Panic disorder is characterized by recurrent unexpected panic attacks. The cognitive model (Clark, 1986) proposes the central maintaining mechanism is:

• A Conditioned avoidance of feared objects
• B Catastrophic misinterpretation of benign bodily sensations as imminently dangerous ✓
• C Suppression of intrusive thoughts leading to paradoxical increase
• D Learned helplessness from uncontrollable stressors

Explanation

Clark's (1986) cognitive model proposes that panic disorder is maintained by catastrophic misinterpretation of physiological sensations (e.g., interpreting palpitations as a heart attack, dizziness as imminent fainting or stroke). This creates a positive feedback loop: bodily sensation → catastrophic interpretation → increased anxiety → amplified sensation → more catastrophic interpretation. CBT targets this vicious cycle through cognitive restructuring and interoceptive exposure.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.