Recent Stressful Life Research Articles

Practical tips for paediatricians: Assessment and management of bladder and bowel dysfunction in the office

Bladder and bowel dysfunction (BBD) is a term used to describe a spectrum of lower urinary tract symptoms (LUTS) and associated bowel complaints (constipation and/or encopresis) (1). It is a common, but under-recognized problem encountered by general paediatricians. Most cases are due to functional voiding disorders and constipation, rather than secondary or organic causes (1). BBD symptoms can negatively impact a child’s quality of life; thus, timely diagnosis and management are essential. Begin by obtaining a detailed clinical history of voiding routines, LUTS (i.e., frequency, dysuria, and enuresis), and prior urinary tract infections (UTI). Recognize overactive bladder symptoms including incontinence, urinary urgency, and holding manoeuvres (i.e., crossing of legs) (1). Requesting and reviewing voiding and bowel diaries (48 to 72 hours duration), a Bristol Stool Scale, and fluid/dietary intake can help to objectively identify patterns of BBD symptoms (1). Be aware of red flags that may suggest an underlying organic cause (Table 1). As there is a known association between BBD and neuropsychiatric disorders (i.e., anxiety, hyperactivity) (2), it is important to inquire about behaviour difficulties. Social history of recent life stressors and screening for sexual abuse should be considered.

Mental Health and Functional Competence in the Cape Town Adolescent Antiretroviral Cohort.

The impact of HIV and antiretrovirals (ART) on long-term mental health in perinatally infected children has not been well studied in sub-Saharan Africa where HIV is most prevalent. Cape Town, South Africa. We investigated mental health measures, including depression, anxiety, attention-deficit hyperactivity disorder, motivation, disruptive behavior, and functioning in perinatally infected adolescents (PHIV+) stable on ART within the Cape Town Adolescent Antiretroviral Cohort. Two hundred four adolescents living with HIV (median age 10 years; mean CD4 953) and a sample of 44 uninfected adolescents were enrolled. The Beck Youth Inventories, Children's Motivation Scale, Conner's Parent's Rating Scale, and Child Behavior Checklist were administered. Among PHIV+, we explored independent associations between HIV-related stigma, recent life stressors, sociodemographic, clinical, and caregiver-related variables, and mental health measures. PHIV+ had poorer functional competence, self-concept and motivation, higher levels of disruptive behavior, depression and attention-deficit hyperactivity disorder symptoms and clinically significant anger and disruptive behavior. Within the PHIV+ group, the loss of both biological parents was associated with higher levels of disruptive behavior. Within the PHIV+, factors associated with mental health symptoms and poorer functioning were mostly sociodemographic factors, HIV-related stigma, and life stressors. Age of initiation of ART was associated with self-concept, and failing first-line ART with internalizing and externalizing behavior problems. PHIV+ are likely to face future physical and psychological health consequences related to the functional competence challenges they face if mental health care is not made a priority in the fight against HIV.

Divergence of an association between depressive symptoms and a dopamine polygenic score in Caucasians and Asians.

A recent study reported a negative association between a putatively functional dopamine (DA) polygenic score, indexing higher levels of DA signaling, and depressive symptoms. We attempted to replicate this association using data from the Duke Neurogenetics Study. Our replication attempt was made in a subsample of 520 non-Hispanic Caucasian volunteers (277 women, mean age 19.78 ± 1.24years). The DA polygenic score was based on the following five loci: rs27072 (SLC6A3/DAT1), rs4532 (DRD1), rs1800497 (DRD2/ANKK1), rs6280 (DRD3), and rs4680 (COMT). Because the discovery sample in the original study consisted mostly of Asian participants, we also conducted a post hoc analysis in a smaller subsample of Asian volunteers (N = 316, 179 women, mean age 19.61 ± 1.32years). In the primary sample of non-Hispanic Caucasians, a linear regression analysis controlling for sex, age, socioeconomic status (SES), body mass index, genetic ancestry, and both early and recent life stress, revealed that higher DA polygenic scores were associated with higher self-reported symptoms of depression. This was in contrast to the original association of higher DA polygenic scores and lower depressive symptoms. However, the direction of the association in our Asian subsample was consistent with this original finding. Our results also suggested that compared to the Asian subsample, the non-Hispanic Caucasian subsample was characterized by higher SES, lower early and recent life stress, and lower depressive symptoms. These differences may have contributed to the observed divergence in associations. Collectively, the current findings add to evidence that specific genetic associations may differ between populations and further encourage explicit modeling of race/ethnicity in examining the polygenic nature of depressive symptoms and depression.

