The psychological treatment of panic attacks: Theoretical conceptualization and review of evidence

Psychological treatments of panic attacks have received scant attention, perhaps due to the tendency of many researchers to view panic attacks as purely central physiological phenomena. In view of the few psychological treatment studies which have been performed, it is felt that a review of the literature could be enhanced by being placed into a theoretical framework. A cognitive/physiological model of panic attacks is presented which contains a number of points at which psychological intervention can be aimed. A review of the literature on the psychological treatment of panic attacks supports the predictions made by the model that breathing retraining, cognitive alterations, and exposure to somatic sensations may all be of value in the alleviation of panic attacks. In concluding, it is suggested that there is a major need for appropriately controlled trials which examine the specific mechanisms by which change is being produced.