Separation anxiety in panic disorder

Abstract

The hypothesis that separation anxiety is a prevalent affective undercurrent in the dreams and screen memories of panic disorder patients was supported. Significantly higher covert hostility in the panic disorder patients' dreams may support Bowlby's observation that people with high separation anxiety tend to disavow their anger.

Characteristics of dreams and nightmares in patients with anxiety disorders.

“…Previous research has shown that anxiety disorders directly influence, affect, and alter dreams and dream contents of clinical patients diagnosed with such disorders (Desroches & Kaiman, 1964; Foss, 1994; Free et al, 1993; Gentil & Lader, 1978; Khodarahimi, 2009; Kirschner, 1999; Miller et al, 2015; Nadorff et al, 2014; Simon et al, 2016; Swart et al, 2013). In terms of the influence of anxiety disorders on dreams and dream characteristics, it might be assumed that the presence of a clinical anxiety disorder may lead to more frequent and more intense, fearful, frightening, and harming dreams, instigate anxiety-related feelings, thoughts, or emotions in dreams and may also enhance nightmare frequency, as well as increase subjective distress from nightmares.…”

“…However, despite a relatively large body of research on dreams and nightmares in anxiety disorders, studies on the relationships between anxiety disorders and specific dream characteristics and on nightmare distress are very scarce (Rimsh & Pietrowsky, 2020; Skancke et al, 2014). The scarce existing data indicate that dreams of anxiety patients often contain different kinds of threats and dangers and various frightening, unpleasant, threatening, and negative events of high emotional intensity (Foss, 1994; Free et al, 1993; Gentil & Lader, 1978; Khodarahimi, 2009; Kirschner, 1999; Sikka et al, 2018). Investigating the emotionality of dreams of clinical patients with anxiety disorders showed that their dreams exhibit a generally lower emotional tone, more negative and sad mood and affect, higher levels of general anxiety, fright, fear, and sadness, and other negative emotions and contain various frightening, unpleasant, and negative events of high emotional intensity (Desroches & Kaiman, 1964; Free et al, 1993; Gentil & Lader, 1978).…”

Analysis of dream contents of patients with anxiety disorders and their comparison with dreams of healthy participants.

“…A large number of psychological studies indicates that dream contents are directly influenced and affected by an individual’s psychopathology (Cartwright et al, 2006; Desroches & Kaiman, 1964; Free et al, 1993; Gentil & Lader, 1978; Hartmann, 1996; Kirschner, 1999; Miller et al, 2015; Nadorff et al, 2014; Simon et al, 2016; Swart et al, 2013). According to these studies, we can assume that dreams and dream content of individuals suffering from anxiety disorders will directly reflect their mental state and be immediately associated with it.…”

“…Although there are a number of studies that address and explore the relationships between anxiety disorders and the frequency of nightmares or bad dreams (Kellner et al, 1991; Levin & Hurvich, 1995; Nadorff et al, 2014; Nielsen et al, 2000; Ohayon et al, 1997; Picard-Deland et al, 2018; Schredl et al, 2001; Simon et al, 2016; Simonds & Parraga, 1984; Swart et al, 2013), there is still an evident lack of psychological research concerning the subject of associations between anxiety disorders and dream contents in general (Rimsh & Pietrowsky, 2020; Skancke et al, 2014). It is also necessary to note that not only are such studies scarce, the existing investigations on this particular topic bear mostly an isolated and segregated character and highlight and investigate only specific individual minor facets, aspects, and particularities of dreams and dream contents of clinical anxiety sufferers (DeCicco et al, 2013; Foss, 1994; Free et al, 1993; Gentil & Lader, 1978; Khodarahimi, 2009; Kirschner, 1999; Miller et al, 2015; Sikka et al, 2018). Anxiety disorders, however, still remain one of the most prevalent and common psychiatric disorders in the contemporary western world and become more and more widespread among European and U.S. populations each year (Remes et al, 2016).…”

“…The existing data regarding specific qualities and characteristics of dreams of patients with different anxiety disorders (which included, primarily, generalized anxiety disorder, panic disorder, social anxiety disorder, and agoraphobic disorder) indicate that their dreams are distinguished by a considerably lower general emotional tone; a significantly more negative, sad, and despondent mood and affect; higher frequencies of aggressive interactions and higher levels of overall aggression; lower numbers of friendly or welcoming interactions and actions; fewer successful and fortunate events, happenings, or occasions; higher frequencies of failures and unsuccessful events; highly unpleasant, traumatic, frightening, and fearful experiences; lower numbers of known characters and acquaintances; and higher rate of frequency of change of locations and scenes (Foss, 1994; Free et al, 1993; Gentil & Lader, 1978; Khodarahimi, 2009; Kirschner, 1999; Sikka et al, 2018). We might clearly see that dreams of anxiety patients suffering from specific anxiety disorders are distinguished by the presence of particular contents, which are specific only for a certain kind of anxiety disorder: dreams of patients with panic disorder contain higher rates of separation anxiety (Free et al, 1993); dreams of an agoraphobic sufferer involve higher numbers of wide, big, open spaces, areas and places, which are, in fact, highly frightening, threatening, traumatic, and unpleasant for patients with this disorder (Foss, 1994); and dreams of a social anxiety sufferer exhibit higher frequencies of frightening and threatening individuals of the opposite gender as well as frightening and fearful social situations and events, such as public speeches and examinations (Khodarahimi, 2009). Likewise, it is highly evident that the presence of various clinical anxiety disorders instigates a higher frequency of nightmares and frightening dreams (Burgess et al, 1998; Cellucci & Lawrence, 1978; Desroches & Kaiman, 1964; Kellner et al, 1991; Levin, 1998; Levin & Hurvich, 1995; Mallon et al, 2000; Miller & DiPilato, 1983; Nadorff et al, 2014; Ohayon et al, 1997; Picard-Deland et al, 2018; Schredl et al, 2001; Simon et al, 2016; Simonds & Parraga, 1984; Swart et al, 2013), which may also indicate that dreams of patients with anxiety disorders involve notably higher numbers of various unpleasant, traumatic, frightening, and threatening events.…”