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Fear of Autonomic Arousal and Use of Coping Strategies as Predictors of Agoraphobic Avoidance in Panic Disorder

Published online by Cambridge University Press:  06 October 2014

Patricia Rayment  and
Jeff Richards
Patricia Rayment
Affiliation:
University of Adelaide
Jeff Richards*
Affiliation:
University of Ballarat
*
School of Behavioural and Social Sciences, University of Ballarat, PO Box 663, Ballarat VIC 3353, Australia
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Extract

Despite the very significant proportion of people with panic disorder who have accompanying agoraphobia, there is considerable controversy about the variables that influence the development of this avoidance behaviour. This study investigated whether degree of avoidance is a function of extent of fear and prevalence of negative cognitions about autonomic arousal symptoms and whether the use of, and confidence in, behavioural strategies to cope with panic sensations also influences agoraphobic avoidance. Thirty-nine people who met DSM-IV criteria for panic disorder completed questionnaires measuring fear and negative cognitions about autonomic arousal and panic sensations, and a questionnaire measuring their use of largely behavioural strategies to cope with panic attacks. Fear of autonomic arousal and negative cognitions in response to the occurrence of these arousal symptoms were jointly related to situational avoidance. There was little relationship between the use of, and confidence in, panic coping strategies and less agoraphobic avoidance, although simply allowing panic symptoms to develop and pass predicted less avoidance. The results were interpreted as providing an empirical basis for treatment that reduces fear of panic sensations and allows their experience to be tolerated while preventing escape and avoidance of situations in which panic occurs. There was little evidence that additional teaching of behavioural coping strategies would be useful in reducing agoraphobic avoidance.

Type
Articles
Information
Behaviour Change , Volume 15 , Issue 4 , December 1998 , pp. 228 - 236
Copyright
Copyright © The Author(s) 1998

