Abstract
The purpose of this study was to test Nelles and Barlow's (1988) hypothesis that spontaneous panic attacks are rare or nonexistent prior to adolescence as children lack the ability to make the internal, catastrophic attributions (i.e., thoughts of losing control, going crazy, or dying) characteristic of panic according to the cognitive model (Clark, 1986). Conceptions of panic attacks, including the understanding of symptoms and causes, and cognitive interpretations of the somatic symptoms of panic were examined in children from Grades 3, 6, and 9. A significant main effect for grade was found for conceptions of panic attacks, with third graders receiving significantly lower scores than sixth and ninth graders. However, the majority of all children, regardless of age, tended to employ internal (e.g., “I'd think I was scared or nervous”) rather than external (e.g., “I'd think I was feeling that way because of the temperature or the weather”) explanations of panic attacks. No significant grade differences were found for the tendency to make internal versus external and catastrophic versus noncatastrophic attributions in response to the somatic symptoms of panic. When presented with panic imagery in a panic induction phase, children, regardless of age, made more internal and noncatastrophic attributions. Finally, internal attributional style in response to negative outcomes and anxiety sensitivity were found to be significant predictors of internal, catastrophic attributions. The challenge that these findings pose to Nelles and Barlow's hypothesis, and their relevance for understanding children's cognitive interpretations of panic symptomatology are discussed.
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REFERENCES
Alessi, N. E., & Magen, J. (1988). Panic disorder in psychiatrically hospitalized children. American Journal of Psychiatry, 145, 1450–1452.
Alessi, N. E., Robbins, D. R., & Dilsaver, S. C. (1987). Panic and depressive disorders among psychiatrically hospitalized adolescents. Psychiatry Research, 20, 275–283.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Anderson, D. J., Noyes, R., & Crowe, R. (1984). A comparison of panic disorder and generalized anxiety disorder. American Journal of Psychiatry, 141, 572–575.
Ballenger, J. C., Carek, D. J., Steele, J. J., & Cornish-McTighe, D. (1989). Three cases of panic disorder with agoraphobia in children. American Journal of Psychiatry, 146, 922–924.
Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford Press.
Bibace, R., & Walsh, M. E. (1977, August). The development of children's concepts of health, illness, and medical procedures. Paper presented at the annual meeting of the American Psychological Association, San Francisco.
Bibace, R., & Walsh, M. E. (1979). Developmental stages of children's conceptions of illness. In G. Stone, F. Cohen, & N. Adler (Eds.), Health psychology: A handbook (pp. 285–301). San Francisco: Jossey-Bass.
Bibace, R., & Walsh, M. E. (1980). Development of children's concepts of illness. Pediatrics, 66, 912–917.
Bibace, R., & Walsh, M. E. (1981). Children's conceptions of illness. In R. Bibace & M. Walsh (Eds.), New directions for child development: Children's conceptions of health, illness, and bodily functions (pp. 31–47). San Francisco: Jossey-Bass.
Bibace, R., & Walsh, M. E. (1990). Conceptions of Illness Questionnaire. Unpublished manuscript, Clark University, Worcester, MA.
Biederman, J. (1987). Clonazepam in the treatment of prepubertal children with panic-like symptoms. Journal of Clinical Psychiatry, 48, 38–41.
Black, B., & Robbins, D. R. (1990). Panic disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 36–44.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.
Cox, B. J., Endler, N. S., & Swinson, R. P. (1991). Clinical and nonclinical panic attacks: An empirical test of a panic-anxiety continuum. Journal of Anxiety Disorders, 5, 21–34.
Garland, E. J., & Smith, D. H. (1991). Simultaneous prepubertal onset of panic disorder, night terrors, and somnambulism. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 553–555.
Hayward, C., Killen, J. D., & Taylor, C. B. (1989). Panic attacks in young adolescents. American Journal of Psychiatry, 146, 1061–1062
Herskowitz, J. (1986). Neurologic presentations of panic disorder in childhood and adolescence. Developmental Medicine and Child Neurology, 28, 617–623.
Hollingshead, A. B. (1975). Four Factor Index of Social Status. Unpublished manuscript, Yale University, New Haven.
Kaslow, N. J., Tanenbaum, R. L., & Seligman, M. E. P. (1978). The KASTAN: A children's attributional style questionnaire. Unpublished manuscript, University of Pennsylvania, Philadelphia.
