Olfactory-triggered panic attacks among Cambodian refugees attending a psychiatric clinic.
Olfactory panic attacks have not been systematically assessed in a psychiatric population by any previous studies. Among Cambodian refugees attending a psychiatric clinic, the present investigation determines the following: (a) 1-month current prevalence of olfactory-triggered panic attacks, (b) associated psychopathology (Hopkins Symptom Checklist and the Structured Clinical Interview for DSM-IV-diagnosed posttraumatic stress disorder [PTSD]), and (c) frequency in events of olfactory panic of catastrophic cognitions (Panic Attack Cognitions Scale [PACQ]) and flashbacks (Clinician-Administered PTSD flashback scale). Forty-five percent of 100 consecutive psychiatric patients were found to have suffered an olfactory-triggered panic attack in the previous month; having current olfactory panic attacks was highly correlated with psychopathology (e.g., to PTSD diagnosis: and chi(2)=50.0; df=1; p<.001); and during olfactory-triggered panic attacks, catastrophic cognitions and flashbacks were common. Possible mechanisms for generation of high rates of olfactory-triggered panic attacks in this population are discussed (the "traumatic memory/catastrophic cognitions/interoceptive conditioning/escalating arousal" or "TCIE" model of panic generation) as are treatment implications.
Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. devon_hinton@hms.harvard.edu
Devon E
DE
Hinton
Vuth
V
Pich
Dara
D
Chhean
M H
MH
Pollack
David H
DH
Barlow
D000328:Adult; D001244:Association; D002160:Cambodia / Q000208:ethnology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D008404:Massachusetts; D011939:Mental Recall; D008875:Middle Aged; D009812:Odorants; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011599:Psychopathology; D012036:Refugees / Q000523:psychology*; D012903:Smell; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology