Skip to main content
SpringerLink
Log in

Do Youth with Separation Anxiety Disorder Differ in Anxiety Sensitivity From Youth with Other Anxiety Disorders?

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

Studies on the relationship between separation anxiety disorder (SAD) in childhood and panic disorder (PD) in adolescence and adulthood have yielded results which suggest a common underlying vulnerability for both disorders. In this study, we examined whether one such possible vulnerability—anxiety sensitivity—differed for youth diagnosed with SAD versus other anxiety disorders. Anxiety sensitivity was assessed using the Childhood Anxiety Sensitivity Index (CASI) in 315 clinic-referred youth (ages 6–17, 113 girls). 145 children (46%) were diagnosed with one or more primary anxiety disorder, including SAD (n = 22), generalized anxiety (GAD) (n = 79), social anxiety (SocA) (n = 55), and specific phobia (SP) (n = 45). Children with SAD reported higher levels of anxiety sensitivity and fears of physical symptoms than children with SP and SocA, but not children with GAD. We speculate that children who have SAD and GAD and high anxiety sensitivity may be more vulnerable to develop PD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602

    Article  Google Scholar 

  2. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L et al (2010) Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49:980–989

    Article  Google Scholar 

  3. Shear K, Jin R, Ruscio AM, Walters EE, Kessler RC (2006) Prevalence and correlates of estimated DSM-IV child and adult SAD disorder in the National Comorbidity Survey Replication. Am J Psychiatry 163:1074–1083

    Article  Google Scholar 

  4. Allen JL, Lavallee KL, Herren C, Ruhe K, Schneider S (2010) DSM-IV criteria for childhood SAD disorder: informant, age, and sex differences. J Anxiety Disord 24:946–952

    Article  Google Scholar 

  5. Kearney CA, Albano AM (2004) The functional profiles of school refusal behavior diagnostic aspects. Behav Modif 28:147–161

    Article  Google Scholar 

  6. Egger HL, Costello EJ, Erkanli A, Angold A (1999) Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. J Am Acad Child Adolesc Psychiatry 38:852–860

    Article  Google Scholar 

  7. Hofflich SA, Hughes AA, Kendall PC (2006) Somatic complaints and childhood anxiety disorders. Int J Clin Health Psychol 6:229–242

    Google Scholar 

  8. Last CG (1991) Somatic complaints in anxiety disordered children. J Anxiety Disord 5:125–138

    Article  Google Scholar 

  9. Crawley SA, Caporino NE, Birmaher B, Ginsburg G, Piacentini J, Albano AM et al (2014) Somatic complaints in anxious youth. Child Psychiatry Hum Dev 45:398–407

    Article  Google Scholar 

  10. Ginsburg GS, Riddle MA, Davies M (2006) Somatic symptoms in children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry 45:1179–1187

    Article  Google Scholar 

  11. Klein DF (1964) Delineation of two drug-responsive anxiety syndromes. Psychopharmacology 5:397–408

    Article  Google Scholar 

  12. Ollendick TH, Hannesdottir D (2010) Separation anxiety and panic disorder in children and adolescents. In: Öst LG (ed) Kognitiv beteendeterapi inom barn-och ungdomspsykiatrin (Cognitive behavior therapy in child and adolescent psychiatry). Natur & Kultur, Stockholm, pp 95–109

    Google Scholar 

  13. Battaglia M, Bertella S, Politi E, Bernardeschi L, Perna G, Gabriele A, Bellodi L (1995) Age at onset of panic disorder: influence of familial liability to the disease and of childhood SAD disorder. Am J Psychiatry 152:1362–1364

    Article  Google Scholar 

  14. Roberson-Nay R, Eaves LJ, Hettema JM, Kendler KS, Silberg JL (2012) Childhood SAD disorder and adult onset panic attacks share a common genetic diathesis. Depress Anxiety 29:320–327

    Article  Google Scholar 

  15. Battaglia M, Pesenti-Gritti P, Medland SE, Ogliari A, Tambs K, Spatola CA (2009) A genetically informed study of the association between childhood SAD, sensitivity to CO2, panic disorder, and the effect of childhood parental loss. Arch Gen Psychiatry 66:64–71

    Article  Google Scholar 

  16. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association Publishing, Arlington

    Book  Google Scholar 

  17. Hayward C, Wilson KA, Lagle K, Killen JD, Taylor CB (2004) Parent-reported predictors of adolescent panic attacks. J Am Acad Child Adolesc Psychiatry 43:613–620

    Article  Google Scholar 

  18. Lewinsohn PM, Holm-Denoma JM, Small JW, Seeley JR, Joiner TE (2008) SAD disorder in childhood as a risk factor for future mental illness. J Am Acad Child Adolesc Psychiatry 47:548–555

