Although panic disorder has been frequently associated with increased suicidal ideation and behaviors, there are multiple explanations for this association in the literature. For example, some research has demonstrated panic disorder symptoms to mediate agoraphobia and suicidal ideation, while other researchers have hypothesized that comorbid depression symptoms contribute to suicidal ideation across anxiety disorders. Of note, none of these studies were completed in veterans, a population at higher risk for suicide relative to civilian samples. The present study investigated relations between the symptoms of panic, agoraphobia, depression, and suicidal ideation in 58 veterans diagnosed with panic disorder via correlations, hierarchical regression, and exploratory path analyses. Multiple models were investigated based on prior research. The final path model demonstrated that symptoms of panic disorder predicted agoraphobia symptoms, with agoraphobia predicting symptoms of depression. Symptoms of depression, then, predicted suicidal ideation. Discussion of the findings related to comorbid depressive symptoms highlight considerations for the assessment and treatment practices for panic disorder, with a particular focus on veterans receiving care within Veterans Affairs Healthcare System.
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The data that support the findings of this study are available from the corresponding author, [DG], upon reasonable request.
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Conflicts of Interest
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Daniel F. Gros, Jeffrey M. Pavlacic, Jennifer M. Wray, and Derek D. Szafranski have no conflicts of interest to disclose.
This study is supported by the Department of Veterans Affairs Office of Research and Development, CSR&D grant# I01 CX001846 (PI: Gros).
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Gros, D.F., Pavlacic, J.M., Wray, J.M. et al. Investigating Relations Between the Symptoms of Panic, Agoraphobia, and Suicidal Ideation: The Significance of Comorbid Depressive Symptoms in Veterans with Panic Disorder. J Psychopathol Behav Assess (2023). https://doi.org/10.1007/s10862-023-10082-4