Panic-fear in asthma: a divergence between subjective report and behavioral patterns.

The reported frequency of occurrence of Panic-Fear symptoms during asthmatic attacks varies widely and is related to treatment response independently of the objective severity of asthma. In a previous study, symptom minimizers (Low Panic-Fear) requested few as-needed (PRN) medications and treatments while hospitalized, even on days when significant airway obstruction was present. In contrast symptom emphasizers (High Panic-Fear) requested PRNs frequently, even on days when no airway obstruction was present. In the present study, these behavioral differences toward PRNs occurred despite the similar ability of patients in various Panic-Fear groups to perceive and report changes in airway obstruction. Together these results suggest that specific behavioral strategies, which do not derive from differences in symptom perception, influence the treatment response of asthmatic patients differing in Panic-Fear symptomatology.