Depression Severity Over 27 Months in Adolescent Girls Is Predicted by Stress-Linked Cortical Morphology

BackgroundEvidence supports the notion that early-life stress and trauma impact cortical development and increase vulnerability to depression. However, it remains unclear whether common stressful life events in community-dwelling adolescents have similar consequences for cortical development. MethodsA total of 232 adolescent girls (mean age 15.29 ± 0.65 years) were assessed with the Stressful Life Events Schedule (a semistructured interview of stressors in the previous 9 months) and underwent a magnetic resonance imaging scan. FreeSurfer 5.3.0 was used to perform whole-brain surface-based morphometry. Dysphoria was assessed at the time of imaging and prospectively at three 9-month follow-up appointments using the Inventory of Depression and Anxiety Symptoms II. ResultsAt least one stressful life event was reported in 90% of the adolescent participants during the 9 months preceding imaging. Greater burden of recent life stress was associated with less left precuneus and left postcentral cortical thickness and smaller left superior frontal and right inferior parietal volume (all p < .05 after multiple comparisons correction). Left precuneus thickness in the stress-associated cluster significantly predicted dysphoria for 27 months after imaging controlling for prior dysphoria (β = −.11, p = .004). Left precuneus cortical thickness accounted for 17.0% of the association between stress and dysphoric mood for 27 months after imaging (β = .04, p = .05). ConclusionsConsistent with evidence from imaging studies of trauma-exposed youths and preclinical stress models, a heavy burden of recent common life stress in community-dwelling adolescent girls was associated with altered frontal/parietal cortical morphology. Stress-linked precuneus cortical thickness represents a candidate prospective biomarker of adolescent depression.

S51. The Effect of Childhood Adversity Exposure and Recent Stressful Life Events on Longitudinal Inflammatory Response

Childhood adversity is an independent risk factor for physical and psychiatric illnesses. Elevated inflammatory activity has been identified as one possible mechanism for the biological translation of childhood adversity exposure. However, limited research has investigated the combined effect of childhood adversity exposure and recent life stress on inflammatory biomarkers over time.

Psychological inflexibility predicts PTSD symptom severity in war veterans after accounting for established PTSD risk factors and personality.

Numerous risk factors for posttraumatic stress disorder (PTSD) have been identified; however, many do not inform treatment. Psychological inflexibility is a modifiable factor that can be targeted in psychological treatment. This study examined whether higher levels of psychological inflexibility predicted unique variance in PTSD symptom severity at 1-year follow-up in 236 U.S. veterans of the wars in Iraq in Afghanistan after accounting for the strongest known risk factors for PTSD. PTSD symptom severity was assessed using the Clinician Administered PTSD Scale. In hierarchical regression analyses, higher baseline psychological inflexibility predicted unique variance in 1-year PTSD symptom severity (p < .001, medium effect) after accounting for the strongest predictors, including: serving in the Army, rank, trauma severity, perceived threat, peritraumatic dissociation, recent life stress, and social support. Psychological inflexibility remained a significant predictor of unique variance in 1-year PTSD symptom severity after accounting for all other predictors and personality factors (neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness; p < .001, small effect) and after accounting for all other predictors, personality factors, and baseline PTSD avoidance symptoms (p < .001; small effect). Findings indicate a key unique association between psychological inflexibility and PTSD symptom severity over time that is not attributable to overlap with personality or PTSD avoidance symptoms. Additional research on psychological inflexibility in the development and maintenance of PTSD is warranted, as well as whether increasing psychological flexibility leads to reductions in PTSD symptoms and improved psychosocial functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The role of familial risk, parental psychopathology, and stress for first-onset depression during adolescence

