Life events in panic disorder-an update on “candidate stressors”

Abstract

Studies on gene-environment interactions in mental disorders are characterized by powerful genetic techniques and well defined "candidate genes," whereas a definition of "candidate stressors," in most cases assessed in the form of life events (LEs), is inconsistent or not even provided. This review addresses this problem, with particular attention to the clinical phenotype of panic disorder (PD), by providing an overview and critical discussion for which life events are known to contribute to the etiology of the disease and how they may be conceptualized. There is converging evidence for a significant impact of cumulative as well as specific life events, such as threat, interpersonal and health-related events in adulthood, and abuse or loss/separation experiences in childhood, respectively, on the pathogenesis of panic disorder with some overlapping effect across the anxiety disorder spectrum as well as on comorbid major depression. Besides genetic vulnerability factors, personality and behavioral characteristics, such as anxiety sensitivity, neuroticism, and cognitive appraisal might moderate the influence of LEs on the development of panic disorder. The present state of knowledge regarding the specification and conceptualization of LEs in PD within a more complex multifactorial model, involving mediating and moderating factors in between genes and the clinical phenotype, is hoped to aid in informing future gene-environment interaction studies in panic disorder.

Serotonin transporter gene and childhood trauma - a G × E effect on anxiety sensitivity

“…[55] ]. Exposure to parental dyscontrol in childhood related to negative emotional states was furthermore found to be positively correlated with all dimensions of AS, [56] and emotional maltreatment in childhood was associated with higher levels of AS in young adults.…”

A genome-wide study of panic disorder suggests the amiloride-sensitive cation channel 1 as a candidate gene

“…[5][6][7][8] However, the mechanism underlying PD is still unknown and presumably involves numerous susceptibility genes with major and/or minor effects. 9,10 Furthermore, the possibility of allelic heterogeneity, which most likely will reduce the power of performed studies to detect associated genes, exists. In this context, isolated populations are considered advantageous, as they possess highly beneficial features for diminishing genetic and allelic heterogeneity.…”

Panico: nosografia di un'entità, clinica di un disturbo

“…Il fumo di sigaretta è un riconosciuto fattore di rischio per l'insorgenza del DP (Moreno et al, 2014;Bakhshaie et al, 2016). Le segnalazioni di esperienze di abuso sessuale e fisico in età infantile sono più comuni nel DP rispetto ad altri disturbi d'ansia (Pribor et al, 1992, Goodwin et al, 2005, Klauke et al, 2010. Alcuni dati di letteratura evidenziano una maggiore prevalenza di AP e DP in soggetti con infezione da HBV, HCV (Carta et al, 2007) ed HIV (Bing et al, 2001;Kessler et al, 2006), rispetto a controlli sani.…”

“…Tale condizione si manifesta come richiesta di attenzione ed assistenza nei confronti delle figure significative e, conseguentemente, verso il terapeuta (Busch et al, 2011;Milrod et al, 2014). Eventi di separazione/perdita precedenti l'insorgenza degli AP sono di frequente riscontro in questi pazienti (Faravelli et al, 1985, Kessler et al, 1997Peter et al, 2005;Klauke et al, 2010), a conferma di una particolare "vulnerabiltà" alla separazione (Klein, 1995;Battaglia et al, 2009Battaglia et al, , 2014. Pan, in fin dei conti, era un bambino abbandonato.…”