Childhood trauma in adults with social anxiety disorder and panic disorder: a cross-national study.

MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa.
African Journal of Psychiatry (Impact Factor: 0.73). 11/2010; 13(5):376-81. DOI: 10.4314/ajpsy.v13i5.63103
Source: PubMed

ABSTRACT The influence of childhood trauma as a specific environmental factor on the development of adult psychopathology is far from being elucidated. As part of a collaborative project between research groups from South Africa (SA) and Sweden focusing on genetic and environmental factors contributing to anxiety disorders, this study specifically investigated rates of childhood trauma in South African and Swedish patients respectively, and whether, in the sample as a whole, different traumatic experiences in childhood are predictive of social anxiety (SAD) or panic disorder (PD) in adulthood.
Participants with SAD or PD (85 from SA, 135 from Sweden) completed the Childhood Trauma Questionnaire (CTQ). Logistic regression was performed with data from the two countries separately, and from the sample as a whole, with primary diagnoses as dependent variables, gender, age, and country as covariates, and the CTQ subscale totals as independent variables. The study also investigated the internal consistency (Cronbach alpha) of the CTQ subscales.
SA patients showed higher levels of childhood trauma than Swedish patients. When data from both countries were combined, SAD patients reported higher rates of childhood emotional abuse compared to those with PD. Moreover, emotional abuse in childhood was found to play a predictive role in SAD/PD in adulthood in the Swedish and the combined samples, and the same trend was found in the SA sample. The psychometric qualities of the CTQ subscales were adequate, with the exception of the physical neglect subscale.
Our findings suggest that anxiety disorder patients may differ across countries in terms of childhood trauma. Certain forms of childhood abuse may contribute specific vulnerability to different types of psychopathology. Longitudinal studies should focus on the potential sequential development of SAD/PD among individuals with childhood emotional abuse.

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    MRC Research Day, MRC, Parrow; 01/2012
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    ABSTRACT: A link between childhood maltreatment and mental disorders is firmly established. Although the link between depression and childhood maltreatment is well established, the same cannot be said for the anxiety disorders. The plausibility of this latter relationship relies, in part, on the evidence of a crucial involvement of hypothalamic-pituitary-axis (HPA) in the mammalian organism’s responses to threats, that is likely to contribute to the brain mechanisms underlying anxiety disorders. Studies on adverse childhood experiences (ACE) suggest that persistent changes occur in the function, structure and epigenetics of the HPA axis after early life stress. To date few studies have assessed this relationship, most focusing on post-traumatic stress disorder, but most of them reported a positive association between childhood maltreatment and anxiety disorders in adulthood. The effects of childhood maltreatment on the development of anxiety disorders is not likely specific but depends on genetic vulnerability and resilience, timing and type of the maltreatment and other environmental and biological factors. Imaging genomic studies will help elucidate the relationship between genetic vulnerability and the observed alterations in activity of cortical brain circuits. Most importantly this will likely lead to development of predictors of treatment response that will allow for matching each anxiety disorder patient with optimal pharmacotherapeutic and psychotherapeutic treatments, a major goal in the new personalized medicine era.
    Minerva Psichiatrica 01/2013;
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    ABSTRACT: Background: Social Phobia (SP) has been shown to be more prevalent in women than men in Western society (Kessler et al., 1994). Women also tend to have more environmental risk factors for social phobia compared to men (Xu et al., 2012). However, very few studies have been performed in the Arab countries in this context. The aim of the present study was to assess the prevalence of SP amongst patients attending the psychiatric outpatient clinics of Mansoura University Hospital, Egypt. Material and Methods: During the study period, a total of 3572 psychiatric outpatients were recorded in the clinic and 52 patients (24 males, 28 females) satisfied the DSM-IV criteria for the diagnosis of SP. We also assessed gender differences amongst the SP group in such factors as rates of attendance, socio-demographic characteristics, comorbidities, severity of SP and early adverse factors. Results: Social phobia was found in 1.5% of the sample (0.7% in males, 0.8% females). Female patients were less likely to report physical or sexual abuse as compared to males. There was no difference in comorbidity patterns or suicidality among patients with SP in relation to gender. Conclusions: Although our sample is not representative of the whole Egyptian population, we conclude that prevalence of social phobia is similar in men and women. Females with social phobia reported lower rates of sexual abuse and similar comorbidity patterns or suicidality. Further studies assessing practice approaches to diagnose and treat social phobia should be tailored in an Arabic context to help detection of early adverse environmental risk factors particularly those related to sexuality or personal issues.