BackgroundAdolescence represents a critical developmental period during which the initial onset of depression emerges. Family risk for depression is a salient risk factor for the initial onset of Major Depressive Disorder (MDD). We examined the effects of familial risk, stress, and behavior on the risk of developing first-onset depression. MethodsAdolescents aged 12 to 15 with high (n = 166) or low (n = 159) familial risk for depression were assessed annually for up to five years. Stress was assessed using the Stressful Life Events Schedule and Childhood Trauma Questionnaire. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version was administered to the adolescents and their parents to assess lifetime psychiatric conditions and diagnose MDD onset. Survival and path analyses were used in tandem to determine the risk for first-onset depression as well as the contributions of additional direct and indirect pathways to onset. ResultsHigh-risk adolescents were eight times more likely to develop first-onset depression compared with low-risk adolescents. The path analyses revealed that the presence of maternal behavioral disorders and increased recent life stress directly predicted an initial onset of MDD in high-risk adolescents. LimitationsThe small samples used in this study limit the generalizability of these findings. ConclusionsAdolescents at high familial risk for depression had an increased risk for the emergence of first-onset depression during adolescence. Stress and maternal behavioral psychopathology directly contributed to depression onset independently of familial risk, while childhood trauma exerted an indirect effect on first-onset MDD through recent stress.

An examination of genes, stress and suicidal behavior in two First Nations communities: The role of the brain-derived neurotropic factor gene

Suicide claims over 800,000 lives each year worldwide. Suicide rates in indigenous populations in Canada are about double that of the national average, making it a serious public health issue. Numerous factors are involved in suicide risk, including genetic factors, as well as various psychosocial stressors, such as historical experience with the Indian Residential School system for Indigenous populations, as well as protective variables such as social support. Here, we report the first genetic study of suicidal behaviors that includes multiple measures of stress and social supports. We investigated the role of the functional Val66Met marker (rs6265) in the Brain-Derived Neurotropic Factor (BDNF) gene in suicidal ideation and suicide attempt in a First Nations community sample (N = 278). We did not find a significant association between the BDNF rs6265 marker and suicidal behaviors. We found childhood adversities, recent life stress, chronic stress, perceived stress, difficulties, and hazardous alcohol use to be associated with both suicidal ideation and suicide attempt. Thus, while additional studies with larger samples are required to elucidate the genetic component of suicide, addressing environmental stressors may be important for suicide prevention.

Determining the mechanisms through which recent life stress predicts working memory impairments: precision or capacity?

Prior research has found that recent life stress exposure is related to poorer working memory performance, but it remains unclear which aspects of working memory are related to stress. To address this important issue, we examined the extent to which recent life stress exposure was associated with working memory capacity (i.e., the number of items that can be held in working memory) and working memory precision (i.e., the quality of representations of items held within working memory) in a sample of 260 healthy young adults (Mage = 19.95 years old; range = 18–33). Recent life stress exposure and working memory were assessed with the Stress and Adversity Inventory for Daily Stress (Daily STRAIN) and color wheel task, respectively. We found that recent life stress was selectively associated with lower working memory capacity; moreover, the association of recent life stress with capacity was significantly stronger in magnitude than the non-significant association of recent life stress with precision. These associations were robust while controlling for potential confounds, including demographic factors, negative affect, and cumulative lifetime stress exposure. These results thus suggest that stress-related degradations in working memory capacity may help explain how recent life stress exposure affects working memory performance.

The social anatomy of adverse childhood experiences and aggression in a representative sample of young adults in the U.S.

Objective The current study assesses the effect of adverse childhood experiences on later aggression and violence across young adult relationships contexts, including intimate partners, friends, or strangers. Method Surveys were conducted with a nationally representative sample of young adults ages 18-32, drawn from the AmeriSpeak panel, a probability-based panel with coverage of 97% of U.S. households. The weighted study sample is 2284 young adult respondents, of whom 1561 reported being in an intimate partnership. Results Rates of verbal aggression perpetrated by young adults declined with the intimacy of the relationship, such that aggression against a partner (72%) exceeded aggression directed at friends (43%) and strangers (34%). Similar rates of physical violence (about 9%) were reportedly perpetrated against partners, friends, and strangers. Adjusting for a range of personal characteristics, both adverse childhood experiences and recent stressors in these young adult lives exhibited direct associations with verbal and physically aggressive outcomes. Conclusions In models of verbal and physical aggression across relationship contexts, childhood adversity exhibits lasting effects unaccounted for by important proximal life circumstances, including recent life stressors, mental health, and substance use behaviors. These results provide empirical insights for clinical treatment of young adults prone to aggressive conflicts as well as input to positive youth development programming to foster healthy approaches to conflict.

Long-term changes in the effects of episode-specific drinking to cope motivation on daily well-being.

