Abstract:
This chapter summarizes the literature on assessment, maintenance, treatment, and mechanisms of change in treatment of patients with panic disorder with or without agoraphobia. Relevant theoretical contributions which are discussed may help to understand the genesis and maintenance factors of panic disorder and agoraphobia. Further, we provide an overview of empirically supported treatment approaches for these disorders and discuss the mechanisms of change involved in these treatments Knowledge of the burgeoning literature in this area is relevant for the development of basic and expert clinical competencies in panic disorder/agoraphobia. It is argued that the clinician should first be familiar with the diagnostic criteria for panic disorder and for agoraphobia. Knowledge of structured clinical interviews is needed to be able to formalize the diagnosis. In addition, knowledge of self-report measures, behavioral assessment, and self-monitoring is needed to assess the quality and severity of panic disorder and agoraphobia and to evaluate progress of treatment. Further, basic competencies also require knowledge on which factors are involved in the maintenance of these disorders. In addition, basic clinical competencies should entail knowledge about psycho-education, and evidence-based protocols for conducting interoceptive exposure and exposure in vivo outside the therapist office. Expert clinical competencies may entail advanced understanding and skills of applying psychological and pharmacological procedures to augment exposure therapy, skills in enactment of cognitive therapy and couple therapy, knowledge and skills to deal with panic disorder and agoraphobia in cases with comorbid disorders (e.g. substance abuse/dependence, and depression) as well sensitivity to anxiety related cultural factors.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Antony, M. M., Ledley, D. R., Liss, A., & Swinson, R. P. (2006). Responses to symptom induction exercises in panic disorder. Behaviour Research and Therapy, 44, 85–98.
Arntz, A., & van den Hout, M. (1996). Psychological treatment of panic disorder without agoraphobia: Cognitive therapy versus applied relaxation. Behaviour Research and Therapy, 34, 113–121.
Bakker, A., van Balkom, A. J. L. M., Spinhoven, P., Blaauw, B. M. W. J., & van Dyck, R. (1998). Follow-up on the treatment of panic disorder with or without agoraphobia: A Quantitative review. Journal of Nervous and Mental Disease, 186, 414–419.
Ballenger, J. C., Davidson, J. R., Lecrubier, Y., Nutt, D. J., Baldwin, D. S., den Boer, J. A., et al. (1998). Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety. Journal of Clinical Psychiatry, 59(Suppl 8), 47–54.
Barlow, D. H. (1988). Anxiety and its disorders. New York: Guilford.
Barlow, D. H. (2008). Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed.). New York: Guilford.
Barlow, D. H., & Craske, M. G. (2007). Mastery of your anxiety and panic (4th ed.). New York: Oxford University Press.
Barlow, D. H., Craske, M., Cerny, J., & Klosko, J. (1989). Behavioral treatment of panic disorder. Behavior Therapy, 20, 261–282.
Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2000). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. Journal of the American Medical Associatio, 283(19), 2529–2536.
Baum, M. (1988). Spontaneous recovery from the effects of flooding (exposure) in animals. Behaviour Research and Therapy, 26, 185–186.
Beck, A. T., Emery, G., & Greenberg, R. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.
Beck, A. T., Sokol, L., Clark, D. A., Berschick, R., & Wright, F. (1992). A cross-over study of focused cognitive therapy for panic disorder. American Journal of Psychiatry, 149, 778–783.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Beck, J., Stanley, M. A., Baldwin, L. E., Deagle, E. A., & Averill, P. M. (1994). Comparison of cognitive therapy and relaxation training for panic disorder. Journal of Consulting and Clinical Psychology, 62, 818–826.
Bekker, M. H. J., & van Mens-Verhulst, J. (2007). Anxiety disorders: Sex differences in prevalence, degree, and background, but gender-neutral treatment. Journal of Gender Medicine, 4(Suppl.), S178–S193.
Bouchard, S., Gauthier, J., Laberge, B., French, D., Pelletier, M., & Godbout, D. (1996). Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 34, 213–224.
Bouchard, S., Pelletier, M.-H., Gauthier, J., Cote, G., & Laberge, B. (1997). The assessment of panic using self-report: A comprehensive survey of validated instruments. Journal of Anxiety Disorders, 11, 89–111.
Bouton, M. E. (1993). Context, time, and memory retrieval in the interference paradigms of Pavlovian learning. Psychological Bulletin, 114(1), 80–99.
Bouton, M. E., Mineka, S., & Barlow, D. H. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108(1), 4–32.
Bouton, M. E., Woods, A. M., & Pineno, O. (2004). Occasional reinforced trials during extinction can slow the rate of rapid reacquisition. Learning and Motivation, 35, 371–390.
Bowen, R. C., D’Arcy, C., Keegan, D., & Van Senthilsel, A. (2000). A controlled trial of cognitive behavioral treatment of panic in alcoholic inpatients with comorbid panic disorder. Addictive Behavior, 4, 593–597.
Brown, T. A., DiNardo, P. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV. Graywind Publications, Albany, NY.
Brown, T., DiNardo, P., & Barlow, D. (2004). Anxiety disorders interview schedule adult version (ADIS-IV): Client interview schedule. Boston, MA: Graywind.
