psychiatry. 2007;7:73.

    Article  PubMed  Google Scholar 

  161. Rusinek S, Graziani P, Servant D, et al. Cognitive therapy and cognitive schemas. Eur Rev Appl Psychol. 2004;54(3):173–7.

    Article  Google Scholar 

  162. Clerkin EM, Teachman BA, Smith-Janik SB. Sudden gains in group cognitive-behavioral therapy for panic disorder. Behav Res Ther. 2008;46:1244–50.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA

    David A. Katerndahl M.D., M.A.

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  1. David A. Katerndahl M.D., M.A.
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    Joachim P. Sturmberg

  2. Northern Ontario School of Medicine, Merchandise Mart Plaza, Suite 1212 222, Chicago, 60654, Illinois, USA

    Carmel M. Martin

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Katerndahl, D.A. (2013). Multilevel Interdependencies and Constraints in Panic Disorder: Many Triggers, Few Responses. In: Sturmberg, J., Martin, C. (eds) Handbook of Systems and Complexity in Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4998-0_23

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