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1
Wittmann, A., F. Schlagenhauf, A. Guhn, U. Lueken, C. Gaehlsdorf, M. Stoy, F. Bermpohl, et al. "Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia." Cambridge University Press, 2014. https://tud.qucosa.de/id/qucosa%3A39008.
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Background: Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia. Method. We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm). Results: During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures. Conclusions: This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobiaspecific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.
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Wittchen, Hans-Ulrich, Agnes Nocon, Katja Beesdo, Daniel S. Pine, Michael Höfler, Roselind Lieb, and Andrew T. Gloster. "Agoraphobia and Panic." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-100091.
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Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions.
Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview – Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14–24 years at baseline.
Results: (1) Incidence patterns for PA (9.4%), PD (with and without AG: 3.4%) and AG (5.3%) revealed differences in age of onset, incidence risk and gender differentiation. (2) Temporally primary PA and PD revealed only a moderately increased risk for subsequent onset of AG, and primary AG had an even lower risk for subsequent PA and PD. (3) In strictly prospective analyses, all baseline groups (PA, PD, AG) had low remission rates (0–23%). Baseline PD with AG or AG with PA were more likely to have follow-up AG, PA and other anxiety disorders and more frequent complications (impairment, disability, help-seeking, comorbidity) as compared to PD without AG and AG without PA.
Conclusions: Differences in incidence patterns, syndrome progression and outcome, and syndrome stability over time indicate that AG exists as a clinically significant phobic condition independent of PD. The majority of agoraphobic subjects in this community sample never experienced PA, calling into question the current pathogenic assumptions underlying the classification of AG as merely a consequence of panic. The findings point to the necessity of rethinking diagnostic concepts and DSM diagnostic hierarchies.
3
Pappas, Sylvie Rachelle. "The familial aggregation of agoraphobia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0017/MQ47079.pdf.
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Wittmann, André, Florian Schlagenhauf, Anne Guhn, Ulrike Lueken, Manja Elle, Meline Stoy, Carolin Liebscher, et al. "Effects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobia." Karger, 2018. https://tud.qucosa.de/id/qucosa%3A38916.
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Background: Patients suffering from panic disorder and agoraphobia are significantly impaired in daily life due to anxiety about getting into a situation due to apprehension about experiencing a panic attack, especially if escape may be difficult. Dysfunctional beliefs and behavior can be changed with cognitive behavioral therapy; however, the neurobiological effects of such an intervention on the anticipation and observation of agoraphobia-specific stimuli are unknown. Methods: We compared changes in neural activation by measuring the blood oxygen level-dependent signal of 51 patients and 51 healthy controls between scans before and those after treatment (group by time interaction) during anticipation and observation of agoraphobia-specific compared to neutral pictures using 3-T fMRI. Results: A significant group by time interaction was observed in the ventral striatum during anticipation and in the right amygdala during observation of agoraphobia-specific pictures; the patients displayed a decrease in ventral striatal activation during anticipation from pre- to posttreatment scans, which correlated with clinical improvement measured with the Mobility Inventory. During observation, the patients displayed decreased activation in the amygdala. These activational changes were not observed in the matched healthy controls. Conclusions: For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorderspecific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.
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Goodwin, Renee D., Carlo Faravelli, S. Rosi, F. Cosci, E. Truglia, Ron de Graaf, and Hans-Ulrich Wittchen. "The epidemiology of panic disorder and agoraphobia in Europe." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110237.
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A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7–2.2) and 1.3% (0.7–2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.
6
Fell, Alison. "Agoraphobia : mental disorder or societal constraint? : a gendered exploration of symptoms of agoraphobia in a non-clinical population." Thesis, University of East London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532493.
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The first aim of the research was to extend the work of Gelfond (1991) to consider how far the symptoms of agoraphobia were present in a non-clinical sample of males and females. This was achieved using both statistical and qualitative (Interpretative Phenomenological Analysis) methods. The results indicated that both male and female participants' experience discomfort when alone in public places on a continuum with clinical descriptions of agoraphobia. Two differences between clinical and non-clinical accounts were identified. The first being that differences appeared to be dimensional (e. g. intensity, preoccupation). Secondly, non-clinical participants' accounts did not describe 'catastrophic misinterpretations' of physiological arousal as seen in clinical accounts. The second aim of the research related to how a gender analysis of male and female participants' accounts of their use of public places alone would contribute to our understanding of agoraphobia. Statistical results suggested that only female participants were significantly avoidant of public places alone compared to when they were accompanied. In addition, three qualitative tools of analysis (Interpretative Phenomenological Analysis, Rhetorical Discourse Analysis and Foucauldian Analysis) were adopted. These analyses highlighted social processes by which lone women may experience greater discomfort than lone men in public places, as well as exploring how such processes predispose males and females to react to discomfort in different ways. It is argued that these social processes 'prepare' women, in particular, for anxiety and avoidance on a continuum with symptoms of agoraphobia. This in turn provides an explanation as to why the majority of those diagnosed with agoraphobia are women. This poses questions for the assertion in DSM IV (American Psychiatric Association, 1994) that social practices that restrict women's use of public places should be distinguished from agoraphobia. Clinical and research implications are discussed.
7
Capreol, Martha Jean. "Chronic construct accessibility in socially phobic and agoraphobic outpatients." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/30421.
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According to theories of social cognition, individuals screen incoming information from the environment using certain cognitive constructs (Wyer & Srull, 1986). Personally relevant construct systems develop from an individuals's particular history of social interactions (Wyer & Srull, 1986). A concern in social cognition theory is whether there are cognitive processes specific to different complaints (Beck & Emery, 1985). This study investigated whether the content of chronically accessible or salient constructs interpersonal constructs could differentiate individuals with social fears from those with different emotional complaints. The accessibility and salience of social constructs of social phobics, agoraphobics, and normal subjects were examined. No differences were found between the groups on an unstructured measure of construct accessibility. Group differences did emerge on a structured task reflecting salience of specific traits. Individuals with agoraphobia reported that they would be more attentive to the dimensions supportive-critical and enabling-bossy. This is consistent with current conceptualizations of agoraphobics as individuals who do not feel they can cope with the dangers of the outside world, and are compelled to seek help from a 'caregiver' (Beck & Emery, 1985). Social phobics reported that they would not be particularly attentive to any of the traits. This may be a result of socially phobic individuals self-focused attention.Arts, Faculty of
Psychology, Department of
Graduate
8
Dijkman-Caes, Chantal Irma Mauricette. "Panic disorder and agoraphobia in daily life." [Maastricht : Maastricht : Rijksuniversiteit Limburg] ; University Library, Maastricht University [Host], 1993. http://arno.unimaas.nl/show.cgi?fid=6673.
