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Kelly CM, Jorm AF, Kitchener BA.


ORYGEN Research Centre, University of Melbourne, Australia


Background: Panic attacks are common, and while they are not life-threatening events, they can lead to the development of panic disorder and agoraphobia. Appropriate help at the time that a panic attack occurs may decrease the fear associated with the attack and reduce the risk of developing an anxiety disorder. However, few people have the knowledge and skills required to assist. Simple first aid guidelines may help members of the public to offer help to people who experience panic attacks.


Methods: The Delphi method was used to reach consensus in a panel of experts. Experts included 50 professionals and 6 people who had experience of panic attacks and were active in mental health advocacy. Statements about how to assist someone who is having a panic attack were sourced through a systematic search of both professional and lay literature. These statements were rated for importance as first aid guidelines by the expert and consumer panels and guidelines were written using the items most consistently endorsed.


Results: Of 144 statements presented to the panels, 27 were accepted. These statements were used to develop the guidelines appended to this paper.


Conclusion: There are a number of actions which are considered to be useful for members of the public to do if they encounter someone who is having a panic attack. These guidelines will be useful in revision of curricula of mental health first aid programs. They can also be used by members of the public who want immediate information about how to assist someone who is experiencing panic attacks.


Source + Full text…
© 2009 Kelly et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract: Diversity of effective treatments of panic attacks: what do they have in common?


Diversity of effective treatments of panic attacks: what do they have in common?


Roth WT.


Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; Department of Veterans Affairs Health Care System, Palo Alto, California


Funded by:
National Institutes of Health; Grant Number: MH066953-01
Department of Veterans Affairs; Grant Number: ROT0042825



By comparing efficacious psychological therapies of different kinds, inferences about common effective treatment mechanisms can be made.


We selected six therapies for review on the basis of the diversity of their theoretical rationales and evidence for superior efficacy: psychoanalytic psychotherapy, hypercapnic breathing training, hypocapnic breathing training, reprocessing with and without eye-movement desensitization, muscle relaxation, and cognitive behavior therapy.


The likely common element of all these therapies is that they reduce the immediate expectancy of a panic attack, disrupting the vicious circle of fearing fear.


Modifying expectation is usually regarded as a placebo mechanism in psychotherapy, but may be a specific treatment mechanism for panic. The fact that this is seldom the rationale communicated to the patient creates a moral dilemma: Is it ethical for therapists to mislead patients to help them? Pragmatic justification of a successful practice is a way out of this dilemma.


Therapies should be evaluated that deal with expectations directly by promoting positive thinking or by fostering non-expectancy.


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