Panic Disorder

Panic Attack

Panic Disorder

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Anticipatory Anxiety

Agoraphobia

Hypochondriasis

Demoralisation

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Stressful Life Events

Early Life Events

Maternal Over-Protection

Separation Anxiety

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Panic Disorder: Pathogenesis

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The Evolutionary Perspective

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Overcoming Anxiety (Home) > Panic Disorder > Separation Anxiety

Separation Anxiety: Symptom and Treatment

Increasing evidence points to an association between childhood anxiety and PD during adult life though some reports failed to confirm this association Silove et al. found that early separation anxiety was associated with risk of adult PD and that subjects with a lifetime history of PD–agoraphobia had more separation anxiety symptoms than those with GAD or other phobic disorders without a history of PD reported that 55% of adult patients with PD met the criteria for childhood anxiety disorder, and found that those cases where a childhood history of anxiety was retraceable had a higher rate of comorbid anxiety disorders. Patients with a childhood history of anxiety disorders were also characterised by greater avoidance and greater fear of anxiety symptoms, even though they did not demonstrate a greater overall severity of PD. Only one prospective study of well-diagnosed children with separation anxiety has been conducted: although panic disorder was infrequent in the cases, it was significantly higher than in the controls. Kagan et al. reported that behavioural inhibition in childhood might be a risk factor for the later development of anxiety disorders. Rosenbaum et al. have reported a high rate of behavioural inhibition in young children of parents with panic disorder and agoraphobia. To investigate further the link between behavioural inhibition and anxiety disorders, Biederman et al. examined the psychiatric correlates of behavioural inhibition by evaluating a sample of offspring of parents with panic disorder and agoraphobia and an existing epidemiological derived sample of children, followed over a seven-year period by Reznick et al.. They found that inhibited children had increased risk for multiple anxiety, over-anxious, and phobic disorders, especially social phobia.

Further evidence for the link between childhood and adult anxiety psychopathology comes from family studies reporting high rates of childhood anxiety difficulties in the offspring of adult patients with panic disorder; whether childhood anxiety predisposes the individual to adult panic disorder by influencing cognitive or behavioural reactions to symptoms, or whether it is an early manifestation of the same disorder, is still unclear.

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