Article by Alex Diamond

Panic attacks are defined as rapid occurrences of anxiety or rapid escalations in current anxiety in which there are at least 4 of 13 somatic or cognitive symptoms (DSM-IV; APA, 1994). Four or more symptoms have to escalate or occur within a ten-minute period, to meet panic criteria.

Although many individuals experience some degree of apprehension in everyday social situations, the experience of increased anxiety for nonphobics is usually not a serious concern or problem. For the social phobic, however, such anxiety can be excessive and debilitating, as in the case of a musician who must rely on public performances for financial security but whose performance technique is compromised by sweating and trembling as a result of increased physiological arousal.

Fear is an inborn response to certain stimuli that becomes differentiated from other feelings in the first year of life. The startle reaction which newborn infants show seems to be a precursor of later normal fear. Any intense, sudden, or unexpected stimulus to the infant will cause him to throw up both hands and feet and perhaps cry- After about age six months, fear becomes recognizably different from startle and is seen in response to strangers. Fear of animals begins a bit later.The common fears change as the child grows

Youngsters are usually nervous when first at school, though they adapt readily within a few hours. School phobia or refusal is uncommon, but it can be a serious problem. Unlike truancy, it is not associated with other delinquent behavior, absence of parents, or inconsistent discipline at home. It occurs especially at times when children change schools, for example, at age eleven to twelve in the United States and Britain.

The prevalence of anxiety disorders in the general population is greater than that of any other mental disorder, including depression and substance abuse.

In relationships anxious individuals may experience considerable difficulty with others. They are often highly reactive and inappropriately scapegoat themselves or others. Further relational difficulties can arise from excessive approval-seeking behaviors and, at the same time, being hypercritical of others. Often anxious persons have diffuse or rigid personal boundaries, a narrow range of skills in communicating, are incongruent in the way they relate to others, and often alternate between seeking and avoiding power.

Since the beginning of modern theories and treatments of mental illness, the phenonemon of anxiety has been a cornerstone in the formulation and understanding of abnormal behavior. Freud’s early work with the hysterical “Anna O” and the phobic “Little Hans” led him to view the experience of pathological anxiety in the form of specific phobias or nonspecific generalized anxiety as defensive mechanisms that possessed adaptive features for the individual.

It is apparent that the term “anxiety” may refer to a concept which is central to the psychoanalytic view of personality development. In addition, anxiety is a pathological state of personality development. In addition, anxiety is a pathological state of substantial clinical significance, not only because it poses a management problem, but also because its appearance often seems to precede and to accompany the emergence of significant psychopathology.

PD is characterized by the occurrence of unexpected panic attacks, which are discrete periods of intense apprehension, terror, or feelings of impending doom. These attacks are distinguished from high levels of general anxiety by their sudden and unexpected onset and tendency to surge to a peak, usually within 10 minutes.

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