Using Cognitive-Behavioral Therapy to Reduce Panic Attacks (Essay Sample)

Using Cognitive-Behavioral Therapy to Reduce Panic Attacks
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Abstract
Conventionally, panic attacks are initiated by one’s thinking of a situation or activity when broken down into their separate elements, can lead to a dangerous sensation. These sensations are catastrophic and can result in changes in the standard body functioning of an individual. Research suggests that Cognitive-Behavioral Therapy (CBT) is an effective measure in reducing panic attacks among individuals. The primary objective encompassed in this single case study design is to prove that utilization of Cognitive Behavioral interventions is imperative when tackling panic attacks among people. For the following single case study, CBT intervention will entail cognitive restructuring, modeling and relaxation technique to reduce panic disorder in the case. It was evident that CBT highly affected the outcome of the patient. Conclusively the study suggested by outlining the limitations and recommendations are significant in future studies to reduce the levels of panic attacks by using CBT.
A Case Study: Panic Attacks
The Use of Cognitive Behavioral Therapy to Reduce Panic Attacks
Introduction
According to the DSM-V, panic disorders are classified under the Anxiety disorders. An individual is considered to have a panic disorder if he experiences “recurrent unexpected panic attacks” (American Psychiatric Association, 2013). A panic attack can be referred to as a sudden surge of intense fear or discomfort that escalates within minutes within a particular situation. Panic attacks can be expected or unexpected, a scenario in which a clinician can determine through intensive questioning and multiple assessments on a client. Panic attacks are characterized by feelings of losing control, palpitations, sweating, shaking or trembling, feelings of discomfort, feelings of shock, abdominal distress, heat and tingling sensations, breathing difficulties as well as feelings of unreality. Panic attacks’ repetitive nature leads to the anxiety of future attacks or avoidance of similar situation that creates panic attacks. As an individual tends to avoid the similar situations, Agoraphobia is developed (American Psychiatric Association, 2013).
Literature Review
Panic disorders have a particular pattern that clips the patient into different types of fears. First, there are fears of anxiety where the patient will risk for the onset of panic attacks, its biological provocation and the panic disorder relapse (American Psychiatric Association, 2013). Secondly, there are catastrophic thoughts where the individual develops fears of death, losing sanity and fear of being humiliated or embarrassed before the general public.
According to a study by Lim, et al. (2005) suggests that, the initial prevalence of 1.5% for generalized anxiety disorder (GAD), including panic disorder. Also, it is noted that there is low preference to seek for intervention among the Singaporean. After Lim, et al, (2005) case study, the results suggested that the lifetime and the current prevalence in Singapore were 3.3% and 3.0% respectively. Additionally, it was concluded that the female population is more prone to contacting GAD with panic episodes, with female to male ratio of 3.6:1. Notably, Singapore statistics concerning the development of GAD was affected by other psychiatric co-morbidities such as dysthymia, panic disorder, agoraphobia, and social phobia. Also, the study suggested that prevalence rates increase as Singaporeans reach their old age.
Cognitive behavioral therapy is an intervention procedure that is action-oriented as a form of psychosocial therapy which assumes that the maladaptive thinking patterns initiate maladaptive behavior and negative emotions. Additionally, cognitive behavioral assumes that individuals react to a distorted viewpoint of a similar or different scenario in place of reacting to the reality of the scenario at hand (Beck, Cognitive behavior therapy: Basics and beyond, 2011). Therefore, the goal of Cognitive behavioral therapy in treating panic attacks focuses on restructuring the patient’s mind by making them aware of such distorted thinking patterns or cognitive distortion and changing them through a process called Cognitive Restructuring.
Numerous studies suggest that cognitive therapy is efficient in its psychosocial approach to acting as an intervention method to reduce the panic attacks in patients.CBT has been officially introduced as a choice of treatment in the Singaporean health care facility due to empirical study for its efficacy and effectiveness (Hofmann, Asnaani, Vonk, Sawyer, & Fang, 2012). On the other hand, CBT encompasses the use of non-pharmacological strategies that are efficient in reducing panic attacks (Butcher, Mineka, & Hooley, 2013).
