SEARCH · PubMed Health

Results for “Agoraphobia”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed1992

The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia.

In 2163 personally interviewed female twins from a population-based registry, the pattern of age at onset and comorbidity of the simple phobias (animal and situational)--early onset and low rates of comorbidity--differed significantly from that of agoraphobia--later onset and high rates of comorbidity. Consistent with an inherited "phobia proneness" but not a "social learning" model of phobias, the familial aggregation of any phobia, agoraphobia, social phobia, and animal phobia appeared to result from genetic and not from familial-environmental factors, with estimates of heritability of liability ranging from 30% to 40%. The best-fitting multivariate genetic model indicated the existence of genetic and individual-specific environmental etiologic factors common to all four phobia subtypes and others specific for each of the individual subtypes. This model suggested that (1) environmental experiences that predisposed to all phobias were most important for agoraphobia and social phobia and relatively unimportant for the simple phobias, (2) environmental experiences that uniquely predisposed to only one phobia subtype had a major impact on simple phobias, had a modest impact on social phobia, and were unimportant for agoraphobia, and (3) genetic factors that predisposed to all phobias were most important for animal phobia and least important for agoraphobia. Simple phobias appear to arise from the joint effect of a modest genetic vulnerability and phobia-specific traumatic events in childhood, while agoraphobia and, to a somewhat lesser extent, social phobia result from the combined effect of a slightly stronger genetic influence and nonspecific environmental experiences.

Adolescent↗

PubMedDate not supplied

Familial analysis of panic disorder and agoraphobia. Gruppo Italiano Disturbi d'Ansia.

In this paper we studied the distribution of age at onset in 144 patients with panic disorder (PD) and/or agoraphobia (according to DSM-III criteria). We also investigated the incidences in their first-degree relatives of PD, agoraphobia, affective disorders, other anxiety disorders and alcoholism. Our aim was to detect the existence of a specific susceptibility system in these families, considering a wide spectrum of disorders. We found an earlier onset of PD and agoraphobia in the subgroup of our probands who previously met criteria for a separation anxiety disorder in childhood. The presence of both separation anxiety disorder and agoraphobia in the probands increased the familial risk for PD and agoraphobia. Nevertheless, the main finding appeared to be the specific familial concentration of agoraphobia, a disorder exclusively clustered in families of agoraphobic patients.

Adult↗

PubMed1989

Relationship and chronology of depression, agoraphobia, and panic disorder in the general population.

The comorbidity of disorders and chronology of first symptoms of depression, agoraphobia, and panic disorder were investigated. The Diagnostic Interview Schedule was administered to 3258 household residents. Strong associations were shown among all three disorders. However, the comorbidity of agoraphobia and panic disorder seemed to be accounted for by the relationship of both disorders with depression. The mean age at appearance of first symptoms was earlier for agoraphobia (low teens) than for depression or panic disorder (both about age 20). The results do not support the view that panic disorder is an integral component of agoraphobia, but rather that it is more closely associated with depression. The fact that agoraphobia precedes depression casts doubt on the thesis that depression is primary to anxiety disorders. Interpretation should, however, be viewed with caution because of the retrospective nature of the diagnostic instrument.

Adolescent↗

PubMed1990

Risk factors for the onset of Diagnostic Interview Schedule/DSM-III agoraphobia in a prospective, population-based study.

We analyzed the onset of agoraphobia in a large prospective study of the general population. The annual incidence of Diagnostic Interview Schedule/DSM-III agoraphobia is estimated at 22 per 1000 population per year. Latent class analysis of new cases in the at-risk population reveals the existence of two subtypes of agoraphobia. The relationship of the incidence of the two subtypes to sociodemographic and psychopathologic risk factors suggests different origins. The data also show that in two thirds of the 260 new cases of Diagnostic Interview Schedule/DSM-III agoraphobia, onset occurs without a history of panic attack. We analyzed the relationship of these epidemiologic results to earlier clinical findings in terms of possible measurement and sampling differences.

Adolescent↗

PubMed1991

Agoraphobia in phenylketonuria.

