Childhood Separation Anxiety and Separation Events in Women with Agoraphobia with or without Panic Disorder
| Autor: | Helmut Peter, Michael Rufer, Iver Hand, Eva Brückner |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Separation (statistics) Comorbidity Life Change Events Behavior Therapy Anxiety Separation Attachment theory medicine Humans Child Psychiatry Agoraphobia Retrospective Studies Panic disorder Separation anxiety disorder Infant Newborn Infant Panic medicine.disease Psychiatry and Mental health Child Preschool Panic Disorder Anxiety Female medicine.symptom Psychology Anxiety disorder Follow-Up Studies |
| Zdroj: | The Canadian Journal of Psychiatry. 50:941-944 |
| ISSN: | 1497-0015 0706-7437 |
| DOI: | 10.1177/070674370505001409 |
| Popis: | Objective: This study aimed to investigate the association between separation anxiety and actual separation events during childhood in adult patients with agoraphobia with or without panic disorder (PD). Method: Forty-two women with agoraphobia with or without PD participated in long-term follow-ups after exposure-in-vivo treatment. We assessed separation anxiety and separation events from age 0 to 18 years, as well as adult separation from a spouse. Results: Childhood separation experiences (55%) and separation anxiety were significantly higher in patients than in healthy subjects, but both conditions were not associated with each other. Childhood separation anxiety was related to adult separation events. Conclusions: Retrospective measures of childhood separation anxiety appear to be confounded by adult separation events. Thus the conclusion of whether childhood anxiety is a consequence of actual childhood separation events cannot be drawn, owing to a lacking association between both ratings. (Can J Psychiatry 2005;50:941-944) Information on funding and support and author affiliations appears at the end of the article. Clinical Implications * Patients with agoraphobia with or without PD reported rates of separation anxiety and actual separation events during childhood similar to those reported by patients with PD. * Patients with agoraphobia reported more separation anxiety and actual separation events during childhood than did healthy control subjects. * Measures of childhood separation anxiety can be confounded by adult separation events. Limitations * Retrospective data, especially childhood separation anxiety, may be distorted by faulty recall or systematic biases. * The use of female patients only limits the conclusion. * The study did not assess an independent control group but used data of healthy control subjects from an external study. This weakens the conclusions concerning the comparison between patients and healthy control subjects. Key Words: agoraphobia, panic disorder, separation anxiety, separation events Biological as well as psychological concepts stress the importance of SA during childhood in the etiology of adult PD and agoraphobia (1,2). Attachment theory claims that SA during childhood is an instinctive response to the experience of separation from an attachment figure (2). Thus recurrent or lasting experiences of separation can be an important factor in the development of separation anxiety disorder as well as panic disorder and agoraphobia. In contrast, Klein postulates a joint neurobiological disturbance, widely independent of interpersonal events, as the origin for these disorders (1). As higher rates of SA and separation events during childhood have been found in patients with PD and agoraphobia when compared with control subjects (3-5), Bowlby's assumption seems to be supported. So far, only one study with PD patients investigated the association between SA and separation experiences during childhood and surprisingly found the 2 conditions to be completely independent of each other (6). The authors concluded that, in some patients, SA might have been an antecedent of later PD, whereas in other patients, actual separation experiences might have predisposed PD development in adulthood but that there was little overlap between the groups. From a theoretical perspective, it appears not very plausible that separation events do not trigger SA at least to some degree. Thus there may be an alternative explanation for these data. Our study aimed to replicate the data from Bandelow and others (6) and to further investigate the association between SA and separation events during childhood. Like Bandelow and others (6), we assumed that retrospective data are susceptible to faulty recall. We speculated that retrospective ratings of childhood SA could be distorted by separation events during adulthood. … |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|