Impact of childhood trauma on course of panic disorder: contribution of clinical and personality characteristics (original) (raw)
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Childhood trauma in adults with social anxiety disorder and panic disorder: a cross-national study
African Journal of Psychiatry, 2011
Objectives: The influence of childhood trauma as a specific environmental factor on the development of adult psychopathology is far from being elucidated. As part of a collaborative project between research groups from South Africa (SA) and Sweden focusing on genetic and environmental factors contributing to anxiety disorders, this study specifically investigated rates of childhood trauma in South African and Swedish patients respectively, and whether, in the sample as a whole, different traumatic experiences in childhood are predictive of social anxiety (SAD) or panic disorder (PD) in adulthood. Method: Participants with SAD or PD (85 from SA, 135 from Sweden) completed the Childhood Trauma Questionnaire (CTQ). Logistic regression was performed with data from the two countries separately, and from the sample as a whole, with primary diagnoses as dependent variables, gender, age, and country as covariates, and the CTQ subscale totals as independent variables. The study also investigated the internal consistency (Cronbach alpha) of the CTQ subscales. Results: SA patients showed higher levels of childhood trauma than Swedish patients. When data from both countries were combined, SAD patients reported higher rates of childhood emotional abuse compared to those with PD. Moreover, emotional abuse in childhood was found to play a predictive role in SAD/PD in adulthood in the Swedish and the combined samples, and the same trend was found in the SA sample. The psychometric qualities of the CTQ subscales were adequate, with the exception of the physical neglect subscale. Conclusion: Our findings suggest that anxiety disorder patients may differ across countries in terms of childhood trauma. Certain forms of childhood abuse may contribute specific vulnerability to different types of psychopathology. Longitudinal studies should focus on the potential sequential development of SAD/PD among individuals with childhood emotional abuse.
An investigation of Childhood Trauma in Patients with Panic Disorder
European Psychiatry, 2017
Methods Retrospective study (n = 80). Structured interview were based on WHO instruments: WHO WMH CIDI and WHO Pathways to care encounter form. Results Average age was 38 years, more females (72.5%). The delay period was 7 years (GAD = 8.7; SF = 8.2, PD = 5.9), during which at least 2 episodes of the disease. The most popular specialists were: neurologists (19%), psychiatrists (17%) (one-time visits to which were not accompanied by the appointment of a standardized course of treatment for an adequate period of time) and therapists (15%). Non-medical care was 10% of all studied (psychologists-5%, healers-3%, priests-2%). SF-psychiatrists (43%), therapists (14%), psychologists (14%); GAD-psychiatrists (22%), neurologists (19%), psychotherapists (11%), ambulance doctor (11%); PD-therapists (22%), neurologists (22%), ambulance doctor (17%), cardiologists (9%). Conclusions The findings suggest that patients with anxiety disorders have a long period of delay in receiving specialized care that causes the value of the social and economic burden of anxiety disorders in the community. Disclosure of interest The authors have not supplied their declaration of competing interest.
Perievent Panic Attacks and Panic Disorder After Mass Trauma: A 12-Month Longitudinal Study
Journal of traumatic stress, 2013
Abstract Panic attacks frequently lead to psychopathological disorders, including panic disorder. Even though panic disorder is a highly comorbid and disabling mental health problem associated with stressful life or traumatic events, perievent panic attacks and their association with panic disorder have hardly been investigated as a central topic after mass trauma. Using data from a longitudinal population-based assessment of Madrid residents after the March 11, 2004 train bombings (N = 1,589), with assessments conducted 1, 6, and 12 months after the attacks, the rate of perievent panic attacks was 10.9%. Level of exposure, previous life stressors, and negative emotionality were associated with perievent panic attacks (β = .12, .15, and .10, respectively), which in turn mediated the relationship between exposure to the terrorist event and panic disorder in the following year. Previous life stressors (β = .15) and low social support (β = -.14) were directly associated with panic disorder during the subsequent year. The most vulnerable individuals who experienced perievent panic attacks were 3.7 times, 95% confidence interval [CI] = [2.1, 6.4], more likely to suffer from panic disorder in the following year. Results suggest that early identification of perievent panic attacks following mass trauma may be helpful for reducing panic disorder.
Comprehensive Psychiatry, 2002
Objective . Only few studies have compared the frequency of traumatic life events during childhood in inpatients with depression with a healthy control group. Methods . Consecutively admitted inpatients with depression (n ϭ 79), most of whom belonged to the melancholic subtype (n ϭ 73; 92.4%), and healthy controls (n ϭ 110) were investigated using a comprehensive retrospective interview with 203 questions regarding childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. Results . Depressed patients had signifi cantly more severe traumatic events (mean score 1.33; SD 1.4) than control subjects (0.85; SD 1.2) on a 0 -10 point " severe trauma scale " . 70.9% (n ϭ 56) of the depressed patients, but only 48.2% (n ϭ 53) of the controls reported at least one severe traumatic event. When looking at single events, only few diff erences were found between patients and controls. Compared to controls, patients described signifi cantly higher rates of psychiatric disorders in their families, in particular depression. Parental rearing styles were rated as more unfavorable in the patient group.