Brown, T. A., Di Nardo, P. A., Lehman, C. L., & Campbell, L. A. (2001). Reliability of DSM-IV anxiety and mood disorders: Implications for the classification of emotional disorders. Journal of Abnormal Psychology, 110(1), 49–58.
Bruce, T. J., Spiegel, D. A., Gregg, S. F., & Nuzzarello, A. (1995). Predictors of alprazolam discontinuation with and without cognitive behavior therapy in panic disorder. American Journal of Psychiatry, 152(8), 1156––1160.
Burke, M., Drummond, L. M., & Johnston, D. W. (1997). Treatment choice for agoraphobic women: exposure of cognitive-behaviour therapy? British Journal of Clinical Psychology, 36, pp. 409–420.
Cain, C. K., Blouin, A. M., & Barad, M. (2004). Adrenergic transmission facilitates extinction of conditional fear in mice. Learning & Memory, 11(2), 179–187.
Carlbring, P., Bohman, S., Brunt, S., Buhrman, M., Westling, B. E., Ekselius, L., et al. (2006). Remote treatment of panic disorder: A randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. American Journal of Psychiatry, 163, 2119–2125.
Cerny, J. A., Barlow, D., Craske, M. G., & Himadi, W. G. (1987). Couples treatment of agoraphobia: A two-year follow-up. Behavior Therapy, 18, 401–415.
Chambless, D. L. (1982). Characteristics of agoraphobics. In Chambless, D. L., & Goldstein, A. J. (Eds.), Agoraphobia: Multiple perspectives on theory and treatment. New York: Wiley.
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: The body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097.
Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The Mobility Inventory for Agoraphobia. Behaviour Research & Therapy, 23, 35–44.
Chelonis, J. J., Calton, J. L., Hart, J. A., & Schachtman, T. R. (1999). Attenuation of the Renewal Effect by Extinction in Multiple Contexts. Learning and Motivation, 30(1), 1–14.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470.
Clark, D. M., Salkovskis, P. M., & Chalkley, A. J. (1985). Respiratory control as a treatment for panic attacks. Journal of Behavior Therapy and Experimental Psychiatry, 16, 23–30.
Clark, D. M., Salkovskis, P. M., Hackman, A., Middleton, H., Anastasiades, P., & Gelder, M. (1994). A comparison of cognitive therapy, applied relaxation and imipramine in the treatment of panic disorder. British Journal of Psychiatry, 164, 759–769.
Clum, G. A. (1990). Coping with panic. Pacific Grove, CA: Brooks/Cole.
Cobb, J. P., Mathews, A. A., Childs-Clarke, A., & Blowers, C. M. (1984). The spouse as co-therapist in the treatment of agoraphobia. British Journal of Psychiatry, 144, 282–287.
Cote, G., Gauthier, J. G., Laberge, B., & Cormier, H. J. (1994). Reduced therapist contact in the cognitive behavioral treatment of panic disorder. Behavior Therapy, 25, 123–145.
Cox, B. J. (1996). The nature and assessment of catastrophic thoughts in panic disorder. Behaviour Research and Therapy, 34, 363–374.
Craske, M. G. (1999). Anxiety disorders. Psychological approaches to theory and treatment. Boulder, CO: Westview.
Craske, M. G., & Barlow, D. H. (2008). Panic disorder and agoraphobia. In Barlow, D. H. (Ed.), Clinical handbook of emotional disorders (4th ed., pp 1–52). New York: Guilford Press.
Craske, M. G., Brown, T. A., & Barlow, D. H. (1991). Behavioral treatment of panic disorder: A two-year follow-up. Behavior Therapy, 22, 289–304.
Craske, M. G., Hermans, D., & Vansteenwegen, D. (2006). Fear and learning. Washington DC: American Psychological Association.
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46(1), 5–27.
Craske, M. G., Maidenberg, E., & Bystritsky, A. (1995). Brief cognitive-behavioral versus nondirective therapy for panic disorder. Journal of Behavior Therapy and Experimental Psychiatry, 26, 113–120.
Craske, M. G., Poulton, R., Tsao, J. C. I., & Plotkin, D. (2001). Paths to panic disorder/agoraphobia: An exploratory analysis from age 3 to 21 in an unselected cohort. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 556–563.
Craske, M. G., Rowe, M., Lewin, M., & Noriega-Dimitri, R. (1997). Interoceptive exposure versus breathing retraining within cognitive-behavioral therapy for panic disorder with agoraphobia. Journal of Clinical Psychology, 36, 85–99.
Craske, M. G., & Waters, M. A. (2005). Panic disorder, phobias, and generalized anxiety disorder. Annual Review of Clinical Psychology, 1, 197–226.
Davey, G. C. L. (1987). An integration of human and animal models of Pavlovian conditioning Associations, cognitions, and attributions. In Davey, G. (Ed.), Cognitive processes and Pavlovian conditioning in humans. (Vol. 83–114). Chichester, UK: Wiley.
Davey, G. C. L. (1997). A conditioning model of phobias. In Davey, G. C. L. (Ed.), Phobias: A handbook of theory, research and assessment. Chichester, UK: Wiley.
Davis, M., Ressler, K., Rothbaum, B. O., & Richardson, R. (2006). Effects of D-cycloserine on extinction: Translation from preclinical to clinical work. Biological Psychiatry, 60(4), 369–375.
