AGORAPHOBIA
Keerthana V
II MSc Psychology
INDEX
INTRODUCTION
CLINICAL FEATURES
PREVALENCE, AGE OF ONSET, AND GENDER DIFFERENCES
COMORBIDITY WITH OTHER DISORDERS
BIOLOGICAL CAUSAL FACTORS
PSYCHOLOGICAL CAUSAL FACTORS
TREATMENTS
INTRODUCTION
• Agoraphobia is an anxiety disorder characterized by an intense fear of
situations where escape might be difficult or help unavailable in case of a
panic attack.
• Common triggers: Open spaces, crowded places, public transportation, or
being outside the home alone.
• Often misunderstood as a fear of open spaces, but it’s more about fear of
experiencing panic in inescapable situations.
• Can severely impair daily functioning and quality of life.
CLINICAL FEATURES
Physical Symptoms: Rapid heartbeat, sweating, trembling, shortness of breath,
chest pain, dizziness.
Psychological Symptoms: Fear of losing control, fear of dying, fear of
embarrassment.
Behavioral Symptoms: Avoidance of triggering situations, dependence on a
companion, staying indoors for prolonged periods.
Panic Attacks: Often accompany agoraphobia, leading to anticipatory anxiety.
EPIDEMIOLOGY
PREVALENCE, AGE OF ONSET, AND GENDER DIFFERENCES
Global Prevalence: Approximately 1-2% of the general population.
Lifetime Prevalence: Around 1.7% of adults experience agoraphobia at some point.
Higher prevalence in urban areas due to increased exposure to triggering environments.
Age of Onset: Typically begins in late adolescence or early adulthood (around 20-30 years).
Gender Differences: Women are 2-3 times more likely to develop agoraphobia than men.
Possible reasons: Sociocultural factors, hormonal influences, and differences in coping
mechanisms
COMORBIDITY WITH OTHER DISORDERS
Common Comorbid Disorders:
Panic Disorder (most common)
Generalized Anxiety Disorder (GAD)
Major Depressive Disorder
Social Anxiety Disorder
Substance Use Disorders (e.g., alcohol or drugs used to self-medicate)
Comorbidity often complicates diagnosis and treatment.
ETIOLOGY
Biological Factors: Genetic predisposition, dysregulation of
neurotransmitters (e.g., serotonin, norepinephrine).
Psychological Factors: History of panic attacks, learned
avoidance behaviors, hypervigilance to bodily sensations.
Environmental Factors: Traumatic events, stressful life
events, or a history of childhood adversity.
Cognitive Factors: Catastrophic thinking patterns (e.g., "I will
die if I have a panic attack").
TREATMENTS
Psychotherapy:
Cognitive Behavioral Therapy (CBT) is the gold standard for treatment. It focuses on
identifying and challenging irrational thoughts and gradually exposing the patient to feared
situations.
Exposure Therapy: Systematic desensitization to triggers.
Medications:
SSRIs (e.g., sertraline, fluoxetine) or SNRIs (e.g., venlafaxine) for anxiety management.
Benzodiazepines (short-term use due to dependency risk).
Lifestyle Changes: Stress management, regular exercise, and mindfulness practices.
Support Groups: Peer support to reduce isolation and share coping strategies.
REFERENCE
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Craske, M. G., & Barlow, D. H. (2014). Mastery of your anxiety and panic: Therapist
guide (5th ed.). Oxford University Press.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and
comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey
Replication. Archives of General Psychiatry, 62(6), 617–627.
