Marital Interactions in Predicting Treatment Outcome in Panic Disorder with Agoraphobia

Abstract

Abstract — T his study had two goals. First, it investigated marital interaction variables as predictors of treatment outcome in panic disorder with agoraphobia (PDA) in sixty-five couples with one spouse suffering from PDA. Second, it analyzed the impact of PDA improvement, following therapy, on marital interaction patterns of both spouses. The partners were observed during a problem-solving task, before and after treatment. Negative behaviors at the outset of therapy, both in the PDA and the NPDA partners, predicted less improvement at post-test. It also appears that improvement in some PDA symptoms following therapy is linked to increase in the dominant behavior of the NPDA spouse and to an improvement in terms of his intrusiveness. Keywords — Communication and problem-solving skills, Emotional overinvolvement, Marital relationship, Panic disorder with agoraphobia, Treatment outcome. . I. I NTRODUCTION ANIC disorder with agoraphobia (PDA) afflicts 1.5 to six percent of the population yearly [1], [2] and causes severe limitations to the individual and high costs for society [3]. When compared to individuals without PDA, PDA patients tend to be more dependent, less self-confident, more submissive, and more demanding towards their spouses and to generate fewer effective solutions during problem-solving tasks [4]-[7]. They are more likely to have the impression of being criticized and are more irritable and hostile [8]-[10]. Several studies link the onset, severity and evolution of PDA following treatment to interpersonal conflicts, marital stress, family problems, poor problem-solving skills, and expressed emotions in non-PDA spouses [6], [11]-[15]. Although PDA seems to negatively affect the couple, the marital relationship can contribute to the development and maintenance of the disorder.