Childhood separation anxiety and panic disorder: A comparative study

Ayuso, José Luis; Alfonso, Susana; Rivera, A.T.

doi:10.1016/0278-5846(89)90053-5

Cited by 27 publications

(11 citation statements)

References 10 publications

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“…Since that time, many researchers have observed a link between retrospectively reported childhood SAD and prospective adolescent panic attacks 18 or retrospectively reported childhood SAD and adult PD/PD-Ag. [19][20][21][22][23][24] The estimated percentage of adults with PD/PD-Ag who experienced juvenile SAD have ranged from 18% 25 to 50%. 26 Although a multitude of research groups have detected a link between juvenile SAD and subsequent PD/PD-Ag, others have failed to replicate this relationship in prospective studies.…”

Section: Childhood Sad Predicting Subsequent Nonanxious Disordersmentioning

confidence: 99%

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Lewinsohn

Holm‐Denoma

Small

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

152

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Objective-To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30).Method-A subset of the participants of the Oregon adolescent depression project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and concurrent reports of current mental illness at age 16, and were then followed prospectively until age 30. Diagnostic assessments were conducted twice during adolescence, and again at ages 24 and 30. Based on diagnosis during childhood/adolescence, the subjects were partitioned into four orthogonal groups: SAD (n = 42), other anxiety disorders (n = 88), a heterogeneous psychiatric disorders control group (n = 389), and a not mentally ill control group (n = 297). Adjusting for demographic variables that were significantly associated with group status and for comorbid disorders prior to age 19, the results were analyzed with hierarchical multiple logistic regression.Results-SAD was a strong (78.6%) risk factor for the development of mental disorders during young adulthood. The major vulnerabilities were for panic disorder and depression.Conclusions-Because SAD creates a major vulnerability for mental disorders during young adulthood, clinicians should be sensitive to the presence of SAD, and children and adolescents with SAD should be provided with treatment. Future research should evaluate whether successful treatment for SAD and/or the provision of a preventative intervention during childhood/adolescence reduce the risk for future psychopathology.

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Section: Childhood Sad Predicting Subsequent Nonanxious Disordersmentioning

confidence: 99%

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Lewinsohn

Holm‐Denoma

Small

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

152

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“…Specifically, not all previous studies have been able to confirm the postulated specificity between SAD and PDAG. Evidence concluding that there is a specific association comes primarily from studies in which PDAG patients were compared with healthy controls [7,8,9], which cannot confirm specificity. However, studies using controls affected by other mental disorders have argued against specificity or confirmed it only for females [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

Brückl

Wittchen

Höfler

et al. 2006

Psychother Psychosom

148

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Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

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“…In one study, 36 a minority of individuals with those life events went on to develop PD, and the majority of patients with PD did not experience these life events. Similarly, although it has been noted that early separation anxiety frequently precedes PD, 34,35 it does not appear to be a specific predictor of PD or agoraphobia, 38 but rather shares an association with other anxiety disorders as well. 39,40 Nevertheless, interest is growing in the neurobiological underpinnings of maternal separation in particular, 41,42 as well as of stress in general, 43,44 and this work may prove relevant to understanding aspects of the vulnerability to PD and to understanding fluctuation of symptoms in response to stressors.…”

Section: Separation and Stressorsmentioning

confidence: 97%

“…PD has been associated with earlier separation anxiety. 28,34,35 Some epidemiological studies have found associations between stressful life events (eg, maternal death, parental separation, or parental divorce) and agoraphobia with panic attacks. 36,37 Several authors have therefore emphasized the role of separation and other stressors in the pathogenesis of PD.…”

Section: Separation and Stressorsmentioning

confidence: 99%

The Neurobiology of Panic Disorder: Toward an Integrated Model

Stein

2005

CNS Spectr.

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Panic disorder (PD) is a complex, multidimensional psychiatric disorder characterized by the presence of panic attacks as well as anticipatory anxiety and panic-related phobias (eg, agoraphobia). Although the etiology of this disabling disorder remains unclear, advances in basic neuroscience and in imaging studies have led to a greater understanding of the neurocircuitry and neurochemistry that are involved in modulating fear and anxiety and that are relevant to understanding PD. A preliminary integrated model can be outlined, but there is a need for additional research that cuts across genetic investigation, provocation studies, neuroimaging techniques, and treatment trials. As research continues and greater insight into the mechanisms underlying PD is achieved, additional treatment strategies may emerge.

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Childhood separation anxiety and panic disorder: A comparative study

Cited by 27 publications

References 10 publications

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study

The Neurobiology of Panic Disorder: Toward an Integrated Model

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