Childhood trauma and dissociative symptoms in panic disorder.
OBJECTIVE
Childhood trauma has been associated with increased risk for both panic disorder and dissociative symptoms in adulthood. The authors hypothesized that among individuals with a primary diagnosis of panic disorder, those experiencing depersonalization/derealization during panic attacks would be more likely to have a history of childhood trauma.


METHODS
Rates of traumatic events were compared between panic disorder patients with (N=34) and without (N=40) prominent depersonalization/derealization during panic attacks. Symptom severity in the two groups was also examined.


RESULTS
Contrary to the authors' hypothesis, no evidence was found that depersonalization/derealization during panic attacks was associated with childhood trauma. Minimal differences in severity of illness were found between patients with dissociative symptoms and those without such symptoms.


CONCLUSIONS
This finding is consistent with a multifactorial model of dissociation. Factors other than childhood trauma and general psychopathology may underlie vulnerability to dissociative symptoms in panic disorder.
Marshall
R D
RD
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. randall@nyspi.cpmc.columbia.edu
Schneier
F R
FR
Lin
S H
SH
Simpson
H B
HB
Vermes
D
D
Liebowitz
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000706:statistics & numerical data; D015897:Comorbidity; D003861:Depersonalization / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D004213:Dissociative Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index