title: Impact of stressful life events on the course of panic disorder in adults.
abstract: BACKGROUND
  Panic disorder with/without agoraphobia (PD/PDA) is a prevalent anxiety disorder, associated with impairment in quality of life and functionality, as well as increased healthcare utilization. Extant research shows a relationship between stressful life events (SLEs) and the onset of panic attacks in adults who ultimately develop PD/PDA. However, limited attention has been paid to how SLEs might affect the severity of panic symptoms in individuals with PD/PDA. In this study, we examined the relationship between SLEs and panic symptom severity in adults with PD/PDA.
  
  
  METHODS
  Four hundred-eighteen adults with PD/PDA from the Harvard/Brown Anxiety Research Program (HARP), a long-term prospective longitudinal observational multicenter study of adults with a current or past history of anxiety disorders were included in this study. We examined occurrence of SLEs and their impact on panic symptom severity 12-weeks pre- and post-SLE.
  
  
  RESULTS
  A time-slope effect showed that participants had worsened panic symptoms over the course of the 12-weeks after family/friends/household and work SLEs. That is, their symptoms worsened progressively after the event, rather than immediately thereafter (i.e., significant symptom change within the same week of the event).
  
  
  CONCLUSIONS
  The sample may not be representative of the general population.
  
  
  CONCLUSIONS
  These findings provide new insights into how SLEs affect panic symptoms in adults with PD/PDA in that household-related SLEs, such as serious family arguments, and work-related SLEs, such as being fired, put some adults at risk for worsened panic symptoms within 12-weeks of the event.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02912, United States. ethan_moitra@brown.edu
authors.forename: Ethan
authors.initials: E
authors.lastname: Moitra
authors.forename: Ingrid
authors.initials: I
authors.lastname: Dyck
authors.forename: Courtney
authors.initials: C
authors.lastname: Beard
authors.forename: Andri S
authors.initials: AS
authors.lastname: Bjornsson
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Sibrava
authors.forename: Risa B
authors.initials: RB
authors.lastname: Weisberg
authors.forename: Martin B
authors.initials: MB
authors.lastname: Keller
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D004651:Employment; D005195:Family Relations; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012720:Severity of Illness Index