Methods
In this case scenario, the participant will utilize some components of the CBT program as intervention strategies. The method of therapy will entail an ABA1B1 design study, which is an evidence-based efficient method to reduce panic attacks among individuals (Furukawa, et al., 2013). ABA1B1 structure is an efficient strategy was efficient in this case scenario through the administration of the cognitive and behavioral techniques to improve the situation of the patient in question.
Participant: Brenda’s case
The Cognitive-Behavioral Intervention was administered to a 28-year-old, who experiences panic attacks. The participant is a student at Swinburne University taking a course in psychology. In this scenario, the participant experiences palpitations, sweating and shortness of breath when she visits a dentist. During the tooth removal procedure, the doctor leaves the room, and the participant experiences a panic attack episode that leads him to ask questions as a sign of discomfort. The participant perception of the tooth removal procedure is fearful and losing control of herself in the dental room. Additionally, the participant experiences fright moment when he/she thinks of tooth removal. After three months, the participant experiences another episode of panic attacks during a flight. Notably, the participant recalled the situation with the dentist a couple of months ago, and the situation at the plane makes her feel unsettled and fearful. These feelings are escalated when the pilot announces a delay for landing.
The participant experiences another episode of panic attacks that leaves her to create attention by asking the air hostess to change the seating position because of fright and to an extent the participant takes Panadol just to calm the bodily functions. Analytically, it is evident that participant experiences panic attacks. In this case report, the patient experienced a panic attack three months after another panic attack. Diagnosis entails that for such a situation, the patient will have persistent concern or worry regarding future panic attacks and its effects. Additionally, it is evident that significant maladaptive changes in the participant’s behavior lead to panic attacks. Evidently, the panic attacks he/she experienced in the dentist room were equally likely to the panic attack on the plane. After an initial clinical assessment, Brenda agreed to the one-month intervention procedure and was given the necessary forms to fill and record. She was also given a client workbook Mastery of Your Anxiety and Panic by Barlow and Craske 2000
Measurements
Since the case was multi-factorial, the case study assessed three dimensions associated with panic attacks: cognitive, affective and physical. The scales that were used as measurements were filled on weekly bases in the intervention and baseline phases during the visits made by the participants, mostly during mid-week for each week.
(i) Heart Rate (Using the Polar Heart Rate monitor)
The participant’s heart rate was measured using Polar Heart rate monitor so that the therapist could know the increases in heart rates during the initial assessment and the subsequent 20 minutes in her visits. Panic attacks are characterized by heart palpitations with increases of heart beats per minute and dryness of the mouth (Parkman, 2006). Therefore the reading of the heart rate at the initial visit, dentist room, will indicate elements of panic attacks on the participant from the beginning of the case study as compared to the end of the intervention program.
(ii) Panic and Agoraphobic Scale (PAS)
“PAS is a 13 –item measure of panic disorder symptoms” (Bandelow, 1995) that majorly used in the observatory and self-reporting scenarios, case in point, Brenda’s case.. The PAS assess panic attacks, anticipatory anxiety, agoraphobic avoidance, and health concerns. It possesses “excellent inter-rater reliability, construct validity and internal consistency” (Shear et al., 2001). In this case, the PAS was given to the participant at Phase “A1” and at the end of Phase “B1” (Final to assess the overall outcome of the intervention.
(iii) Mini International Neuropsychiatric Interview (MINI)
Brenda’s diagnosis for panic disorder was initially established by utilization of anxiety and mood disorders sections from the MINI. The MINI is more integrated into clinical practice. It demonstrates good validity and reliability and has a higher concordance rate with the SCID diagnosis (Amorism, Lecrubier, Weiller, Hergueta, & Sheehan, 1998).
Procedure
In this quasi-experiment, an ABA1B1 was used to monitor if the CBT technique would improve the patient’s episodic panic attacks. Since this w...