Childhood separation anxiety and adult-onset panic disorders

The similarity between the symptoms of separation anxiety and those of agoraphobia may be of etiological significance. The hypothesis that early object loss and/or separation anxiety specifically predisposes one to agoraphobia or panic disorder is incorporated into DSM-III-R. The purpose of the present study was to test this hypothesis. Forty-one patients with agoraphobia or panic disorder were compared with 83 nonpanicking patient controls and 50 normal controls. The three groups did not differ in actual parental separation (death of one or both parents, divorce, boarding school, etc.). Ten percent of the normal controls had suffered from separation anxiety disorder according to DSM-III criteria, as did 17.5% of the agoraphobics and 35.4% of the patient controls. The only significant difference found was between patient controls and normal controls. The present data do not support the hypothesis that separation anxiety selectively leads to agoraphobia or panic disorder in later life. Childhood separation or separation anxiety probably reflects some general susceptibility to future psychopathology. These findings are discussed in the context of the existing literature in this area.