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Hodgson, D. L. "Self-help in the treatment of agoraphobia." Thesis, University of Sussex, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.373151.
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McCarthy, Lisa Kay. "Agoraphobia and Interpersonal Relationships: Theory and Research." W&M ScholarWorks, 1994. https://scholarworks.wm.edu/etd/1539625929.
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Goodwin, Renee D., Carlo Faravelli, S. Rosi, F. Cosci, E. Truglia, Ron de Graaf, and Hans-Ulrich Wittchen. "The epidemiology of panic disorder and agoraphobia in Europe." Technische Universität Dresden, 2005. https://tud.qucosa.de/id/qucosa%3A26823.
Full textAbstract:
A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7–2.2) and 1.3% (0.7–2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.
12
Gournay, Kevin. "Agoraphobia : a study of the syndrome and its treatment." Thesis, University of Leicester, 1985. http://hdl.handle.net/2381/34658.
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The basis of the thesis is a treatment outcome study of agoraphobia which took place over a 4 year period. 132 subjects met inclusion criteria and 100 completed a trial of treatment using a standard exposure in vivo programme with follow-up to 1 year. Of the 32 subjects who refused or dropped out, 21 subjects were followed up to 1 year. Chapter One of the thesis reviews the literature on the nature of agoraphobia. Chapter Two reviews the literature on exposure treatment and describes the outcome of such treatment with the study population. Also included was a comparison of treatment base (home or out-patient clinic) and an assessment of the relationship between marital satisfaction and outcome and some other minor variables. Chapter Three reviews the relevant literature on treatment failure and describes a study of the 60 treatment failures in the study (i.e. drop outs, treatment refusers, treatment non-responders and treatment relapsers). This was effected by statistical analyses of the measures used in Chapter Two and additional questionnaire data. Chapter Four reviews the relevant literature on cognitive variables and describes a study of cognitive processing in 12 of the study subjects. The principal measures used were those of subjective probability and value of aversive outcome, rated over treatment for six target behaviours for each subject. Chapter Five reviews the relevant literature on sex role variables and describes a study of the differential outcome of the 102 females and 30 male subjects, and of the subjects' responses to a measure of sex role stereotyping. The thesis concludes with a summary which attempts to integrate the findings of the various chapters.
13
Fink, Janet Lynn. "The Evaluation of treatments for agoraphobia and panic disorders a meta-analytic review /." Access abstract and link to full text, 1992. http://0-wwwlib.umi.com.library.utulsa.edu/dissertations/fullcit/9222147.
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Angle, Susan Pugh. "Perceptions of College Students Diagnosed with Panic Disorder with Agoraphobia: Academic, Psychosocial, and Environmental Views of their College Experience." Diss., Virginia Tech, 1999. http://hdl.handle.net/10919/28107.
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The number of reported students with psychiatric disabilities who are seeking services and/or accommodations is steadily increasing on college campuses. Much of the research and documentation that surround the study of college students with psychiatric disorders is extremely broad in focus and tends to group all psychiatric diagnoses together when reporting outcome studies.
The research literature that is devoted to the study of the college student diagnoses with Panic Disorder with Agoraphobia is limited in scope and nature. The majority of the literature is devoted to the physiological and behavioral ramifications of the disorder or treatment modalities. a review of the extant literature reveals that there is no substantive research available that provides insight into the college experiences of the student diagnoses with Panic Disorder with Agoraphobia.
In summary, it is safe to say that there is not enough pertinent information readily available to enlighten college and university faculty and staff about the experiences of college students diagnosed with Panic Disorder with Agoraphobia. specifically, little is known about: (1) the academic, psychosocial, and environmental needs of these students (2) what disability related barriers these student may have experienced (3) what coping mechanisms are typically employed, and (4) what services and accommodations these students have found to be the most effective while they were enrolled in college.
The purpose of this study was to examine the nature and the scope of the college experiences of students who were diagnosed with Panic Disorder with Agoraphobia. The subjects for this study consisted of a select group of upperclassmen at Virginia Tech. Gender or age was not a factor in the selection process. For purposes of this study, the qualitative in-depth interview method was considered the most appropriate form of data collection.
Analysis of the data revealed the following common experiences among the subjects in the study: (1) All subjects experienced difficulties in the classroom due to their Panic Disorder. (2) All of the subjects had concerns with the physical setting of the campus (i.e. preferential seating, avoidance of large classrooms and auditoriums, and anxiety-like symptoms as the result of bright or fluorescent lighting). (3) A lack of social contacts both in and out of the classroom was a common experience. (4) While all subjects had tried medication to control their Panic Disorder, two of the subjects stopped their medication even though they reported an improvement I their symptoms. The majority of the subjects stated that they did not want to remain on the medication for fear of addiction or using the medication as a "crutch." (5) All of the subjects sought out counseling while attending Virginia Tech. All of the subjects, with the exception of one, did not seek any treatment for their anxiety of Panic Attacks until after they arrived at Virginia Tech. (6) All of the subjects, with the exception of one suffered with either chronic anxiety, or Panic Attacks for over one year before seeking any medical relief or counseling. (7) All of the subjects reported that counseling was helpful and for the most part, they all tried to use relaxation techniques when experiencing a Panic Attack. (8) All of the subjects are still having difficulty with chronic anticipatory anxiety and occasional Panic Attacks. (9) While the majority of the subjects interviewed were optimistic about their career options, it was evident that all of the subjects have encountered significant anxiety-related barriers that have impacted their choice of major and possible future jobs. the majority of the subjects reported that it was important to have a job where the workload was not too stressful and the workplace was viewed as a "safe" environment.Ph. D.
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Wittchen, Hans-Ulrich, Agnes Nocon, Katja Beesdo, Daniel S. Pine, Michael Höfler, Roselind Lieb, and Andrew T. Gloster. "Agoraphobia and Panic: Prospective-Longitudinal Relations Suggest a Rethinking of Diagnostic Concepts." Karger, 2008. https://tud.qucosa.de/id/qucosa%3A25264.
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Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions.
Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview – Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14–24 years at baseline.
Results: (1) Incidence patterns for PA (9.4%), PD (with and without AG: 3.4%) and AG (5.3%) revealed differences in age of onset, incidence risk and gender differentiation. (2) Temporally primary PA and PD revealed only a moderately increased risk for subsequent onset of AG, and primary AG had an even lower risk for subsequent PA and PD. (3) In strictly prospective analyses, all baseline groups (PA, PD, AG) had low remission rates (0–23%). Baseline PD with AG or AG with PA were more likely to have follow-up AG, PA and other anxiety disorders and more frequent complications (impairment, disability, help-seeking, comorbidity) as compared to PD without AG and AG without PA.
