Adult Attachment Disturbances in Panic Disorder : a Comparison with Social Phobia and Specific Phobia

The present study used attachment theory as a framework to explore the role of attachment related constructs as potential risk factors for panic disorder. A group of panic disordered participants were compared with a group of social phobics, a group of specific phobics (fearful flyers), and a group of nonclinical controls. The groups were compared on attachment dimensions, fear of emotions, fear of bodily changes, death attitudes, information processing style and self-efficacy. Results indicated that the panic disorder group and control group differed in a number ofways. Panic disordered participants evidenced higher levels of attachment anxiety and attachment avoidance than control participants. Also, the panic group reported lower social and generalized self-efficacy, and greater fear of losing emotional control than the control group. In addition, the panic group reported higher fear of death and of bodily changes than the control group. Finally, panic disordered participants indicated using less rational strategies when coping under stress. Social phobics presented no significantly different levels of attachment anxiety and avoidance than panic disordered participants. Also, no significant differences were found between the panic disorder and the social phobia groups regarding their perceived levels of social and generalized self-efficacy. The two groups significantly differed on fear of death and of bodily changes: the panic group evidenced higher levels than the social phobia group. The specific phobia group was most similar to the control group, except for their higher fear of death and of bodily changes. In addition, the associations between the different constructs were also studied. Results are broadly consistent with attachment theory in that attachment disturbances are not exclusive to panic disorder. Findings suggest that distinct combined influenced of the variables are associated with the different disorders. The implications and limitations of the findings are discussed in relation to current conceptual, research and clinical issues in panic disorder theory and attachment theory