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Shannon Stirman and Melissa Hunt
University of Pennsylvania, United States



A Cognitive Theory of Panic Disorder During Pregnancy

Shannon Stirman


Past studies have been inconsistent in their analysis of pregnancy's effect on panic disorder. Some have suggested that pregnancy only allows for improvement in the disorder, while others have argued that pregnancy acts to exacerbate the condition. Hormonal theories, for example, have been discounted since they only provide evidence for the worsening of panic.

In contrast, Klein's Suffocation False-Alarm Theory argues that pregnancy decreases the likelihood of panic symptoms since pregnancy acts to prevent the misfiring of our biological suffocation alarm, which Klein hypothesizes to be the cause of panic disorder. Both of these conflicting theories of pregnancy's effect on panic are incomplete since pregnancy can lead to either marked improvement or worsening of panic disorder.

Based on Clark's cognitive model of panic, this paper investigated the tendency of pregnant women to misinterpret somatic sensations, thereby making pregnancy-specific, catastrophic attributions of bodily sensations. Study 1 examined the somatic awareness of women with panic disorder, pregnant women, and non-pregnant/non-panic controls. Results suggested that pregnant women experienced more bodily sensations than non-pregnant women and worried less about them. Study 2 investigated the level of catastrophizing by condition, which included pregnant/panic, pregnant, panic, and control women.

Results linked pregnancy to a higher level of panic in panic patients on pregnancy-specific questions thus fitting with Clark's cognitive model of panic.