Conclusions: Differences in incidence patterns, syndrome progression and outcome, and syndrome stability over time indicate that AG exists as a clinically significant phobic condition independent of PD. The majority of agoraphobic subjects in this community sample never experienced PA, calling into question the current pathogenic assumptions underlying the classification of AG as merely a consequence of panic. The findings point to the necessity of rethinking diagnostic concepts and DSM diagnostic hierarchies.
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Lewis, Susanne. "Agoraphobia in women : associated factors, therapy techniques and their outcomes /." Title page, contents and abstract only, 1985. http://web4.library.adelaide.edu.au/theses/09P/09pl676.pdf.
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Siegel, Suzie. "Safe at Home: Agoraphobia and the Discourse on Women’s Place." Scholar Commons, 2001. http://scholarcommons.usf.edu/etd/3881.
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My thesis explores how discourse and material practices have created agoraphobia, the fear of public places. This psychological disorder predominates among women. Throughout much of Western history, women have been encouraged to stay home for their safety and for the safety of society. I argue that agoraphobic women have internalized this discourse, expressing fears of being in public or being alone without a companion to support and protect them; losing control over their minds or their bodies; and endangering or humiliating themselves. Therapeutic discourse also has created agoraphobia by naming it, categorizing the emotions and behaviors associated with it, and describing the characteristics of agoraphobics. The material practice of therapy reinforces this discourse. Meanwhile, practices such as rape and harassment reinforce the dominant discourse on women’s safety.
I survey psychological literature, beginning with the naming of agoraphobia in 1871, to explain why the disorder is now diagnosed primarily in women. I examine nineteenth-century discourse that told women they belonged at home while men controlled the public domain. In 1871, the Paris Commune revolt epitomized the fear of women publicly out of control. I return to Paris a century later for a reading of the novel
Certificate of Absence, in which Sylvia Molloy explores identity through the eyes of a woman who might be labeled agoraphobic. I ask whether homebound women are resisting or retreating from a hostile world. Instead of seeing agoraphobia only as a personal problem, people should question why so many women fear themselves and the world outside their home.
My methodology includes an analysis of nineteenth-century texts as well as current media, prose, and poetry. I also support my arguments with material from professional journals and nonfiction books in different disciplines. Common to feminist research, an interdisciplinary approach was needed to situate a psychological disorder within a social context.
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Sharp, Donald MacFie. "The psychological and pharmacological treatment of panic disorder and agoraphobia in primary care." Thesis, University of Stirling, 1997. http://hdl.handle.net/1893/21521.
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Following a review of treatment outcome study methodology, a comparative study of psychological versus pharmacological treatments was conducted; subsidiary studies investigated aspects of treatment outcome in more detail. 193 patients with DSM III-R panic disorder with or without agoraphobia were randomly allocated to; fluvoxamine, placebo, fluvoxamine + CBT (cognitive behaviour therapy), placebo + CBT, or CBT alone. Patients received no concurrent treatments and were treated to the same schedule, with therapist contact balanced across groups. Treatments were conducted in the primary care setting. Outcome at treatment end-point and 6 month follow-up, assessed in terms of both statistical and clinical significance, showed patients receiving active treatments improved significantly, with improvement better preserved over follow-up in the groups receiving CBT. The CBT alone and fluvoxamine + CBT groups showed the most consistent gains, the latter group showing gains earliest in treatment. Outcome was also investigated using brief global ratings of symptom severity, change in symptoms following treatment, general wellbeing and social disruption, completed by psychologist, referring GPs, and patients. Using these measures all active treatments showed statistical advantage over placebo with the groups employing CBT showing the most robust and consistent response. Overall there were no significant differences in drop-out rates between groups although the drop-out rate for patients receiving CBT alone was higher than that for placebo + CBT. Agreement with main outcome measures was demonstrated for psychologist and patient ratings, but not for GP ratings. An investigation of panic attack variables as treatment outcome measures indicated that these did not function as discriminative treatment outcome measures with all treatment groups showing significant reductions in panic attack variables over treatment with few significant differences between treatment groups on any variable throughout treatment. An investigation of prognostic indicators of treatment outcome indicated good prediction of post treatment response using pre-treatment measures of anxiety level, frequency of panic attacks, extroversion and treatment group. Predictions of outcome at 6 month follow-up were less robust. Results are discussed in terms of their relevance to wider clinical practice.
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Davidson, Joyce. "Agoraphobic geographies : an exploration of subjectivity and socio-spatial anxiety." Thesis, University of Edinburgh, 2001. http://hdl.handle.net/1842/15802.
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This thesis examines the phenomenology and significance of agoraphobia for its mostly women sufferers, principally by means of in-depth individual and group interviews. It argues that agoraphobia, typically characterised by fear and avoidance of social spaces, can be usefully conceptualised in terms of a 'crisis' in the boundaries of the embodied self. That is to say, the disorder radically problematizes the distinction individuals 'normally' experience between 'inner' self and 'outer' space, initiating a profound sense of exposure and insecurity in the face of many social situations. In response, sufferers retreat from the social sphere to the seclusion of their homes, whose walls serve to reinforce their weakened and fragile boundaries. The initial impetus behind this project stems from the fact that, while there has been no shortage of clinical research conducted on agoraphobia, it has received very little attention outside bio-medical and psychological contexts. Chapter l reviews relevant bodies of literature and highlights some of the gaps the project seeks to address. Chapter 2 offers a detailed account of the research design, and the ways in which data were generated and analysed, while chapter 3 offers reflections on what was found to be the 'processual' nature of qualitative research. In each of the five substantive chapters that remain, the thesis interweaves experiential accounts with existential problematics, and presents a general movement from concerns with theory to therapy. It also follows the unfolding development of the existential and phenomenological tradition. Chapter 4 links the more esoteric and subjectivist existentialism of Kierkegaard with experiential accounts of consumption, and chapter 5 explores the socially grounded work of Sartre in relation to sufferers' accounts of extreme discomfort in the public eye. Chapters 6 and 7 utilise the explicitly spatial, embodied, and inter-subjective account of existentialism presented by Merleau-Ponty to present first, a case study, and second, an analysis of sufferers' accounts of pregnancy. In this way the thesis ii also moves from abstract philosophical arguments about the human condition per se to a more nuanced feminist geography capable of accounting for the diversity of experiences of agoraphobia and its gendered relations to pa11icular times and places. In its final chapter, the thesis turns to an explicit discussion of treatment, and critiques the unacknowledged predominance of and reliance on masculinist Cartesian conceptions of selfhood within self-help resources, questioning what treatment based on models of embodied subjectivity more inclusive of unusual spatial relations might look like. In its conclusion, the thesis suggests that by taking account of personal narratives of agoraphobia, and of its wider social contexts and relations, a sensitive, sympathetic and fully spatialised account of the disorder more faithful to the way sufferers actually describe their experiences can be offered.