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References

Adler, C.M., Craske, M.G., Kirshenbaum, S., & Barlow, D.H. (1989). “Fear of panic”: An investigation of its role in panic occurrence, phobic avoidance, and treatment outcome. Behaviour Research and Therapy, 27(4), 391–396.Google Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Arrindell, W.A. (1993). The fear of fear concept: Stability, retest artefact and predictive power. Behaviour Research and Therapy, 31(2), 139–148.Google Scholar
Barlow, D.H. (1991). Disorders of emotion. Psychological Inquiry, 2(1), 58–71.CrossRefGoogle Scholar
Barlow, D.H., Vermilyea, J., Blanchard, E.B., Vermilyea, B.B., Di Nardo, P.A., & Cerny, J.A. (1985). The phenomenon of panic. Journal of Abnormal Psychology, 94, 320–328.Google Scholar
Beck, A.T., & Emery, G. (1985). Anxiety disorders and phobias. New York: Basic Books.Google Scholar
Beitman, B.D., Basha, I., Flaker, G., DeRosear, L., Mukerji, V., & Lamberti, J. (1987). Non-fearful panic disorder: Panic attacks without fear. Behaviour Research and Therapy, 25(6), 487–492.CrossRefGoogle ScholarPubMed
Borden, J.W., Clum, G.A., Broyles, S.E., & Watkins, P.L. (1988). Coping strategies and panic. Journal of Anxiety Disorders, 2, 339–352.CrossRefGoogle Scholar
Borden, J.W., Clum, G.A., & Salmon, P.G. (1991). Mechanisms of change in the treatment of panic. Cognitive Therapy and Research, 75(4), 257–272.Google Scholar
Brown, T.A., DiNardo, P.A., & Barlow, D.H. (1994). Anxiety Disorders Interview Schedule for DSM-IV. New York: Graywind.Google Scholar
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, 32(6), 1090–1097.CrossRefGoogle Scholar
Chambless, D.L., & Gracely, E.J. (1989). Fear of fear and the anxiety disorders. Cognitive Therapy and Research, 13(1), 9–20.Google Scholar
Clark, D.M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461–470.Google Scholar
Clum, G.A., & Knowles, S.L. (1991). Why do some people with panic disorders become avoidant?: A review. Clinical Psychology Review, 11, 295–313.Google Scholar
Cox, B.J., Endler, N.S., & Swinson, R.P. (1995). An examination of levels of agoraphobic severity in panic disorder. Behaviour Research and Therapy, 33(1), 57–62.Google Scholar
Cox, B.J., Endler, N.S., Swinson, R.P. & Norton, G.R. (1992). Situations and specific coping strategies associated with clinical and nonclinical panic attacks. Behavior Research and Therapy, 30(1), 67–69.CrossRefGoogle ScholarPubMed
Cox, B.J., Swinson, R.P., Norton, G.R., & Kuch, K. (1991). Anticipatory anxiety and avoidance in panic disorder with agoraphobia. Behaviour Research and Therapy, 29(4), 363–365.CrossRefGoogle ScholarPubMed
Craske, M.G., & Barlow, D.H. (1993). Panic disorder and agoraphobia. In Barlow, D.H. (Ed.), Clinical handbook of psychological disorders (2nd ed., pp. 1–47). New York: Guildford.Google Scholar
Craske, M.G., Rapee, R.M., & Barlow, D.H. (1988). The significance of panic-expectancy for individual patterns of avoidance. Behavior Therapy, 19, 577–592.CrossRefGoogle Scholar
Craske, M.G., Sanderson, W.C., & Barlow, D.H. (1987). The relationships among panic, fear and avoidance. Journal of Anxiety Disorders, 1, 153–160.Google Scholar
Fleming, B., & Faulk, A. (1989). Discrirninating factors in panic disorder with and without agoraphobia. Journal of Anxiety Disorders, 3, 209–219.Google Scholar
Goldstein, A.J., & Chambless, D.L. (1978). A reanalysis of agoraphobia. Behavior Therapy, 9, 47–59.Google Scholar
Klein, D.F. (1981). Anxiety reconceptualised. In Klein, D.F. & Rabkin, J. (Eds.), Anxiety: New research and changing concepts (pp. 164–235). New York: Raven.Google Scholar
Margraf, J., Barlow, D.H., Clark, D.M., & Telch, M.J. (1993). Psychological treatment of panic: Work in progress on outcome, active ingredients, and follow-up. Behaviour Research and Therapy, 31(1), 1–8.Google Scholar
Margraf, J., Ehlers, A., & Roth, W.T. (1986). Panic attacks: Theoretical models and empirical evidence. In Hand, I. & Wittchen, H.-U. (Eds.), Panic and phobias (pp. 35–52). Berlin: Springer-Verlag.Google Scholar
Mavissakalian, M. (1988). The relationship between panic, phobic and anticipatory anxiety in agoraphobia. Behaviour Research and Therapy, 26(3), 235–240.Google Scholar
McNally, R.J., & Lorenz, M. (1987). Anxiety sensitivity in agoraphobics. Journal of Behavior Therapy and Experimental Psychiatry, 18(1), 3–11.Google Scholar
Noyes, R., Clancy, J., Garvey, M.J., & Anderson, D.J. (1987). Is agoraphobia a variant of panic disorder or a separate illness? Journal of Anxiety Disorders, 1, 3–13.CrossRefGoogle Scholar
Rapee, R.M., & Murrell, E. (1988). Predictors of agoraphobic avoidance. Journal of Anxiety Disorders, 2, 203–217.CrossRefGoogle Scholar
Reiss, S., & McNally, R.J. (1985). The expectancy model of fear. In Reiss, S. & Bootzin, R.R. (Eds.), Theoretical issues in behavior therapy (pp. 107–121). New York: Academic Press.Google Scholar
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), 1–8.Google Scholar
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.CrossRefGoogle ScholarPubMed
Turner, S.M., Williams, S.L., Beidel, D.C., & Mezzich, J.E. (1986). Panic disorder and agoraphobia with panic attacks: Covariation along the dimensions of panic and agoraphobic fear. Journal of Abnormal Psychology, 95(4), 384–388.Google Scholar
Wardle, J., Ahmad, T., & Hayward, P. (1990). Anxiety sensitivity in agoraphobia. Journal of Anxiety Disorders, 4(4), 325–333.CrossRefGoogle Scholar
Warren, R., Zgourides, G., & Jones, A. (1989). Cognitive bias and irrational belief as predictors of avoidance. Behaviour Research and Therapy, 27(2), 181–188.Google Scholar