Panic attacks during traumatic events not harbinger of PTSD

Geisinger

New Geisinger Health System-lead research dispels a recent notion in psychiatry that if a person experiences a panic attack during a traumatic event that they will likely suffer from post-traumatic stress disorder (PTSD) in the future.

The study co-authored by Geisinger Senior Investigator Joseph Boscarino, PhD, MPH, and Kent State University social psychologist Richard E. Adams, Ph.D. appears in the April edition of the journal Psychiatry Research. Both are also affiliated with Mt. Sinai School of Medicine in New York.

The new research suggests that factors such as a prior history of depression, a person's emotional support network and self-esteem are better indicators of a susceptibility to PTSD.

It was previously thought that panic attacks immediately following traumatic events such as a car accident would trigger or predict PTSD in the long-term. But the researchers say there is more to it.

"Clinicians should look at other signs of mental-health stress such as not sleeping, recently experiencing stressful life events and withdrawing from social interactions," Boscarino said. "Our study suggests that many factors contribute to post-traumatic stress disorder-not just panic attacks during the event."

The study examined panic attacks during a traumatic experience among people exposed to the events at the World Trade Center in New York City on Sept. 11, 2001. Among the study's key findings:

• People between the ages of 30 and 44 suffered the highest rate of panic attacks, compared to other age groups;
• People with the highest education were the least likely to suffer a panic attack;
• Hispanics were more likely to have panic attacks than other ethnic groups;
• Thirty percent of those who suffered panic attacks in the aftermath of Sept. 11 had depression prior to the event.

Panic attacks can include shortness of breath, heart pounding, sweating, trembling or shaking, chills or hot flashes, and a sense that there is no reality.

About 10 percent of Americans suffer isolated panic attacks each year, according to federal government statistics. That rate increases dramatically when people are involved in traumatic events.

"We encourage trauma victims to seek counseling immediately after disasters and other traumatic events," Dr Boscarino said. "We're learning that the long-term mental-heath consequences of trauma are far reaching and more complex than originally thought."

The research was supported with funding from Geisinger Health System and the U.S. National Institute of Mental Health.

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Boscarino JA, Adams RE. Peritraumatic panic attacks and health outcomes two years after psychological trauma: Implications for intervention and research. Psychiatry Res 2009;doi:10.1016/j.psychres.2008.03.019 [Abstract]