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Reuter, Shelley Z. ""The very opposite of calm", a socio-cultural history of agoraphobia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ63447.pdf.
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Lemon, David John. "Living in the shadow of fear: an interactionist examination of agoraphobia." Thesis, University of Canterbury. Sociology, 2004. http://hdl.handle.net/10092/921.
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This thesis investigates the experience of agoraphobia among one hundred research participants by focusing on how social interactions contribute to the onset, the unmanaged symptoms stage, and the managed symptoms stage of this anxiety disorder. The study investigates how social interactions such as family upbringings, familial stressful events, one-off and clusters of traumatic events and accumulated stressful events can contribute to the onset of agoraphobia. It examines how research participants' social interactions during their primary and secondary school years, youth, everyday life, travel, marriage/intimate relationships, parenting, post secondary education and employment were affected during the unmanaged symptom stage of agoraphobia. Participants' experiences of the public perception of agoraphobia, stigma and discrimination, coming out experiences and family and friends' reaction to agoraphobia are also explored. The third stage of the study examines social interactions that hinder or promote the management of agoraphobia. The former are found to include hiding panic attacks, making excuses, using flawed personal coping mechanisms and alcohol. Social interactions that were found to assist in the management of agoraphobia include labelling and learning about the mental illness from others, using companions in public places and situations, and seeking help from knowledgeable health professionals. Other forms of interaction that helped with management included participants' usage of Internet chat-rooms and websites as well as the discovery of faith and spiritual experience. Finally the study investigates research participants' changed social interactions following their emergence from the shadow of agoraphobia.
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Brown, A. T. "Coping with agoraphobia : A study of strategies and help-seeking behaviour." Thesis, University of Southampton, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.375511.
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Richter, Jan, Alfons O. Hamm, Christiane A. Pané-Farré, Alexander L. Gerlach, Andrew T. Gloster, Hans-Ulrich Wittchen, Thomas Lang, et al. "Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120100.
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Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG).
Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test.
Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks.
Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder.
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Self, Carolyn. "Comparison of the Effectiveness of Two Interentions for the Treatment of Agoraphobia." Thesis, University of North Texas, 1989. https://digital.library.unt.edu/ark:/67531/metadc332272/.
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The problem with which this investigation was concerned is that of treating agoraphobia with cognitive-behavioral group therapy and cognitive-behavioral group therapy combined with the drug alprazolam (Xanax). The purpose of the research was twofold. The first goal was to determine the relative effectiveness of the two treatment conditions on phobic behavior, anxiety, and depression. A second goal was to analyze the results and make recommendations concerning each of these modalities available to agoraphobics, their families, and to treatment specialists. The research design of this study was a randomized, pretest-posttest, experimental group design. The sample (N = 15) consisted of Group I (N = 7), who received behavioral-cognitive group therapy combined with the medication alprazolam, and Group II (N = 8), who received behavioral-cognitive group therapy only. The treatment included 15, 2-hour weekly group sessions, with the addition of a brief medication evaluation prior to each group meeting for Group I. During these sessions, the subjects received information about agoraphobia in the form of brief didactic segments, treatment materials, homework assignments, group interaction, and various forms of desensitization. Based on the findings of this study, the following conclusions were drawn: 1. Multidimensional behavioral-cognitive group therapy can significantly reduce phobic avoidance, anxiety, and depression associated with agoraphobia; and 2. Multidimensional behavioral-cognitive group therapy in combination with administration of alprazolam, can significantly reduce phobic avoidance and anxiety associated with agoraphobia.
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Lüken, Ulrike, Markus Mühlhan, Hans-Ulrich Wittchen, Thilo Kellermann, Isabelle Reinhardt, Carsten Konrad, Thomas Lang, et al. "(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-120053.
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Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.
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Richter, Jan, Alfons O. Hamm, Christiane A. Pané-Farré, Alexander L. Gerlach, Andrew T. Gloster, Hans-Ulrich Wittchen, Thomas Lang, et al. "Dynamics of Defensive Reactivity in Patients with Panic Disorder and Agoraphobia: Implications for the Etiology of Panic Disorder." Technische Universität Dresden, 2012. https://tud.qucosa.de/id/qucosa%3A27104.
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Background: The learning perspective of panic disorder distinguishes between acute panic and anxious apprehension as distinct emotional states. Following animal models, these clinical entities reflect different stages of defensive reactivity depending upon the imminence of interoceptive or exteroceptive threat cues. The current study tested this model by investigating the dynamics of defensive reactivity in a large group of patients with panic disorder and agoraphobia (PD/AG).
Methods: Three hundred forty-five PD/AG patients participated in a standardized behavioral avoidance test (being entrapped in a small, dark chamber for 10 minutes). Defense reactivity was assessed measuring avoidance and escape behavior, self-reports of anxiety and panic symptoms, autonomic arousal (heart rate and skin conductance), and potentiation of the startle reflex before and during exposure of the behavioral avoidance test.
Results: Panic disorder and agoraphobia patients differed substantially in their defensive reactivity. While 31.6% of the patients showed strong anxious apprehension during this task (as indexed by increased reports of anxiety, elevated physiological arousal, and startle potentiation), 20.9% of the patients escaped from the test chamber. Active escape was initiated at the peak of the autonomic surge accompanied by an inhibition of the startle response as predicted by the animal model. These physiological responses resembled the pattern observed during the 34 reported panic attacks.
Conclusions: We found evidence that defensive reactivity in PD/AG patients is dynamically organized ranging from anxious apprehension to panic with increasing proximity of interoceptive threat. These data support the learning perspective of panic disorder.
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Lüken, Ulrike, Markus Mühlhan, Hans-Ulrich Wittchen, Thilo Kellermann, Isabelle Reinhardt, Carsten Konrad, Thomas Lang, et al. "(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session." Technische Universität Dresden, 2011. https://tud.qucosa.de/id/qucosa%3A27099.
Full textAbstract:
Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.
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Lueken, U., B. Straube, I. Reinhardt, N. I. Maslowski, H. U. Wittchen, A. Ströhle, A. Wittmann, et al. "Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia." Cambridge University Press, 2014. https://tud.qucosa.de/id/qucosa%3A39007.
