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Article
June 1994

Klein's Suffocation Theory of Panic

Author Affiliations

Department of Psychiatry University of British Columbia 2255 Westbrook Mall Vancouver, British Columbia V6T 2A1 Canada
Vancouver

Arch Gen Psychiatry. 1994;51(6):505-506. doi:10.1001/archpsyc.1994.03950060069011
Abstract

In a recent stimulating article, Dr Klein1(p306) boldly proposed that "many spontaneous panics occur when the brain's suffocation monitor erroneously signals a lack of useful air, thereby maladaptively triggering an evolved suffocation alarm system." Klein postulated that this is a physiological mechanism and that spontaneous panic attacks occur when the suffocation alarm threshold is pathologically lowered, or when psychosocial cues to suffocation are particularly salient. The theory spans a wide range of phenomena, although its primary focus is on spontaneous panic attacks.

We investigated the theory's main assumption that suffocation alarm hypersensitivity is a risk factor for panic disorder. Alarm hypersensitivity was operationalized by a recently developed measure of suffocation fear,2 which we administered to a sample of 179 university students. The sample's mean age was 20 years and two thirds were women. We reasoned that people with hypersensitive alarms are more likely to have their

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