    Article  Google Scholar 

  19. Kossowsky J, Pfaltz MC, Schneider S, Taeymans J, Locher C, Gaab J (2013) The SAD hypothesis of panic disorder revisited: a meta-analysis. Am J Psychiatry 170:768–781

    Article  Google Scholar 

  20. Bruckl TM, Wittchen HU, Hofler M, Pfister H, Schneider S, Lieb R (2007) Childhood SAD and the risk of subsequent psychopathology: results from a community study. Psychother Psychosom 76:47–56

    Article  Google Scholar 

  21. Biederman J, Petty CR, Hirshfeld-Becker DR, Henin A, Faraone SV, Fraire M et al (2007) Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression. Psychiatry Res 153:245–252

    Article  Google Scholar 

  22. Aschenbrand SG, Kendall PC, Webb A, Safford SM, Flannery-Schroeder E (2003) Is childhood SAD disorder a predictor of adult panic disorder and agoraphobia? A seven-year longitudinal study. J Am Acad Child Adolesc Psychiatry 42:1478–1485

    Article  Google Scholar 

  23. Reiss S, McNally R (1985) The expectancy model of fear. In: Reiss S, Bootzin RR (eds) Theoretical issues in behavior therapy. Academic Press, London, pp 107–121

    Google Scholar 

  24. Silverman WK, Fleisig W, Rabian B, Peterson RA (1991) Childhood anxiety sensitivity index. J Clin Child Psychol 20:162–168

    Article  Google Scholar 

  25. Joiner TE, Schmidt NB, Schmidt KL, Laurent J, Catanzaro SJ, Perez M, Pettit JW (2002) Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients. J Abnorm Child Psychol 30:167–175

    Article  Google Scholar 

  26. Noël VA, Francis SE (2011) A meta-analytic review of the role of child anxiety sensitivity in child anxiety. J Abnorm Child Psychol 39:721–733

    Article  Google Scholar 

  27. Schmidt NB, Zvolensky MJ, Maner JK (2006) Anxiety sensitivity: prospective prediction of panic attacks and Axis I pathology. J Psychiatr Res 40:691–699

    Article  Google Scholar 

  28. Calamari JE, Hale LR, Heffelfinger SK, Janeck AS, Lau JJ, Weerts MA et al (2001) Relations between anxiety sensitivity and panic symptoms in nonreferred children and adolescents. J Behav Ther Exp Psychiatry 32:117–136

    Article  Google Scholar 

  29. Lebowitz ER, Shic F, Campbell D, Basile K, Silverman WK (2015) Anxiety sensitivity moderates behavioral avoidance in anxious youth. Behav Res Ther 74:11–17

    Article  Google Scholar 

  30. Allan NP, Capron DW, Lejuez CW, Reynolds EK, MacPherson L, Schmidt NB (2014) Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity. J Abnorm Child Psychol 42:589–600

    Article  Google Scholar 

  31. Knapp AA, Frala J, Blumenthal H, Badour CL, Leen-Feldner EW (2013) Anxiety sensitivity and childhood learning experiences: impacts on panic symptoms among adolescents. Cognit Ther Res 37:1151–1159

    Article  Google Scholar 

  32. Eley TC, Stirling L, Ehlers A, Gregory AM, Clark DM (2004) Heart-beat perception, panic/somatic symptoms and anxiety sensitivity in children. Behav Res Ther 42:439–448

    Article  Google Scholar 

  33. Kearney CA, Albano AM, Eisen AR, Allan WD, Barlow DH (1997) The phenomenology of panic disorder in youngsters: an empirical study of a clinical sample. J Anxiety Disord 11:49–62

    Article  Google Scholar 

  34. Chorpita BF, Daleiden EL (2000) Properties of the Childhood Anxiety Sensitivity Index in children with anxiety disorders: autonomic and nonautonomic factors. Behav Ther 31:327–349

    Article  Google Scholar 

  35. Essau CA, Sasagawa S, Ollendick TH (2010) The facets of anxiety sensitivity in adolescents. J Anxiety Disord 24:23–29

    Article  Google Scholar 

  36. Silverman WK, Goedhart AW, Barrett P, Turner C (2003) The facets of anxiety sensitivity represented in the Childhood Anxiety Sensitivity Index: confirmatory analyses of factor models from past studies. J Abnorm Psychol 112:364–374

    Article  Google Scholar 

  37. Lambert SF, Cooley MR, Campbell KD, Benoit MZ, Stansbury R (2004) Assessing anxiety sensitivity in inner-city African American children: psychometric properties of the childhood anxiety sensitivity index. J Clin Child Adolesc Psychol 33:248–259