Kearney, C. A., & Silverman, W. K. (1992). Let's not push the “panic” button: A critical analysis of panic and panic disorder in adolescents. Clinical Psychology Review, 12, 293–305.
King, N. J., Gullone, E., Tonge, B. J., & Ollendick, T. H. (1993). Self-reports of panic attacks and manifest anxiety in adolescents. Behaviour Research and Therapy, 31, 111–116
King, N. J., Ollendick, T. H., Mattis, S. G., & Yang, B. (in press). Nonclinical panic attacks in adolescents: Prevalence, symptomatology, and associated features. Journal of Behaviour Change.
Kovacs, M., & Beck, A. T. (1977). An empirical-clinical approach toward a definition of childhood depression. In J. G. Schulterbrandt & A. Raskin (Eds.), Depression in childhood: Diagnosis, treatment, and conceptual models (pp. 1–25). New York: Raven Press.
Last, C. G., & Strauss, C. C. (1989). Panic disorder in children and adolescents. Journal of Anxiety Disorders, 3, 87–95.
Macaulay, J. L., & Kleinknecht, R. A. (1989). Panic and panic attacks in adolescents. Journal of Anxiety Disordersi, 3, 221–241.
McNally, R. J. (1990). Psychological approaches to panic disorder: A review. Psychological Bulletin, 108, 403–419.
Moreau, D. L., Weissman, M., & Warner, V. (1989). Panic disorder in children at high risk for depression. American Journal of Psychiatry, 146, 1059–1060.
Nelles, W. B., & Barlow, D. H. (1988). Do children panic? Clinical Psychology Review, 8, 359–372.
Ollendick, T. H. (1995). Cognitive-behavioral treatment of panic disorder with agoraphobia in adolescents: A multiple baseline design analysis. Behavior Therapy, 26, 517–531.
Ollendick, T. H., Mattis, S. G., & King, N. J. (1994). Panic in children and adolescents: A review. Journal of Child Psychology and Psychiatry, 35, 113–134.
Peterson, R. A., & Reiss, S. (1987). Anxiety Sensitivity Index manual. Orland Park, IL: International Diagnostic Systems.
Rapee, R., Mattick, R., & Murrell, E. (1986). Cognitive mediation in the affective component of spontaneous panic attacks. Journal of Behaviour Therapy and Experimental Psychiatry, 17, 245–253.
Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–121). New York: Academic Press.
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.
Seligman, M. E. P., & Peterson, C. (1986). A learned helplessness perspective on childhood depression: Theory and research. In M. Rutter, C. E. Izard, & P. B. Read (Eds.), Depression in young people: Developmental and clinical perspectives (pp. 223–249). New York: Guilford Press.
Seligman, M. E. P., Peterson, C., Kaslow, N. J., Tanenbaum, R. L., Alloy, L. B., & Abramson, L. Y. (1984). Attributional style and depressive symptoms among children. Journal of Abnormal Psychology, 93, 235–238.
Silverman, W. K., Fleisig, W., Rabian, B., & Peterson, R. A. (1991). Childhood Anxiety Sensitivity Index. Journal of Clinical Child Psychology, 20, 162–168.
Smucker, M. R., Craighead, W. E., Craighead, L. W.,& Green, B. J. (1986). Normative and reliability data for the Children's Depression Inventory. Journal of Abnormal Child Psychology, 14, 25–39.
Van Winter, J. T., & Stickler, G. B. (1984). Panic attack syndrome. The Journal of Pediatrics, 105, 661–665.
Vitiello, B., Behar, D., Wolfson, S., & McLeer, S. V. (1990). Diagnosis of panic disorder in prepubertal children. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 782–784.
Warren, R., & Zgourides, G. (1988). Panic attacks in high school students: Implications for prevention and intervention. Phobia Practice and Research Journal, 1, 97–113.
Whitaker, A., Johnson, J., Shaffer, D., Rapoport, J., Kalikow, K., Walsh, B. T., Davies, M., Braiman, S., & Dolinsky, A. (1990). Uncommon troubles in young people: Prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population. Archives of General Psychiatry, 47, 487–496.
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Mattis, S.G., Ollendick, T.H. Children's Cognitive Responses to the Somatic Symptoms of Panic. J Abnorm Child Psychol 25, 47–57 (1997). https://doi.org/10.1023/A:1025707424347
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DOI: https://doi.org/10.1023/A:1025707424347