Gender differences in patients with panic disorder: Evaluating cognitive mediation of phobic avoidance

Epidemiologic reports have a consistently found that females are greater ri sk for the development of panic disorder, in particular, when it is accompa nied by agoraphobia. Although gender appears to be a well-established risk factor for the development of phobic avoidance, the mechanisms that account for this increased risk have yet to be delineated. Often, gender differenc es in phobic avoidance are speculated to arise from differences in courage (e.g., men are expected to be brave and endure fear-provoking situations). Our study evaluated this popular but unsubstantiated theory and advanced an other hypothesis: Differences in panic- and arousal-related cognitions may account for gender differences in phobic avoidance. Male (n = 27) and femal e (n = 61) patients meeting DSM-IV criteria for panic disorder with or with out agoraphobia were evaluated. Data did not support gender differences in courage; nor were these indices related to phobic avoidance. In contrast, t here were significant gender differences in several cognitive domains. More over, anxiety sensitivity and panic-related appraisals mediated gender diff erences in phobic avoidance.