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Background: Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients.
Method: The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls.
Results: Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation.
Conclusions: The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
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Ramnerö, Jonas. "Behavioral Treatments of Panic Disorder with Agoraphobia : Treatment Process and Determinants of Change." Doctoral thesis, Stockholm University, Department of Psychology, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-404.
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The present dissertation comprises four empirical studies within the area of behavioral treatment of panic disorder with agoraphobia. The focus is on studying issues pertaining to outcome, treatment process and determinants of change. The first study is a randomized controlled treatment study of 73 patients undergoing 16 sessions of either exposure in vivo (E), or cognitive behavior therapy (CBT). Both treatments showed clear improvements at post-treatment that were well maintained at 1-year follow up, and there were no significant differences between the treatments.
The second study concerned prediction of outcome in the same sample. From a variety of pre-treatment characteristics severity of avoidance was the one most related to outcome. Most predictors were found unrelated. Two approaches of prediction were also compared: treating outcome as a categorical vs. continuous variable. The different approaches yielded a somewhat dissimilar picture of the impact of pre-treatment severity of avoidance. The third study examined different aspects of the therapeutic relationship, and their relation to outcome. Clients’ perceptions of therapists and their ratings of the working alliance were generally not related to outcome at any point. On the other hand, therapists’ perceptions of patients as showing goal-direction and active participation were related to outcome from early on in therapy. The fourth study examined different aspects of change. It was found that change in indices of the frequency of panic attacks was not closely related to change in agoraphobic avoidance at post-treatment. Change in avoidance was also more related to other aspects of outcome. At one-year follow-up, a more unitary picture, regarding the different aspects of change was observed.
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Ramnerö, Jonas. "Behavioral treatments of panic disorder with agoraphobia : treatment process and determinants of change /." Stockholm : Department of Psychology [Psykologiska institutionen], Stockholm University, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-404.
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Shapiro, David Morris. "An experimental investigation of the relationship between physiological arousal, panic expectancy and agoraphobia." Diss., Virginia Tech, 1991. http://hdl.handle.net/10919/39446.
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Gould, Robert Andrew. "The use of a self-help treatment intervention for panic disorder with agoraphobia." Diss., Virginia Tech, 1993. http://hdl.handle.net/10919/38543.
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A recent study suggested that bibliotherapy may be an effective intervention for panic disordered individuals with agoraphobia. The present study attempted to enhance this bibliotherapy intervention by adding audio- and videotape self-help supplements. Thirty subjects suffering panic disorder with mild to moderate agoraphobia were matched on level of avoidance and then randomly assigned to 1) a Wait-list control condition (WL). or 2) a Self-help condition (SH). The intervention lasted four weeks followed by an eight week post treatment phase. and follow-up measures at the end of this phase. Results indicated that, from pre-treatment to follow-up, SH subjects improved significantly on 11 of the 12 dependent measures used in this study. while WL subjects did not. Furthermore. SH subjects were significantly more improved than WL subjects at follow-up with regard to agoraphobic avoidance, coping with panic attacks, self efficacy for mild, moderate and severe attacks, and for two critical measures of distress: frequency of panic attacks. and total severity of each attack. Clinical outcome measures also supported the effectiveness of the self-help approach. More than two-thirds of SH subjects met the criteria for clinical improvement. While only one-quarter of WL subjects met these criteria. Implications for the treatment of panic disordered individuals are discussed, as is the role of self-efficacy in mediating clinical change.Ph. D.
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Lang, Thomas, Sylvia Helbig-Lang, Andrew T. Gloster, Jan Richter, Alfons O. Hamm, Lydia Fehm, Thomas Fydrich, et al. "Effekte therapeutenbegleiteter versus patientengeleiteter Exposition bei Panikstörung mit Agoraphobie." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-117711.
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Theoretischer Hintergrund: Die Rolle der Therapeutenbegleitung während Expositionsübungen bei Panikstörung mit Agoraphobie (P/A) ist bislang ungeklärt. Eine kürzlich durchgeführte klinische Studie (MAC-Studie) lieferte Hinweise auf ein günstigeres Behandlungsergebnis bei Therapeutenbegleitung. Fragestellung: Wie lassen sich Effekte therapeutenbegleiteter Exposition (T+) im Vergleich zu Exposition ohne Therapeutenbegleitung (T–) erklären? Methode: Daten von 301 Patienten, die eine expositionsbasierte KVT mit bzw. ohne Therapeutenbegleitung erhalten hatten, wurden analysiert. Untersucht wurden der Einfluss der initialen Störungsschwere, des Sicherheitsverhaltens sowie differenzielle Effekte der Bedingungen auf die Angst vor der Angst. Zusätzlich wurde überprüft, inwieweit die Übungshäufigkeit in den Behandlungsbedingungen variiert und einen Mediator des Behandlungserfolgs darstellt. Ergebnisse: Störungsschwere und Sicherheitsverhalten zeigten keine differenziellen Effekte zwischen den Bedingungen; die T+ Bedingung führte jedoch zu stärkeren Reduktionen der Angst vor der Angst im Angstsensitivitätsindex. Patienten der T+ Bedingung führten häufiger selbständig Expositionsübungen durch, während Patienten in T– im Durchschnitt länger übten. Die Übungshäufigkeit stellte dabei einen Mediator des Behandlungserfolgs dar. Schlussfolgerungen: Günstigere Effekte einer therapeutenbegleiteten Exposition gehen auf stärkere Reduktionen der Angst vor der Angst sowie auf eine höhere Übungshäufigkeit im Selbstmanagement zurückTheoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapist-guided exposure compared to programmed practice. Objectives: Examining potential mechanisms of therapist-guided exposure. Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework. Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome. Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear
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Gloster, Andrew T., Hans-Ulrich Wittchen, Franziska Einsle, Michael Höfler, Thomas Lang, Sylvia Helbig-Lang, Thomas Fydrich, et al. "Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-106614.
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Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
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Gloster, Andrew T., Hans-Ulrich Wittchen, Franziska Einsle, Michael Höfler, Thomas Lang, Sylvia Helbig-Lang, Thomas Fydrich, et al. "Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia." Technische Universität Dresden, 2009. https://tud.qucosa.de/id/qucosa%3A26684.
Full textAbstract:
Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
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Al-Qasem, Ruby. "True Selves: Narrative Distance in Stories of Fiction and Nonfiction." Thesis, University of North Texas, 2009. https://digital.library.unt.edu/ark:/67531/metadc12069/.
