A number of controlled studies reported that panic disorder patients were stressful after experiencing their first panic attack. Around 80% of them were often afflicted by the past tragic events in their personal lives such as family conflict, accident, and death of loved ones (Sahley, 2008). Whereas, prospective researches have proven the interrelation between panic attacks and stress, the judgment on the effect of past life stress on the present state of patients depends largely on their respective memories concerning their traumatic experiences.

It is also possible that other psychological and physiological constructs can shape the vulnerability of individuals to panic attacks under stressful conditions (Sahley, 2008). Typically, the symptoms of panic disorder are set during the late adolescence period to early adult stage. During panic attack, the different symptoms, which may last for an hour, appear within 10 minutes after the emergence of the first sign. Its severity and frequency varies from a single attack in a week to a bunch of attacks between months of dormancy.

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Over time, some affected individuals develop anticipatory anxiety which eventually lead to generalized fear and avoidance of situations, events, and places which may possibly trigger panic attack. Meanwhile, agoraphobia generally develops among panic disorder patients. It is an irrational fear on places where one thinks that he or she can possibly be trapped. This condition put limits on the socialization skills of the affected individual for he or she is prone to embarrassment due to the manifestation of peculiar symptoms in unpredicted panic disorder attack.

Thus, agoraphobia patients tend to confine themselves at home and become dependent on the other members of their families. Assessment and Diagnosis In clinical practice, mental and behavioral disorders are generally classified as pathological phenomena characterized by impairment in the physiological functioning of the brain affecting emotions, behavior and cognitive aspects of the patient (WHO, 2001). In addition, the disorder, either sustained or recurring, should be a result of malfunctioning or distress from several aspects of patient’s life (WHO, 2001).

Meanwhile, in the assessment and diagnosis of any psychiatric disorders, clinical methods similar to physical disorder diagnosis are employed. These clinical methods require historical and medical background of the client not only from himself or herself but also from the collaborative details given by the family, school, community, and medical institution (WHO, 2001). This information will be utilized for further assessment of the mental health status of the client. Further, in the recent decades, advancement in the medical science progresses as well as the clinical methods of mental health assessment.

Standard criteria on the evaluation of signs and symptoms and well structured instrument of high validity and reliability degrees have been established (WHO, 2001). Hence, the signs and symptoms assessment for psychological disorders are now internationally standardized which facilitated the accurate and reliable diagnosis worldwide (WHO, 2001). The selection of appropriate treatment depends largely on the assessment of the client; as such, the efficient diagnosis of mental health problems must be carried out (WHO, 2001).

Diagnosis is the crucial part of creating medical intervention on the ground that different disorders require different or specialized treatment (WHO, 2001). It must be expressed in terms of the type and level of disorder, and in nosological terms (WHO, 2001). Moreover, early detection of the disorder and intervention are of prime importance in the prevention of full-blown disease development. For instance, prolonged untreated psychosis in schizophrenic patients leads to poor outcomes of any medical treatment (WHO, 2001).

These are implications that an effective mental health treatment program requires a clinical-based integration of psychological, psychosocial, and pharmacological interventions (WHO, 2001). Panic Disorder Differential Diagnosis After the identification of the etiology of the patient’s panic attacks, a medical diagnosis of panic disorder is made. Most of the time, other medical conditions such as neurologic, endocrine, cardiovascular, and respiratory problems co-occur with anxiety (Katon, 1996).

In medical diagnosis, at least four symptoms are required to meet the clinical criteria for panic attack. These symptoms last for half of an hour but may extend up to one hour. However, a panic disorder patient experiences specific symptoms different from other diseases. In particular, about 20% of patients with reported symptoms of panic disorder after undergoing diagnosis were instead found with substance-abuse disorder and mood or anxiety problems (Hirschfeld, 1996).