Experimental analyses of panic—III. Claustrophobic subjects

Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative

“…We measured self‐reported anxiety, defensive behavior, protective reflex modulation, and autonomic responses during anticipation of (patients were sitting in front of the test chamber with its door open for 10 minutes) and exposure to a small (75 cm wide, 120 cm long, and 190 cm high) dark and closed test chamber (for a maximum of 10 minutes), constructed according to descriptions by Öst, Johansson, and Jerremalm (). Rachman and colleagues (Rachman, Levitt, & Lopatka, ; Rachman & Taylor, ) have successfully used this test as an experimental model to investigate physiological and cognitive symptoms of panic attacks in patients with claustrophobia. Because marked fear of entrapment and avoidance of being in enclosed places is also a prominent symptom in patients with panic disorder and agoraphobia (Arrindell, Cox, Van der Ende, & Kwee, ; Cox, Swinson, Kuch, & Reichman, ; Kwon, Evans, & Oei, ; Rodriguez, Pagano, & Keller, ), we expected to evoke defensive responses during this test in a large proportion of the PD/AG patient group.…”

Component fears of claustrophobia associated with mock magnetic resonance imaging

“…For example, restriction and suffocation have emerged as somewhat independent themes in factor analyses of responses on fear questionnaires (e.g., Valentiner, Telch, Petruzzi, & Bolte, 1996), and fears of restriction and suffocation have responded independently to treatments that target one but not the other (Harris, Robinson, & Menzies, 1999). The empirical literature suggests further that a complete picture of claustrophobia will include a role for cognitive elaborations such as catastrophic misappraisals of bodily anxiety symptoms (Booth & Rachman, 1992;Craske, Mohlman, Yi, Glover, & Valeri, 1995;Craske & Sipsas, 1992;Curtis, Hill, & Lewis, 1990;Rachman, Levitt, & Lopatka, 1988) and exaggerated expectations of danger (Ö st & Csatlos, 2000;. Indeed, Rachman and Taylor (1993) argued that something akin to ''anxiety sensitivity'' (Reiss, Peterson, Gursky, & McNally, 1986) might need to be added to fears of restriction and suffocation in order to describe claustrophobia adequately.…”

One 3 hour exposure session was as effective as 5 one hour sessions of either exposure or cognitive therapy for claustrophobia

“…This may be because the cognitions in claustrophobia are similar to those in panic disorder. 4 The treatments in this study require experienced cognitive behaviour therapists. Clinicians should also note that, although clearly handicapped by their phobia, these patients had low scores on standard symptom inventories and no other complicating psychiatric conditions.…”