Tools for Treating Panic Disorder Among Latinos



A substantial number of Spanish-speaking individuals are impacted by panic disorder. Resources for clinicians who work with this group are limited. This chapter provides useful information for working Spanish-speaking Latinos who have panic disorder as well as several tools that can be used with Spanish-speaking clients. The following information and resources are provided in this chapter:
  • Brief overview of current research on evidence-based practices with Latino populations with panic disorder.

  • Cultural consideration therapists should be aware of and employ in their work with Latino populations with panic disorder (help the provider modify current treatment practices).

  • Session plan complete with worksheets and culturally relevant examples.


Panic disorder Latinos Hispanics Anxiety 


  1. Alfonso, S., & Dziegielewski, S. F. (2001). Self-directed treatment for panic disorder: A holistic approach. The Journal of Research and Social Work Evaluation: An International Publication., 2(1), 5–18.Google Scholar
  2. Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior., 36, 1–10.CrossRefPubMedGoogle Scholar
  3. APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist. Copyright 2006 by the American Psychological Association 0003-066X/06/$12.00, (4), 61, 271–285.Google Scholar
  4. Armstrong, K., Ravenell, K. L., McMurphy, S., & Putt, M. (2007). Racial/ethnic differences in physician distrust in the United States. American Journal of Public Health, 97(7), 1283–1289.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Asnaani, A., Gutner, C. A., Hinton, D. E., & Hofmann, S. G. (2009). Panic disorder, panic attacks and panic attack symptoms across race-ethnic groups: Results of the collaborative psychiatric epidemiology studies. CNS Neuroscience & Therapeutics, 15, 249–254.CrossRefGoogle Scholar
  6. Asnaani, A., Richey, J. A., Dimaite, R., Hinton, D. E., & Hofmann, S. G. (2010). A cross-ethnic comparison of lifetime prevalence rates of anxiety disorders. The Journal of Nervous and Mental Disease., 198, 551–555.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Avoidance Hierarchy/Fear Hierarchy. (n.d.). Retrieved September 19, 2016, from
  8. Barrera, T. L., Wilson, K. P., & Norton, P. J. (2010). The experience of panic symptoms across racial groups in a student sample. Journal of Anxiety Disorders, 24(8), 873–878.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Benuto, L. (2013a). A guide to psychological assessment with Hispanics: An introduction. In L. Benuto (Ed.), Guide to psychological assessment with Hispanics. New York, NY: Springer.CrossRefGoogle Scholar
  10. Benuto, L. (Ed.). (2013b). Guide to psychological assessment with Hispanics. New York, NY: Springer.Google Scholar
  11. Benuto, L., & O’Donohue, W. (2015). Is culturally sensitive cognitive behavioral therapy an empirically supported treatment?: The case for Hispanics. International Journal of Psychology and Psychological Therapy, 15(3), 405–421.Google Scholar
  12. Benuto, L., O’Donohue, W., & Bennett, N. (Under Review). Treatment outcomes for latinos and non-hispanic white victims of crime: An effectiveness study.Google Scholar
  13. Biology & Psychology of Panic. (2006). Centre for clinical intervention. Retrieved September 22, 2016, from
  14. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., … Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.Google Scholar
  15. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.CrossRefPubMedGoogle Scholar
  16. Cabassa, L. J., & Zayas, L. H. (2007). Latino immigrants’ intentions to seek depression care. American Journal of Orthopsychiatry, 77(2), 231–242.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Cabassa, L. J., Zayas, L. H., & Hansen, M. C. (2006). Latino adults’ access to mental health services: A review of epidemiological studies. Administration and Policy in Mental Health and Mental Health Services Research., 33(3), 316–330.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Canino, G. (2004). Are somatic symptoms and related distress more prevalent in Hispanic/Latino youth? Some methodological considerations. Journal of Clinical Child and Adolescent Psychology, 33, 272–275.CrossRefPubMedGoogle Scholar
  19. Carter, M., Mitchell, F., & Sbrocco, T. (2012). Treating ethnic minority adults with anxiety disorders: Current status and future recommendations. The Journal of Anxiety Disorders., 26(4), 488–501.CrossRefPubMedGoogle Scholar
  20. Cintron, J. A., Carter, M. M., & Sbrocco, T. (2005). Ataques de Nervios in relation to anxiety sensitivity among island Puerto Ricans. Culture, Medicine, and Psychiatry., 29, 415–431.CrossRefGoogle Scholar
  21. Corbie-Smith, G., Thomas, S. B., & St. George, D. M. M. (2002). Distrust, race, and research. Archives of Internal Medicine., 162(21), 2458–2463.CrossRefPubMedGoogle Scholar
  22. Cuijpers, P., Cristea, I. A., Weitz, E., Gentili, C., & Berking, M. (2016). The effects of cognitive and behavioural therapies for anxiety disorders on depression: A meta-analysis. Psychological Medicine. doi: 10.1017/S0033291716002348
  23. Cummings, J. R., & Druss, B. G. (2011). Racial/ethnic differences in mental health service use among adolescents with major depression. Journal of the American Academy of Child & Adolescent Psychiatry., 50, 160–170.CrossRefGoogle Scholar
  24. Craske, M. G., & Barlow, D. H. (2014). Panic disorder and agoraphobia. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (5th ed., pp. 1–61). New York, NY: Guilford Press.Google Scholar
