Predictors of panic attacks in adolescents

Objective: To identify risk factors for onset of panic attacks in adolescen ts, a prospective cohort design was used to evaluate the following risk fac tors: negative affectivity, female sex, anxiety sensitivity, and childhood separation anxiety disorder. These risk factors were also evaluated for pre dicting onset of major depression to test their specificity. Method: The sa mple consisted of 2,365 high school students assessed over a 4-year period. Assessments included self-report questionnaires and structured clinical in terviews. Cox proportional hazards models were used to evaluate risk. Resul ts: Consistent with previous studies, prior major depression predicted onse t of panic attacks and a history of panic attacks predicted onset of major depression. After adjusting for the effects of prior major depression, nega tive affectivity and anxiety sensitivity, but not female sex or childhood s eparation anxiety disorder, predicted onset of 4-symptom panic attacks. How ever, female sex and negative affectivity but not anxiety sensitivity or ch ildhood separation anxiety disorder predicted onset of major depression aft er adjustment for the effects of prior panic attacks. Conclusion: Negative affectivity appears to be a nonspecific risk factor for panic attacks and m ajor depression, whereas anxiety sensitivity appears to be a specific facto r that increases the risk for 4-symptom panic attacks in adolescents.