Characterization of different types of anxiety disorders in relation to structural integration of personality and adverse and protective childhood experiences in psychotherapy outpatients - a cross-sectional study.
Adverse childhood experiences
Generalized anxiety disorder
Panic disorder
Phobia
Protective childhood experiences
Structural integration of personality
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
12 07 2023
12 07 2023
Historique:
received:
19
03
2023
accepted:
27
06
2023
medline:
14
7
2023
pubmed:
13
7
2023
entrez:
12
7
2023
Statut:
epublish
Résumé
Current research has emphasized the role of structural integration of personality and childhood experiences for the understanding of anxiety disorders. In this study, we examined the relationship between anxiety disorders (generalized anxiety disorder vs. panic disorder vs. phobic disorders), the level of structural integration of personality, and negative and protective childhood experiences at the beginning of outpatient psychodynamic psychotherapy treatment. Differences were characterized in comparison to patients with no anxiety disorders. The sample included a total of 1646 outpatient psychodynamic psychotherapy treatments, of which 695 treatments included the diagnosis of at least one anxiety disorder. Levels of structural integration of personality were assessed according to the Operationalized Psychodynamic Diagnosis (OPD-2) system. Self-reported negative and protective childhood experiences were examined by using the Questionnaire for the Assessment of Adverse and Protective Childhood Experiences (APC). Associations were tested using single factor ANOVAs. Patients with anxiety disorders showed lower levels of structural integration of personality and reported more adverse childhood experiences than patients with no anxiety disorders. Regarding the subscales of structural integration of personality, phobic disorders were associated with impaired external communication, whereas for generalized anxiety disorder, an (uncorrected) association with impaired self-regulation was found. Also, generalized anxiety disorder was associated with sexual abuse and other traumatization (accidents etc.) during childhood, while panic disorder and phobic disorders were associated with emotional neglect, abuse, and fewer protective childhood experiences. Our findings emphasize the need of considering structural integration of personality and childhood experiences in order to understand and treat various types of anxiety disorders.
Sections du résumé
BACKGROUND
Current research has emphasized the role of structural integration of personality and childhood experiences for the understanding of anxiety disorders. In this study, we examined the relationship between anxiety disorders (generalized anxiety disorder vs. panic disorder vs. phobic disorders), the level of structural integration of personality, and negative and protective childhood experiences at the beginning of outpatient psychodynamic psychotherapy treatment. Differences were characterized in comparison to patients with no anxiety disorders.
METHODS
The sample included a total of 1646 outpatient psychodynamic psychotherapy treatments, of which 695 treatments included the diagnosis of at least one anxiety disorder. Levels of structural integration of personality were assessed according to the Operationalized Psychodynamic Diagnosis (OPD-2) system. Self-reported negative and protective childhood experiences were examined by using the Questionnaire for the Assessment of Adverse and Protective Childhood Experiences (APC). Associations were tested using single factor ANOVAs.
RESULTS
Patients with anxiety disorders showed lower levels of structural integration of personality and reported more adverse childhood experiences than patients with no anxiety disorders. Regarding the subscales of structural integration of personality, phobic disorders were associated with impaired external communication, whereas for generalized anxiety disorder, an (uncorrected) association with impaired self-regulation was found. Also, generalized anxiety disorder was associated with sexual abuse and other traumatization (accidents etc.) during childhood, while panic disorder and phobic disorders were associated with emotional neglect, abuse, and fewer protective childhood experiences.
CONCLUSIONS
Our findings emphasize the need of considering structural integration of personality and childhood experiences in order to understand and treat various types of anxiety disorders.
Identifiants
pubmed: 37438712
doi: 10.1186/s12888-023-04988-2
pii: 10.1186/s12888-023-04988-2
pmc: PMC10339566
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
501Informations de copyright
© 2023. The Author(s).
