Am J Psychiatry 1993; 150:595-599
Copyright © 1993 by American Psychiatric Association
Separation anxiety in panic disorder
NK Free, CN Winget and RM 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. METHOD: 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.