We describe agoraphobia as a complication of phenylketonuria (PKU) in young adults. The five patients have classic PKU and received phenylalanine-restricted diet only in childhood. Only one has normal intelligence. All but one were also depressed. All were anxious. Three of the five had initiated the phenylalanine-restricted diet after 3 months of age. Two returned to the phenylalanine-restricted diet with dramatic reduction of symptoms. The frequency of manifestations of agoraphobia was also examined in 50 young women with PKU enrolled in a longitudinal study of psychosocial factors in maternal PKU, 47 of their acquaintances and 49 women with diabetes. All were administered a test of agoraphobic-avoidant behaviour. The women with PKU appeared to be more prone to social withdrawal and fear of leaving home. Twenty per cent were within the agoraphobia range of the Mobility Inventory. Those still on diet and those with non-PKU hyperphenylalaninaemia reported less avoidant behaviour than those who had terminated the diet in childhood. These results suggest that young adults with PKU are at risk for agoraphobia but that return to the phenylalanine-restricted diet may be an effective treatment.

Adult↗

PubMed1990

The Agoraphobia Scale: an evaluation of its reliability and validity.

This article presents the Agoraphobia Scale (AS), and evidence for its reliability, validity, and sensitivity to change after treatment. The scale consists of 20 items depicting various typical agoraphobic situations, which are rated for anxiety/discomfort (0-4) and avoidance (0-2). The results show that AS has high internal consistency. Regarding concurrent validity it correlated significantly with other self-reported measures of agoraphobia (Mobility Inventory and Fear Questionnaire). The scale's predictive validity was shown as it correlated with avoidance behavior and self-rated anxiety during both an individualized and a standardized behavioral test of agoraphobia. The AS also discriminated between an agoraphobic sample and a normal sample, and a sample of simple phobia patients. Finally, it was sensitive to changes after behavioral treatment. The AS is useful both as a state, and as an outcome self-report measure of agoraphobia.

Adult↗

PubMed1990

Major depression and agoraphobia in patients with angiographically normal coronary arteries and panic disorder.

Patients with panic disorder and/or agoraphobia appearing in psychiatric settings report rates for lifetime major depression between 24% and 91%. Between 40% and 90% of patients with panic disorder in psychiatric populations report concomitant agoraphobia. A recent study of panic disorder subjects appearing in an outpatient cardiology clinic confirmed the strong link between panic and depression but found only a weak association between panic disorder and agoraphobia. In order to test the reliability of these outpatient cardiology findings, the authors studied major depression and agoraphobia in patients with angiographically normal coronary arteries and panic disorder. Twelve of the 32 (37.5%) panic disorder subjects reported a lifetime history of major depression (nine current, three past only). Only two of the 32 (six percent) reported any phobic avoidance. This study confirms the previous findings which suggest that major depression is common in cardiology populations with panic disorder and that phobic avoidance is uncommon in this group.

Adult↗

PubMed1991

Value of the Fear Questionnaire in differentiating agoraphobia and social phobia.

The present study examined responses on the Fear Questionnaire (FQ) of 68 patients suffering panic disorder with agoraphobia, 50 social phobics, 75 subjects with 'non-clinical' panic attacks, and 188 non-panicking controls. The FQ agoraphobia and social subscales had satisfactory internal consistency and were accurate (82%) in correctly differentiating the patients. In general, the patient and control groups differed as expected. The highest level of social fear was reported by social phobics and the highest level of agoraphobic fear was reported by patients with panic disorder and agoraphobia. Five items from these two subscales significantly differentiated social phobia from panic disorder with agoraphobia. The results support the reliability and validity of the FQ.

Adult↗

PubMedDate not supplied

Factors in the panic-agoraphobia transition.

