A Comparison of Symptom Structure between Panic Disorder with and without Comorbid Agoraphobia Using Network Analysis

Area of Science:

• Psychiatry
• Clinical Psychology
• Network Science

Background:

• Panic Disorder (PD) and PD with Agoraphobia (PDA) share clinical features but may have different underlying symptom structures.
• Research specifically comparing the network structures of PD and PDA is limited.

Purpose of the Study:

• To conduct a network analysis of PD and PDA, focusing on panic symptom severity, anxiety sensitivity, anticipatory fear, and avoidance.
• To compare network structures, identify central and bridge symptoms, and suggest clinical implications for targeted interventions.

Main Methods:

• Network analysis was performed on a sample of 147 patients (55 male, 92 female) from a psychiatric outpatient clinic.
• Crucial nodes within PD and PDA networks were examined, and the networks were compared to identify structural disparities and similarities.

Main Results:

• Anxiety Sensitivity Index-Revised (ASI-R1; fear of respiratory symptom) was the most influential node in the PD network.
• Panic Disorder Severity Scale (PDSS5; phobic avoidance of physical sensations) was the most influential node in the PDA network.
• Specific bridge nodes were identified for each group, including ASI-R1 and APPQ3 for PD, and PDSS5 and APPQ1 for PDA.

Conclusions:

• While network comparison tests showed no statistical differences, distinct community structures and central/bridging symptoms suggest potential differences in etiology and treatment targets between PD and PDA.
• The findings support the need for tailored interventions based on the unique network characteristics of PD and PDA.