Panic disorder phenomenology in urban self-identified caucasian-non-hispanics and caucasian-hispanics

Abstract

The epidemiology of panic disorder is well known, but data about some phenomenological aspects are sparse. The symptom criteria for panic disorder were developed largely from rational expert consensus methods and not from empirical research. This fact calls attention to the construct validity of the panic disorder diagnosis, which may affect accuracy of epidemiological findings. Seventy self-identified Non-Hispanic-Caucasian (Anglo) and Hispanic-Caucasian (Hispanic) people who were diagnosed with DSM-III-R panic disorder with or without agoraphobia were invited to complete a Panic Phenomenological Questionnaire (PPQ), which was constructed for this study from the Hamilton Anxiety Scale Items and The DSM-III-R panic symptoms. Fifty (71%) subjects agreed to participate, and there was no response bias detected. Seven symptoms on the PPQ that are not in the DSM-IV diagnostic criteria were reported to occur with a high prevalence in this study. Furthermore, many symptoms that occurred with a high frequency and were reported to be experienced as severe are also not included in current nosology. A few of the DSM-IV criterion symptoms occurred with low prevalence, frequency, and severity. Cognitive symptoms were reported to occur with higher frequency and severity during attacks than autonomic or other symptoms. There were modest differences between ethnic groups with regard to panic attack phenomena. Further research using multiple empirical methods aimed at improving the content validity of the panic disorder diagnosis is warranted. This includes utilizing consistent methods to collect data that will allow for rational decisions about how to construct valid panic disorder criteria across cultures.

Panic Disorder Respiratory Subtype: Psychopathology, Laboratory Challenge Tests, and Response to Treatment

“…11 There are differences in the respiratory symptom prevalence between Caucasian Hispanic and Caucasian non-Hispanic PD patients, with a significantly higher prevalence of choking in the Hispanic population. 10 Compared to European Americans, African Americans had more numbing and tingling sensations, fear of dying, and fear of going crazy. 12…”

“…10 PD patients have high levels of perceived disablement and comorbidities with major depression and anxiety disorders. 11 There are differences in the respiratory symptom prevalence between Caucasian Hispanic and Caucasian non-Hispanic PD patients, with a significantly higher prevalence of choking in the Hispanic population.…”

Culture and the Anxiety Disorders: Recommendations for DSM-V

“…Thirteen symptoms: The specified DSM-IV symptoms have been identified during the PAs of many cultural groups. [21][22][23] Their specific frequency appears to vary cross-culturally, although research in this area is limited and requires further replication. Examples include higher rates of paresthesias in African Americans, [24] trembling in Caribbean Latinos, [25] dizziness in several Asian groups, [26] and fear of dying in Arabs and African Americans.…”

“…[24] Catastrophic cognitions may increase the symptom in two main ways: by attentional mechanisms, namely, a hypervigilant surveying of the body for the feared symptom, and by positive feedback mechanisms, whereby discovery of the feared symptom leads to increased arousal, resulting in potentiation of the feared symptom and other related symptoms as well. [21,26,29,30] A second cultural reason involves the influence on PA symptom endorsement of cultural syndromes and more general local understandings of the workings of the body ("local ethnophysiologies"), which cause certain symptoms to "run together" in a particular culture. [31] This may help explain not only variation in the frequency of the 13 specified symptoms, but also why certain autonomic arousal symptoms other than those indicated in DSM-IV are prominent during PAs in other cultures.…”

Panic Disorder Severity Scale: Reliability and validity of the Turkish version

“…There has been one population study in Turkey (age range ¼ 18-85, mean age ¼ 39.3, 54.9% female, 45.1% male) that reported 12-month prevalence of panic disorder as 0.5% among women, 0.2% among men, and .4% in total population using ICD-10 diagnostic criteria [Kılıç, 2001]. A .4-4.2% prevalence of panic disorder has been reported in community samples [Hollifield et al, 2003]. Hollifield et al [2001] have noted that there might be symptom variation between ethnic groups and that cultural studies about panic were primarily epidemiological.…”