A cause-and-effect relation between panic attacks and agoraphobia is an accepted concept. It is believed that, left unchecked, a subgroup of patients with panic attacks will consistently develop agoraphobia. However, to date, there are no means for early identification of this at-risk group. This study analyzed patients with panic attacks and phobic avoidance behaviors by using population-based, survey-collected data. Path analysis was used to determine relations among panic symptoms, phobic behaviors, panic-phobic lag times, and measures of pervasiveness and severity of fears and panic. Panic-related chest pain, dyspnea, trembling, and fear were important factors in the development, pervasiveness, and severity of situational fears and anticipatory anxiety. However, full-blown agoraphobia was only related to the presence of anticipatory anxiety and the pervasiveness of phobic avoidance behaviors. Although the age-of-onset of panic and phobic avoidance was unrelated to other factors, lag times were dependent upon panic symptomatology and the presence of depression. These findings suggest that patients with panic attacks who are at risk for agoraphobia can be identified by the nature of their panic symptoms, and perhaps, through early treatment, the development of phobic avoidance can be averted.

Agoraphobia↗

PubMed1989

CSF prostaglandin-E in agoraphobia with panic attacks.

Prostaglandins are thought to act as neuromodulators of both central catecholamine and endocrine systems. Abnormalities of these systems have been described in affective disorders, in general, and in agoraphobia with panic attacks, in particular. This study measured basal prostaglandin-E (PGE) cerebrospinal fluid (CSF) levels in 20 patients with agoraphobia with panic attacks and 10 nonpsychiatric controls. In a subgroup of patients and controls, CSF levels of adrenocorticotrophic hormone (ACTH) and corticotropin-releasing factor (CRF) were also measured. There was no significant difference in CSF PGE levels between patients and controls. However, patients with higher depression scores had lower CSF PGE levels. CSF PGE levels tended to correlate with CSF ACTH, but not CSF CRF in the patient group, in general, and in the female patients, in particular. These findings do not support an abnormality in basal CNS PGE production in agoraphobia with panic attacks, but suggest further study of the PGE modulatory effect on the hypothalamic-pituitary-adrenal axis in this disorder.

Adrenocorticotropic Hormone↗

PubMedDate not supplied

Hypochondriacal fears and beliefs in agoraphobia.

In order to evaluate hypochondriacal fears and beliefs in agoraphobia, the authors administered the self-rated Illness Attitude Scales to 18 agoraphobic patients. The patients reported hypochondriacal concerns similar to those of patients with hypochondriasis. After agoraphobia had been treated with exposure therapy in ten patients, hypochondriacal concerns did not differ significantly from those of normals. The findings suggest that hypochondriacal concerns are substantial in agoraphobia and that these wane when anxiety decreases.

Adult↗

PubMedDate not supplied

Follow-up study of patients with panic disorder and agoraphobia with panic attacks treated with tricyclic antidepressants.

One hundred and seven patients with panic disorder or agoraphobia with panic attacks were studied 1-4 years after treatment with a tricyclic antidepressant. At follow-up more than 80% of the patients remained symptomatic but fewer than half were experiencing panic attacks and only 40% were avoiding phobic situations. Although patients with agoraphobia were more severely ill and had been ill longer than those with panic disorder, their response to tricyclics and eventual outcome was similar to that for patients with panic disorder. Panic and agoraphobic patients who had the most severe symptoms initially showed the least improvement. The results suggest that panic disorder and agoraphobia with panic attacks are variants of a single illness and that, despite its chronicity, this illness has a favorable outcome.

Adult↗

PubMed1991

Characterological traits of recovered patients with panic disorder and agoraphobia.

Three self-rating personality inventories were administered to 33 patients who had recovered from panic disorder associated with agoraphobia and to 33 healthy subjects matched for sociodemographic variables. The personality inventories comprised the Tridimensional Personality Questionnaire (TPQ), which provides three major dimensions (novelty seeking, harm avoidance and reward dependence), the Anxiety Sensitivity Index (ASI) and the Emotional Inhibition Scale (EIS). Agoraphobic patients reported significantly more TPQ harm avoidance and anxiety sensitivity than controls. Although these findings might have been influenced by residual anxiety symptoms in panic-free patients and could also apply to patients with other anxiety disorders, they suggest that harm avoidance and anxiety sensitivity may be risk factors for developing agoraphobia and panic disorder. There may be overlap between this characterologic cluster and prodromal symptoms of panic disorder with agoraphobia, such as anxiety, phobias and hypochondriasis.