De Beurs, E., Lange, A., van Dyck, R., Blonk, R. W. B., & Koele, P. (1991). Behavioral assessment of behavioral avoidance in agoraphobia. Journal of Psychopathology and Behavioral Assessment, 13, 285–300.
Dreessen, L., & Arntz, A. (1998). The impact of personality disorders on treatment outcome of anxiety disorders: Best-evidence synthesis. Behaviour Research and Therapy, 36(5), 483–504.
Dreessen, L., Arntz, A., Luttels, C., & Sallaerts, S. (1994). Personality disorders do not influence the results of cognitive behavior therapies for anxiety disorders. Comprehensive Psychiatry, 35(4), 265–274.
Eelen, P., Hermans, D., & Baeyens, F. (2001). Learning perspectives on anxiety disorders. In Griez, E. J. L., Faravelli, C., Nutt, & D. J., Zohar, J. (Eds.), Anxiety disorders: An introduction to clinical management and research. New York: Wiley.
Ehlers, A., & Margraf, J. (1989). The psychophysiological model of panic attacks. In Emmelkamp, P. M. G., Everaerd, W., Kraaimaat, F., & van Son, M. (Eds.), Fresh perspectives on anxiety (pp. 1–29). Amsterdam: Swets.
Emmelkamp, P. M. G. (1994). Behavior therapy with adults. In Bergin, A., & Garfield, S. (Eds.), Handbook of psychotherapy and behavior change. New York: Wiley.
Emmelkamp, P. M. G. (2004). Behavior therapy with adults. In Lambert, M., Bergin, A., & Garfield, S. (Eds.), Handbook of psychotherapy and behavior change (5th ed.). New York: Wiley.
Emmelkamp, P. M. G. (2005). Technological innovations in clinical assessment and psychotherapy. Psychotherapy & Psychosomatics, 74, 336–343.
Emmelkamp, P. M. G., Bouman, T. K., & Scholing, A. (1993). Anxiety disorders. Chichester, UK: Wiley.
Emmelkamp, P. M. G., Brilman, E., Kuiper, H., & Mersch, P. P. (1986). The treatment of agoraphobia: A comparison of self-instructional training, rational emotive therapy and exposure in vivo. Behavior Modification, 10, 37–53.
Emmelkamp, P. M. G., & Gerlsma, C. (1994). Marital functioning and the anxiety disorders. Behavior Therapy, 25, 407–429.
Emmelkamp, P. M. G., & Kamphuis, J. H. (2007). Personality disorders. New York: Psychology Press/Taylor & Francis.
Emmelkamp, P. M. G., Kuipers, A., & Eggeraat, J. (1978). Cognitive modification versus prolonged exposure in vivo: A comparison with agoraphobics. Behaviour Research and Therapy, 16, 33–41.
Emmelkamp, P. M. G., & Mersch, P. P. (1982). Cognition and exposure in vivo in the treatment of agoraphobia: Short-term and delayed effects. Cognitive Therapy and Research, 6, 77–90.
Emmelkamp, P. M. G., & Powers, M. B. (2009). Neo-Kraepelinian diagnosis: Adequacy for phobias and panic. In McKay, D., Abramowitz, J. S., Taylor, S., & Asmundson, G. J. G. (Eds.), Current perspectives on the anxiety disorders: Implications for DSM-V and beyond. New York: Springer (in press).
Emmelkamp, P. M. G., Van Dyck, R., Bitter, M., Heins, R., Onstein, E. J., & Eisen, B. (1992). Spouse-aided therapy with agoraphobics. British Journal of Psychiatry, 160, 51–56.
Emmelkamp, P. M. G., & Vedel, E. (2002). Spouse-aided therapy. In Hersen, M., & Sledge, W. (Eds.), The encyclopedia of psychotherapy, Vol. II. New York: Academic, 693–698.
Emmelkamp, P. M. G., & Vedel, E. (2006). Evidence-based treatment of alcohol and drug abuse: A practitioners guide to theory, research and treatment. New York: Routledge/Taylor & Francis.
Falls, W. A., Miserendino, M. J., & Davis, M. (1992). Extinction of fear-potentiated startle: Blockade by infusion of an NMDA antagonist into the amygdala. Journal of Neuroscience, 12(3), 854–863.
Fanner, D., & Urquhartt, C. (2008). Bibliotherapy for mental health service users Part 1: A systematic review. Health Information and Libraries Journal, 25, 237–252.
Faravelli, C., & Pallanti, S. (1989). Recent live events and panic disorder. American Journal of Psychiatry, 146, 622–626.
Fava, G. A., Rafanelli, C., Grandi, S., Conti, S., Ruini, C., Mangelli, L., et al. (2001). Long-term outcome of panic disorder with agoraphobia treated by exposure. Psychological Medicine, 31, 891–898.
Feldner, M. T., Zvolensky, M. J., & Leen-Feldner, E. W. (2004). A critical review of the empirical literature on coping and panic disorder. Clinical Psychology Review, 24, 123–148.
First, M. B., Spitzer, R. L., & Gibbon, M. (1994). Structured clinical interview for DSM-IV disorders, SCID-I. New York: Biometrics Research.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I, Research version). New York: Biometric Research Department.
Foa, E. B., Grayson, J. B., Steketee, G. S., Doppelt, H. G., Turner, R. M., & Latimer, P. R. (1983). Success and failure in the behavioral treatment of obsessive-compulsives. Journal of Consulting and Clinical Psycholgy, 51(2), 287–297.
Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35.
Foa, E. B., & McNally, R. J. (1996). Mechanisms of change in exposure therapy. In Rapee, R. M. (Ed.), Current controversies in the anxiety disorders (pp. 329–343). New York: Guilford.
Furukawa, T. A., Watanabe, N., & Churchill, R. (2007). Combined psychotherapy plus antidepressants for panic disorder with or without agoraphobia. Cochrane Database Systematic Reviews, 24(1), CD004364.
Ghane, S., Kolk, A. M., & Emmelkamp, P. M. G. (in press). Assessment of explanatory models of mental illness: Effects of patient and interviewer characteristics. Social Psychiatry and Psychiatric Epidemiology.
Gladsjo, J. A., Rapaport, M. H., McKinney, R., Auerbach, M., Hahn, T., Rabin, A., et al. (2001). Absence of neuropsychologic deficits in patients receiving long-term treatment with alprazolam-XR for panic disorder. Journal of Clinical Psychopharmacology, 21(2), 131–138.
Goldstein, A. J., & Chambless, D. L. (1978). A reanalysis of agoraphobia. Behavior Therapy, 9, 47–59.
Gonzalez-Lima, F., & Bruchey, A. K. (2004). Extinction memory improvement by the metabolic enhancer methylene blue. Learning and Memory, 11(5), 633–640.
Gould, R. A., & Clum, G. A. (1995). Self-help plus minimal therapist contact in the treatment of panic disorder: A replication and extension. Behavior Therapy, 26, 533–546.
Gould, R. A., Otto, M. W., & Pollack, M. H. (1995). A meta-analysis of treatment outcome for panic disorder. Clinical Psychology Review, 15, 819–844.
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., et al. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders. Archives of General Psychiatry, 61, 807–816.
Gunther, L. M., Denniston, J. C., & Miller, R. R. (1998). Conducting exposure treatment in multiple contexts can prevent relapse. Behaviour Research and Therapy, 36(1), 75–91.
Hazen, A. L., Walker, J. R., & Eldridge, G. D. (1996). Anxiety sensitivity and treatment outcome in panic disorder. Anxiety, 2, 34–39.
Hecker, J. E., Losee, M. C., Roberson-Nay, R., & Maki, K. (2004). Mastery of your anxiety and panic and brief therapist contact in the treatment of panic disorder. Journal of Anxiety Disorders, 18, 111–126.
Hegel, M. T., Lewis Ravaris, C., & Ahles, T. A. (1994). Combined cognitive-behavioral and time-limited alprazolam treatment of panic disorder. Behavior Therapy, 25(2), 183–195.
Hoffart, A. (1995). A comparison of cognitive and guided mastery therapy of agoraphobia. Behaviour Research and Therapy, 33, 423––434.
Hoffart, A., & Martinsen, E. W. (1990). Exposure-based integrated vs. pure psychodynamic treatment of agoraphobic inpatients. Psychotherapy, 27, 210–218.
Hofmann, S. G., Meuret, A. E., Smits, J. A., Simon, N. M., Pollack, M. H., Eisenmenger, K., et al. (2006). Augmentation of exposure therapy with D-cycloserine for social anxiety disorder. Archives of General Psychiatry, 63(3), 298–304.
Houck, P. R., Spiegel, D. A., Shear, K., & Rucci, P. (2002). Reliability of the self-report version of the panic disorder severity scale. Depression and Anxiety, 15, 183–185.
Hunsley, J., & Lee, C. M. (2007). Research-informed benchmarks for psychological treatments: Efficacy studies, effectiveness studies, and beyond. Professional Psychology, Research & Practice, 38, 21–33.
Ietsugu, T., Sukigara, M., & Furukawa, T. A. (2007). Evaluation of diagnostic criteria for panic attack using item response theory: Findings from the national comorbidity survey in USA. Journal of Affective Disorders, 104, 197–201.
Kamphuis, J. H., & Telch, M. J. (2000). Effects of distraction and guided threat reappraisal on fear reduction during exposure-based treatments for specific fears. Behaviour Research and Therapy, 38, 1163–1181.
Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg, J., & Anthony, J. C. (1997). The lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the national comorbidity survey. Archives of General Psychiatry, 54, 313–321.
Khawaja, N. G., & Oei, T. P. S. (1992). Development of a Catastrophic cognition questionnaire. Journal of Anxiety Disorders, 6, 305–318.
Kingdon, D., Tyrer, P., Seivewright, N., Ferguson, B., & Murphy, S. (1996). The Nottingham study of neurotic disorders: Influence of cognitive therapists on outcome. British Journal of Psychiatry, 169, 93–97.
Kiropoulos, L. A., Klein, B., Austin, D. W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008). Is Internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders, 22, 1273–1284.
Klass, E. T., Milrod, B. L., Leon, A. C., Kay, S. J., Schwalberg, M., Li, C., & Markowitz, J. C. (2009). Does interpersonal loss preceding panic disorder onset moderate response to psychotherapy? An exploratory study. Journal of Clinical Psychiatry (in press).
Klein, B., Richards, J. C., & Austin, D. W. (2006). Efficacy of internet therapy for panic disorder. Journal of Behav-ior Therapy and Experimental Psychiatry, 37, 213–238.