Life events in childhood, adolescence and adulthood and the relationship to panic disorder
Acta Psychiatrica Scandinavica, 1997
The aim of this study was to explore the association between stressful life events (SLE) and the development of panic disorder (PD) in an Israeli sample. A total of 44 PD patients and a matched control group were studied with regard to SLE over the life cycle (in childhood, adolescence, adulthood and the year preceding the outbreak of the disorder). The major findings were as follows, (i) With regard to the total number of life events experienced in childhood and adolescence, the PD group had experienced significantly more life events than the control group, (ii) No differences were detected in the total amount of SLE between the PD group and the control group with regard to adulthood and the year preceding the outbreak of the disorder, although the PD group had more life events relating to loss in adulthood, whereas in the year before the outbreak of PD life events relating to ‘love and family’, negative and loss events were more prevalent. These results expand previous findings by demonstrating that SLE in childhood and adolescence may contribute to the development of PD in adulthood.
Childhood Antecedents to Panic Disorder in Referred and Nonreferred Adults
Journal of Child and Adolescent Psychopharmacology, 2005
Objective: We used a recursive partitioning method to examine antecedent childhood anxiety disorders in large samples of referred and nonreferred subjects with and without panic disorder. Methods: Referred subjects included adults treated for panic disorder (n = 131) and comparison adults with neither major anxiety nor mood disorders (n = 61). The nonreferred adult group derived from an opportunistic sample originally ascertained through family studies of probands with and without attention-deficit/hyperactivity disorder (ADHD), yielding 58 adults with panic disorder and 587 who were free of major anxiety and mood disorders. Results: The majority of referred (65%) and nonreferred (52%) adults with panic disorder had antecedent childhood anxiety or disruptive behavior disorders. Classification and Regression Trees (CART) analysis showed that both separation anxiety disorder and overanxious disorder were independent predictors of subsequent panic disorder in both referred and nonreferred samples. Conclusions: These results confirm and extend previously reported findings by documenting that childhood anxiety disorders are important antecedent risk factors for panic disorder, independently of referral bias.
Impact of stressful life events on the course of panic disorder in adults
Journal of Affective Disorders, 2011
Disorder with/without Agoraphobia (PD/PDA) is a prevalent anxiety disorder, associated with impairment in quality of life and functionality, as well as increased healthcare utilization. Extant research shows a relationship between stressful life events (SLEs) and the onset of panic attacks in adults who ultimately develop PD/PDA. However, limited attention has been paid to how SLEs might affect the severity of panic symptoms in individuals with PD/PDA. In this study, we examined the relationship between SLEs and panic symptom severity in adults with PD/PDA.
Psychiatria Danubina
Background: The purpose of the current study is to investigate the relationship of symptoms of Posttraumatic Stress Disorder (PTSD) to childhood trauma and personality characteristics among patients with the diagnosis of mixed anxiety-depression disorder. Subjects and methods: A total of 130 patients who were admitted to the psychiatry outpatient and were diagnosed with mixed anxiety-depression disorder were conveniently sampled in the current study. In order for the researchers to complete the assessment, the patients with a history of at least one traumatic experience (40.8%, n=53) were asked to complete a socio-demographic form, the Beck Anxiety Inventory and Beck Depression Inventory, the Childhood Trauma Questionnaire-Short Form, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Eysenck Personality Questionnaire Revised/Abbreviated Form. Results: One hundred thirty patients participated in the current study. In the study, 40.8 % of the patients (n=53) reported that they had been exposed to at least one traumatic event during their lifetime. Patients with a history of at least one traumatic experience (40.8%, n=53) were separated into two groups: those with a diagnosis of PTSD (n=21) (39.6%) and those without PTSD (n=32) (60.4%) (cut off score is 50 and above). The mean comparisons concluded that the group with PTSD and the group without PTSD were significantly different from each other in terms of depression and anxiety symptom severity, neuroticism, and history of physical abuse and neglect. Spearman's correlation analysis revealed that PTSD severity was significantly and positively correlated with neuroticism, and with depression and anxiety symptom severity, as the scores were significantly and negatively correlated with extraversion. The two-step logistic analysis first revealed the severity of the depression symptom, and secondly, physical abuse significantly predicted PTSD in the PTSD group. Conclusions: In patients with anxiety and/or depressive disorder, PTSD is one of the most frequently-observed comorbid psychiatric disorders. The current study revealed that a history of childhood trauma, neuroticism, and introversion can be considered risk factors for PTSD among patients with mixed anxiety-depression disorder in adulthood. Therefore, it should be taken into consideration that those neurotic and introverted patients with childhood trauma history could be more at risk for PTSD.
Revista Brasileira de …, 2009
OBJECTIVE: The aim of this study is to evaluate the association between childhood trauma and the quality of parental bonding in panic disorder compared to non-clinical controls. METHOD: 123 patients and 123 paired controls were evaluated with the Mini International Neuropsychiatric Interview, the Childhood Trauma Questionnaire and the Parental Bonding Instrument. RESULTS: The Parental Bonding Instrument and the Childhood Trauma Questionnaire were highly correlated. Panic disorder patients presented higher rates of emotional abuse (OR = 2.54, p = 0.001), mother overprotection (OR = 1.98, p = 0.024) and father overprotection (OR = 1.84, p = 0.041) as compared to controls. Among men with panic disorder, only mother overprotection remained independently associated with panic disorder (OR = 3.28, p = 0.032). On the other hand, higher father overprotection (OR = 2.2, p = 0.017) and less father warmth (OR = 0.48, p = 0.039) were independently associated with panic disorder among female patients. CONCLUSION: Higher rates of different types of trauma, especially emotional abuse, are described in panic disorder patients as compared to controls. The differences regarding gender and parental bonding could be explained in the light of the psychodynamic theory.