Cox B J, Endler N S, Swinson R P
Anxiety Disorders Clinic, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Behav Res Ther. 1995 Jan;33(1):57-62. doi: 10.1016/0005-7967(93)e0029-5.
Based on the results of previous studies, several factors believed to be related to the development of agoraphobia were simultaneously assessed in 195 panic disorder patients (57 males, 138 females) with various levels of DSM-III-R-defined agoraphobia: none, mild, moderate, or severe. The four groups of patients significantly differed from each other on self-reports of phobic avoidance, although all the groups reported a similar type of panic attack. The four groups also did not significantly differ on catastrophic panic cognitions (e.g. fear of dying), fear of anxiety symptoms (anxiety sensitivity), or variables related to spontaneous panic. Neither severity or frequency of panic was predictive of severity of agoraphobia. The anticipation of panic only in relation to agoraphobic situations was predictive of severity of agoraphobia, followed by perceived lifestyle restrictions due to panic, and trait anxiety regarding ambiguous or novel situations. Regardless of level of agoraphobia, patients tended to avoid situations where they anticipated panic would occur, indicating that panic and agoraphobia do not share a unique or exclusive relationship. Panic disorder with various levels of phobic avoidance, rather than just agoraphobia, would appear to be a more valid diagnostic category.
基于先前研究的结果，在195名患有不同程度DSM-III-R定义的广场恐惧症的惊恐障碍患者（57名男性，138名女性）中，同时评估了几个被认为与广场恐惧症发展相关的因素：无、轻度、中度或重度。四组患者在恐惧回避的自我报告上有显著差异，尽管所有组报告的惊恐发作类型相似。四组患者在灾难性惊恐认知（如害怕死亡）、对焦虑症状的恐惧（焦虑敏感性）或与自发性惊恐相关的变量上也没有显著差异。惊恐发作的严重程度或频率均不能预测广场恐惧症的严重程度。仅与广场恐惧情境相关的惊恐预期可预测广场恐惧症的严重程度，其次是因惊恐发作导致的感知生活方式受限，以及对模糊或新情境的特质焦虑。无论广场恐惧症的程度如何，患者往往会回避他们预期会发生惊恐发作的情境，这表明惊恐发作和广场恐惧症并非具有独特或排他的关系。具有不同程度恐惧回避的惊恐障碍，而不仅仅是广场恐惧症，似乎是一个更有效的诊断类别。
