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.

Thesis (Ed. D.)--University of Toronto, 2005.

Agoraphobia is the most pervasive and serious of all the phobic disorders. Marks (1969) reported that agoraphobics represent between 50%-60% of all phobic clients seen by practicing mental health professionals. The syndrome includes fears of leaving home, being in closed spaces, shopping, and traveling especially when alone. There is much fear generalization throughout the course of the disorder, and numerous other symptoms are commonly present, including panic attacks, tension, dizziness, frequent depression, depersonalization, and obsessions. The present study included a large-scale media outreach campaign directed towards gathering demographic and normative data regarding agoraphobia. Seventy individuals agreed to complete an extensive questionnaire survey. Data derived from this sample confirmed the findings presented in the literature that the majority of agoraphobics are middle-aged female housewives. A number of other demographic characteristics and scores on self-report inventories were also reported. Ten of the respondents to the questionnaire survey agreed to participate in a treatment outcome study that compared assertion training and in vivo exposure according to a multiple baseline across subjects experimental design. Dependent measures included (1) self-report; (2) self-monitoring of daily anxiety, stress-related physical symptoms, and psychotropic medication; and (3) an in vivo behavioral assessment that incorporated a behavioral duration measure, heart rate, and self-ratings of anxiety level. Results indicated that all subjects improved from pretreatment to post-treatment assessment periods on a number of dependent measures (self-report and self-monitoring). These treatment gains appeared to be maintained at three-month follow-up. Results of the behavioral in vivo assessment procedure were equivocal. There were no significant differences between the assertion training and in vivo exposure procedures on any measures of treatment outcome. Treatment subjects were compared to a no-treatment control group and showed significantly greater improvement on a number of self-report measures. Methodological problems precluded firm conclusions and competing hypotheses of demand characteristics and subject expectancies were discussed. Results were discussed within the context of the empirically derived literature and clinical reports and a model for the development and maintenance of agoraphobic behavior was presented. Directions for future research in the assessment and treatment of agoraphobia were suggested. / Ph. D.

No description available.

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.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2004. / Härtill 5 uppsatser.

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.

Thesis (M.A.)--University of Toronto, 2004. / Adviser: Jeanne Watson.

This dissertation presents theoretical and empirical research on the agoraphobia. The theoretical part outlines the history and diagnosis of agoraphobia since the mid- nineteenth century to the present through selected theories of this disorder. Concept of normality and diagnosis of agoraphobia disorder according to ICD -10, DSM IV and DSM V are also addressed. Space is also devoted to the philosophical concept of anxiety and body in relation to space. In the empirical part of the thesis the life story narrative analysis as well as analysis of narrative interviews with women suffering from agoraphobia was carried out. Ten women represent the sample. Received research data were analysed using the categorial- formal analysis. Following research objectives were set: to analyse importance of the disease in lives of participants, to describe the individual specific form of the disease, to analyse individual meaning and purpose attributed by the participants to their disease, to describe diverse aspects of life depicting. The aim was also to learn about the ways participants manage their disease including the use of therapy. Life story narrative analysis of female agoraphobia proved to be a suitable method for understanding the very meaning of agoraphobia disorder and also the meaning that is being...

Made available in DSpace on 2015-06-17T19:34:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-07-17. Added 1 bitstream(s) on 2015-06-18T12:46:58Z : No. of bitstreams: 1 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; ...