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Agoraphobic symptoms may arise out of a number of physical and psychological processes and a comprehensive assessment approach is advised.
Assessment of the symptoms and associated cognitions and behaviour
Initially it is important to identify:
- Description of presenting problem.
- Frequency of the symptoms, how often do they occur
- Severity of the symptoms.
Differential diagnostic issues
People with agoraphobia are sometimes brought to the attention of the health system as a consequence of the panic attacks and the symptoms may be misdiagnosed as symptoms of a serious health condition such as myocardial infarction. The predominance of panic in the symptomatology may lead to a diagnosis of panic disorder but it is now generally thought that agoraphobia is the result of a particular avoidant response to the panic experience with consequences significant enough for it to be considered a condition in its own right. So for example DSM-IV allows for the diagnosis of panic disorder with agoraphobia and also panic disorder without agoraphobia. The comorbidity of panic disorder with agoraphobia ranges from 30% to 60%. For example in the National Comorbidity Study (Eaton et al., 1994) 50% of the panic disorder patients had comorbid agoraphobia.
References & Bibliography
- Mavissakalian, M.(1987)Trimodal assessment in agoraphobia research: Further observations on heart rate and synchrony/ desynchrony. Journal of Psychopathology and Behavioral Assessment Vol 9, 1, 89-98. ISSN 0882-2689 (Print) 1573-3505 (Online). DOI 10.1007/BF00961634