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Predictors of panic attacks in adolescents.
C Hayward1, J D Killen, H C Kraemer
1Department of Psychiatry and Behavioral Sciences, Stanford University, CA 94305-5722, USA. Hayward@Leland.Stanford.Edu
Journal of the American Academy of Child and Adolescent Psychiatry
|February 16, 2000
Summary
Negative affectivity is a general risk factor for adolescent panic attacks and depression. Anxiety sensitivity specifically increases the risk for panic attacks in teens, distinguishing it from depression risk.
Area of Science:
- Psychiatry
- Developmental Psychology
- Epidemiology
Background:
- Adolescent mental health is a growing concern, with panic attacks and major depression being prevalent conditions.
- Identifying specific risk factors for these disorders is crucial for targeted prevention and intervention strategies.
- Previous research suggests potential links between negative affectivity, anxiety sensitivity, and demographic factors with panic and depression, but their specificity requires further investigation.
Purpose of the Study:
- To prospectively identify risk factors for the onset of panic attacks in adolescents.
- To evaluate the specificity of these risk factors (negative affectivity, female sex, anxiety sensitivity, childhood separation anxiety disorder) for panic attacks versus major depression.
- To examine the predictive value of these factors in a large adolescent cohort.
Main Methods:
- A prospective cohort design involving 2,365 high school students assessed over 4 years.
- Utilized self-report questionnaires and structured clinical interviews for comprehensive data collection.
- Employed Cox proportional hazards models to analyze the risk and predict the onset of panic attacks and major depression.
Main Results:
- Prior major depression predicted panic attack onset, and panic attack history predicted major depression onset, confirming bidirectional relationships.
- Negative affectivity and anxiety sensitivity predicted the onset of 4-symptom panic attacks after adjusting for prior major depression.
- Female sex and negative affectivity predicted major depression onset after adjusting for prior panic attacks, indicating differential risk factor profiles.
Conclusions:
- Negative affectivity is a nonspecific risk factor, contributing to both adolescent panic attacks and major depression.
- Anxiety sensitivity emerges as a specific risk factor, uniquely increasing the likelihood of 4-symptom panic attacks in adolescents.
- These findings highlight the importance of considering distinct risk profiles when addressing panic attacks and major depression in adolescent populations.