Puberty and Panic

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Ellen W. Leen-Feldner

FAYETTEVILLE, Ark. — For most teenagers a run up the stairs is simply the quickest way to get from one floor to another, but for some the resulting breathlessness and pounding heart triggers anxiety or fear — possibly predicting a future vulnerability to panic symptoms.

Ellen W. Leen-Feldner, a University of Arkansas psychologist, has found that adolescents who tend to respond fearfully to such common bodily reactions can have a tough time during adolescence. As an adolescent grows and the body changes, the adolescent may become more vulnerable to panic symptoms, which can lead to other serious problems.

“Panic might be thought of as a 'gateway condition’ that can predict the development of an array of mental health problems,” Leen-Feldner said. “We have had little understanding of the risk factors for adolescents.”

To begin to fill the gap, Leen-Feldner and colleagues Laura E. Reardon, Kimberly Babson and Matthew Feldner, all of the University of Arkansas, as well as Laura McKee and Michael J. Zvolensky of the University of Vermont, conducted a study that is the first direct test of the relation between puberty and panic-type responding for both male and female adolescents. They published the results, titled “The Interactive Role of Anxiety Sensitivity and Pubertal Status in Predicting Anxious Responding to Bodily Sensations among Adolescents,” in a recent issue of Journal of Abnormal Child Psychology.

While existing research has suggested that puberty might be a critical period of high risk in terms of the development of mental illnesses, relatively little was known about the link between puberty and vulnerability to panic attacks. Given that puberty is a stage of life marked by significant physical changes, it makes sense that it might be an important phase when teenagers are at risk for developing panic-type problems.

The researchers designed their study to look specifically at one factor in the relationship between puberty and panic — the role of “anxiety sensitivity” or the general tendency to respond with fear or anxiety to normal bodily sensations. They limited study participation to psychologically healthy adolescents to eliminate the impact of factors related to existing mental illnesses. They also used a more sophisticated assessment process than had been used in previous studies. That is, to elicit a panic-type experience, researchers guided each volunteer through a three-minute breathing challenge, a laboratory procedure that has proven safe with adolescents. This was done with 123 adolescent participants, and the adolescents or their parents had the option to withdraw at any time. None did.

The researchers found that those adolescents who were further along in puberty and high in anxiety sensitivity were more afraid of the bodily sensations elicited by the breathing challenge. For those low in anxiety sensitivity, there was little relationship between their maturity and anxious responding to the breathing challenge.

Their data, in conjunction with earlier studies, “suggest that elevations in anxiety sensitivity may potentiate panic-relevant learning that occurs during the course of puberty,” the researchers wrote.

In light of theories about the development of panic disorder, the researchers added that adolescents who tend to respond anxiously to bodily sensations may “perceive the bodily events that occur during puberty as personally threatening” and thus “learn to fear bodily sensations, thereby setting the stage for panic development.” This learning process might be even more likely to occur when bodily experiences related to puberty happen unexpectedly.

Leen-Feldner is an assistant professor of psychology in the J. William Fulbright College of Arts and Sciences, and director of the Arkansas Institute of Developmental Science. The research project was supported by grants from Child & Adolescent Research and Training Inc., the National Institute on Drug Abuse and the Anxiety Disorders Association of America.