Panic attacks without fear: An overview*

Matt G. Kushner, Bernard D. Beitman

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


'Non-fearful panic disorder' (NFPD) is a condition that meets DSM III-R criteria for panic disorder but lacks a report of subjective fear or anxiety. Presenting the first comprehensive overview of this issue, the authors describe studies investigating a wide range of apparently overlapping phenomena including NFPD, 'somatically expressed panic', 'non-cognitive panic', 'alexithymic panic', 'non-clinical panic', and 'masked anxiety'. The review shows that such conditions account for from 20 to 40% of the panic disorder found in various medical populations, and that this group resembles conventional panic disorder in cross-sectional comparisons. We emphasize that a 'triple-response' model of anxiety is consistent with our conclusion that NFPD should be conceptualized as a panic disorder subtype. Finally, we discuss unresolved issues regarding the construct and predictive diagnostic validity of NFPD.

Original languageEnglish (US)
Pages (from-to)469-479
Number of pages11
JournalBehaviour Research and Therapy
Issue number6
StatePublished - 1990
Externally publishedYes


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