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Responses to voluntary hyperventilation in children with separation anxiety disorder: implications for the link to

Joe Kossowsky1, Frank H Wilhelm, Silvia Schneider

  • 1Department of Clinical Psychology & Psychotherapy, University of Basel, Switzerland; Department of Anesthesiology, Perioperative, and Pain Medicine, Children's Hospital Boston, Harvard Medical School, USA.

Journal of Anxiety Disorders
|September 26, 2013
PubMed

Insights

Children with separation anxiety disorder (SAD) exhibit breathing regulation deficits during hyperventilation, unlike those with panic disorder (PD). SAD children showed altered respiratory and physiological responses, not increased panic symptoms.

Area of Science:

  • Pediatric Psychology
  • Neuroscience
  • Respiratory Physiology

Background:

  • Separation anxiety disorder (SAD) is theoretically linked to panic disorder (PD) via respiratory regulation mechanisms.
  • Previous research suggests PD patients exhibit heightened psychophysiological responses to hyperventilation.

Purpose of the Study:

  • To investigate if children with SAD display similar hyperventilation-induced anxiety and psychophysiological responses as observed in PD patients.
  • To assess respiratory regulation and recovery patterns in children with SAD during voluntary hyperventilation.

Main Methods:

  • 49 children with SAD, 21 clinical controls, and 39 healthy controls (ages 5-14) underwent hyperventilation tests.
  • Assessed cardiac, respiratory (pCO2), electrodermal, electromyographic, and self-report measures during baseline, hyperventilation, and recovery.

Main Results:

  • SAD children did not report increased anxiety or panic symptoms during hyperventilation.
  • Elevated reactivity in respiratory variability, heart rate, and facial muscle activity (musculus corrugator supercilii) was observed in SAD children.
  • No signs of compromised recovery were noted in SAD children post-hyperventilation.

Conclusions:

  • Hyperventilation responses in SAD children are less pronounced compared to PD patients.
  • Children with SAD demonstrate deficits in voluntary breathing regulation.
Abstract

Keywords:
AXCCChildhood anxietyECGEMGETHCHFHRIBIICGMAPNSFnPDPEPPsychophysiologyRLRMSSDRRRSASADSCLSeparation anxiety disorderTPRVHVminVoluntary hyperventilationVtVtVanxietyarterial partial pressure of carbon dioxideclinical controlselectrocardiogramelectromyographyend taskhealthy controlsheart ratehigh frequency range of heart period variabilityimpedance cardiographyinterbeat intervalsmean arterial pressureminute ventilationnon-specific skin conductance fluctuationspCO(2)panic disorderpreejection periodrespiratory raterespiratory sinus arrhythmiarestlessnessroot mean squared successive breath-by-breath differences of tidal volumeroot mean squared successive differenceseparation anxiety disorderskin conductance leveltidal volumetotal peripheral resistancevoluntary hyperventilation

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