The Search for Youthful Panic: A Systematic Review of the Relationship between Anxiety Sensitivity, Emotion Regulation, and Panic Symptoms Via a Developmental Lens.

Panic disorder (PD) is a debilitating anxiety disorder consisting of episodes of intense fear that may emerge in childhood and adolescence; however, the factors leading to the emergence of PD in youth remain poorly understood. The risk of experiencing panic symptoms may increase due to changes in developmental capabilities in late childhood and adolescence. In particular, two constructs have frequently been examined as likely candidates: increased anxiety sensitivity (AS) and emotion regulation (ER) difficulties associated with socioemotional and cognitive changes that arise in childhood and adolescence. AS has been consistently identified as a precursor and maintaining factor of panic; meanwhile, fewer studies have examined the role of ER difficulties in the development and maintenance of panic symptoms in youth. This systematic review utilized a developmental perspective to identify and summarize the (1) phenomenology of panic symptoms in children and adolescents, (2) the association between AS and panic symptoms, (3) the relationship between ER and panic symptoms, and (4) the interaction of AS and ER in the etiology of panic symptoms. A total of 47 articles were included in this review. Youth (e.g., negative affectivity) and parental factors (e.g., parental modeling) were associated with AS and panic, while only youth factors (e.g., gender, puberty status, stressors, and baseline anxiety) were associated with ER difficulties and panic. Overall findings suggest AS and ER difficulties are independent correlates of panic symptoms in children and adolescents. Due to the lack of studies examining the interactive effects of AS and ER difficulty on panic symptoms in youth, future research is needed to clarify these relations.