Klosko, J. S., Barlow, D. H., Toussinari, R. B., & Cerny, J. A. (1990). A comparison of alprazolam and behavior therapy in the treatment of panic disorder. Journal of Consulting and Clinical Psychology, 58, 805–810.
Kozak, M. J., Foa, E. B., & Steketee, G. (1988). Process and outcome of exposure treatment with obsessive-compulsives: Psychophysiological indicators of emotional processing. Behavior Therapy, 19, 157–169.
Kushner, M. G., Kim, S. W., Donahue, C., Thuras, P., Adson, D., Kotlyar, M., et al. (2007). D-cycloserine augmented exposure therapy for obsessive-compulsive disorder. Biological Psychiatry, 62, 835–838.
Lelliott, P. T., Marks, I. M., Monteiro, W. O., Tsakiris, F., & Noshirvani, H. (1987). Agoraphobia 5 years after imipramine and exposure: Outcome and prediction. Journal of Nervous and Mental Disease, 175, 599–605.
Marcaurelle, R., Bélanger, C., & Marchand, A. (2003). Marital relationship and the treatment of panic disorder with agoraphobia: A critical review. Clinical Psychology Review, 23, 247–276.
Marchand, M., Coutu, M. F., Dupuis, G., Fleet, R., Borgeat, B., Todorov, C., et al. (2008). Treatment of panic disorder with agoraphobia: Randomized placebo-controlled trial of four psychosocial treatments combined with imipramine or placebo. Cognitive Behavior Therapy, 37, 146–159.
Marks, I., Swinson, R. P., Basoglu, M., Kuch, K., Noshirvani, H., O’Sullivan, G., et al. (1993). Alprazolam and exposure alone and combined in panic disorder with agoraphobia. A controlled study in London and Toronto. British Journal of Psychiatry, 162, 776–787.
Mathew, S. J., Price, R. B., & Charney, D. S. (2008). Recent advances in the neurobiology of anxiety disorders: Implications for novel therapeutics. American Journal of Medical Genetics, Part C: Seminars in Medical Genetics, 148(2), 89–98.
Michelson, L., Mavissakalian, M., & Marchione, K. (1988). Cognitive, behavioral and psychophysiological treatments of agoraphobia: A comparative outcome investigation. Behavior Therapy, 19, 97–120.
Milrod, B., Leon, A. C., Busch, F., Shapiro, T., Aronson, A., & Roiphe, J., et al. (2007). A randomized controlled clinical trial of psychoanalytic psychotherapy for panic disorder. American Journal of Psychiatry, 164, 265–272.
Milrod, B., Leon, A. C., & Shear, M. K. (2004). Can interpersonal loss precipitate panic disorder? American Journal of Psychiatry, 161, 758–759.
Mineka, S. (1985). Animal models of anxiety-based disorders: Their usefulness and limitations. In Tuma, A. H., & Maser, J. D. (Eds.), Anxiety and the anxiety disorders. Hillside, NJ: Lawrence Erlbaum.
Mohlman, J., & Zinbarg, R. E. (2000). What kind of attention is necessary for fear reduction? An empirical test of the emotional processing model. Behavior Therapy, 31, 113–133.
Morris, R. W., & Bouton, M. E. (2007). The effect of yohimbine on the extinction of conditioned fear: A role for context. Behavioral Neuroscience, 121(3), 501–514.
Mystkowski, J. L., Craske, M. G., Echiverri, A. M., & Labus, J. S. (2006). Mental reinstatement of context and return of fear in spider-fearful participants. Behavior Therapy, 37(1), 49–60.
Mystkowski, J. L., Mineka, S., Vernon, L. L., & Zinbarg, R. E. (2003). Changes in caffeine states enhance return of fear in spider phobia. Journal of Consulting and Clinical Psychology, 71(2), 243–250.
NIH. (1991). Treatment of panic disorder: NIH consensus statement. Retrieved on January 20, 2009, from http://consensus.nih.gov/1991/1991PanicDisorder085html.htm
NIH. (1992). NIH releases consensus statement on panic disorder. American Family Physician, 45(1), 261–262, 264.
NIH. (1993). Treatment of panic disorder: Summary of the NIH consensus statement. Maryland Medical Journal, 42(3), 306–307.
Norton, P. J., Zvolensky, M. J., Bonn-Miller, M. O., Cox, B. J., & Norton, G. R. (2008). Use of the panic attack questionnaire-IV (PAQ-IV) to assess non-clinical panic attacks and limited symptom panic attacks in student and community samples. Journal of Anxiety Disorders, 22, 1159–1171.
Oei, T. P., Llamas, M., & Devilly, G. J. (1999). The efficacy and cognitive processes of cognitive behaviour therapy in the treatment of panic disorder with agoraphobia. Behavioural and Cognitive Psychotherapy, 27, 63–88.
Otto, M. W., Pollack, M. H., & Sabatino, S. A. (1996). Maintenance of remission following cognitive behavior therapy for panic disorder: Possible deleterious effects of concurrent medication treatment. Behavior Therapy, 27, 473–482.
Otto, M. W., Pollack, M. H., Sachs, G. S., Reiter, S. R., Meltzer-Brody, S., & Rosenbaum, J. F. (1993). Discontinuation of benzodiazepine treatment: Efficacy of cognitive-behavioral therapy for patients with panic disorder. American Journal of Psychiatry, 150(10), 1485–1490.
