The Fear to Move in a Crowded Environment. Poor Spatial Memory Related to Agoraphobic Disorder

Individuals with agoraphobia exhibit impaired exploratory activity when navigating unfamiliar environments. However, no studies have investigated the contribution of visuospatial working memory (VSWM) in these individuals' ability to acquire and process spatial information while considering the use of egocentric and allocentric coordinates or environments with or without people. A total of 106 individuals (53 with agoraphobia and 53 controls) navigated in a virtual square to acquire spatial information that included the recognition of landmarks and the relationship between landmarks and themselves (egocentric coordinates) and independent of themselves (allocentric coordinates). Half of the participants in both groups navigated in a square without people, and half navigated in a crowded square. They completed a VSWM test in addition to tasks measuring landmark recognition and egocentric and allocentric judgements concerning the explored square. The results showed that individuals with agoraphobia had reduced working memory only when active processing of spatial elements was required, suggesting that they exhibit spatial difficulties particularly in complex spatial tasks requiring them to process information simultaneously. Specifically, VSWM deficits mediated the relationship between agoraphobia and performance in the allocentric judgements. The results are discussed considering the theoretical background of agoraphobia in order to provide useful elements for the early diagnosis of this disorder.