The upcoming DSM-V has some new criteria for Panic Attacks,
(Note: A Panic Attack is not a codable disorder. List Panic
Attack as a specifier (categorical or dimensional) for all DSM disorders to
which it may apply (e.g., panic disorder).)
A Panic Attack is an abrupt surge of intense fear or intense discomfort that
reaches a peak within minutes, and during which time four or more of the
following symptoms occur. The abrupt surge can occur from a calm state or an
1. Palpitations, pounding heart, or accelerated heart rate
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or
depersonalization (being detached from oneself)
12. Fear of losing control or going crazy
13. Fear of dying
NOTE: Culture-specific symptoms (e.g., tinnitus, neck
soreness, headache, and uncontrollable screaming or crying) may be seen. Such
symptoms should not count as one of the four required symptoms.
To be diagnosed with Panic Disorder, a person must have:
A. Recurrent unexpected panic attacks
B. At least one of the attacks has been followed by 1 month
(or more) of one or both of the following:
1. Persistent concern or worry about additional panic
attacks or their consequences (e.g., losing control, having a heart attack,
2. Significant maladaptive change in behavior related to the
attacks (e.g., behaviors designed to avoid having panic attacks, such as
avoidance of exercise or unfamiliar situations).
C. The Panic Attacks are not restricted to the direct
physiological effects of a substance (e.g., a drug of abuse, a medication) or a
general medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).
D. The Panic Attacks are not restricted to the symptoms of
another mental disorder, such as social phobia (e.g., in response to feared
social situations), Specific Phobia (e.g., in response to a circumscribed
phobic object or situation), Obsessive-Compulsive Disorder (e.g., in response
to dirt in someone with an obsession about contamination), Posttraumatic Stress
Disorder (e.g., in response to stimuli associated with a traumatic event), or
Separation Anxiety Disorder (e.g., in response to being away from home or close
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