To further understand the role of drinking to cope (DTC) motivation in the development of drinking-related problems during young adulthood, we tested whether the association between episode-specific levels of nighttime DTC motivation and next-day negative affect and self-control depletion symptoms (SCDS) changed from college years to postcollege years (5 years later). We also examined whether these changes were moderated by recent life stress, adult social role attainment and gender, and whether mean levels of these variables were associated with changes in drinking-related problems from college to postcollege years. Participants (N = 927; 54% women) completed a 30-day daily diary during college and again 5 years later in which they reported their previous night's drinking level and motivation and their current negative affect and SCDS. We assessed drinking-related problems at both waves and recent life stress and adult social roles at Wave 2. DTC motivation was positively associated with next-day levels of negative affect and SCDS. The effect of DTC motivation on anxiety and SCDS became stronger over time. The effect of DTC motivation on depressive affect and anger (a) decreased across time among individuals who attained more adult roles and (b) was weaker among individuals who reported lower levels of postcollege life stress. Mean levels of postcollege DTC motivation was indirectly related to changes in drinking-related problems from college to postcollege through mean levels of negative affect and SCDS. Our findings indicate that DTC might exert its unique long-term effects on alcohol use disorders through disruption of daily emotion-regulation processes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Modification of Ozone-Induced Changes in Lung Function by Moderate Recent Life Stress

While changes in lung function (LF) due to ozone (OZ) exposure are well-documented in healthy populations, potential sources of response heterogeneity, like stress, remain uncharacterized. Though e...

Kappa opioid receptor binding in major depression: A pilot study.

Endogenous kappa opioids mediate pathological responses to stress in animal models. However, the relationship of the kappa opioid receptor (KOR) to life stress and to psychopathology in humans is not well described. This pilot study sought, for the first time, to quantify KOR in major depressive disorder (MDD) in vivo in humans using positron emission tomography (PET). KOR binding was quantified in vivo by PET imaging with the [11 C]GR103545 radiotracer in 13 healthy volunteers and 10 participants with current MDD. We examined the relationship between regional [11 C]GR103545 total volume of distribution (VT ) and diagnosis, childhood trauma, recent life stress, and, in a subsample, salivary cortisol levels during a modified Trier Social Stress Test (mTSST), amygdala, hippocampus, ventral striatum and raphe nuclei. Whole-brain voxel-wise analyses were also performed. [11 C]GR103545 VT did not differ significantly between MDD participants and healthy volunteers in the four a priori ROIs (p = 0.50). [11 C]GR103545 VT was unrelated to reported childhood adversity (p = 0.17) or recent life stress (p = 0.56). A trend-level inverse correlation was observed between [11 C]GR103545 VT and cortisol area-under-the curve with respect to ground during the mTSST (p = 0.081). No whole-brain voxel-wise contrasts were significant. Regional [11 C]GR103545 VT , a measure of in vivo KOR binding, does not differentiate MDD from healthy volunteers in this pilot sample. Future studies may examine KOR binding in subgroups of depressed individuals at increased risk for KOR abnormalities, including co-occurring mood and substance use disorders, as well as depression with psychotic features.

Heightened connectivity between the ventral striatum and medial prefrontal cortex as a biomarker for stress-related psychopathology: understanding interactive effects of early and more recent stress.

The experience of childhood maltreatment is a significant risk factor for the development of depression. This risk is particularly heightened after exposure to additional, more contemporaneous stress. While behavioral evidence exists for this relation, little is known about biological correlates of these stress interactions. Identifying such correlates may provide biomarkers of risk for later depression. Here, we leverage behavioral, experiential, and neuroimaging data from the Duke Neurogenetics Study to identify potential biomarkers of stress exposure. Based on the past research, we were specifically interested in reward-related connectivity and the interaction of early and more recent stress. We examined psychophysiological interactions between the ventral striatum and other brain regions in relation to these stress variables, as well as measures of internalizing symptomatology (n = 926, participant age range = 18-22 years of age). We found relatively increased reward-related functional connectivity between the left ventral striatum and the medial prefrontal cortex in individuals exposed to greater levels of childhood maltreatment who also experienced greater levels of recent life stress (β = 0.199, p < 0.005). This pattern of functional connectivity was further associated with elevated symptoms of depression (β = 0.089, p = 0.006). Furthermore, using a moderated mediation framework, we demonstrate that this functional connectivity provides a biological link between cumulative stress exposure and internalizing symptomatology. These findings suggest a novel biomarker linking cumulative stress exposure with the later experience of depressive symptoms. Our results are discussed in the context of past research examining stress exposure in relation to depression.

