8 anxiety - Agoraphobia

Westphal in 1871

Who first coined the term “agoraphobia” and when?

Observing three males who experienced intense anxiety

when walking across open spaces.

What triggered the identification of agoraphobia according to Westphal?

1. Palpitations

2. blushing

3. trembling

4. sensations of heat.

What physiological symptoms of anxiety did Westphal describe in agoraphobia?

• one of the most disabling

• one of the most challenging phobias to treat.

How is agoraphobia characterized today?

marked fear and avoidance

of being alone, or in public places

from which escape might be difficult or help unavailable

in case of sudden incapacitation (عجز مفاجىء) 

How did the APA (1980) define agoraphobia?

a type of anxiety disorder in which

a person fears and avoids

places or situations that might cause panic

and make them feel trapped, helpless, or embarrassed.

What is agoraphobia?

• Actual or anticipated situations

1. Being alone outside the home

2. Using public transportation; traveling in a car, bus, or airplane

3. being in crowded areas (standing in line)

4. being in enclosed places such as shops and cinema or being on a bridge جسر or in an elevator.

5. being in open spaces; (markets, parking lots)

6. being in places where escape might be difficult.

7. Active avoidance of all fear-provoking situations and becoming housebound for prolonged periods.

8. Feelings of detachment or estrangement غربةfrom others, feelings of helplessness, and dependence upon others.

9. Anxiety or panic attack (acute severe anxiety).

What situations do people with agoraphobia commonly avoid? (What are agoraphobia symptoms?)

What are the DSM-5 criteria for agoraphobia?

Approximately 1.7%

What is the prevalence of agoraphobia among adolescents and adults?

Women more 

2:1 

How does the prevalence of agoraphobia differ between men and women?

► Usually in late adolescence

► or early adulthood (before 35)

► it can also occur in childhood.

When does agoraphobia typically onset?

► Children fear becoming lost

► adults fear panic-like symptoms

older adults fear falling.

How do fear thoughts in agoraphobia change with age?

• Other anxiety disorders (such as panic disorder or specific phobia)

• depressive disorders.

Which disorders commonly co-occur with agoraphobia?

Most people develop it after having one or more panic attacks,

which causes them to worry about another attack

and avoid places where it may happen again.

How does agoraphobia usually develop?

Because they often feel unsafe, especially where crowds gather.

Why do people with agoraphobia have difficulty in public places?

They may feel the need for a companion, such as a relative or friend, to accompany them.

What strategy might a person with agoraphobia use to go to public places?

It can be so overwhelming that a person may feel unable to leave home.

How severe can the fear in agoraphobia become?

Because many sufferers find ways to avoid the situations that trigger their phobia.

Why is agoraphobia often unreported?

• Agoraphobic situations must almost always create fear and anxiety that are out of proportion to the actual danger,

• these signs typically last for a minimum of six months.

What criteria must be met for agoraphobia to be considered a diagnosis? 

• It can cause serious disability

•  some people are unable to work

• rely heavily on family members for

1. shopping

2.  household errands

3. accompanying them outside the “safety zone.”

How can agoraphobia affect daily functioning?

People may become housebound for years, resulting in impaired relationships.

What long-term effect can agoraphobia have on social relationships?

More than one-third 1/3

What proportion of people with agoraphobia do not leave their home or cannot work?

A combination of life experiences, psychological traits, and/or genetic factors.

What factors contribute to the development of agoraphobia?

• 61%

• making it the phobia most strongly linked to genetic predisposition.

What is the reported heritability of agoraphobia?

1. Having panic disorder or other phobias

2. responding to panic attacks with excessive fear and avoidance

3. having an anxious or nervous temperament

4. Relative with agoraphobia 

What individual risk factors contribute to agoraphobia?

• Experiencing stressful events (death of a parent, being attacked or mugged)

• being raised in a household with little warmth and high overprotection.

What environmental factors are associated with developing agoraphobia?

false

people with social anxiety disorder must develop agoraphobia✅❌

True

people with social anxiety disorder not necessarily develop agoraphobia✅❌

► agoraphobia: results from fear of panic attacks

► SAD: fear of social interactions.

What is the main cause of agoraphobia compared to social phobia?

What treatments can be provided to agoraphobia patients?

by Emmelkamp and colleagues

The self-observation procedure for treating agoraphobia was introduced by?