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Predictors of the development of phobic avoidance
1Department of Family Practice, University of Texas Health Science Center at San Antonio, 78284-7795, USA. katerndahl@uthscsa.edu
The Journal of Clinical Psychiatry
|September 12, 2000
Summary
Phobic avoidance often develops rapidly after panic attacks, especially with panic disorder and depersonalization. Understanding these predictors can help identify individuals at risk for developing agoraphobia.
Area of Science:
- Psychiatry
- Clinical Psychology
- Epidemiology
Background:
- Panic disorder and agoraphobia are frequently comorbid conditions.
- Predicting the development of phobic avoidance after panic attacks has been challenging.
Purpose of the Study:
- To identify independent predictors of phobic avoidance development.
- To analyze the time course of phobic avoidance development following panic attacks.
Main Methods:
- Secondary analysis of community-based survey data.
- Structured Clinical Interview of DSM-III-R (SCID) used for diagnosis confirmation.
- Assessment of panic characteristics, psychiatric comorbidity, and psychosocial factors.
Main Results:
- 37% of subjects developed phobic avoidance, with 81% doing so within a year of panic onset.
- Panic disorder, psychiatric comorbidity, and social support predicted avoidance development.
- Depersonalization during panic attacks predicted progression to agoraphobia and rapid onset of avoidance.
Conclusions:
- Phobic avoidance is a common and often rapid consequence of panic attacks.
- Panic disorder, comorbidity, and depersonalization are key factors in avoidance development.
- Identifying these predictors can aid in early intervention for panic disorder and agoraphobia.
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