Marital Interactions as Predictors of Symptoms Severity in Panic Disorder with Agoraphobia

Abstract

Several studies showed associations among marital variables and panic disorder with agoraphobia (PDA) symptomatology. However, very few explored this issue using behavioural coding of couples' interactions. We www.ccsenet.org/ijps International Journal of Psychological Studies Vol. 3, No. 2; December 2011 ISSN 1918-7211 E-ISSN 1918 108 conducted this study to investigate whether observed marital interaction patterns would predict PDA severity.Cross-sectional, pre-treatment multi-center study of 65 married couples in which one spouse was diagnosed with panic disorder with agoraphobia (PDA).All participants completed seven self-reported PDA symptoms measures commonly used in PDA research and two self-reported marital measures. Couples were observed during a 15-minute video-taped problem-solving task. The spouses' marital interactions were coded by two independent coders using two validated observational coding systems.After controlling for socio-economical variables, the presence of negative marital interaction patterns, namely criticism and dominance behaviour, predicted higher symptom severity, whereas the presence of positive interaction patterns, namely support and validation behaviours, predicted lower symptom severity . Emotional over-involvement of the non-PDA partner, a manifestation of expressed emotions, failed to predict PDA severity.Discord in the couple could exacerbate the PDA and maintain it. A therapist evaluating a married PDA client may need to assess his or her client's marital interaction patterns with his or her partner and adjust his intervention accordingly.

Social support and symptom severity among patients with obsessive-compulsive disorder or panic disorder with agoraphobia: A systematic review

“…No significant correlation was found between PDA total clinical severity and marital adjustment. El-Baalbaki and colleagues (2011) were also interested in marital interactions as a predictor of panic and agoraphobia symptom severity. Comparable to the results of Marcaurelle and colleagues (2005) described above, they found significant negative correlations between DAS and catastrophic thoughts ( r = -.46, p < .01), fear of bodily sensations ( r = -.31, p < .05), and fear of consequences of anxiety ( r = -.49, p < .01).…”

“… El-Baalbaki and colleagues (2011) used a different observational measure, the Global Couple Interaction Coding System (GCIS). It also evaluates partners during a problem-solving situation but it evaluates each partner on five components of their verbal and non-verbal marital interaction.…”

“…However, given that most marital adjustment questionnaires assess some aspects of marital support (for example “do you confide in your partner”), it cannot be disregarded when looking at marital support. Also, results from El-Baalbaki and colleagues (2011) have shown that a higher level of marital adjustment was associated with more displays of support and validation during a problem solving interaction between spouses. Since marital adjustment seems to be associated with an observational measure of marital support, it is likely that these two concepts share common aspects.…”

“…This concept includes three dimensions: hostility, criticism and emotional over-involvement. Emotional over-involvement can be described as intrusiveness, excessively self-sacrificing behavior, or exaggerated emotional response to the patient’s illness ( El-Baalbaki et al, 2011 ). Criticism and hostility refer to critical comments and negative attitudes toward the patient about the disorder and, as such, are manifestations of negative social support.…”

Predictors of Dropout From Cognitive-Behavioral Group Treatment for Panic Disorder With Agoraphobia

“…To better understand and address this problem, it is essential to differentiate the profile of people who complete treatment from those who unilaterally discontinue the intervention. In this regard, studies suggest different variables of interest, such as the severity of the disorder and comorbidities (Brown & Barlow, 2002; Issakidis & Andrews, 2004; Keijsers et al, 2001; Taylor, 2000; White et al, 2010); sociodemographic variables, such as income, education, and age (Grilo et al, 1998; Santana & Fontenelle, 2011; Swift & Greenberg, 2012); client’s expectations (Katerelos, Bélanger, et al, 2011; Katerelos, Perreault, Bélanger, Marchand, & Pecknold, 2011; Perreault et al, 2014); and dyadic variables (Bélanger, Leduc, Fredman, El-Baalbaki, & Baucom, 2008; El-Baalbaki, Bélanger, Perreault, Fredman, & Baucom, 2010; Marcaurelle, Bélanger, Marchand, Katerelos, & Mainguy, 2005).…”