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True Selves: Narrative Distance in Stories of Fiction and Nonfiction consists of a scholarly preface and four creative works. The preface discusses narrative distance as used in both fiction and nonfiction, and as compares to other narrative agents such as point of view, especially in contemporary creative writing. The selection of stories examines relationships, especially familial, and themes of isolation, community, and memory. Collection includes two chapters of a novel-in-progress, Fences, short fiction story "Trees and Furniture," and creative nonfiction essays, "Floating" and "On the Sparrow."
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Siegel, Suzie. "Safe at home [electronic resource] : agoraphobia and the discourse on women's place / by Suzie Siegel." University of South Florida, 2002. http://purl.fcla.edu/fcla/etd/SFE0000025.
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Title from PDF of title page.Document formatted into pages; contains 90 pages.
Thesis (M.A.)--University of South Florida, 2001.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
ABSTRACT: My thesis explores how discourse and material practices have created agoraphobia, the fear of public places. This psychological disorder predominates among women. Throughout much of Western history, women have been encouraged to stay home for their safety and for the safety of society. I argue that agoraphobic women have internalized this discourse, expressing fears of being in public or being alone without a companion to support and protect them; losing control over their minds or their bodies; and endangering or humiliating themselves. Therapeutic discourse also has created agoraphobia by naming it, categorizing the emotions and behaviors associated with it, and describing the characteristics of agoraphobics.
The material practice of therapy reinforces this discourse. Meanwhile, practices such as rape and harassment reinforce the dominant discourse on women&softsign;s safety. I survey psychological literature, beginning with the naming of agoraphobia in 1871, to explain why the disorder is now diagnosed primarily in women. I examine nineteenth-century discourse that told women they belonged at home while men controlled the public domain. In 1871, the Paris Commune revolt epitomized the fear of women publicly out of control. I return to Paris a century later for a reading of the novel Certificate of Absence, in which Sylvia Molloy explores identity through the eyes of a woman who might be labeled agoraphobic.
I ask whether homebound women are resisting or retreating from a hostile world. Instead of seeing agoraphobia only as a personal problem, people should question why so many women fear themselves and the world outside their home.My methodology includes an analysis of nineteenth-century texts as well as current media, prose, and poetry. I also support my arguments with material from professional journals and nonfiction books in different disciplines. Common to feminist research, an interdisciplinary approach was needed to situate a psychological disorder within a social context.
System requirements: World Wide Web browser and PDF reader.
Mode of access: World Wide Web.
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Kirby, Peter F. "The combined use of cognitive-behavioural therapy with Parkinson's Law in the treatment of agoraphobia." Thesis, Keele University, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.314801.
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Winnette, Miles. "Frankel's Hypothesis of a Relation Between Phobic Symptoms and Hypnotic Responsiveness: Its Generalization to Agoraphobia." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc501266/.
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The present study was designed to test Frankel and Orne's hypothesis that persons with a clinically significant phobia also show high susceptibility to hypnosis. The hypnotic susceptibility scores of 10 persons who sought treatment with hypnosis for agoraphobia were compared with the susceptibility scores of a control group of 20 persons having comparable motivation to succeed in hypnosis. The susceptibility measure was the Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C, Weitzenhoffer & Hilgard, 1962). The groups were also compared on: a) the Archaic Involvement Measure (AIM; Nash, 1984); b) the Field Depth Inventory (FDI; Field, 1965); and c) the Tellegen Absorption Scale (TAS; Tellegen & Atkinson, 1974). No significant differences were found between the groups on the dependent measures. Factors which qualify the results are discussed.
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Gloster, Andrew T., Rainer Sonntag, Jürgen Hoyer, Andrea H. Meyer, Simone Heinze, Andreas Ströhle, Georg Eifert, and Hans-Ulrich Wittchen. "Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial." Karger, 2015. https://tud.qucosa.de/id/qucosa%3A71640.
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Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-ofprinciple data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed.
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Carlbring, Per. "Panic! Its Prevalence, Diagnosis and Treatment via the Internet." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4148.
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Drobny, Juliette Victoria. "Relationships between treatment knowledge, beliefs and outcome following cognitive behaviour therapy for panic disorder and agoraphobia." University of Sydney, 2010. http://hdl.handle.net/2123/6621.
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Doctor of Philosophy (PhD)The purpose of this thesis was to investigate relationships between treatment knowledge, beliefs and outcome in Panic Disorder and/or Agoraphobia (Panic-Ag). Research from the psychotherapy and medical literature indicates patients’ treatment knowledge and beliefs, specifically acceptance of the treatment rationale (ATR), expectancies of treatment outcome (ETO) and treatment self-efficacy (TSE), are associated with clinical outcomes for a range of disorders. However, methodological limitations surrounding measurement of these constructs have undermined conclusions and/or such relationships have not been investigated in the field of Panic-Ag. Relationships between treatment knowledge, beliefs and outcome in Panic-Ag were examined using a 2 phase procedure. Phase 1 involved developing measures of treatment knowledge, ATR, ETO and TSE using patient and clinician samples. The psychometric properties of these measures were found to be satisfactory. Phase 2 investigated associations between treatment knowledge, beliefs and outcome following cognitive behaviour therapy (CBT) among 41 Panic-Ag participants. Measures were administered at pretreatment and 6-months posttreatment. It was hypothesised that treatment knowledge, ATR, ETO and TSE would be related to outcome, with associations mediated by belief in catastrophic cognitions. Of 4 Panic- Ag outcome measures (panic attack frequency, panic sensation severity, frequency of catastrophic cognitions and agoraphobic avoidance), results indicated improved treatment knowledge was significantly associated with frequency of catastrophic cognitions and agoraphobic avoidance. Posttreatment TSE was significantly associated with panic attack sensation severity, frequency of catastrophic cognitions and agoraphobic avoidance. Contrary to the hypothesis, ATR was not related to outcome. Similar findings concerning TSE and ATR were obtained in an independent sample of 34 Panic-Ag participants. Exploratory analyses found that pretreatment beliefs including outcome expectancies were unrelated to outcome. Mediational analyses revealed relationships between TSE and outcome were partially mediated by belief in catastrophic cognitions while relationships between treatment knowledge and outcome were not. Results are discussed in light of previous research, methodological limitations, clinical implications and future research directions.
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Basoglu, Metin. "Patterns and predictors of treatment outcome in panic disorder and agoraphobia treated with alprazolam and exposure." Thesis, King's College London (University of London), 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295473.
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Emmrich, Angela, Katja Beesdo-Baum, Andrew T. Gloster, Susanne Knappe, Michael Höfler, Volker Arolt, Jürgen Deckert, et al. "Depression Does Not Affect the Treatment Outcome of CBT for Panic and Agoraphobia: Results from a Multicenter Randomized Trial." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133613.
