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(p. 23) The Nature of Panic Disorder and Agoraphobia 

(p. 23) The Nature of Panic Disorder and Agoraphobia
(p. 23) The Nature of Panic Disorder and Agoraphobia

Michelle G. Craske

, and David H. Barlow

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date: 20 May 2022

This chapter discusses the nature of panic disorder (PD) and agoraphobia. The hallmark symptom of PD is a history of unexpected panic attacks that are experienced by the patient as occurring from out of the blue, without any obvious trigger or cue. However, some patients may be quite adept at predicting their panic attacks, and upon initial screening may even deny having unexpected panic attacks. Therapists should inquire carefully into the patient’s experiences of initial panic attacks to determine whether there is an early history of unexpected panic attacks. Meanwhile, according to DSM-5, and in a change from DSM-IV, agoraphobia is diagnosed separately from PD, though it can co-occur with PD if criteria are met for both. Agoraphobia is characterized by intense fear or anxiety about going into certain places or situations in which individuals might have panic-like or other embarrassing symptoms, especially in contexts where escape might be difficult or help unavailable. In severe cases, individuals with agoraphobia will not leave their homes, may avoid work, and (very rarely) may confine themselves to a single room in their home due to an intense fear of experiencing panic attacks or other symptoms. The chapter then looks at the psychobiological conceptualization of PD, before considering the development of agoraphobia. It also assesses nocturnal panic.

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