O’Sullivan, G., & Marks, I. (1990). Long-term outcome of phobic and Obsessive-compulsive disorders after treatment. In Noyes, R., Roth, M., & Burrows, C. D. (eds.), Handbook of Anxiety, Vol. 4, pp. 87–108. Elsevier: Amsterdam.
Patten, S. B., & Williams, J. V. A. (2007). Chronic obstructive lung diseases and prevalence of mood, anxiety, and substance-use disorders in a large population sample. Psychosomatics, 48, 496–501.
Penfold, K., & Page, A. C. (1999). The effect of distraction on within-session anxiety reduction during brief in vivo exposure for mild blood-injection fears. Behavior Therapy, 30, 607–621.
Peter, H., Brückner, E., Hand, I., Rohr, W., & Rufer, M. (2008). Treatment outcome of female agoraphobics 3–9 years after exposure in vivo: A comparison with healthy controls. Journal of Behavior Therapy and Experimental Psychiatry, 39, 3–10.
Peterson, R. A., & Reiss, S. (1987). Anxiety sensitivity index. Palos Heights, IL: International Diagnostic Systems.
Peterson, R. A., & Reiss, S. (1993). Anxiety sensitivity index revised test manual. Worthington, OH: IDS.
Pollard, A. C., Pollard, H. J., Corn, K. J. (1989). Panic onset and major events in the lives of agoraphobics: A test of contiguity. Journal of Abnormal Psychology, 3, 318–321.
Powers, M. B., & Emmelkamp, P. M. G. (2009). Dissemination of research findings. In Richard, D., & Huprick, S. (Eds.), Clinical psychology: Assessment, treatment and research (pp. 495–524). Burlington, MA: Elsevier.
Powers, M. B., Smits, J. A. J., Otto, M. W., Sanders, C., & Emmelkamp, P. M. G. (2009). Facilitation of fear extinction in phobic participants with a novel cognitive enhancer: A randomized placebo controlled trial of yohimbine augmentation. Journal of Anxiety Disorders, 23, 350–356.
Powers, M. B., Smits, J. A., & Telch, M. J. (2004). Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: A placebo-controlled trial. Journal of Consulting and Clinical Psychology, 72(3), 448–454.
Powers, M. B., Smits, J. A. J., Whitley, D., Bystritsky, A., & Telch, M. J. (2008). The Effect of Attributional Processes Concerning Medication Taking on Return of Fear. Journal of Consulting and Clinical Psychology, 76(3), 478–490.
Rachman, S. (1980). Emotional processing. Behavior Research and Therapy, 18(1), 51–60.
Rachman, S. (1994). The overprediction of fear: A review. Behaviour Research and Therapy, 32(7), 683–690.
Rachman, S., Craske, M. G., Tallman, K., & Solyom, C. (1986). Does escape behavior strengthen agoraphobic avoidance? A replication. Behavior Therapy, 17, 366–384.
Raffa, S. D., White, K. S., & Barlow, D. H. (2004). Feared consequences of panic attacks in panic disorder: A qualitative and qualitative analysis. Cognitive Behaviour Therapy, 33, 199–207.
Reiss, S., Peterson, R. A., Gursky, D. M., McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8.
Rescorla, R. A., & Heth, C. D. (1975). Reinstatement of fear to an extinguished conditioned stimulus. Journal of Experimental Psychology: Animal Beha-viour Process, 1(1), 88–96.
Rescorla, R. A., & Wagner, A. R. (1972). A theory of Pavlovian conditioning: Variations in the effectiveness of reinforcement and nonreinforcement. In Black, A. H., & Prokasy, W. F. (Eds.), Classical conditioning II: Current research and theory (pp. 64–99). New York: Appleton-Century-Crofts.
Ressler, K. J., Rothbaum, B. O., Tannenbaum, L., Anderson, P., Graap, K., Zimand, E., et al. (2004). Cognitive enhancers as adjuncts to psychotherapy: Use of D-cycloserine in phobic individuals to facilitate extinction of fear. Archives of General Psychiatry, 61(11), 1136–1144.
Ricker, S. T., & Bouton, M. (1996). Reacquisition following extinction in appetitive conditioning. Animal Learning and Behavior, 24, 423–436.
Rijken, H., Kraaimaat, F., de Ruiter, C., & Garssen, B. (1992). A follow-up study on short-term treatment of agoraphobia. Behaviour Research and Therapy, 30, 63–66.
Rollman, B. L., Belnap, B. H., & Mazumdar, S., et al. (2005). A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care. Archives of General Psychiatry, 62, 1332–1341.
Rowe, M. K., & Craske, M. G. (1998). Effects of an expanding-spaced vs massed exposure schedule on fear reduction and return of fear. Behaviour Research and Therapy, 36(7–8), 701–717.
Roy-Byrne, P., Russo, J., Dugdale, D. C., Lessler, D., Cowley, D., & Katon, W. (2002). Undertreatment of panic disorder in primary care: Role of patient and physician characteristics. Journal of the American Board of Family Medicine, 15(6), 443–450.
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic. Behavioural Psychotherapy, 19, 6–19.