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Background: Controversy surrounds the questions whether co-occurring depression has negative effects on cognitivebehavioral therapy (CBT) outcomes in patients with panic disorder (PD) and agoraphobia (AG) and whether treatment for PD and AG (PD/AG) also reduces depressive symptomatology. Methods: Post-hoc analyses of randomized clinical trial data of 369 outpatients with primary PD/AG (DSM-IV-TR criteria) treated with a 12-session manualized CBT (n = 301) and a waitlist control group (n = 68). Patients with comorbid depression (DSM-IV-TR major depression, dysthymia, or both: 43.2% CBT, 42.7% controls) were compared to patients without depression regarding anxiety and depression outcomes (Clinical Global Impression Scale [CGI], Hamilton Anxiety Rating Scale [HAM-A], number of panic attacks, Mobility Inventory [MI], Panic and Agoraphobia Scale, Beck Depression Inventory) at post-treatment and follow-up (categorical). Further, the role of severity of depressive symptoms on anxiety/depression outcome measures was examined (dimensional). Results: Comorbid depression did not have a significant overall effect on anxiety outcomes at post-treatment and follow-up, except for slightly diminished post-treatment effect sizes for clinician-rated CGI (p = 0.03) and HAM-A (p = 0.008) when adjusting for baseline anxiety severity. In the dimensional model, higher baseline depression scores were associated with lower effect sizes at post-treatment (except for MI), but not at follow-up (except for HAM-A). Depressive symptoms improved irrespective of the presence of depression. Conclusions: Exposure-based CBT for primary PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbid depression or depressive symptomatologyDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
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Richter, Jan [Verfasser]. "Defensive reactivity in patients with panic disorder and agoraphobia: from basic research to clinical application / Jan Richter." Greifswald : Universitätsbibliothek Greifswald, 2013. http://d-nb.info/1034946048/34.
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Lang, Thomas, Sylvia Helbig-Lang, Andrew T. Gloster, Jan Richter, Alfons O. Hamm, Lydia Fehm, Thomas Fydrich, et al. "Effekte therapeutenbegleiteter versus patientengeleiteter Exposition bei Panikstörung mit Agoraphobie." Technische Universität Dresden, 2012. https://tud.qucosa.de/id/qucosa%3A27044.
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Theoretischer Hintergrund: Die Rolle der Therapeutenbegleitung während Expositionsübungen bei Panikstörung mit Agoraphobie (P/A) ist bislang ungeklärt. Eine kürzlich durchgeführte klinische Studie (MAC-Studie) lieferte Hinweise auf ein günstigeres Behandlungsergebnis bei Therapeutenbegleitung. Fragestellung: Wie lassen sich Effekte therapeutenbegleiteter Exposition (T+) im Vergleich zu Exposition ohne Therapeutenbegleitung (T–) erklären? Methode: Daten von 301 Patienten, die eine expositionsbasierte KVT mit bzw. ohne Therapeutenbegleitung erhalten hatten, wurden analysiert. Untersucht wurden der Einfluss der initialen Störungsschwere, des Sicherheitsverhaltens sowie differenzielle Effekte der Bedingungen auf die Angst vor der Angst. Zusätzlich wurde überprüft, inwieweit die Übungshäufigkeit in den Behandlungsbedingungen variiert und einen Mediator des Behandlungserfolgs darstellt. Ergebnisse: Störungsschwere und Sicherheitsverhalten zeigten keine differenziellen Effekte zwischen den Bedingungen; die T+ Bedingung führte jedoch zu stärkeren Reduktionen der Angst vor der Angst im Angstsensitivitätsindex. Patienten der T+ Bedingung führten häufiger selbständig Expositionsübungen durch, während Patienten in T– im Durchschnitt länger übten. Die Übungshäufigkeit stellte dabei einen Mediator des Behandlungserfolgs dar. Schlussfolgerungen: Günstigere Effekte einer therapeutenbegleiteten Exposition gehen auf stärkere Reduktionen der Angst vor der Angst sowie auf eine höhere Übungshäufigkeit im Selbstmanagement zurück.Theoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapist-guided exposure compared to programmed practice. Objectives: Examining potential mechanisms of therapist-guided exposure. Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework. Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome. Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear.
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Bauer, Victor Augusto [UNESP]. "Suicidalidade em pacientes com transtorno de pânico e agorafogia: prevalência e fatores associados." Universidade Estadual Paulista (UNESP), 2014. http://hdl.handle.net/11449/124107.
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000830335.pdf: 452662 bytes, checksum: 44515188d9f84455feb4fd27d299f837 (MD5)Introdução: Os transtornos psiquiátricos são os principais fatores de risco para comportamentos suicidas ou suicidalidade, mas são relativamente escassos os estudos sobre este tema com portadores de transtornos de ansiedade em geral e transtorno de pânico (TP) em particular. A maioria dos pacientes com TP que procura tratamento apresenta agorafobia associada. Pesquisas sobre suicidalidade em pacientes com TP ainda são poucas e inconclusivas, não havendo estudos nacionais publicados sobre o tema. Objetivos: Este estudo objetivou estimar a prevalência de vários comportamentos suicidas na vida (achar que não vale a pena viver, desejar estar morto, ideação suicida, planejamento e tentativas de suicídio) em pacientes com TP e agorafobia (TPA), assim como avaliar fatores sóciodemográficos e clínicos associados à ocorrência de tais comportamentos. Método: Estudo transversal, com uma amostra clínica de conveniência de pacientes adultos (18 anos ou mais) portadores de TPA (critérios do DSM-IV) em tratamento em uma clínica privada de Bauru e no ambulatório de transtornos ansiosos e obsessivo-compulsivos (ATAOC) da Faculdade de Medicina de Botucatu-Unesp de janeiro de 2011 a outubro de 2013. Os instrumentos de avaliação utilizados foram: um questionário especialmente elaborado para obtenção de dados sociodemográficos e clínicos, a Panic and Agoraphobia Scale (PAS) para avaliar a gravidade dos sintomas de TPA e a Mini International Neuropsychiatric Interview (M.I.N.I.) para avaliar a ocorrência de comorbidades psiquiátricas. Calculou-se a prevalência de comportamentos suicidas (desfechos de interesse) e, a seguir, foram feitas análises bivariadas entre estes e diversas variáveis sociodemográficas e clínicas. Para as variáveis categóricas foi utilizado o teste de qui-quadrado ou de Fisher, quando indicado, e para variáveis quantitativas (ex. idade, anos de escolaridade, pontuação na PAS) utilizaram-se os ...
