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Agoraphobia

Agoraphobia. Shay Shivers Luis Gonzalez. Biological Fight or flight reflex Neurotransmitter imbalance Fear Network Spatial Awareness Previous History of mental illnesses. Cognitive Traumatic childhood experience Experiencing a stressful event Having alcohol or drug misuse problems

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Agoraphobia

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  1. Agoraphobia Shay Shivers Luis Gonzalez

  2. Biological • Fight or flight reflex • Neurotransmitter imbalance • Fear Network • Spatial Awareness • Previous History of mental illnesses Cognitive • Traumatic childhood experience • Experiencing a stressful event • Having alcohol or drug misuse problems Sociocultural • Being in an unhappy relationship, or one that the partner is too controlling. Etiology terms

  3. Physical Symptoms include: • Accelerated heart beat • Hyperventilating • Feeling hot, flushing • Upset stomach • Diarrhea • Trouble swallowing • Breaking out in a sweat • Nausea • Trembling • Dizziness • Feeling light headed • Ringing in the ears Symptoms

  4. Fear that people will notice a panic attack • Fear that during a panic attack their heart might stop, or they won’t be able to breathe, and may die • Fear that they are crazy • Low self confidence and self-esteem • Feeling a loss of control • Depression • General dread and anxiety • Dread of being left alone • Thinking that without the help of others the sufferer would never be able to function Psychological Symptoms

  5. Avoidance • Reassurance • Safety Behavior • Escape Behavioral Symptoms

  6. 1.4 lifetime prevalence (Kessler & Colleagues, 2005) • 0.8 12 month prevalence (Kessler & Colleagues, 2005) • 0.3 12 month prevalence classified as severe Prevalence

  7. A general practitioner refers to a psychiatrist. • Psychiatrist will ask about feelings, symptoms and general background. • Will try to find out whether it is caused by another mental illness first. Diagnosis

  8. The person is anxious about being in a place or situation where escape or help may be difficult in the event of a panic attack, or panic like symptoms. • The person avoids these places (described above). • The person endures these places (described above) with extreme anxiety. • The person endures these places (described above) only with the help of a friend or companion. • There is no other underlying condition that may explain the person's symptoms. Diagnosis According to DSM-IV

  9. Mainly described in Western cultures • Richard McNally • Asian and African Cultures • India and Middle East- tendencies more commonly found in men because women do not leave home alone because of culture • In US, African Americans have higher prevalence rates than non-Hispanic whites Cultural Factors

  10. More women experience agoraphobia (either with or without panic disorder) than men. • Women are twice as likely to be diagnosed with Agoraphobia as men. • Research so far has not provided a single clear explanation for this gender difference. • Some speculate that there are social-cultural factors at play, such as women are more likely to seek help than men, and women’s greater willingness to express emotions than men. • It is important to note that in some cultures the movement of women away from the home is restricted and this is not the same thing as agoraphobia. Gender Variations

  11. The standard treatment approach combines cognitive-behavioral therapy (CBT) with an antidepressant medication. • Selective serotonin reuptake inhibitors (SSRIs) are usually the first choice of antidepressant. • Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another choice. Other antidepressants and some anti-seizure drugs may be used for more severe cases. • Other anti-anxiety medications may also be prescribed. For example, benzodiazepines when antidepressants don't help or before they take effect. Treatment Approaches

  12. Biological Factors- SSRIs, SNRIs, and other anti-anxiety medications are given to even out hormones, balance neurotransmitter levels, and increase spatial awareness. • Cognitive Factors- CBT is used to help patient gain understanding and control of distorted feelings or views of stressful events or situations, learn to recognize and replace panic-causing thoughts, and learn stress management and relaxation techniques. • Sociocultural Factors- the patient is removed from the unhealthy relationship/situation and placed in a more stable environment while also utilizing the abovementioned treatment methods. Relationship Between Etiology and Therapeutic Approach

  13. Stress (Sociocultural Factors): being in an unhappy relationship, or one that the partner is too controlling; having a family role model with Agoraphobia, parents that are overly critical or controlling • Neuromaturational Factors (Biological): neurotransmitter imbalance; imbalances in hormone levels Psychiatric Outcome (Agoraphobia) Constitutional (biological) vulnerability • Cognitive Factors: traumatic childhood experience; experiencing a stressful event; having alcohol or drug misuse problems; the need for approval, control, and oversensitivity to emotional stimuli • Inherited Factors: previous history of mental illnesses; Oversensitivity to hormone changes and physical stimuli, chemical imbalances in the body and brain. Walker-Tessner Model

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