  25. Fight or Flight Response. (n.d.). Retrieved September, 20, 2016, from
  26. Finch, B. K., Kolody, B., & Vega, W. A. (2000). Perceived discrimination and depression among Mexican-origin adults in California. Journal of Health and Social Behavior., 41, 295–313.CrossRefPubMedGoogle Scholar
  27. Foster, R. P. (2007). Treating depression in vulnerable urban women: A feasibility study of clinical outcomes in community service settings. American Journal of Orthopsychiatry., 77, 443–453.CrossRefPubMedGoogle Scholar
  28. Guarnaccia, P. J., Canino, G., Rubio-Stipec, M., & Bravo, M. (1993). The prevalence of ataques de nervios in the Puerto Rico disaster study. Journal of Nervous and Mental Disease., 181, 157–165.CrossRefPubMedGoogle Scholar
  29. Guarnaccia, P. J., Lewis-Fernandez, R., Pincay, I. M., Shrout, P., Guo, J., Torres, M., et al. (2010). Ataques de nervios as a marker of social and psychiatric vulnerability: Results from the NLAAS. International Journal of Social Psychiatry., 56, 298–309.CrossRefPubMedGoogle Scholar
  30. Guarnaccia, P. J., Rivera, M., Franco, F., & Neighbors, C. (1996). The experiences of ataques de nervios: Towards an anthropology of emotions in Puerto Rico. Culture, Medicine and Psychiatry, 20, 343–367.CrossRefPubMedGoogle Scholar
  31. Hahn, E. A., Kim, G., & Chiriboga, D. A. (2011). Acculturation and depressive symptoms among Mexican American elders new to the caregiving role: Results from the Hispanic-EPESE. Journal of Aging and Health, 23, 417–432.CrossRefPubMedGoogle Scholar
  32. Hajcak, G. (2016). Panic Disorder. Retrieved September 2, 2016, from
  33. Hicks, T. V., Leitenberg, H., Barlow, D. H., & Gorman, K. M. (2005). Physical, mental, and social catastrophic cognitions as prognostic factors in cognitive-behavioral and pharmacological treatment for panic disorder. Journal of Consulting and Clinical Psychology., 73, 506–514.CrossRefPubMedGoogle Scholar
  34. Hollifield, M., Finley, M. R., & Skipper, B. (2003). Panic disorder phenomenology in urban self-identified Caucasian-non-Hispanics and Caucasian-Hispanics. Depression and Anxiety., 18, 7–17.CrossRefPubMedGoogle Scholar
  35. Institute of Medicine. (2004). In the national compelling interest: Ensuring diversity in health care workforce. Washington, DC: National Academy Press.Google Scholar
  36. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York, NY: Hyperion.Google Scholar
  37. Katerndahl, D. A., & Realini, J. P. (1998). Panic disorder in Hispanic patients. Family Medicine., 150(2), 246–249.Google Scholar
  38. Keyes, K. M., Martins, S. S., Hatzenbhuehler, M. L., Blanco, C., Bates, L. M., & Hasan, D. S. (2012). Mental health service utilization for psychiatric disorders among Latinos living in the United States: The role of ethnic subgroup, ethnic identity, and language/social preferences. Social Psychiatry and Psychiatric Epidemiology., 47(3), 383–394.CrossRefPubMedGoogle Scholar
  39. LaBruzza, A. L., & Méndez-Villarrubia, J. M. (1994). Using DSM-IV: A clinician’s guide to psychiatric diagnosis. Lanham, MD: Jason Aronson.Google Scholar
  40. Lara, M., Gamboa, C., Kahramanian, M. I., Morales, L. S., & Bautista, D. E. H. (2005). Acculturation and Latino health in the United States: A review of the literature and its sociopolitical context. Annual Review of Public Health., 26, 367–397.CrossRefPubMedGoogle Scholar
  41. Lewis-Fernández, R., Gorritz, M., Raggio, G. A., Peláez, C., Chen, H., & Guarnaccia, P. J. (2010). Association of trauma-related disorders and dissociation with four idioms of distress among Latino psychiatric outpatients. Culture, Medicine, and Psychiatry., 34(2), 219–243.CrossRefGoogle Scholar
  42. Liebowitz, M. R., Salmán, E., Jusino, C. M., & Garfinkel, R. (1994). Ataque de nervios and panic disorder. American Journal of Psychiatry., 151, 871–875.CrossRefPubMedGoogle Scholar
  43. Lopez, S. R., & Guarnaccia, P. J. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology., 51, 571–598.CrossRefPubMedGoogle Scholar
  44. Mendoza, D. B., Williams, M. T., Chapman, L. K., & Powers, M. (2012). Minority inclusion in randomized clinical trials of panic disorder. Journal of Anxiety Disorders., 26, 574–582.CrossRefPubMedGoogle Scholar
  45. Pescosolido, B. A., Wright, E. R., Alegría, M., & Vera, M. (1998). Social networks and patterns of use among the poor with mental health problems in Puerto Rico. Medical Care., 36, 1057–1072.CrossRefPubMedGoogle Scholar
  46. Snipes, C. (2013). Assessment of anxiety with Hispanics. In L. Benuto (Ed.), Guide to psychological assessment with Hispanics. New York, NY: Springer.Google Scholar
  47. United States Census Bureau, Population Division. Annual estimates of the resident population by sex, age, race, and Hispanic origin for the United States and States: April 1, 2010 to July 1, 2015. (2016, June). Retrieved from
  48. Varela, R. E., Vernberg, E. M., Sanchez-Sosa, J. J., Riveros, A., Mitchell, M., & Mashunkashey, M. (2004). Anxiety reporting and culturally associated interpretation biases and cognitive schemas: A comparison of Mexican, Mexican American, and European American families. Journal of Clinical Child and Adolescent Psychology., 33, 237–247.CrossRefPubMedGoogle Scholar
  49. Vickers, K., & McNally, R. J. (2006). Panic disorder. In J. E. Fisher & W. T. O’Donohue (Eds.), Evidence-based psychotherapy (pp. 494–502). New York: Springer.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of Nevada, RenoRenoUSA
  2. 2.University of NevadaRenoUSA

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