Prediction of Outcome in the Treatment of Agoraphobia

Thomas-Peter, Brian; Jones, R. B.; Sinnott, A.; Fordham, Ann

doi:10.1017/s0141347300008624

Cited by 15 publications

(2 citation statements)

References 14 publications

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“…In an intriguing study, Thomas-Peter, Jones, Sinnott, and Scott Fordham (1983) conducted interviews with patients' spouses before treatment on the basis of which they reliably rated how effective the spouses were at managing the patient's illness. These ratings proved to be strongly related to patients' severity of agoraphobia after treatment, with pretreatment severity controlled.…”

Section: Prediction Of Outcome Of Exposure Treatment For Agoraphobiamentioning

confidence: 99%

Interpersonal aspects of panic disorder and agoraphobia.

Chambless¹

2010

Interpersonal Processes in the Anxiety Disorders: Implications for Understanding Psychopathology and Treatment.

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attack come on. This avoidance may be relatively subtle-for example, the man with panic disorder who gives up running because his rapid heartbeat makes him feel like he is panicking or having a heart attack. Or it may be highly obvious-for example, the woman who becomes afraid to leave her home unless she is accompanied by a trusted person who will take care of her should she panic. When avoidance is significant, the person is said to have panic disorder with agoraphobia, for which the lifetime prevalence is about 1% (Kessler et al., 2006). Another 1% will have agoraphobia with panic attacks but will not meet full diagnostic criteria for panic disorder (Kessler et al., 2006); for example, they will not have had recurrent unexpected panic attacks. Much of the literature cited in this chapter was written before diagnostic distinctions between agoraphobia with and without panic disorder were made, and phenomenologically there is little difference to the patient between these disorders. I use the term agoraphobia to refer to both groups. Moreover, some more recent studies have focused on panic disorder without reference to whether there is associated agoraphobia. Thus, it is not always be possible to make distinctions between panic disorder with and without agoraphobia. When possible, I do so.The social and health consequences of panic disorder are great. According to epidemiologic research, these include increased risk of alcohol and drug abuse, mood disorders, other anxiety disorders, subjectively poor health, poor social functioning, high use of health care services and emergency rooms, and financial dependence on disability and welfare payments (Kessler et al., 2006;Markowitz, Weissman, Ouellette, Lish, & Klerman, 1989). Disability is greatest for those who develop agoraphobia as a complication of panic disorder (Kessler et al., 2006). The more disabled patients become, the more likely they are to rely on family members for their daily functioning, posing a heavy burden on their intimate others. Reflecting not only agoraphobic patients' restricted lives but also the preponderance of women with the disorder-as many as 80% in clinical samples (Chambless & Mason, 1986)-an early synonym for agoraphobia was housebound housewives. Epidemiologic research has suggested that although women still predominate in the general population, the ratio of women to men with panic disorder and agoraphobia (about 2:1) is not as extreme as in clinical samples (Kessler et al., 2006).The mass of research on interpersonal aspects of agoraphobia is substantially greater and older than that for the other anxiety disorders. No doubt this is because the role of the phobic companion in agoraphobia is so striking that the interpersonal context of the disorder could not be ignored. Marks (1970) estimated that 95% of people with agoraphobia are able to venture further into phobic situations or to enter phobic situations with less anxiety if accompanied by a trusted other. In laboratory research, Carter, Hollon, Carson, and Shelton (1995) demonst...

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Section: Prediction Of Outcome Of Exposure Treatment For Agoraphobiamentioning

confidence: 99%

Interpersonal aspects of panic disorder and agoraphobia.

Chambless¹

2010

Interpersonal Processes in the Anxiety Disorders: Implications for Understanding Psychopathology and Treatment.

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“…This was Mathews et al's (1977) study of partner-assisted exposure. In the remaining eleven studies, no association was found between the initial quality of couples' relationships and their immediate response to treatment or the severity of PDA symptoms during the follow-up periods of up to sixteen months Barlow et al, 1981;Chambless and Gracely, 1988;Cobb et al, 1984;Craske et al, 1989;Emmelkamp, 1980;Emmelkamp et al, 1992;Himadi et al, 1986;Peter and Hand, 1988;Thomas-Peter et al, 1983). In eight of these studies individually based treatment conditions such as individual exposure therapy were evaluated, and in five studies couples-based treatment conditions such as partner-assisted exposure were evaluated.…”

Section: General Characteristics Of Couples-based Pda Treatment Outcomentioning

confidence: 99%

The efficacy of couples‐based interventions for panic disorder with agoraphobia

Byrne

Carr

Clark

2004

Journal of Family Therapy

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From this systematic literature review it was concluded that panic disorder with agoraphobia (PDA) can sometimes occur in conjunction with marital problems. Couples‐based treatments for PDA – partner‐assisted exposure and marital therapy – can be an effective treatment for the condition. It is as effective as individually based cognitive behaviour therapy. Involving partners of people with PDA in therapy may be appropriate in some cases, particularly those in which there are marital difficulties. Couple‐focused interventions may enhance the maintenance of treatment gains by facilitating interactions that positively reinforce and perpetuate attempts by people with PDA to enter feared situations and cope with these effectively. People with PDA who have good marital relationships show a better response to both individual and couples‐based treatment programmes. In some instances effective couples‐based treatment leads to improvement in marital adjustment as well as in PDA symptomatology.

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Predicting treatment outcome for panic disorder and agoraphobia in primary care

Sharp

Power

1999

Clin. Psychol. Psychother.

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Prediction of Outcome in the Treatment of Agoraphobia

Cited by 15 publications

References 14 publications

Interpersonal aspects of panic disorder and agoraphobia.

Interpersonal aspects of panic disorder and agoraphobia.

The efficacy of couples‐based interventions for panic disorder with agoraphobia

Predicting treatment outcome for panic disorder and agoraphobia in primary care

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