Panic Disorder
- Panic Attack
- Panic Disorder
- Recurrent Panic Attacks
- Anticipatory Anxiety
- Agoraphobia
- Hypochondriasis
- Demoralisation
- Epidemiology
- Age of Onset
- Situation of Onset
- Stressful Life Events
- Early Life Events
- Maternal Over-Protection
- Separation Anxiety
- Short and Long-term Outcomes
- Comorbidity
- Panic Disorder: Pathogenesis
- Biological Findings
- Provocative Agents
- Neurotransmitter Systems
- Neuroanatomical Models
- Brain Imaging
- Psychological Models
- Psychodynamic Models
- Behavioural Models
- Cognitive Models
- Areas of Controversy and Debate
- The Evolutionary Perspective
- Panic Disorder: Treatment
- Pharmacotherapy
- Benzodiazepines
- Tricyclic Antidepressants
- Monoamine Oxidase Inhibitors
- Selective Serotonin Re-uptake Inhibitors
- Other Drugs
- Psychotherapy
Early Life Events
It has been suggested that there may be a link between the experience of traumatic life events during childhood and adolescence and the development of anxiety disorder in adults: Raskin et al. , examining developmental antecedents in a variety of types of anxiety disorder, found that 53% of panic disorder group had some record of parental separation in childhood. It was found that agoraphobic patients with panic attacks experience more traumatic life events (such as death of parents, prolonged separation from parents, divorce of parents) during childhood and adolescence compared with normal subjects . Although part of the excess of these events is the result of a greater prevalence of psychiatric disorders in their families , this does not account entirely for the bulk of the difference, and a cause-and-effect relationship between early traumatic life events and anxiety disorders should be considered.
Almost all the studies that considered the effects of early traumata for adult psychopathology are consistent in reporting early events are associated with an increased risk for all anxiety and depressive disorders, somatization and greater comorbidity, but with little specificity for any single disorder.
On the other hand, at least restricting the field of observation to panic/agoraphobia phenomenon, the occurrence of separation events during childhood/adolescence seems to be specifically associated with later development of agoraphobia. In fact, two-thirds of patients with panic and agoraphobia showed at least one traumatic event in the first 16 years of life, compared with 22% of panic patients without agoraphobia . Early events of separation can lead to experiences of deep insecurity. These, in turn, in the absence of a protective figure, may discourage the normal exploratory behaviour. The subject, therefore, faces a world where he senses his precariousness and where several situations can be seen as dangerous. Together with the feelings of anger and desperation, which involve the vegetative system in a continuous alertness, the necessity to be independent may give rise to dysfunctional patterns of attachment.