'Fear of panic': an investigation of its role in panic occurrence, phobic avoidance, and treatment outcome

The concept of 'fear of fear' has recently received empirical attention regarding its role in panic occurrence and phobic avoidance. Overall, the results of such studies have indicated that anticipation of panic is positively correlated (albeit weakly) with self-reports of avoidance. The present study examined the relationship of panic anticipation--panic occurrence, phobic avoidance and treatment outcome, using a more direct measure of this fear than has been used in previous studies. Results indicated that anticipation of panic was slightly correlated with breadth and severity of avoidance, and moderately correlated with overall clinical severity. In addition, anticipation of panic was found to decrease significantly throughout treatment, but appeared to be independent of actual panic experience. These results may suggest the operation of an intervening variable which accounts for the reduction of both anticipated and actual panic events. Implications for assessment and treatment are discussed.