Salkovskis, P. M., Jomes, D. R. G., & Clark, D. M. (1986). Respiratory control in the treatment of panic attacks: Replication and extension with concurrent measurement of behaviour and pCO2. British Journal of Psychiatry, 148, 526–532.
Schadé, A., Marquenie, L. A., Van Balkom, A. J. L. M., Koeter, M. W. J., De Beurs, E., Van den Brink, W., et al. (2004). Alcohol-dependent patients with comorbid phobic disorders: A comparison between comorbid patients, pure alcohol-dependent and pure phobic patients. Alcohol and Alcoholism, 39, 241–246.
Schadé, A., Marquenie, L. A., Van Balkom, A. J. L. M., Koeter, M. W. J., De Beurs, E., Van Dyck, R., et al. (2005). The effectiveness of anxiety treatment on alcohol-dependent patients with a comorbid phobic disorder: A randomized controlled trial. Alcoholism: Clinical and Experimental Research, 29, 794–800.
Schmidt, N. B., Wollaway-Bickel, K., Trakowski, J. H., Santiago, H. T., & Vasey, M. (2002). Antidepressant discontinuation in the context of cognitive behavioral treatment for panic disorder. Behaviour Research & Therapy, 40(1), 67–73.
Schmidt, N. B., Woolaway-Bickel, K., Trakowski, J., Santiago, H., Storey, J., Koselka, M., et al. (2000). Dismantling cognitive-behavioral treatment for panic disorder: Questioning the utility of breathing retraining. Journal of Consulting and Clinical Psychology, 68(3), 417–424.
Schneider, A. J., Mataix-Cois, D., Marks, I. M., & Bachofen, M. (2005). Internet guided self-help with or without exposure therapy for phobic and panic disorders. Psychotherapy and Psychosomatics, 74, 154–164.
Schneider, U., Altmann, A., Baumann, M., Bernzen, J., Bertz, B., Bimber, U., et al. (2001). Comorbid anxiety and affective disorder in alcohol-dependent patients seeking treatment: The first multicentre study in Germany. Alcohol and Alcoholism, 36, 219–223.
Scocco, P., Barbieri, I., & Frank, E. (2007). Interpersonal problem areas and onset of panic disorder. Psychopathology, 40, 8–13.
Scupi, B. S., Benson, B. E., Brown, L. B., & Uhde, T. W. (1997). Rapid onset: A valid panic disorder criterion? Depression and Anxiety, 5, 121–126.
Sharp, D. M., Power, K. G., Simpson, R. J., Swanson, V., Moodie, E., Anstee, J. A., et al. (1996). Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia. Journal of Anxiety Disorders, 10(4), 219–242.
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., et al. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154(11), 1571–1575.
Shear, M. K., Brown, T. A., Sholomskas, D. E., Barlow, D. H., Gorman, J. M., Woods, S. W. et al. (1992). Panic disorder severity scale (PDSS). Pittsburgh, PA: Department of Psychiatry, University of Pittsburgh School of Medicine.
Shear, M. K., Pilkonis, P. A., Cloitre, M., & Leon, A. C. (1994). Cognitive behavioral treatment compared with nonprescriptive treatment of panic disorder. Archives of General Psychiatry, 53, 395–401.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R., & Dunbar, C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(suppl 20), 22–33.
Smits, J. A., Powers, M. B., Cho, Y., & Telch, M. J. (2004). Mechanism of change in cognitive-behavioral treatment of panic disorder: Evidence for the fear of fear mediational hypothesis. Journal of Consulting and Clinical Psychology, 72(4), 646–652.
Spiegel, D. A., & Bruce, T. J. (1997). Benzodiazepines and exposure-based cognitive behavior therapies for panic disorder: Conclusions from combined treatment trials. American Journal of Psychiatry, 154, 773–781.
Spiegel, D. A., Bruce, T. J., Gregg, S. F., & Nuzzarello, A. (1994). Does cognitive behavior therapy assist slow-taper alprazolam discontinuation in panic disorder? American Journal of Psychiatry, 151(6), 876–881.
Spira, A. P., Zvolensky, M. J., Eifert, G. H., & Feldner, M. T. (2004). Avoidance-oriented coping as a predictor of panic-related distress: A test using biological challenge. Journal of Anxiety Disorders, 18, 309–323.
Swinson, R. P., Fergus, K. D., Cox, B. J., Wickwire, K. (1995). Efficacy of telephone-administered behavioral therapy for panic disorder with agoraphobia. Behaviour Research & Therapy, 33, 465–469.
Taylor, C., King, R., Margraf, J., Ehlers, A., Telch, M., Roth, W., et al. (1989). Use of medication and in vivo exposure in volunteers for panic disorder research. American Journal of Psychiatry, 146(11), 1423–1426.
Taylor, S., Koch, W. J., & McNally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6(3), 249–259.
Telch, M. J. (1987). The panic appraisal inventory. Unpublished manuscript: University of Texas at Austin.
Telch, M. J., Agras, W. S., Taylor, C. B., Roth, W. T., & Gallen, C. C. (1985). Combined pharmacological and behavioral treatment for agoraphobia. Behaviour Research and Therapy, 23, 325–335.
Telch, M. J., Brouillard, M., Telch, C. F., Agras, W. S., & Taylor, C. B. (1989). Role of cognitive appraisal in panic-related avoidance. Behaviour Research and Therapy, 27(4), 373–383.
