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Diseases » Agoraphobia » Wikipedia
 

Agoraphobia in Wikipedia

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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Agoraphobia". (Source - Retrieved 2006-09-07 14:10:26 from http://en.wikipedia.org/wiki/Agoraphobia)

Introduction

Agoraphobia is a form of anxiety disorder. Sufferers of agoraphobia do not fear crowded situations, which is a common misunderstanding of this disorder. Agoraphobia is the fear of having a panic attack in general in any place whether it be the grocer, at work or in the privacy of your own home. Social anxiety disorder is what people mean when they generally say "agoraphobia".

The word is an English adoption of the Greek words agora (αγορά) and phobos (φόβος). Literally translated in modern Greek as "a fear of the marketplace". A common misconception is that agoraphobia is a fear of open spaces. This is most often not the case since people suffering from agoraphobia usually are not afraid of the open spaces themselves, but of public spaces or of situations where a person is afraid of having a panic attack and will not be able to recieve help. The Greek word agora should be interpreted using the Ancient Greek meaning of the word agora (αγορά) which translates as "where the people gather" (later "forum" in Latin), which gives the idea of a crowded marketplace rather than just an open space -- this makes the common combination of agoraphobia and claustrophobia less conflicting.

Agoraphobia is not being afraid of public places nor is it being afraid of no escape from public places; it is the fear of having an anxiety attack and not being able to recieve help. (DSM-IV). Some people with agoraphobia are comfortable seeing visitors, but only in a defined space they feel in control of. Such people may live for years without leaving their homes, while happily seeing visitors and working, as long as they can stay within their safety zones.

An agoraphobic may experience severe panic attacks in situations where he feels trapped, insecure, out of control, or too far from his personal comfort zone. During severe bouts of anxiety, the agoraphobic is confined not only to his home, but to one or two rooms and he may even become bed-bound until his over-stimulated nervous system can quiet down, and his adrenaline levels can return to a more normal level.

Agoraphobics are often extremely sensitized to their own bodily sensations, subconsciously over-reacting to perfectly normal events. To take one example, the exertion involved in climbing a flight of stairs may be the cause for a full-blown panic attack, because it increases the heartbeat and breathing rate, which the agoraphobic interprets as the start of a panic attack instead of a normal fluctuation.

Prevalence

The one-year prevalence of agoraphobia is about 5 percent. Agoraphobia occurs about twice as commonly among women than men (Magee et al., 1996 $[1]$). The gender difference may be attributable to social/cultural factors that encourage, or permit, the greater expression of avoidant coping strategies by women (DSM-IV), although other explanations are possible.

Diagnosis

Most people who present to mental health specialists develop agoraphobia after the onset of panic disorder (American Psychiatric Association, 1998). Agoraphobia is best understood as an adverse behavioral outcome of repeated panic attacks and the subsequent worry, preoccupation, and avoidance. $[2]$ Thus, the formal diagnosis of panic disorder with agoraphobia was established. However, for those people in communities or clinical settings who do not meet full criteria for panic disorder, the formal diagnosis of Agoraphobia Without History of Panic Disorder is used (DSM-IV).

Treatments

Agoraphobia can be successfully treated in many cases through a very gradual process of graduated exposure therapy combined with cognitive therapy and sometimes anti-anxiety or antidepressant medications. Anti-anxiety medications include benzodiazepines such as alprozolam. Anti-depressant medications which are used to treat anxiety disorders are mainly in the SSRI (selective serotonin reuptake inhibitor) class such as sertraline, paroxetine and fluoxetine.

Treatment options for agoraphobia and panic disorder are similar.

Alternate academic theories

Attachment theory and agoraphobia

GA FAVA, C RAFANELLI, S GRANDI, S CONTI, C RUINI (2001), Long-term outcome of panic disorder with agoraphobia treated by exposure. Psychological Medicine. Vol. 31, pp 891-898 Cambridge: University Press. Conclusions The findings suggest that exposure treatment can provide lasting relief to the majority of patients with panic disorder and agoraphobia. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.

Some scholars (e.g., Liotti 1996 $[3]$, Bowlby 1998 $[4]$) have explained agoraphobia as an attachment deficit, i.e., the temporary loss of the ability to tolerate spatial separations from a secure base.

Spatial theory and agoraphobia

In the social sciences there is a perceived clinical bias (e.g., Davidson 2003 $[5]$) in agoraphobia research. Branches of the social sciences, especially geography, have increasingly become interested in what may be thought of as a spatial phenomenon.

Agoraphobics

See also Category:Agoraphobic celebrities

Real

  • Paula Deen had agoraphobia at one point in her life
  • Olivia Hussey also had agoraphobia at one point in her life
  • Philip K. Dick, American science fiction writer
  • Woody Allen, American film director
  • Kim Basinger, American actress
  • Roy Castle, British TV presenter

Fictional

  • Matthew Malone from Game On
  • Arthur "Boo" Radley from the novel To Kill A Mockingbird
  • Ambrose Monk the brother of Adrian Monk from the television series Monk. Despite his agoraphobia he has made a decent living writing manuals for electronics.
  • Dr. Helen Hudson, a Sigourney Weaver's character, in Copycat.
  • Auric Goldfinger, in Ian Fleming's Goldfinger (James Bond Novel)
  • Pearl Burton from Family Guy episode Brian Wallows and Peter's Swallows
  • Father Jack Hackett from Father Ted was claimed agoraphobic by Ted in the episode 'Are you Right There, Father Ted?'
  • Wanda from Corner Gas.
  • In Stark Raving Dad, Homer Simpson meets an agoraphobe in a mental institution.
  • Harold Smith in the television series Twin Peaks.

References

  1. Magee, W. J., Eaton, W. W., Wittchen, H. U., McGonagle, K. A., & Kessler, R. C. (1996). Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey, Archives of General Psychiatry, 53, 159–168.
  2. Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. Guilford Press.
  3. G. Liotti, (1996). Insecure attachment and agoraphobia, in: C. Murray-Parkes, J. Stevenson-Hinde, & P. Marris (Eds.). Attachment Across the Life Cycle.
  4. J. Bowlby, (1998). Attachment and Loss (Vol. 2: Separation).
  5. J. Davidson, (2003). Phobic Geographies

Footnotes

Materials for this topic are obtained from the public domain source:

  • David Satcher etal. (1999). “Chapter 4.2”, $Mental Health: A Report of the Surgeon General$.
 

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