title: Characteristics of initial fearful spells and their associations with DSM-IV panic attacks and panic disorder in adolescents and young adults from the community.
abstract: BACKGROUND
  Few studies examined characteristics of initial fearful spells (FS) or panic attacks (PA) and their relation to DSM-IV PA and panic disorder (PD).
  
  
  METHODS
  A community sample of adolescents and young adults (N=3021) was followed up in 4 waves (T0-T3) over up to 10 years. FS, PA, and PD were assessed at each wave using the DSM-IV/M-CIDI. Characteristics of the initial FS/PA including perceived reasons/triggers, appraisal, duration, and behavioral/emotional consequences of the initial FS/PA were retrospectively assessed at T1 and T2 in those reporting the experience of lifetime FS or PA at these waves (N=363). Multinomial logistic regressions adjusted for sex and age were used to reveal associations of initial FS/PA characteristics (aggregated data from T1 and T2) with PA only (N=88) and PD (N=62; lifetime incidences cumulated across assessment waves) (reference group: No PA/PD).
  
  
  RESULTS
  Alcohol consumption, drugs/medication, and physical illness as perceived reasons for the initial FS/PA were associated with PA-only (OR 2.46-5.44), while feelings of depression, feelings of anxiety, and having always been anxious/nervous as perceived reasons for the initial FS/PA, appraising the initial FS/PA as terrible and long-term irritating/burdensome, subsequent feelings of depression, subsequent avoidance, and subsequent consumption of medication, alcohol, or drugs were associated with PD (OR 2.64-4.15). A longer duration until "feeling okay again" was associated with both PA-only (OR=1.29 per category) and PD (OR=1.63).
  
  
  CONCLUSIONS
  Initial FS/PA characteristics were necessarily assessed retrospectively by self-report only. Thus, our data might be subject to recall/evaluation biases. Aggregated data were used and strictly prospective-longitudinal studies are necessary that replicate our findings.
  
  
  CONCLUSIONS
  Assessing initial FS/PA characteristics might be useful to identify individuals at increased risk for more severe panic pathology.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany. Electronic address: eva.asselmann@tu-dresden.de.
authors.forename: Eva
authors.initials: E
authors.lastname: Asselmann
authors.affiliation: Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Pané-Farré
authors.affiliation: Institute for Therapy and Health Research (IFT-Nord), Kiel, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Isensee
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland.
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo-Baum
mesh_terms: D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000150:complications / Q000523:psychology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Appraisal; Characteristic; Consequence; Fearful spell; Panic attack; Panic disorder; Trigger