Agoraphobia Definition Etiology Treatment

1. By Aisha Shakeel
Clinical Psychologist
Agoraphobia DSM-5 300.22
(F40.00)

2. AGORA
(in ancient Greece) a public open space used for assemblies and
markets

4. AGORAPHOBIA
 Translated from Greek as "fear of the
marketplace," agoraphobia involves intense fear
and anxiety to a real or anticipated place or
situation where escape might be difficult.
 People with agoraphobia may avoid situations
such as being alone outside of the
home, traveling in a car, bus, or airplane, being
in a crowded area, being in enclosed spaces
such as shops and cinemas, or being on a
bridge or in an elevator.

5. AGORAPHOBIA
 Agoraphobia is a type of anxiety disorder in
which a person fear and avoid places or
situations that might cause to panic and
make feel trapped, helpless or embarrassed.
 A person fear is an actual or anticipated
situation, such as using public transportation,
being in open or enclosed spaces, standing
in line, or being in a crowd.

6.  The anxiety is caused by fear that there's no
easy way to escape or get help if the anxiety
intensifies.
 Most people who have agoraphobia develop
it after having one or more panic attacks,
causing them to worry about having another
attack and avoid the places where it may
happen again.

7.  People with agoraphobia often have a hard
time feeling safe in any public place,
especially where crowds gather.
 A person may feel that he need a
companion, such as a relative or friend, to go
with his to public places.
 The fear can be so overwhelming that a
person may feel unable to leave his home.

8.  Agoraphobia is a fear of being outdoors or
otherwise being in a situation from which one
either cannot escape or from which escaping
would be difficult or embarrassing.
 Like other phobias, agoraphobia often goes
unreported, probably because
many phobia sufferers find ways to avoid the
situations to which they are phobic.

9.  Agoraphobia often co-occurs with panic
disorder
 Agoraphobia occurs alone in less than 1% to
nearly 7% of the population, more often in
girls and women compared to boys and men.
 Agoraphobia refers to a fear of any place
where escape may be difficult, including
large open spaces or crowds, as well as
various means of travel.

10.  An individual with agoraphobia fears these
situations because of thoughts that escape
might be difficult in the event of an
emergency, or that help might not be
available if the person develops panic-like
symptoms or other embarrassing symptoms.

11.  Such high discomfort and stress may require
another person's company in such situations.
For agoraphobia to be considered as a
diagnosis, the agoraphobic situations must
almost always create fear and anxiety that
are out of proportion to the actual danger posed,
and these signs of distress typically last for a
minimum of six months.
 In its most severe form, people with
agoraphobia are completely unable to leave
their home.

12.  Approximately 1.7 percent of adolescents and adults are
diagnosed with agoraphobia. Women are twice as likely
as men to experience agoraphobia. Initial onset is
typically in late adolescence or early adulthood, although
agoraphobia can occur in childhood as well. The thoughts
that usually cause fear and anxiety tend to change with
age:
 Children often fear becoming lost, adults may fear
experiencing panic-like symptoms, and older adults may
fear falling
 Agoraphobia often accompanies another anxiety disorder
(such as panic disorder or a specific phobia) and
depressive disorders.

13.  Typically, people with agoraphobia restrict
themselves to a "zone of safety" that may
include only the home or the immediate
neighborhood.
 Any movement beyond the edges of this
zone creates mounting anxiety

14.  People with agoraphobia can be seriously
disabled by their condition. Some are unable to
work, and they may need to rely heavily on
other family members, who must do shopping
and household errands as well as accompany
the affected person on rare excursions outside
the "safety zone.“
 People with this disorder may become
housebound for years, with resulting impairment
of relationships. It has been estimated that more
than one-third of people with agoraphobia do
not leave their home and are unable to work.

16. SYMPTOMS
 Fear or anxiety about: being outside of the
home alone
 using public transportation
 being in enclosed places (stores, movie
theaters)
 standing in line or being in a crowd
 being in open spaces (markets, parking lots)
 being in places where escape might be
difficult

17.  Active avoidance of all situations that
provoke fear and anxiety
 Becoming housebound for prolonged periods
 Feelings of detachment or estrangement
from others
 Feelings of helplessness
 Dependence upon others
 Anxiety or panic attack (acute severe
anxiety)

19. DIAGNOSIS
 Agoraphobia is diagnosed based on:
 Signs and symptoms
 In-depth interview with your doctor or a mental
health professional
 Physical exam to rule out other conditions that
could be causing your symptoms
 Criteria for agoraphobia listed in the Diagnostic
and Statistical Manual of Mental Disorders
(DSM-5), published by the American Psychiatric
Association

21. DIAGNOSTIC CRITERIA DSM 5
 All of the below features must be present in order to make a
proper diagnosis of agoraphobia:
 Marked and disproportionate fear when confronted with at least
two different situations, such as open spaces, public transport or
crowded areas
 An immediate anxiety response such as a panic attack when
exposed to the phobic stimulus
 Recognition of the fear as disproportionate
 Avoidance behaviors, distress or anticipatory anxiety that
significantly disrupts normal routine, relationships, occupational or
social activities
 Symptoms recorded for at least six months across all age groups
 No other underlying condition that may explain the symptoms

23. CAUSES
 The etiology of most anxiety disorders, although
not fully understood, has come into sharper
focus in the last decade. In broad terms, the
likelihood of developing anxiety involves a
combination of life experiences, psychological
traits, and/or genetic factors.
 Heritability for agoraphobia is reported to be 61
percent, making it the phobia most strongly
linked to the genetic factor that represents
predisposition to phobias.

24.  Some of the environmental factors that are
known to be associated with the
development of agoraphobia are
experiencing stressful events (the death of a
parent, being attacked or mugged) and being
raised in a household characterized by little
warmth and high levels of overprotection

25. RISK FACTORS
 Agoraphobia can begin in childhood, but
usually starts in the late teen or early adult
years — usually before age 35 — but older
adults can also develop it. Women are
diagnosed with agoraphobia more often than
men are.
 Risk factors for agoraphobia include:
 Having panic disorder or other phobias

26.  Responding to panic attacks with excessive
fear and avoidance
 Experiencing stressful life events, such as
abuse, the death of a parent or being
attacked
 Having an anxious or nervous temperament
 Having a blood relative with agoraphobia

27. DIFFERENCE B/W AGORAPHOBIA AND SOCIAL
PHOBIA
 Contrary to popular conception, people
with social anxiety disorder do not develop
agoraphobia.
 Agoraphobia results from the fear of panic
attacks, not from the fear
of social interactions

28. Thank You..!!