Panic-Fear in Asthma: Symptomatology as an Index of Signal Anxiety and Personality as an Index of Ego Resources

Clinical observations and studies of asthmatic patients have often concluded that there is a strong relationship between the degree of the patientʼs anxiety and the medical intractability of his illness. However, psychotherapeutic interventions designed to alleviate patient anxiety have been noticeably inconsistent in achieving meaningful alleviation of the patientʼs asthma. The present paper addresses this apparent paradox by positing the existence of two types of anxietya) asthma-specific anxiety, as indexed by Panic-Fear symptomatology scores of the Asthma Symptom Checklist; and b) characterological and pervasive anxiety, as indexed by Panic-Fear personality scores of the Minnesota Multiphasic Personality Inventory. In this study, long term medical outcome was found to be influenced by the combination of these types of anxiety. When high asthma-specific anxiety coexisted with high characterological anxiety, medical outcome following intensive long term medical treatment was exceptionally poor. In contrast, when high asthmaspecific anxiety coexisted with average levels of characterological anxiety, medical outcome was exceptionally good. These results are discussed relative to the theoretical distinctions between signal anxiety and anxiety concomitant with a lack of basic ego resources.