Introduction: Psychiatric disorders are the main risk factors for suicidal behaviors or 'suicidality', but there are few studies on this issue involving patients with anxiety disorders in general and panic disorder (PD) in particular. Most PD patients that seek treatment have agoraphobia associated to the disorder (PAD). Investigations of suicidality among PAD patients have been largely inconclusive and there are no Brazilian publications on this issue. Objectives: this study aimed to estimate the prevalence of various lifetime suicidal behaviors (feeling that life is not worth living, wishing to be dead, suicidal thoughts, plans and attempts) in PAD patients and to evaluate sociodemographic and clinical factors associated with these behaviors. Method: A cross-sectional study was conducted with a sample of adult patients presenting PAD (DSM-IV criteria) undergoing treatment in a private clinic in Bauru and in the outpatient service for anxiety and obsessive-compulsive disorders at Botucatu Medical School - São Paulo State University from January 2011 to October 2013. The assessment instruments used were: a questionnaire designed to collect sociodemographic and clinical data, the Panic and Agoraphobia Scale (PAS) to evaluate PAD clinical severity and the Mini International Neuropsychiatric Interview (M.I.N.I.) to evaluate the co-occurrence of other psychiatric disorders. Initially, the prevalence of the outcomes of interest (suicidal behaviors) was calculated; then, bivariate analyses were performed between these outcomes and several demographic and clinical variables. For the categorical explanatory variables the Chi-squared and the Fisher exact tests were used, whereas for the quantitative variables (e.g.: age, schooling years, PAS score) the Student t test (normal distribution) and the Mann-Whitney test (non-normal distribution) were used. Results: 45 patients (66.7% women and 33.3% men) were assessed. Ages ranged from 19 to 68; ...
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Bauer, Victor Augusto. "Suicidalidade em pacientes com transtorno de pânico e agorafogia : prevalência e fatores associados /." Botucatu, 2014. http://hdl.handle.net/11449/124107.
Full textAbstract:
Orientador: Albina Robrigues TorresBanca: Ricardo Torresan
Banca: Jair Sucro
Banca: Ana Teresa de Abreu Ramos Cerqueira
Resumo: Introdução: Os transtornos psiquiátricos são os principais fatores de risco para comportamentos suicidas ou "suicidalidade", mas são relativamente escassos os estudos sobre este tema com portadores de transtornos de ansiedade em geral e transtorno de pânico (TP) em particular. A maioria dos pacientes com TP que procura tratamento apresenta agorafobia associada. Pesquisas sobre suicidalidade em pacientes com TP ainda são poucas e inconclusivas, não havendo estudos nacionais publicados sobre o tema. Objetivos: Este estudo objetivou estimar a prevalência de vários comportamentos suicidas na vida (achar que não vale a pena viver, desejar estar morto, ideação suicida, planejamento e tentativas de suicídio) em pacientes com TP e agorafobia (TPA), assim como avaliar fatores sóciodemográficos e clínicos associados à ocorrência de tais comportamentos. Método: Estudo transversal, com uma amostra clínica de conveniência de pacientes adultos (18 anos ou mais) portadores de TPA (critérios do DSM-IV) em tratamento em uma clínica privada de Bauru e no ambulatório de transtornos ansiosos e obsessivo-compulsivos (ATAOC) da Faculdade de Medicina de Botucatu-Unesp de janeiro de 2011 a outubro de 2013. Os instrumentos de avaliação utilizados foram: um questionário especialmente elaborado para obtenção de dados sociodemográficos e clínicos, a Panic and Agoraphobia Scale (PAS) para avaliar a gravidade dos sintomas de TPA e a Mini International Neuropsychiatric Interview (M.I.N.I.) para avaliar a ocorrência de comorbidades psiquiátricas. Calculou-se a prevalência de comportamentos suicidas (desfechos de interesse) e, a seguir, foram feitas análises bivariadas entre estes e diversas variáveis sociodemográficas e clínicas. Para as variáveis categóricas foi utilizado o teste de qui-quadrado ou de Fisher, quando indicado, e para variáveis quantitativas (ex. idade, anos de escolaridade, pontuação na PAS) utilizaram-se os ...
Abstract: Introduction: Psychiatric disorders are the main risk factors for suicidal behaviors or 'suicidality', but there are few studies on this issue involving patients with anxiety disorders in general and panic disorder (PD) in particular. Most PD patients that seek treatment have agoraphobia associated to the disorder (PAD). Investigations of suicidality among PAD patients have been largely inconclusive and there are no Brazilian publications on this issue. Objectives: this study aimed to estimate the prevalence of various lifetime suicidal behaviors (feeling that life is not worth living, wishing to be dead, suicidal thoughts, plans and attempts) in PAD patients and to evaluate sociodemographic and clinical factors associated with these behaviors. Method: A cross-sectional study was conducted with a sample of adult patients presenting PAD (DSM-IV criteria) undergoing treatment in a private clinic in Bauru and in the outpatient service for anxiety and obsessive-compulsive disorders at Botucatu Medical School - São Paulo State University from January 2011 to October 2013. The assessment instruments used were: a questionnaire designed to collect sociodemographic and clinical data, the Panic and Agoraphobia Scale (PAS) to evaluate PAD clinical severity and the Mini International Neuropsychiatric Interview (M.I.N.I.) to evaluate the co-occurrence of other psychiatric disorders. Initially, the prevalence of the outcomes of interest (suicidal behaviors) was calculated; then, bivariate analyses were performed between these outcomes and several demographic and clinical variables. For the categorical explanatory variables the Chi-squared and the Fisher exact tests were used, whereas for the quantitative variables (e.g.: age, schooling years, PAS score) the Student t test (normal distribution) and the Mann-Whitney test (non-normal distribution) were used. Results: 45 patients (66.7% women and 33.3% men) were assessed. Ages ranged from 19 to 68; ...
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Ebenfeld, Lara Verfasser], and Matthias [Akademischer Betreuer] [Berking. "Development and evaluation of a hybrid online training for panic disorder and agoraphobia / Lara Ebenfeld ; Betreuer: Matthias Berking." Lüneburg : Universitätsbibliothek der Leuphana Universität Lüneburg, 2020. http://nbn-resolving.de/urn:nbn:de:gbv:luen4-opus-146484.
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Ebenfeld, Lara [Verfasser], and Matthias [Akademischer Betreuer] Berking. "Development and evaluation of a hybrid online training for panic disorder and agoraphobia / Lara Ebenfeld ; Betreuer: Matthias Berking." Lüneburg : Universitätsbibliothek der Leuphana Universität Lüneburg, 2020. http://d-nb.info/120754292X/34.
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