Post-secondary maternal education buffers against neural risk for psychological vulnerability to future life stress

We have previously reported that threat-related amygdala activity measured during a baseline fMRI scan predicts the experience of depression and anxiety associated with stressful life events years later. Here, we examine whether two broad measures of childhood environmental enrichment, namely parental educational achievement and subjective parental socioeconomic status, buffer against the effects of amygdala activity on future vulnerability to stress. Analyses of data available from 579 young adults revealed that maternal, but not paternal, educational achievement moderates the association between amygdala activity, recent life stress, and changes in mood and anxiety symptoms, even when controlling for participants’ current subjective socioeconomic status. Specifically, only participants reporting lower maternal educational achievement exhibited our previously observed interaction between amygdala activity and future life stress predicting increases in depression and anxiety. These results suggest that higher maternal educational achievement may help buffer stress sensitivity associated with heightened threat-related amygdala activity.

HTR1A/1B DNA methylation may predict escitalopram treatment response in depressed Chinese Han patients

BackgroundThe serotonin receptor 1A and 1B (HTR1A/1B) gene have been suggested to be involved in the pathogenesis of major depressive disorder (MDD) and the antidepressant treatment response. Gene expression differences were partly mediated by genetic polymorphism and DNA methylation which might be affected by environmental factors. In the present study, we attempt to identify whether HTR1A/1B DNA methylation and genetic polymorphism could predict antidepressant treatment response. Methods85 Chinese Han MDD patients were clinically assessed 8 weeks after of initiating escitalopram treatment for the first time. Antidepressant treatment response was assessed by changes in the Hamilton Depression Rating Scale-17 items (HAMD-17) score. The Life Events Scale (LES) and the Childhood Trauma Questionnaire (CTQ) were utilized as the assessment of previous life stress. The Illumina HiSeq platform was used to assess DNA methylation at 96 CpG sites located in HTR1A and HTR1B gene promoter regions. Six single nucleotide polymorphisms (SNPs) (HTR1A rs6294, rs116985176; HTR1B rs6296, rs6298, rs1228814, rs1778258) were genotype by using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) or PCR sequencing. Regression analyses were used to explore the relationship between DNA methylation and SNP and antidepressant response. ResultsWe identified two CpG sites predictor of antidepressant treatment response (CpG 668, amplicon HTR1A_1, NC_000005.10, P = 0.025; CpG 1401, amplicon HTR1B_4, NC_000006.12, P = 0.033). The interaction of four CpG sites hypomethylation of HTR1A/1B with high recent stress might result in impaired antidepressant treatment response. What's more, the present data indicated that age, environments and antidepressant treatment might affect DNA methylation status. It was found that DNA methylation status could be influenced by antidepressant treatment in turn. However, HTR1A and HTR1B genotypes did not influence antidepressant response and DNA methylation status. ConclusionsThe results suggest that HTR1A/1B DNA hypomethylation and its interaction with recent life stress might drive impaired antidepressant treatment response. Meanwhile, DNA methylation, in turn, was modified by antidepressant treatment and environments. Our results offer new evidence for the role of epigenetic and genetic polymorphism in pharmacological response to antidepressants.

Choice of a suicide method: Trends and characteristics

The aim of this study was to examine (1) suicide trends by most prevalent methods in Queensland, Australia, during 2000–2015, and (2) characteristics of people by choice of suicide method in 2000–2013. Data were obtained from the Queensland Suicide Register, which includes police and toxicology reports, post-mortem autopsy and Coroner's findings. Poisson and Joinpoint regression were used to study the first aim, and uni-variate and multi-variate logistic regression analyses were applied to investigate the second aim. Suicide method trends showed a significant increase in hanging for both sexes and poisoning with drugs for females, while there was a decline for poisoning by other means for both sexes, and ‘other methods’ decreased for males. Changes in the trends have altered the order of suicide methods, especially in males. Analyses of 8140 suicides were composed by the choice of method, distinguishable profiles by their demographic, clinical and social characteristics, such as having mental or physical illness or different recent life stressors were identified. This suggests that socio-cultural acceptability, and availability are the key drivers in the choice of suicide methods. Continuing increases in hanging is a big challenge in suicide prevention due to its lethality, easy realisation and its increasing acceptability.

Reward-Related Ventral Striatum Activity Buffers against the Experience of Depressive Symptoms Associated with Sleep Disturbances.

