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June 1994

Klein's Suffocation Theory of Panic-Reply

Author Affiliations

Columbia University College of Physicians and Surgeons New York State Psychiatric Institute Unit 22, 722 W 168th St New York, NY 10032

Arch Gen Psychiatry. 1994;51(6):506. doi:10.1001/archpsyc.1994.03950060070012

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In reply  Taylor and Rachman have provided valuable confirmation of my suffocation alarm theory of spontaneous panic. Null results on their part would have challenged the validity of this theory, so their supportive data is most welcome.They propose that psychological factors play an important role; I do not deny this. My theory might be called physiocentric in that it makes a deranged physiological control system central to a broad range of symptomatic precipitants and manifestations. However, I emphasize that the kind of stimuli that elicit the suffocation false alarm are, at times, experiential. Further, my theory does not foreclose the possibility that the origin of the derangement may prove psychogenic, although I rather doubt it.Taylor and Rachman have gone beyond the evidence by stating that panic attacks are readily eliminated by cognitive therapy. Proper controlled trials are still necessary in samples demonstrated to be medication-responsive by calibration against placebo. Also

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