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Transcultural Psychiatry
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Olfactory-Triggered Panic Attacks among Khmer Refugees: A Contextual Approach

Devon Hinton

Massachusetts General Hospital, Harvard University

Vuth Pich

Dara Chhean

Arbour Counseling Services, Lowell

Mark Pollack

Massachusetts General Hospital, Harvard University

One hundred Khmer refugees attending a psychiatric clinic were surveyed to determine the prevalence of olfactory-triggered panic attacks as well as certain characteristics of the episodes, including trigger (i.e. type of odor), frequency, length, somatic symptoms, and the rate of associated flashbacks and catastrophic cognitions. Forty-five of the 100 patients had experienced an olfactory-triggered panic attack in the last month. Trauma associations and catastrophic cognitions (e.g. fears of a ‘wind attack,’ ‘weakness,’ and ‘weak heart’) were common during events of olfactory panic. Several case examples are presented. A multifactorial model of the generation of olfactory panic is adduced. The therapeutic implications of this model for the treatment of olfactory panic are discussed.

Key Words: Cambodians • olfactory • panic attacks • panic disorder • post-traumatic stress disorder

Transcultural Psychiatry, Vol. 41, No. 2, 155-199 (2004)
DOI: 10.1177/1363461504043564
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