CASE HISTORIES AND SHORTER C~~~U~ICAT~~~S Panic disorder: a test of the ~paration anxiety h~thesis

Summary-The DSM-III narrative remarks suggest that childhood separation anxiety disorder and sudden object loss apparently predispose to the development of adult panic disorder, despite the paucity of empirical studies documenting such a relationship. In an attempt to test the validity of this separation anxiety hypothesis of panic disorder, 14 objective questions pertaining to childhood separation experiences were answered by 23 panic disorder patients and 28 small-animal phobics. Although the panic disorder patients scored higher on 2 of the 14 items, these differences appear to have little clinical meaning. Caution is indicated prior to continued uncritical acceptance of the separation anxiety hypothesis of panic disorder. INTRODUCl’ION The third edition of the diagnostic and Stu~~r~cu~anuaf of Mental Disorders (DSM-III) contains a number of nosological refinements and etiological advances over its predecessor (APA, 1980). For example, the label ‘anxiety neurosis ’ found in the DSM-II (APA, 1968) is currently subdivided into two separate diagnoses, ‘generalized anxiety disorder ’ and ‘panic disorder ’ (APA, 1980, pp. 230-233). Moreover, the DSM-III states that, with respect to panic disorder, “Separation anxiety disorder in childhood and sudden object loss apparentiy predispose to the development of this disorder. ” (APA, 1980, p. 231) The editors of the DSM-III have stated that