The misinterpretation of body sensations in nonclinical panic attacks: a test of the cognitive theory

Nonclinical panic attacks (NCP) refer to panic attacks in individuals who do not meet diagnostic criteria for panic disorder. Researchers have found many similarities between NCP and the panic attacks reported by individuals with panic disorder. The cognitive theory of panic disorder suggests that panic attacks are the result of the catastrophic misinterpretation of bodily sensations. However, it is unclear whether this model of panic disorder appropriately describes NCP because little empirical attention has been given to cognitive processes in NCP. This study examined the relationship between the misinterpretation of bodily sensations and NCP. Individuals reporting panic attacks (n=15) did not interpret ambiguous bodily sensations in a catastrophic manner when compared with participants without a history of panic attacks. Yet, the NCP group reported greater levels of psychological distress and elevated levels of emotion-oriented coping. These results suggest that cognitive processes other than those found in panic disorder should be examined in NCP In addition, increased attention should be given to the importance of affective variables. Secondly, this study explored methodological issues in NCP. Studies of NCP have been hampered by inconsistencies in the diagnostic methods used to determine the presence of panic attacks. The results of the Anxiety Disorder Interview Schedule-IV, a structured clinical interview, were compared with the findings from a self-report measure for NCP, the Panic Attack Questionnaire. The self-report of NCP resulted in significantly more individuals reporting panic symptoms when compared with the clinical interview. Individuals reporting NCP by self-report also indicated more panic symptomatology in comparison to individuals diagnosed with NCP via the clinical interview. These results suggest caution should be used when generalizing from NCP samples composed of individuals self-reporting panic symptoms to individuals with panic disorder. They also underscore the need for methodological consistency in NCP research.