In panic disorder, the cognitive model proposes that panic attacks result from:
- A Catastrophic misinterpretation of benign bodily sensations as signs of imminent danger ✓
- B Elevated baseline cortisol levels causing amygdala sensitisation
- C Classical conditioning of fear response to specific stimuli
- D Reduced GABA-A receptor function in the locus coeruleus
Explanation
Clark's cognitive model of panic disorder (1986) proposes that individuals have a tendency to misinterpret bodily sensations (palpitations, dizziness, dyspnoea) as catastrophically dangerous (e.g., 'I am having a heart attack'). This catastrophic misinterpretation increases anxiety, which amplifies bodily sensations, creating a vicious positive feedback cycle culminating in a panic attack. CBT targeting these catastrophic cognitions (interoceptive exposure plus cognitive restructuring) is the most effective treatment. This distinguishes panic disorder (misinterpretation of internal bodily cues) from specific phobias (fear of external cues).
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.