Attachment styles, childhood trauma and sympathetic skin responses relations with panic disorder

Childhood trauma and/or neglect history and attachment styles are found to be related to many psychiatric disorders including panic disorder. Symphatetic skin response may give very important knowledges about possible state/trait markers in panic disorder. The main target of our research is to compare adult panic disorder patients and healthy controls who are matched by gender and age in terms of childhood trauma, attachment styles and sympathetic skin responses. Additionally, if any state/trait marker is found different in panic disorder group, we tried to elaborate which factors predicted this possible marker. We included 39 panic disorder patients according to DSM V diagnosis criteria and compared them with 39 healthy controls matched for age and sex. The researchers performed semi structured clinical interwiev with SCID-1, measured sympathetic skin responses (amplitude and latency) and applied Hospital Anxiety and depression scale (HADS), Childhood Trauma Scale (CTS), Attachment Styles Scale for Adult (ASS) in both groups. Researchers also applied Hamilton Depression Scale (HAMD) , Hamilton Anxiety Scale (HAS) and Panic Agarophobia Scale (PAS) only to panic disorder group. We found no difference in terms of physical and emotional abuse between the groups. However we found difference in physical and emotional neglect childhood in panic disorder patients compared to healty controls. Also, there were no difference in terms of attachment styles and sympathetic skin responses between the two groups. But there were statistically significant negative correlations between anxiety, depression scale scores (HAD A, HAD D) and secure attachment styles and moderate positive correlations between avoidant and anxious attachment styles. There were positive correlations between sympathetic skin responces and anxious and avoidant attachment styles and negative correlations with secure attachment styles in the panic group. When both groups were included into the analysis, positive correlations between avoidant attachment styles and sympathetic skin responses was found. A meaningful lineer regression model was established to analyze for predictors of sympathetic skin responses in panic disorder. The main predictor was found to be the avoidant attachment style for sympatethic skin response amplitude. As a result, this is the first study in Turkish population comparing childhood trauma, attachment styles and sympathetic skin response relationships together in panic disorder. The close relationship between anxiety and depression scale score and childhood trauma and the relation between clinical phenomenology and attachment styles which have been shown in the literature has been highlighted in our study too. But in our study, additionally, as a possible state marker, sympathatetic skin response, was found to be moderately correlated with avoidant attachment style. These results may show that autonomic behaviors like sympathetic skin responses could be established via childhood experinces in early time of life, and this might give an important opportunity to predict the development of these disorders before clinical phenomenology sets in and give another way of frame fort he therapuetic follow up of these disorders. But these results should be confirmed with larger sample sizes with different designs. Key words: Panic disorder, Sympathetic skin response, Attachment, Childhood trauma