Association of childhood trauma and panic symptom severity in panic disorder: Exploring the mediating role of alexithymia.

<bold>Background: </bold>The aim of the present study was to examine the association between childhood trauma (CT), alexithymia, and panic symptom severity in patients with panic disorder (PD). Moreover, the effect of specific subtypes of CT on alexithymia and panic symptom severity was also investigated.<bold>Methods: </bold>142 patients with PD and 146 healthy age-matched and sex-matched controls were enrolled in the study. The Structured Clinical Interview for DSM-IV axis I (SCID-I), Childhood Trauma Questionnaire-28 item Short Form (CTQ-28), Toronto Alexithymia Scale (TAS-20), and Panic Disorder Severity Scale (PDSS) were administered to all subjects. The relationships among CT subtypes, alexithymia, and panic symptom severity were investigated using Pearson's correlation analysis. The types of CT that predict alexithymia and panic symptom severity were also investigated using Regression analyses.<bold>Results: </bold>PD patients showed higher scores on reporting all kinds of CT except sexual abuse. In addition, the TAS-20, DIF (difficulty identifying feelings) and DDF (difficulty describing feelings) scores were significantly higher in patients with PD than in controls. Significant positive correlations were noted among CT, alexithymia and panic symptoms severity. Results of regression analyses showed alexithymia as a mediator between the different types of CT and panic disorder severity, except sexual abuse.<bold>Limitations: </bold>Although self-report questionnaires are reliable and widely used, the phenomenon of patients who underreport or overreport their symptoms cannot be ignored.<bold>Conclusion: </bold>The present study showed that CT and alexithymia are more common in patients with PD and impact the severity of panic symptoms. Results suggest that alexithymia may be an important mediator between CT and panic disorder severity. [ABSTRACT FROM AUTHOR]