Discriminating factors in panic disorder with and without agoraphobia

Abstract

Some individuals with recurrent panic attacks develop agoraphobia, while others maintain a Panic Disorder without avoidance behavior. One hypothesis is that more severe and frequent panic and anxiety symptoms lead to phobic avoidance, while Goldstein and Chambless (1978) argue that low self-sufficiency, a hysterical thought style, and fear of the symptoms of anxiety lead to phobic avoidance. Comparisons were made between 20 subjects having Panic Disorder without Agoraphobia and twenty subjects who met criteria for Panic Disorder with Agoraphobia. There were overall few differences found between the two patient groups, with no significant differences on measures of the severity and frequency of panic and anxiety symptoms. The Agoraphobia Cognitions Questionnaire discriminated significantly between the two groups ( p< .05), while the Body Sensations Questionnaire showed a trend towards significance, providing some limited support for the cognitive — behavioral model. A post hoc analysis revealed that the one item contributing significantly to a discriminant equation was “I am going to act foolish.” If replicated, these differences would suggest the importance of cognitive variables in the prevention and treatment of Panic Disorder with Agoraphobia and would indicate that interpersonal fears may play a more important role in agoraphobia than is generally considered.