Références
Child Abuse Negl. 2019 Oct;96:104082
pubmed: 31374447
Psychol Med. 2008 Mar;38(3):365-74
pubmed: 18047766
Psychol Psychother. 2017 Sep;90(3):353-376
pubmed: 28035751
Br J Psychiatry. 2010 Nov;197(5):378-85
pubmed: 21037215
Psychosomatics. 1997 Mar-Apr;38(2):109-12
pubmed: 9063040
Psychol Med. 2016 Mar;46(4):717-30
pubmed: 26708271
Cognit Ther Res. 2012 Dec 1;36(6):655-669
pubmed: 23162177
Br J Psychiatry. 2000 Jul;177:4-7
pubmed: 10945080
Epidemiol Psychiatr Sci. 2016 Feb;25(1):24-32
pubmed: 25802979
Epidemiol Psychiatr Sci. 2021 May 06;30:e36
pubmed: 33955350
Int J Public Health. 2014 Apr;59(2):359-72
pubmed: 24122075
Arch Gen Psychiatry. 1991 Aug;48(8):700-6
pubmed: 1883252
Dtsch Arztebl Int. 2019 Sep 20;116(38):635-642
pubmed: 31617486
Perspect Psychiatr Care. 2018 Jan;54(1):54-63
pubmed: 27925215
Bull World Health Organ. 2008 Aug;86(8):650-2
pubmed: 18797627
Psychiatry Res. 2020 Nov;293:113462
pubmed: 32987222
J Affect Disord. 2020 Dec 1;277:55-64
pubmed: 32799105
J Marital Fam Ther. 2003 Apr;29(2):209-22
pubmed: 12728779
J Pers Assess. 2021 May-Jun;103(3):365-379
pubmed: 32631173
Br J Psychiatry. 2018 Dec;213(6):698-703
pubmed: 30475193
Trauma Violence Abuse. 2020 Oct;21(4):828-843
pubmed: 30249161
Am J Psychiatry. 2015 Jul;172(7):606-13
pubmed: 26130200
Am Psychol. 2018 Jan;73(1):3-25
pubmed: 29345484
BMC Psychiatry. 2018 Sep 14;18(1):294
pubmed: 30223818
J Affect Disord. 2014 Oct;168:337-48
pubmed: 25089514
Psychother Psychosom Med Psychol. 2012 Jan;62(1):25-32
pubmed: 22271173
Lancet. 2021 Mar 6;397(10277):914-927
pubmed: 33581801
J Clin Psychiatry. 1996;57 Suppl 10:11-8; discussion 19-22
pubmed: 8917128
Psychiatry Res. 2014 Nov 30;219(3):577-82
pubmed: 25023365
Psychiatry Res. 2020 Nov;293:113419
pubmed: 32861098
N Engl J Med. 2005 Jun 16;352(24):2515-23
pubmed: 15958807
Psychopathology. 2007;40(4):209-20
pubmed: 17396047
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
pubmed: 15939837
Lancet. 2007 Sep 8;370(9590):841-50
pubmed: 17826169
Psychiatr Prax. 2020 May;47(4):207-213
pubmed: 32340049
J Pers Soc Psychol. 2000 Feb;78(2):350-65
pubmed: 10707340
Lancet. 2021 Nov 6;398(10312):1700-1712
pubmed: 34634250
Am J Prev Med. 1998 May;14(4):245-58
pubmed: 9635069
J Pers Assess. 2012;94(5):522-32
pubmed: 22808938
J Clin Child Adolesc Psychol. 2015;44(4):676-88
pubmed: 24635645
Arch Gen Psychiatry. 2010 Jan;67(1):47-57
pubmed: 20048222
Trends Psychiatry Psychother. 2018 Apr 05;40(1):16-20
pubmed: 29641649
Curr Opin Psychiatry. 2020 Jan;33(1):62-69
pubmed: 31790374
Psychol Med. 2010 Jun;40(6):899-909
pubmed: 19719899
Am J Psychiatry. 2005 Jun;162(6):1179-87
pubmed: 15930067
Can J Psychiatry. 2006 Feb;51(2):100-13
pubmed: 16989109
Lancet. 2017 Dec 17;388(10063):3048-3059
pubmed: 27349358
PLoS Med. 2012;9(11):e1001349
pubmed: 23209385
Acta Neuropsychiatr. 2016 Oct;28(5):257-71
pubmed: 26916592
PLoS Med. 2007 Oct 16;4(10):e297
pubmed: 17941715
Lancet Public Health. 2017 Aug;2(8):e356-e366
pubmed: 29253477