Sleep disturbances represent one risk factor for depression. Reward-related brain function, particularly the activity of the ventral striatum (VS), has been identified as a potential buffer against stress-related depression. We were therefore interested in testing whether reward-related VS activity would moderate the effect of sleep disturbances on depression in a large cohort of young adults. Data were available from 1129 university students (mean age 19.71 ± 1.25 years; 637 women) who completed a reward-related functional MRI task to assay VS activity and provided self-reports of sleep using the Pittsburgh Sleep Quality Index and symptoms of depression using a summation of the General Distress/Depression and Anhedonic Depression subscales of the Mood and Anxiety Symptoms Questionnaire-short form. Analyses revealed that as VS activity increased the association between sleep disturbances and depressive symptoms decreased. The interaction between sleep disturbances and VS activity was robust to the inclusion of sex, age, race/ethnicity, past or present clinical disorder, early and recent life stress, and anxiety symptoms, as well as the interactions between VS activity and early or recent life stress as covariates. We provide initial evidence that high reward-related VS activity may buffer against depressive symptoms associated with poor sleep. Our analyses help advance an emerging literature supporting the importance of individual differences in reward-related brain function as a potential biomarker of relative risk for depression.SIGNIFICANCE STATEMENT Sleep disturbances are a common risk factor for depression. An emerging literature suggests that reward-related activity of the ventral striatum (VS), a brain region critical for motivation and goal-directed behavior, may buffer against the effect of negative experiences on the development of depression. Using data from a large sample of 1129 university students we demonstrate that as reward-related VS activity increases, the link between sleep disturbances and depression decreases. This finding contributes to accumulating research demonstrating that reward-related brain function may be a useful biomarker of relative risk for depression in the context of negative experiences.

Leukocyte telomere length and personality: associations with the Big Five and Type D personality traits.

Data from the Netherlands Study of Depression and Anxiety were used and included patients with a depression and/or anxiety disorder and healthy controls. Overall, 2936 persons (18-65 years, 66% female) had data on LTL at baseline and 1883 persons had LTL at 6-year follow-up. The Big Five personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) and Type D personality were assessed. Neuroticism was negatively (B = -2.11, p = 0.03) and agreeableness was positively (B = 3.84, p = 0.03) related to LTL measured across two time points, which became just non-significant after adjusting for somatic health, lifestyle factors, and recent life stress (B = -1.99, p = 0.06; and B = 3.01, p = 0.10). Type D personality was negatively (B = -50.16, p < 0.01) related to LTL across two time points, which still remained statistically significant after full adjustment (B = -47.37, p = 0.01). Associations did not differ by age, gender, and current psychiatric status. The Big Five traits high neuroticism and low agreeableness, and Type D personality were associated with shorter LTL measured across a 6-year period. Associations with the Big Five traits became non-significant after controlling for somatic health, lifestyle factors, and recent life stress, yet similar trends were observed. Type D personality remained independently associated with shorter LTL after full adjustment.

Assessing the interplay of childhood adversities with more recent stressful life events and conditions in predicting panic pathology among adults from the general population

BackgroundAlthough research suggests that (a) childhood adversities and more recent stressful life events/conditions are risk factors for panic pathology and that (b) early life stress increases vulnerability to later psychopathology, it remains unclear whether childhood adversities amplify the association between more recent stressful life events/conditions and panic pathology. MethodsData were derived from a general population sample (Study of Health in Pomerania, SHIP). Lifetime panic pathology was assessed with the Munich Composite International Diagnostic Interview (M-CIDI). Childhood adversities (emotional, physical and sexual abuse; emotional and physical neglect) were assessed with the Childhood Trauma Questionnaire (CTQ). More recent separation/loss events and long-lasting stressful conditions were assessed with the Stralsund Life Event List (SEL). Individuals with lifetime panic pathology (fearful spell, panic attack or panic disorder, N = 286) were compared to controls without any psychopathology (N = 286, matched for sex and age). ResultsConditional logistic regressions revealed that childhood adversities as well as more recent separation/loss events and long-lasting stressful conditions were associated with panic pathology (OR 1.1–2.5). Moreover, more recent separation/loss events - but not long-lasting stressful conditions - interacted statistically with each of the examined childhood adversities except for sexual abuse in predicting panic pathology (OR 1.1–1.3). That is, separation/loss events were associated more strongly with panic pathology among individuals with higher childhood adversities. LimitationsData were assessed retrospectively and might be subject to recall biases. ConclusionsFindings suggest that early childhood adversities amplify the risk of developing panic pathology after experiencing separation or loss events.