Parental attitudes of mothers of patients with panic disorder.

Introduction: Maternal overprotection and lack of care during childhood has been repeatedly reported in anxious patients. On empirical grounds, the mother-child relationship has been retrospectively studied using specially devised questionnaires (Parental Bonding Instrument, EMBU, etc.), the results of which actually suggest the presence of maternal overprotection. A further piece of information may derive by the direct assessment of upbringing attitudes of the mothers. The Parental Attitude Research Instrument is specifically directed at exploring such an issue. Method: The Parental Attitude Research Instrument was administered to 26 mothers of patients affected by panic disorder (18 with agoraphobia and 8 without agoraphobia), 25 panic disorder patients (8 without agoraphobia), who were mothers themselves, and to two age-matched control groups of healthy mothers. Results: The mothers of panic disorder patients scored significantly higher on the two scales which explore overprotection and control (scale #2, "Fostering Dependency" and scale #20, " Intrusiveness") (Table I). No significant differences were found between the patients affected by panic disorder who were mothers themselves and the healthy controls on any of the 23 Parental Attitude Research Instrument scales (Table II). Conclusion: The peculiar upbringing attitudes we have found in the mothers of subjects with panic disorder, and panic disorder with agoraphobia give further strength to the theory of a distorted rearing pattern as a common cause of such disorders. Of the 23 scales composing the instrument, in fact, only those specifically correlated with the problem of overcontrol show consistent differences between the mothers of panic disorder patients and the mothers of normal subjects. The results seem to further support the hypothesis of maternal overprotection as a predisposing factor for panic disorder (PD). In fact, early environmental factors seem to increase the probability of developing panic disorders. The etiological role of these factors, however, is still uncertain and must probably be considered in the background of complex relationships with others factors.