Separation anxiety in panic disorder. 1993

N K Free, and C N Winget, and R M Whitman
Department of Psychiatry, University of Cincinnati, OH.

OBJECTIVE A number of researchers have provided evidence that separation anxiety is an important antecedent or current affect in panic disorder. The objective of this pilot study was to test this hypothesis by comparing dreams, screen memories, and life situations of panic disorder patients with those of comparison patients. METHODS A recent dream with associations, screen memories with associations, and life situations at onset of symptoms were recorded verbatim during semistructured interviews with 20 patients with DSM-III-R panic disorder and 20 comparison subjects upon referral to a private outpatient practice. A judge blind to the diagnoses rated each of the dreams, screen memories, and life situations separately on each of the 10 Gottschalk-Gleser Content Analysis Scales, thereby measuring manifest and latent death, mutilation, separation, guilt, and shame anxiety and overt and covert hostility in each group. RESULTS mean separation anxiety scores were significantly higher in both the dreams and screen memories of the panic disorder patients than in the comparison patients. Mean scores for covert hostility directed outward were significantly higher in the dreams of the panic disorder patients than in the comparison patients. CONCLUSIONS The hypothesis that separation anxiety is a prevalent affective undercurrent in the dreams and screen memories of panic disorder patients was supported. Significantly higher covert hostility in the panic disorder patients' dreams may support Bowlby's observation that people with high separation anxiety tend to disavow their anger.

UI MeSH Term Description Entries
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001010 Anxiety, Separation Anxiety experienced by an individual upon separation from a person or object of particular significance to the individual. Separation Anxiety Disorder,Anxiety Disorder, Separation,Separation Anxiety
D016584 Panic Disorder A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. Panic Attacks,Attack, Panic,Attacks, Panic,Disorder, Panic,Disorders, Panic,Panic Attack,Panic Disorders

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