Separation anxiety disorder in children: disorder-specific responses to experimental separation from the mother

被引:29
作者
Kossowsky, Joe [2 ]
Wilhelm, Frank H. [3 ]
Roth, Walton T. [4 ,5 ]
Schneider, Silvia [1 ]
机构
[1] Ruhr Univ Bochum, Klin Kinder & Jugendpsychol, Fak Psychol, D-44789 Bochum, Germany
[2] Univ Basel, Inst Psychol, CH-4003 Basel, Switzerland
[3] Salzburg Univ, Dept Clin Psychol Psychotherapy & Hlth Psychol, A-5020 Salzburg, Austria
[4] Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Palo Alto, CA 94304 USA
[5] Vet Affairs Hlth Care Syst, Palo Alto, CA USA
基金
瑞士国家科学基金会;
关键词
Childhood anxiety; separation anxiety disorder; autonomic nervous system; respiration; COMORBIDITY SURVEY REPLICATION; PANIC DISORDER; AUTONOMIC REACTIVITY; VAGAL TONE; PSYCHOPATHOLOGY; CHILDHOOD; MODEL; RISK; SENSITIVITY; PREVALENCE;
D O I
10.1111/j.1469-7610.2011.02465.x
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Background: Separation anxiety disorder (SAD) is one of the most common anxiety disorders in childhood and is predictive of adult anxiety disorders, especially panic disorder. However, the disorder has seldom been studied and the attempt to distinguish SAD from other anxiety disorders with regard to psychophysiology has not been made. We expected exaggerated anxiety as well as sympathetic and respiratory reactivity in SAD during separation from the mother. Method: Participants were 49 children with a principal diagnosis of SAD, 21 clinical controls (CC) with a principal diagnosis of anxiety disorder other than SAD, and 39 healthy controls (HC) not meeting criteria for any current diagnosis. Analyses of covariance controlling for age were used to assess sympathetic and parasympathetic activation (preejection period and respiratory sinus arrhythmia) as well as cardiovascular (heart rate, mean arterial pressure, total peripheral resistance), respiratory (total breath time, minute ventilation, tidal volume, end-tidal CO2, respiratory variability), electrodermal, and self-report (anxiety, cognitions, symptoms) variables during baseline, 4-min separation from, and reunion with the mother. Results: Children with a diagnosis of SAD were characterized by elevated self-reported anxiety responses to separation and increased sympathetic reactivity compared with CC and HC groups. The SAD group also displayed greater vagal withdrawal and higher reactivity in multiple cardiovascular, respiratory, and electrodermal measures compared with the HC group, while corresponding responses were less in the CC group and not significantly different from the other groups. Conclusions: Separation from the mother elicits greater autonomic, respiratory, and experiential responses in children with SAD. Our findings based on brief experimental separation demonstrate differential subjective and physiological manifestations of specific anxiety diagnoses, thus supporting the validity of the diagnostic category of SAD.
引用
收藏
页码:178 / 187
页数:10
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