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Panic Disorder pp 139–149Cite as

Lifelong Opioidergic Vulnerability Through Early Life Separation: A Recent Extension of the False Suffocation Alarm Theory of Panic Disorder

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Abstract

Suffocation-False Alarm Theory (Klein, Arch Gen Psychiatry 50:306–317, 1993) postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. The expanded Suffocation-False Alarm Theory (Preter and Klein, Biol Psychiatry 32(3):603–612, 2008) hypothesizes that endogenous opioidergic dysregulation may underlie the respiratory pathophysiology and suffocation sensitivity in panic disorder. Opioidergic dysregulation increases sensitivity to CO2, separation distress and panic attacks. That sudden loss, bereavement and childhood separation anxiety are also antecedents of “spontaneous” panic requires an integrative explanation. Our work unveiling the lifelong endogenous opioid system impairing effects of childhood parental loss (CPL) and parental separation in non-ill, normal adults opens a new experimental, investigatory area.

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Authors and Affiliations

  1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Maurice Preter

  2. Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA

    Maurice Preter

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Editors and Affiliations

  1. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Antonio Egidio Nardi

  2. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Rafael Christophe R. Freire

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Preter, M. (2016). Lifelong Opioidergic Vulnerability Through Early Life Separation: A Recent Extension of the False Suffocation Alarm Theory of Panic Disorder. In: Nardi, A., Freire, R. (eds) Panic Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-12538-1_7

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