There is no consensus in the literature about the occurrence of panic attacks in the nonclinical population (i.e., non-anxious people). Notably, one body of research concludes that panic attacks are not common among this population, while another states that they are prevalent. In order to reconcile with these differences, looking as how a panic attack is described and understood is necessary
Defining Panic Attacks
Indeed, it has been proposed that the high number of reported panic attacks among healthy participants could be the result of ‘commonsense” understanding of the concept of panic, which in some cases may be confused with situational anxiety.
A remedial action in this case involves providing a clinical definition of a panic attack and a vignette (i.e., a short description of an actual panic attack) to ensure that everyone has the same valid definition of a panic attack.
The authors of the study subsequently proceeded to survey healthy participants with a battery of questionnaires, including the panic attack questionnaire (PAQ), exposing one group to the definition alone and another with both the definition and the vignette. The results of each group were then compared to those of panic disorders patients.
Non-clinical Vs Clinical Panic Attacks
Overall, the results indicate that very few participants actually reported clinical panic attacks. Specifically, the episodes of panic were less severe, less frequent, and less likely to occur unexpectedly, which are three common features that are present in panic disorder.
Typically, those episodes were provoked by an anxiety-inducing situation (i.e., a trigger) rather than arising “out of the blue”. Furthermore, nonclinical panic attacks were equally reported among men and women.
By contrast, a small subset of the participants did experience clinical-grade panic attacks, particularly among the women. Overall, they reported having experienced a broader range of symptoms at a greater level of severity.
Interestingly, among that subset the panic attacks did not consistently occur out of the blue, which suggests that it may not be a necessary feature of clinical panic attacks. Therefore, the authors argue that clinical panic attacks are not as prevalent as previously supposed.
Reference:
Wilson KG, Sandler LS, Asmundson GJ, Ediger JM, Larsen DK, Walker JR. Panic attacks in the nonclinical population: an empirical approach to case identification. J Abnorm Psychol. 1992 Aug;101(3):460-8. doi: 10.1037//0021-843x.101.3.460. PMID: 1500603.