Teusch, L., Böhme, H., & Gastpar, M. (1997). The benefit of an insight-oriented and experiential approach on panic and agoraphobia symptoms. Psychotherapy and Psychosomatics, 66, 293–301.
Tsao, J. C., & Craske, M. G. (2000). Timing of treatment and return of fear: Effects of massed, uniform-, and expanding-spaced exposure schedules. Behavior Therapy, 31(3), 479–497.
Tsao, J. C., Lewin, M. R., & Craske, M. G. (1998). The Effects of Cognitive-Behavior Therapy for Panic Disorder on Comorbid Conditions. Journal of Anxiety Disorders, 12(4), 357–371.
Tsao, J. C., Mystkowski, J. L., Zucker, B. G., & Craske, M. G. (2002). Effects of cognitive-behavioral therapy for panic disorder on comorbid conditions: Replication and extension. Behavior Therapy, 33(4), 493–509.
Tsao, J. C., Mystkowski, J. L., Zucker, B. G., & Craske, M. G. (2005). Impact of cognitive-behavioral therapy for panic disorder on comorbidity: A controlled investigation. Behaviour Research & Therapy, 43(7), 959–970.
van Balkom, A. J. L. M., Bakker, A., Spinhoven, P., Blaauw, B. M. J. W., Smeenk, S., & Ruesink, B. (1997). A meta-analysis of the treatment of panic disorder with or without agoraphobia: A comparison of psychopharmacological, cognitive-behavioral, and combination treatments. Journal of Nervous and Mental Disease, 185, 510–516.
van Balkom, A. J. L. M., Nauta, M. C. E., & Bakker, A. (1995). Meta-analysis on the treatment of panic disorder with agoraphobia: Review and re-examination. Clinical Psychology and Psychotherapy, 2, 1–14.
Van den Hout, M., Arntz, A., & Hoekstra, R. (1994). Exposure reduced agoraphobia but not panic, and cognitive therapy reduced panic but not agoraphobia. Behaviour Research and Therapy, 32, 447–451.
van der Molen, G. M., van den Hout, M. A., & Halfens, R. (1988). Agoraphobia and Locus of Control. Journal of Psychopathology and Behavioral Assessment, 10, 269–275.
van Hout, W. J. P. J., & Emmelkamp, P. M. G. (2002). Exposure in vivo. In Hersen, M., & Sledge, W. (Eds.), The Encyclopedia of Psychotherapy. New York: Academic.
van Hout, W. J. P. J., Emmelkamp, P. M. G., Koopmans, P. C., Bögels, S. M., & Bouman, T. K. (2001). Assessment of self-statements in agoraphobic situations: Construction and psychometric evaluation of the Agoraphobic Self-statements Questionnaire (ASQ). Journal of Anxiety Disorders, 15, 183–201.
van Hout, W. J. P. J., Emmelkamp, P. M. G., & Scholing, A. (1994). The role of negative self-statements in agoraphobic situations: A process study of eight panic disorder patients with agoraphobia. Behavior Modification, 18, 389–410.
Vansteenwegen, D., Vervliet, B., Iberico, C., Baeyens, F., Van den Bergh, O., & Hermans, D. (2007). The repeated confrontation with videotapes of spiders in multiple contexts attenuates renewal of fear in spider-anxious students. Behaviour Research and Therapy, 45(6), 1169–1179.
Vervliet, B. (2008). Learning and memory in conditioned fear extinction: Effects of D-cycloserine. Acta Psycholiga, 127(3), 601–613.
Watanabe, N., Churchill, R., & Furukawa, T. A. (2007). Combination of psychotherapy and benzodiazepines versus either therapy alone for panic disorder: A systematic review. BMC, Psychiatry, 7, 18.
Weiser, E. B. (2007). The prevalence of anxiety disorders among adults with asthma: A meta-analytic review. Journal of Clinical Psychology in Medical Settings, 14, 297–307.
Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26(1), 153–161.
Whittal, M. L., Otto, M. W., & Hong, J. J. (2001). Cognitive-behavior therapy for discontinuation of SSRI treatment of panic disorder: A case series. Behavior Research and Therapy, 39(8), 939–945.
WHO. (1997). Composite International Diagnostic Interview (CIDI) researcher’s manual. Washington, DC: American Psychiatric Press.
Williams, S. L., & Falbo, J. (1996). Cognitive and per-formance-based treatments for panic attacks in people with varying degrees of agoraphobic disability. Behaviour Research and Therapy, 34, 253–264.
Williams, S. L., & Zane, G. (1989). Guided mastery and stimulus exposure treatments for severe performance anxiety in agoraphobics. Behaviour Research and Therapy, 27, 237–245.
Wolitzky, K. B., & Telch, M. J. (2009). Augmenting in vivo exposure with fear antagonistic actions: A preliminary test. Behavior Therapy, 40, 57–71.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media LLC
About this entry
Cite this entry
Emmelkamp, P.M.G., Powers, M.B. (2010). Agoraphobia. In: Thomas, J.C., Hersen, M. (eds) Handbook of Clinical Psychology Competencies. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09757-2_26
Download citation
DOI: https://doi.org/10.1007/978-0-387-09757-2_26
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-09756-5
Online ISBN: 978-0-387-09757-2
eBook Packages: Behavioral ScienceReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences