Anxiety Disorders: Panic Disorder With and Without Agoraphobia

Therapeutic strategies described as effective for anxiety disorders include behavioral and cognitive-behavioral procedures of exposure and coping of aversive situations. However, considering that the behavioral pattern common in anxiety disorders is the phobic avoidance, the application of these strategies may difficult the adhesion or promote escape and avoidance of the therapeutic process. The Functional Analytic Psychotherapy is an alternative for dealing with these avoidance/escape behaviors and it can promote coping responses. This case report describes an analysis of the therapeutic relationship of a client with Panic Disorder and Agoraphobia. The intervention based on FAP was considered to help dealing with the avoidance behavior in the therapeutic process. Results show the efficacy of the procedures adopted and confirm the possibility of using FAP for improving the effectiveness of the empirically based psychotherapies.

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Overview of Anxiety Disorders

10.2310/im.13019 ◽

2018 ◽

Author(s):

Jon E Grant

Keyword(s):

United States ◽

Anxiety Disorder ◽

Panic Disorder ◽

Anxiety Disorders ◽

Separation Anxiety ◽

The United States ◽

Specific Phobia ◽

Separation Anxiety Disorder ◽

Generalized Anxiety ◽

Psychosocial Impairment

Anxiety disorders are the most common psychiatric disorders among adults in the United States. Although anxiety disorders generally result in significant psychosocial impairment, most adults do not seek treatment until many years after the onset of the anxiety disorder. The treatment literature for anxiety disorder has grown tremendously since the 1980s, and both psychotherapy and medications may prove beneficial for people with anxiety disorders. This review presents a general overview of the anxiety disorders. This review contains 7 tables, and 33 references. Key words: agoraphobia, anxiety disorder, generalized anxiety disorder, panic disorder, separation anxiety disorder, social anxiety disorder, specific phobia, treatment of anxiety

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Vestibulo-ocular function in anxiety disorders

Journal of Vestibular Research ◽

10.3233/ves-2006-164-507 ◽

2007 ◽

Vol 16 (4-5) ◽

pp. 209-215

Author(s):

Joseph M. Furman ◽

Mark S. Redfern ◽

Rolf G. Jacob

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Semicircular Canal ◽

Constant Velocity ◽

Vertical Axis ◽

Velocity Storage ◽

Movement Response ◽

Ocular Reflex ◽

Axis Rotation ◽

High Degree

Previous studies of vestibulo-ocular function in patients with anxiety disorders have suggested a higher prevalence of peripheral vestibular dysfunction compared to control populations, especially in panic disorder with agoraphobia. Also, our recent companion studies have indicated abnormalities in postural control in patients with anxiety disorders who report a high degree of space and motion discomfort. The aim of the present study was to assess the VOR, including the semicircular canal-ocular reflex, the otolith-ocular reflex, and semicircular canal-otolith interaction, in a well-defined group of patients with anxiety disorders. The study included 72 patients with anxiety disorders (age 30.6 +/− 10.6 yrs; 60 (83.3% F) and 29 psychiatrically normal controls (age 35.0 +/minus; 11.6 yrs; 24 (82.8% F). 25 patients had panic disorder; 47 patients had non-panic anxiety. Patients were further categorized based on the presence (45 of 72) or absence (27 of 72) of height phobia and the presence (27 of 72) or absence (45 of 72) of excessive space and motion discomfort (SMD). Sinusoidal and constant velocity earth-vertical axis rotation (EVAR) was used to assess the semicircular canal-ocular reflex. Constant velocity off-vertical axis rotation (OVAR) was used to assess both the otolith-ocular reflex and static semicircular canal-otolith interaction. Sinusoidal OVAR was used to assess dynamic semicircular canal-otolith interaction. The eye movement response to rotation was measured using bitemporal electro-oculography. Results showed a significantly higher VOR gain and a significantly shorter VOR time constant in anxiety patients. The effect of anxiety on VOR gain was significantly greater in patients without SMD as compared to those with SMD. Anxiety patients without height phobia had a larger OVAR modulation. We postulate that in patients with anxiety, there is increased vestibular sensitivity and impaired velocity storage. Excessive SMD and height phobia seem to have a mitigating effect on abnormal vestibular sensitivity, possibly via a down-weighting of central vestibular pathways.

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A study on prevalence and co-morbidity of bipolar and anxiety disorders in chronic headache patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172984 ◽

2017 ◽

Vol 5 (7) ◽

pp. 3038 ◽

Cited By ~ 1

Author(s):

Sivaji M. ◽

Manickavasagam J. ◽

Indumathi Sundaramurthi ◽

Gopinathan S.

Keyword(s):

Anxiety Disorder ◽

Panic Disorder ◽

Anxiety Disorders ◽

Psychiatric Disorders ◽

Depressive Episode ◽

Chronic Headache ◽

Rating Scale ◽

Separation Anxiety Disorder ◽

Co Morbidity ◽

Headache Patients

Background: Co morbidity between headache and psychiatric disorders is more prevalent in chronic headache patients. The bipolar disorders and anxiety disorders are predominant in migraine and TTH respectively. This co morbidities have a poor reflection and impact on quality and outcome of chronic headache patients and results in worst prognosis and poor response to medical treatment.Methods: The chronic headache patients especially migraine and tension type of headache were analyzed with following materials such as the structured psychiatric clinical interview with ICD-10 mental and behavioural disorder, DSM-5 criteria. HAM-A, HAM-D, BDI-2, BPRS, young mania rating scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and panic disorder scale.Results: Various subsets of bipolar disorder and anxiety disorder were found as follows: 74% of migraineurs are associated with psychiatric disorders in which bipolar affective disorder 6%, depressive episode 48%, dysthymia 30%, GAD 10% and Panic disorder 6%. 52% of TTH are associated with psychiatric disorders as follows: major depressive episode 52%, GAD 30%, separation anxiety disorder 6%, PTSD 7%, OCD 3% and panic disorder 2%.Conclusions: From previous and future studies the headache can be identified according to subsets of headache with psychiatric disorders make easier to provide appropriate pharmacological and psychological treatment which may reduce the chronicity and intractability of headache.

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Panic Disorder and Agoraphobia

A Guide to Assessments That Work ◽

10.1093/med-psych/9780190492243.003.0013 ◽

2018 ◽

pp. 266-292

Author(s):

Amy R. Sewart ◽

Michelle G. Craske

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Treatment Planning ◽

Clinical Assessment ◽

Monitoring And Evaluation ◽

Treatment Monitoring ◽

Panic Attacks ◽

Assessment Instruments ◽

Case Conceptualization ◽

Scientific Support

Abstract: Panic disorder refers to recurrent, unexpected panic attacks, followed by at least 1 month of persistent concern about their recurrence and their consequences or a significant maladaptive change in behavior consequent to the attacks. Highly comorbid with panic disorder, agoraphobia refers to marked fear or avoidance of specific situations from which escape is perceived to be difficult or in which help may be unavailable in the event of panic-like or other incapacitating or embarrassing symptoms. This chapter focuses on the assessment of panic disorder and agoraphobia in adults. It begins with a review of the nature of the disorders, which is followed by a review of clinical assessment instruments designed for the assessment purposes of (a) diagnosis, (b) case conceptualization and treatment planning, and (c) treatment monitoring and evaluation. Recommendations are included for instruments with the greatest scientific support and for assessing these anxiety disorders in a clinically sensitive manner.

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Treatment of Anxiety Disorders in a Psychology Clinic

The Spanish Journal of Psychology ◽

10.1017/sjp.2015.82 ◽

2015 ◽

Vol 18 ◽

Author(s):

Francisco J. Labrador ◽

Francisco J. Estupiñá ◽

Mónica Bernaldo-de-Quirós ◽

Ignacio Fernández-Arias ◽

Pablo Alonso ◽

...

Keyword(s):

Anxiety Disorder ◽

Panic Disorder ◽

Anxiety Disorders ◽

Social Phobia ◽

Average Cost ◽

Average Duration ◽

College Education ◽

Cost Of Treatment ◽

Empirically Supported ◽

Not Otherwise Specified

AbstractPeople with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders.

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Cholecystokinin and panic disorder

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2004.0076.x ◽

2004 ◽

Vol 16 (2) ◽

pp. 85-93 ◽

Cited By ~ 9

Author(s):

Michel Bourin ◽

Eric Dailly

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Pharmacological Studies

Evidence for implication of cholecystokinin (CCK) in the neurobiology of panic disorder is reviewed through animal and human pharmacological studies. The results of these investigations raise two issues: (i) selectivity of action of CCK-2 agonists in anxiety disorders; and (ii) aberrations of the CCK system in anxiety disorders, both of which are discussed.

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A Prospective Study of Panic and Anxiety in Agoraphobia with Panic Disorder

The British Journal of Psychiatry ◽

10.1192/bjp.160.1.57 ◽

1992 ◽

Vol 160 (1) ◽

pp. 57-64 ◽

Cited By ~ 20

Author(s):

Metin Başoǧlu ◽

Isaac M. Marks ◽

Seda Şengün

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Prospective Study ◽

Natural Environment ◽

Public Places ◽

Self Monitoring ◽

Similar Symptom ◽

Sharp Distinction ◽

Symptom Profile ◽

A Prospective Study

The features of panic and anxiety in the natural environment were studied by prospective self-monitoring in 39 patients with chronic agoraphobia and panic disorder. Panics overlapped greatly with anxiety episodes but were more intense. Panics occurred more often in public places than did anxiety episodes, but had otherwise similar symptom profile, time of occurrence, and antecedents. Most panics surged out of a pre-existing plateau of tonic anxiety which lasted most of the day. Spontaneous panics were less frequent than situational panics and occurred more often at home but were otherwise similar. These findings do not support the sharp distinction between panic and anxiety in DSM–III–R, not its emphasis on spontaneous panic in classifying anxiety disorders. Thoughts of dying and ‘going crazy’/losing control accompanied only a minority of panic/anxiety episodes and seemed to be a product of intense panic rather than a cause.

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Genetics of Fear and Anxiety Disorders

The British Journal of Psychiatry ◽

10.1192/bjp.149.4.406 ◽

1986 ◽

Vol 149 (4) ◽

pp. 406-418 ◽

Cited By ~ 38

Author(s):

I. M. Marks

Keyword(s):

Panic Disorder ◽

Anxiety Disorders ◽

Defensive Behaviour ◽

Biological Functions ◽

Obsessive Compulsive ◽

Familial Influences ◽

History Of ◽

Normal Human ◽

Fear And Anxiety ◽

Genetically Determined

From protozoa to mammals, organisms have been selectively bred for genetic differences in defensive behaviour which are accompanied by differences in brain and other biological functions. Studies of twins indicate some genetic control of normal human fear from infancy onwards, of anxiety as a symptom and as a syndrome, and of phobic and obsessive- compulsive phenomena. Anxiety disorders are more common among the relatives of affected probands than of controls, especially among female and first-degree relatives; alcoholism and secondary depression may also be over-represented. Familial influences have been found for panic disorder, agoraphobia, and obsessive-compulsive problems. Panic disorder in depressed probands increases the risk to their relatives of phobia as well as of panic disorder, major depression, and alcoholism. The strongest family history of all anxiety disorders is seen in blood-injury phobia; even though it can be successfully treated by exposure, its roots may lie in a genetically determined specific autonomic susceptibility. Some genetic effects can be modified by environmental means.

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