Severity Measure for Panic Disorder - Adult
Assesses the severity of panic disorder symptoms
Jennifer Glen
Provided by
EVAL FoundationInstructions
Inclusion Criteria
- New or existing panic disorder diagnosis (or clinically significant panic disorder symptoms)
- Age ≥ 18 years
The following questions ask about thoughts, feelings, and behaviors about panic attacks. A panic attack is an episode of intense fear that sometimes comes out of the blue (for no apparent reason). The symptoms of panic attack include: a racing heart, shortness of breath, dizziness, sweating, and fear of losing control or dying.
Ask: Rate the severity of your panic disorder during the past 7 days.
For further clinical evaluation and research, the American Psychiatric Association (APA) is offering a number of “emerging measures” in Section III of DSM-5-TR (APA, 2024). These patient assessment measures were developed to be administered at the initial patient interview and to monitor treatment progress, thus serving to advance the use of initial symptomatic status and patient reported outcome (PRO) information, as well as the use of “anchored” severity assessment instruments. There are four types of measures classified by the APA. One type, called severity measures, are disorder-specific, corresponding closely to criteria that constitute the disorder definition. The Severity Measure for Panic Disorder - Adult is a disorder-specific severity measure for panic disorder (PD) that can complement the clinical assessment of patients with PD (Craske et al, 2013; Locke, Kirst & Shultz, 2015). The assessment scale may be administered to individuals who have received a diagnosis of PD or who have a clinically significant syndrome that falls short of meeting full criteria.
Frequency of Use
To track changes in the severity of the individual’s panic disorder over time, the measure may be completed at regular intervals as clinically indicated, depending on the stability of the individual’s symptoms and treatment status. Consistently high scores on a particular domain may indicate significant and problematic areas for the individual that might warrant further assessment, treatment, and follow-up. Your clinical judgment should guide your decision.
These measures should be used to enhance clinical decision-making and not as the sole basis for making a clinical diagnosis. Further information on these measures can be found in DSM-5-TR. Instructions, scoring information, and interpretation guidelines from the APA are provided here.
.Summary
Instructions to Clinicians
The Severity Measure for Panic Disorder—Adult is a 10-item measure that assesses the severity of symptoms of panic disorder in individuals age 18 and older. The measure was designed to be completed by an individual upon receiving a diagnosis of panic disorder (or clinically significant panic disorder symptoms) and thereafter, prior to follow-up visits with the clinician. Each item asks the individual receiving care to rate the severity of his or her panic disorder during the past 7 days.
Scoring and Interpretation
The 10-item questions ask about thoughts, feelings, and behaviors about panic attacks. A panic attack is an episode of intense fear that sometimes comes out of the blue (for no apparent reason). The symptoms of a panic attack include: a racing heart, shortness of breath, dizziness, sweating, and fear of losing control or dying.
Each item on the measure is rated on a 5-point scale.
- 0=Never
- 1=Occasionally
- 2=Half of the time
- 3=Most of the time
- 4=All of the time
The total score can range from 0 to 40, with higher scores indicating greater severity of panic disorder. The raw scores on the 10 items are summed to obtain a total raw score. In addition, the average total score is calculated. The average total score is calculated by dividing the raw total score by number of items in the measure (i.e., 10). The average total score reduces the overall score to a 5-point scale, which allows the clinician to think of the severity of the individual’s panic disorder in terms of none (0), mild (1), moderate (2), severe (3), or extreme (4). The use of the average total score was found to be reliable, easy to use, and clinically useful to the clinicians in the DSM-5 Field Trials.
.All questions & possible results
InstructionsTitle not visible
Felt moments of sudden terror, fear or fright, sometimes out of the blue (i.e., a panic attack)
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Felt anxious, worried, or nervous about having more panic attacks
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Had thoughts of losing control, dying, going crazy, or other bad things happening because of panic attacks
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Felt a racing heart, sweaty, trouble breathing, faint, or shaky
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Felt tense muscles, felt on edge or restless, or had trouble relaxing or trouble sleeping
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Avoided, or did not approach or enter, situations in which panic attacks might occur
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Left situations early, or participated only minimally, because of panic attacks
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Spent a lot of time preparing for, or procrastinating about (putting off), situations in which panic attacks might occur
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Distracted myself to avoid thinking about panic attacks
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Needed help to cope with panic attacks (e.g., alcohol or medication, superstitious objects, other people)
Select one option:
- Never
- Occasionally
- Half of the time
- Most of the time
- All of the time
Possible results
Panic Disorder Severity: Moderate
Average total score 2 out of 4 possible.
Panic Disorder Severity: Mild
Average total score 1 out of 4 possible.
Panic Disorder Severity: Severe
Average total score 3 out of 4 possible.
Panic Disorder Severity: Extreme
Average total score 4 out of 4 possible.
Panic Disorder Severity: None
Average total score 0 out of 4 possible.
Literature
- A dimensional approach to measuring anxiety for DSM-5. Int J Methods Psychiatr Res. 2012 Dec;21(4):258-72. — Lebeau RT, Glenn DE, Hanover LN, Beesdo-Baum K, Wittchen HU, Craske MG.
- Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015 May 1;91(9):617-24. — Locke AB, Kirst N, Shultz CG.
- Severity Measure for Panic Disorder - Adult. APA. 2013. — Craske M, Wittchen U, Bogels S, Stein M, Andrews G, Lebeu R
- Diagnostic and statistical manual of mental disorders (5th ed., text revision) (DSM-5-TR). (2022). — American Psychiatric Association
