The cognitive theory of panic disorder: A systematic narrative review

Abstract

Background

The cognitive theory of panic disorder proposes that individuals with panic disorder have a relatively enduring tendency to catastrophically misinterpret bodily sensations resulting in panic attacks.

Aims

We investigated whether the evidence is consistent with the theory and its predictions, if updates are required and sought to identify future research considerations.

Methods

We searched Scopus, Web of Science, PsycInfo, EMBASE, MEDLINE and CINAHL (1986 to July 2024). Inclusion criteria were studies collecting quantitative data derived from panic disorder patients, testing one of the predictions and using appropriate outcome measures. Exclusion criteria were non-English language publications, all participants under the age of 18 and studies that were not published in a peer-reviewed journal. Quality was assessed using ‘QualSyst’ and synthesis was based on each prediction tested. PROPSERO registration #CRD42022332211.

Results

53 studies were identified amongst 49 publications. There was substantial evidence for all predictions. Three studies did not support the prediction tested and none were inconsistent.

Limitations

Most studies were ‘medium’ in quality and were predominately from female samples.

Conclusions

Findings are consistent with the theory and its predictions. Higher quality research is needed and implications for future research are discussed.