clude catastrophic cognitions centered on the concern that khyâl  (a windlike substance)
may rise in the body—along wi th blood—and cause a range of  serious effects (e.g., com-
pressing the lungs to cause shortness of breath and asphyxia; entering the cranium to
cause tinnitus, dizziness, blurry vision, and a fatal syncope). Khyâl attacks may occur with-
out warning, but are frequently brought abou t by triggers such as  worrisome thoughts,
standing up (i.e., orthostasis), specific odor s with negative associations, and agoraphobic-
type cues like going to crowded spaces or riding in a car. Khyâl  attacks usually meet panic
attack criteria and may shape the experience  of other anxiety and trauma- and stressor-
related disorders. Khyâl attacks may be associated with considerable disability.
Related conditions in other cultural contexts:  Laos ( pen lom), Tibet ( srog rlung gi nad ),
Sri Lanka ( vata), and Korea (hwa byung ).
Related conditions in DSM-5:  Panic attack, panic disorder, generalized anxiety disor-
der, agoraphobia, posttraumatic stre ss disorder, illness anxiety disorder.
Kufungisisa
Kufungisisa  (“thinking too much” in Shona) is an id iom of distress and a cultural explana-
tion among the Shona of Zimbabwe . As an explanation, it is considered to be causative of
anxiety, depression, and somatic problems (e .g., “my heart is painful because I think too
much”). As an idiom of psychosocial distress, it is indicative of interpersonal and social
difficulties (e.g., marital problems, having no money to take care of children). Kufungisisa