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Beyond Panic Symptoms: A Cognitive-Behavioral Case Study Integrating Familial Anxiety, Parenting Stress, Adverse Life Experiences, and a Child’s Tuberculosis Diagnosis

Panic disorder is characterized by current and unexpected panic attacks accompanied by persistent concern about future attacks and maladaptive behavioral changes. Cognitive-behavioral models propose that panic symptoms are maintained through catastrophic misinterpretations of benign bodily sensations, which trigger escalating anxiety and avoidance behaviors. This case study describes the assessment, cognitive-behavioral formulation, intervention, and clinical evolution of a 31-year-old woman presenting with recurrent panic attacks, anticipatory anxiety, and significant distress related to parenting responsibilities. The client sought psychological support following a severe panic episode that occurred in a public setting and was followed by persistent anxiety, repeated emergency department visits, and fear of experiencing further attacks. Assessment procedures included a clinical interview, the Mini-Mult, and the Beck Anxiety Inventory (BAI). Findings suggested elevated emotional tension and vulnerability to anxiety, with no evidence of severe psychopathology. A cognitive-behavioral formulation highlighted the interaction between childhood adversity, family vulnerability to anxiety, health-related stressors, parental responsibility, catastrophic interpretations of bodily sensations, and safety behaviors. The intervention consisted of nine individual cognitive-behavioral therapy sessions focused on psychoeducation, breathing training, cognitive restructuring, reduction of safety behaviors, and gradual confrontation of previously avoided situations. Over the course of treatment, the client demonstrated a significant reduction in panic-related distress, increased tolerance of anxiety symptoms, decreased avoidance, and improved perceived self-efficacy. Residual vulnerability remained in situation involving concerns about her children’s health and period of increased parental burden. This case illustrates the usefulness of cognitive-behavioral interventions for panic disorder and highlights the importance of considering parenting-related stress and personal developmental experiences when conceptualizing and treating anxiety disorders.

Luísa Freitas, and Luísa Soares*


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Beyond Panic Symptoms: A Cognitive-Behavioral Case Study Integrating Familial Anxiety, Parenting Stress, Adverse Life Experiences, and a Child’s Tuberculosis Diagnosis

Luísa Freitas, and Luísa Soares*

Pages: 11

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Seth J. Worley, MD, FHRS, FACC

Director, Interventional Implant Program MedStar Heart & Vascular Institute, Washington, DC, USA

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