Rationale: Panic attacks are common in chronic obstructive pulmonary disease, and the prevalence of panic disorder is at least ten times higher than in the general population. In the current study, we examined resistive load perception in chronic obstructive pulmonary disease patients with and without panic attacks. Objectives: We tested competing hypotheses, based on conflicting results of earlier studies, that those chronic obstructive pulmonary disease patients with panic attacks or panic disorder would show either heightened or blunted perception of dyspnea as the magnitude of inspiratory resistive loads increased. Method: We compared 20 chronic obstructive pulmonary disease patients with panic attacks or panic disorder, 20 patients without panic, and 20 healthy, age-matched subjects using an inspiratory resistive load testing protocol. Measurements: We administered a diagnostic interview for panic attacks and panic disorder. We measured perceived dyspnea in response to increasing inspiratory resistive loads (modified Borg Scale) and several respiratory variables. Main Results: Dyspnea ratings increased linearly for all groups as the size of resistive loads increased. No significant differences were found between groups on the respiratory variables. Chronic obstructive pulmonary disease patients with panic attacks or panic disorder rated their level of dyspnea significantly higher than did other subjects. Conclusions: Chronic obstructive pulmonary disease patients with panic attacks showed heightened sensitivity to inspiratory loads. The result reinforces the influence of psychological factors on symptom perception in this disease.