    Article  Google Scholar 

  38. Wright KD, Asmundson GJ, McCreary DR, Stewart SH, McLaughlin E, Comeau MN et al (2010) Confirmatory factor analysis of the childhood anxiety sensitivity index: a gender comparison. Cogn Behav Ther 39:225–235

    Article  Google Scholar 

  39. Adornetto C, Hensdiek M, Meyer A, In-Albon T, Federer M, Schneider S (2008) The factor structure of the Childhood Anxiety Sensitivity Index in German children. J Behav Ther Exp Psychiatry 39:404–416

    Article  Google Scholar 

  40. Stassart C, Etienne A (2014) A French translation of the Childhood Anxiety Sensitivity Index (CASI): factor structure, reliability and validity of this scale in a nonclinical sample of children. Psychol Belg 54:222–241

    Article  Google Scholar 

  41. Stevanovic DS (2013) Anxiety sensitivity in relation to anxiety symptoms among Serbian youth. Int J Clin Psychiatry Ment Health 1:25–32

    Google Scholar 

  42. McLaughlin EN, Stewart SH, Taylor S (2007) Childhood Anxiety Sensitivity Index factors predict unique variance in DSM-IV anxiety disorder symptoms. Cogn Behav Ther 36:210–219

    Article  Google Scholar 

  43. Schmidt NB, Lerew DR (2002) Prospective evaluation of perceived control, predictability, and anxiety sensitivity in the pathogenesis of panic. J Psychopathol Behav Assess 24:207–214

    Article  Google Scholar 

  44. Zinbarg RE, Brown TA, Barlow DH, Rapee RM (2001) Anxiety sensitivity, panic, and depressed mood: a reanalysis teasing apart the contributions of the two levels in the hierarchical structure of the Anxiety Sensitivity Index. J Abnorm Psychol 110:372–377

    Article  Google Scholar 

  45. Silverman WK, Albano AM (1996) Manual for the ADIS-IV-C/P. Psychological Corporation, New York

    Google Scholar 

  46. Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40:937–944

    Article  Google Scholar 

  47. Wood JJ, Piacentini JC, Bergman RL, McCracken J, Barrios V (2002) Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol 31:335–342

    Article  Google Scholar 

  48. Grills AE, Ollendick TH (2003) Multiple informant agreement and the anxiety disorders interview schedule for parents and children. J Am Acad Child Adolesc Psychiatry 42:30–40

    Article  Google Scholar 

  49. Muris P (2002) An expanded childhood anxiety sensitivity index: its factor structure, reliability, and validity in a non-clinical adolescent sample. Behav Res Ther 40:299–311

    Article  Google Scholar 

  50. Barlow DH (2002) Anxiety and its disorders: the nature and treatment of anxiety and panic, 2nd edn. The Guildford Press, New York

    Google Scholar 

  51. McWilliams LA, Stewart SH, MacPherson PS (2000) Does the social concerns component of the Anxiety Sensitivity Index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity? Behav Res Ther 38:985–992

    Article  Google Scholar 

  52. Ollendick TH, Jarrett MA, White BA, White SW, Grills AE (2016) Primary versus secondary diagnosis of generalized anxiety disorder in youth: is the distinction an important one. Child Psychiatry Hum Dev 47:548–553

    Article  Google Scholar 

  53. Wittchen HU, Lecrubier Y, Beesdo K, Nocon A (2003) Relationships among anxiety disorders: patterns and implications. Anxiety Disord. https://doi.org/10.1002/9780470986844.ch2

    Article  Google Scholar 

  54. Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, Kendall PC (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359:2753–2766

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for Child Development and Behaviour for the Primary Health Care of the Capital Area (Throska- og hegdunarstod Heilsugaeslu hofudborgarsvaedisins), Thonglabakki 1, 109, Reykjavik, Iceland

    Dagmar Kr. Hannesdottir & Sandra Bjorg Sigurjonsdottir

  2. Department of Psychology, University of Iceland, Saemundargotu 2, 101, Reykjavik, Iceland

    Urdur Njardvik

  3. Department of Psychology, Child Study Center, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA

    Thomas H. Ollendick

Authors
  1. Dagmar Kr. Hannesdottir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandra Bjorg Sigurjonsdottir
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Urdur Njardvik
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas H. Ollendick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dagmar Kr. Hannesdottir.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hannesdottir, D.K., Sigurjonsdottir, S.B., Njardvik, U. et al. Do Youth with Separation Anxiety Disorder Differ in Anxiety Sensitivity From Youth with Other Anxiety Disorders?. Child Psychiatry Hum Dev 49, 888–896 (2018). https://doi.org/10.1007/s10578-018-0805-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-018-0805-9

Keywords

Search

Navigation