Adult↗

PubMed1985

Tritiated imipramine binding to platelets is decreased in patients with agoraphobia.

Controversy exists regarding the relationship between anxiety states and major depression. We studied the binding of tritiated imipramine to platelet membranes in order to determine if patients with agoraphobia and panic attacks differed from depressed subjects or healthy volunteers on this biological parameter. Mean (+/- SD) Bmax and Kd values were significantly lower in patients with agoraphobia and panic attacks (787 +/- 276 fmole/mg protein and 0.35 +/- 0.14 nM, respectively) than in healthy volunteers (1237 +/- 201 fmole/mg protein and 0.71 +/- 0.37 nM, respectively). In addition, patients with agoraphobia and panic attacks had binding parameters that were similar to those of patients with bipolar or familial pure depressive disorder, but significantly lower than those of patients with depressive spectrum or sporadic depressive disorder. These findings have implications for both the nosology and pathophysiology of anxiety disorders.

Adolescent↗

PubMed1989

The role of provocative visual stimuli in agoraphobia.

Three studies examine the role that provocative visual stimuli have in eliciting anxiety reactions in people with agoraphobia. Such stimuli elicit more anxiety in agoraphobic patients than control subjects. The effect of visual stimulation appears to be specific: (1) non-visual stimulation is without comparable effect; (2) both control and agoraphobic groups show similar effects of visual stimulation on another reaction such as headache. The anxiety effects of visual stimuli are correlated with the extent to which subjects experience depersonalization and somatic symptoms of agoraphobia, but not correlated with depression or the behavioural or cognitive aspects of agoraphobia. Alternative accounts of the possible role of visual stimulation in the anxiety reactions of agoraphobic patients are discussed.

Agoraphobia↗

PubMed1978

Relationship between agoraphobia and field dependence.

In recent years agoraphobia has been viewed by clinicians as etiologically distinct from other phobic disorders, with conflicts over the developmentally early issue of separation and individuation (self-other differentiation) playing a central role. In an effort to adduce quantitative evidence for this clinical observation, three groups of phobic patients (totaling 166 outpatients in all) were distinguished on the basis of their symptomatology (agoraphobia, simple phobias, and mixed phobias) and were individually administered the Group Embedded Figures Test as a measure of field dependence, a cognitive style dimension that according to Witkin is, at least in part, a manifestation of self-other differentiation. A one-way analysis of variance, performed separately for men and women for differences among the three phobic groups on field dependence, showed significance (rho less than .05) for the females, with the famale agoraphobic being more field dependent than the female simple phobic groups, but not for the males. Implications for the understanding of agoraphobia are discussed.

Adult↗

PubMed1992

The function of agoraphobia in the marital relationship.

A secondary analysis was carried out of data from a previous experiment on the treatment of agoraphobia. This analysis shows that, contrary to some reports in the literature, agoraphobics do have more problems in the relationship with their partner than the average members of the normal population. The analysis also shows that individual-oriented behavioural treatment of the agoraphobia significantly improves the marital relationship. The findings contradict the theory that agoraphobia serves a function in the relationship with the partner.

Adult↗

PubMed1990

Guttman scaling in agoraphobia: cross-cultural replication and prediction of treatment response patterns.

The Fear and Avoidance Scales (FAS) is an 11-item questionnaire consisting of two subscales that measure features of agoraphobia and claustrophobia and that were demonstrated to be valid Guttman scales in a British clinical population. The purposes of the study reported here were to replicate the scale characteristics in the United States and to determine if improvement during treatment would follow the sequence predicted by the hierarchy implied in the scales. The FAS was given to 25 female agoraphobics before and after behavioural treatment. A principal components analysis replicated the agoraphobia and claustrophobia factors established in the British sample. Scalogram analyses showed that the Claustrophobia subscale of the FAS was a valid Guttman scale in the US sample whereas the Agoraphobia subscale yielded a high coefficient of reproducibility but a low coefficient of scalability. Treatment reduced the patients' fears and avoidances in the predicted sequence since for both scales the hierarchy of items remained unchanged following treatment.

Adult↗