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Is early separation anxiety a specific precursor of panic disorder–agoraphobia? a community study

Published online by Cambridge University Press:  09 July 2009

D. Silove*
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
M. Harris
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
A. Morgan
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
P. Boyce
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
V. Manicavasagar
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
D. Hadzi-Pavlovic
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
K. Wilhelm
Affiliation:
Academic Mental Health Unit, School of Psychiatry, University of New South Wales at Liverpool Hospital, the University of Sydney at Nepean Hospital, Penrith, Academic Mental Health Unit, South Western Sydney Area Health Service, Liverpool, and the School of Psychiatry, University of New South Wales at Prince Henry Hospital, NSW, Australia
*
1Address for correspondence: Professor D. Silove, Academic Mental Health Unit, Level 4 Health Services Building, Liverpool Hospital, Liverpool, NSW 2170, Australia.

Synopsis

The present study aimed to examine memories of early separation anxiety symptoms in a community sample of women at heightened risk to neurotic disorder. The chief finding was that subjects with a lifetime history of panic disorder–agoraphobia (PD–Ag) returned statistically higher scores on a retrospective measure of early separation anxiety compared to subjects with either generalized anxiety or other phobic disorders, a result which was not accounted for by differences in neuroticism or General Health Questionnaire scores. Although limited by its retrospective design and the problem of co-morbidity in subclassifying the anxiety disorders, the present study does provide added support for the hypothesis – endorsed by DSM-III-R – that there is a developmental link between early separation anxiety and panic disorder.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

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References

Andrews, G., Stewart, G., Morris-Yates, A., Holt, P. & Henderson, S. (1990). Evidence for a general neurotic syndrome. British Journal of Psychiatry 157, 612.CrossRefGoogle ScholarPubMed
Berg, I. (1992). Absence from school and mental health. British Journal of Psychiatry 161, 154166.CrossRefGoogle ScholarPubMed
Berg, I., Marks, I., McGuire, R. & Lipsedge, M. (1974). School phobia and agoraphobia. Psychological Medicine 4, 428434.CrossRefGoogle ScholarPubMed
Bowlby, J. (1973). Attachment and Loss Volume II. Separation: Anxiety and Anger. Basic Books: New York.Google Scholar
Breier, A., Charney, D. S. & Heninger, G. R. (1986). Agoraphobia with panic attacks. Archives of General Psychiatry 43, 10291036.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression: A Study of Psychiatric Disorder in Women. Tavistock: London.Google Scholar
Cross-National Collaborative Panic Study, Second Phase Investigators (1992). Drug treatment of panic disorder. British Journal of Psychiatry 169, 191202.Google Scholar
de Ruiter, C. & van Ijzendoorn, M. H. (1992). Agoraphobia and anxious–ambivalent attachment: an integrative review. Journal of Anxiety Disorders 6, 365381.CrossRefGoogle Scholar
Gittelman, R. & Klein, D. F. (1984). Relationship between separation anxiety and panic and agoraphobic disorders. Psychopathology 17, 5665.CrossRefGoogle ScholarPubMed
Gittelman, R. & Klein, D. F. (1985). Childhood separation anxiety and adult agoraphobia. In Anxiety and the Anxiety Disorders (ed. Tuma, A. H. and Maser, J. D.), pp. 389402. Lawrence Erlbaum Associates: Hillsdale, New Jersey.Google ScholarPubMed
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Grayson, D. A. (1986). Latent trait analysis of the Eysenck Personality Questionnaire. Journal of Psychiatric Research 20, 217235.CrossRefGoogle ScholarPubMed
Klein, D. F. (1964). Delineation of two drug-responsive anxiety syndromes. Psychopharmacologia 5, 397408.CrossRefGoogle ScholarPubMed
Klein, D. F. (1980). Anxiety reconceptualized. Early experience with Imipramine and anxiety. Comprehensive Psychiatry 21, 411427.CrossRefGoogle Scholar
Klein, R. G., Koplewizc, H. S. & Kanner, A. (1992). Imipramine treatment of children with separation anxiety disorder. Journal of the American Academy of Child and Adolescent Psychiatry 31, 2127.CrossRefGoogle ScholarPubMed
Margraf, J., Ehlers, A. & Roth, W. T. (1986). Biological models of panic disorders and agoraphobia – a review. Behaviour Research and Therapy 24, 553567.Google Scholar
Morgan, A., Harris, M., Boyce, P. & Wilhelm, K. (1993). Has social psychiatry met its Waterloo? Methodological and ethical issues in a community study. Australian and New Zealand Journal of Psychiatry 27, 411421.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry 38, 381389.Google Scholar
Silove, D. & Manicavasagar, V. (1993). Adults who feared school: is early separation anxiety specific to the pathogenesis of panic disorder? Acta Psychiatrica Scandinavica 88, 385390.CrossRefGoogle Scholar
Silove, D., Manicavasagar, V., O'Connell, D., Blaszczynski, A., Wagner, R. & Henry, J. (1993 a). The development of the Separation Anxiety Symptom Inventory (SASI). Australian and New Zealand Journal of Psychiatry 27, 477488.Google Scholar
Silove, D., Manicavasagar, V., O'Connell, D. & Blaszczynski, A. (1993 b). Reported early separation anxiety symptoms in patients with panic and generalised anxiety disorders. Australian and New Zealand Journal of Psychiatry 27, 489494.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria (RDC); rationale and reliability. Archives of General Psychiatry 35, 773782.CrossRefGoogle ScholarPubMed
Thyer, B. A., Nesse, R. M., Cameron, O. G. & Curtis, G. C. (1985). Agoraphobia: a test of the separation anxiety hypothesis. Behaviour Research and Therapy 23, 7578.CrossRefGoogle ScholarPubMed
Thyer, B. A., Nesse, R. M., Curtis, G. C. & Cameron, O. G. (1986). Panic disorder: a test of the separation anxiety hypothesis. Behaviour Research and Therapy 24, 209211.Google Scholar
Tyrer, P. & Tyrer, S. (1974). School refusal, truancy and adult neurotic illness. Psychological Medicine 4, 416421.CrossRefGoogle ScholarPubMed
van der Molen, G. M., van den Hout, M. A., van Dieren, A. C. & Griez, E. (1989). Childhood separation anxiety and adult-onset panic disorders. Journal of Anxiety Disorders 3, 97106.CrossRefGoogle Scholar
Yeragani, V. K., Meiri, P. C., Balon, R., Patel, H. & Pohl, R. (1989). History of separation anxiety in patients with panic disorder and depression in normal controls. Acta Psychiatrica Scandinavica 79, 550556.Google Scholar
Zitrin, C. M. & Ross, D. C. (1988). Early separation anxiety and adult agoraphobia. Journal of Nervous and Mental Disease 176, 621625.CrossRefGoogle ScholarPubMed