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Related Experiment Videos

A model of panic and agoraphobic development.

D F Klein1, J M Gorman

  • 1Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York.

Acta Psychiatrica Scandinavica. Supplementum
|January 1, 1987
PubMed
Summary

This study proposes a model for agoraphobia with panic attacks, highlighting spontaneous panic as the trigger. Imipramine and exposure therapy effectively treat panic and avoidance behaviors, respectively, suggesting a biological basis for panic disorder.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Agoraphobia with panic attacks is a complex disorder.
  • The development involves spontaneous panic, chronic anxiety, and avoidance behaviors.
  • A biological diathesis for panic disorder is suggested by various studies.

Purpose of the Study:

  • To propose a model for the development of agoraphobia with panic attacks.
  • To differentiate the effects of imipramine and exposure therapy on panic and avoidance.
  • To elucidate the underlying mechanisms of panic disorder.

Main Methods:

  • Development of a theoretical model for agoraphobia.
  • Review of pharmacological (imipramine) and psychotherapeutic (in vivo exposure) interventions.

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  • Consideration of evidence from laboratory challenge, brain imaging, and genetic studies.

    • Main Results:

    • Spontaneous panic is the initiating event in agoraphobia.
    • Imipramine primarily blocks spontaneous panic, not anticipatory anxiety or avoidance.
    • In vivo exposure is more effective than office-based therapy for mobilizing patients.
    • Avoidance behaviors are secondary to panic attacks.

    Conclusions:

    • The proposed model integrates clinical observations and treatment effects.
    • Imipramine and exposure therapy target distinct components of agoraphobia (panic and avoidance).
    • Evidence supports a biological predisposition to panic disorder.