Rosh Psychiatry Board Practice Exam

What factor contributes to the risk of developing panic disorder?

1. Hypoactivity in the amygdala

2. Narcissistic personality disorder

3. Low anxiety sensitivity

4. Smoking in childhood

The correct answer is: Smoking in childhood

The development of panic disorder is influenced by various factors, and one of the significant contributors is smoking in childhood. Engagement in smoking during formative years has been linked to an increased risk of developing anxiety disorders, including panic disorder. The mechanisms by which smoking influences this risk might include the impact of nicotine on neurobiological processes related to anxiety regulation, as well as the potential for smoking to serve as a maladaptive coping mechanism that reinforces anxiety sensitivity. Factors like hypoactivity in the amygdala and low anxiety sensitivity tend to be associated with a decreased likelihood of experiencing anxiety disorders, including panic disorder, since the amygdala plays a crucial role in threat detection and emotional responses. Narcissistic personality disorder does not exhibit a direct relationship with the onset of panic disorder; while it may involve emotional dysregulation, it is not considered a primary risk factor for panic disorder. Therefore, the association between early smoking behavior and the increased prevalence of panic disorder underscores the importance of addressing risk factors related to childhood behaviors and their long-term implications for mental health.