Subpopulations of early separation anxiety: relevance to risk of adult anxiety disorders

Abstract

Background: The present study aims to examine whether discrete subpopulations can be identified according to their levels of early separation anxiety (SA), and if so, whether such a typology of SA influences risk to particular adult anxiety disorders. Methods: Mixture analysis was applied to early SA scores provided retrospectively by a composite group ( n=1800) of adult community and patient samples. The distribution of adult anxiety diagnoses across the SA categories was assessed in a community ( n=136) and a clinic ( n=74) sample. Results: The mixture analysis yielded two subpopulations according to SA scores. Odds ratios for assignment to the high SA category for the various anxiety disorders ranged from 3.6 to 6.7. A logistic regression analysis revealed that when comorbidity was taken into account, the panic disorder-agoraphobia (PD-Ag) group was the only anxiety disorder to be associated with the high SA category. Conclusion: Assignment to a high early SA category appears to increase risk to adult anxiety disorders, particularly PD-Ag. Several possible pathways may account for such a risk including the persistence of separation anxiety disorder into adulthood. Limitations: Assessment of early SA was made using a retrospective measure and the samples included groups which were known to have high SA scores. Clinical Relevance: Only a subpopulation of anxiety sufferers may have elevated levels of SA. Identification of this group may be important for early detection and intervention.