The Fear to Move in a Crowded Environment. Poor Spatial Memory Related to Agoraphobic Disorder

Abstract

Individuals with agoraphobia exhibit impaired exploratory activity when navigating unfamiliar environments. However, no studies have investigated the contribution of visuospatial working memory (VSWM) in these individuals’ ability to acquire and process spatial information while considering the use of egocentric and allocentric coordinates or environments with or without people. A total of 106 individuals (53 with agoraphobia and 53 controls) navigated in a virtual square to acquire spatial information that included the recognition of landmarks and the relationship between landmarks and themselves (egocentric coordinates) and independent of themselves (allocentric coordinates). Half of the participants in both groups navigated in a square without people, and half navigated in a crowded square. They completed a VSWM test in addition to tasks measuring landmark recognition and egocentric and allocentric judgements concerning the explored square. The results showed that individuals with agoraphobia had reduced working memory only when active processing of spatial elements was required, suggesting that they exhibit spatial difficulties particularly in complex spatial tasks requiring them to process information simultaneously. Specifically, VSWM deficits mediated the relationship between agoraphobia and performance in the allocentric judgements. The results are discussed considering the theoretical background of agoraphobia in order to provide useful elements for the early diagnosis of this disorder.

“Where am I?” A snapshot of the developmental topographical disorientation among young Italian adults

“…The internal factors are of greater interest because they directly affect navigational competence; by consequence, it is possible to better intervene on them in order to plan prevention programs related to navigational disorders. The most important internal factors for navigation are: a) the cognitive predisposition to grasp certain environmental information rather than others [12][13][14][15][16]; b) gender [17][18][19][20][21][22][23][24]; c) age [25][26][27][28][29][30]; d) professional experience [31][32][33][34][35][36]; e) familiarity with the environment [37][38][39][40], reflecting the result of repeated exposure to a stimulus or an environment [41,42]; f) navigational strategies used during navigation [36,43]; g) psychiatric (e.g., spatial anxiety, depression, agoraphobia: [44][45][46]) and neurologic diseases (Alzheimer's disease and brain lesions in the navigational brain network: [47][48][49][50]).…”

Application of Virtual Reality in Spatial Memory

“…Six studies investigate which factors affect spatial navigation in VR: two investigate these factors during developmental ages (i.e., [10,11]), and the other four focus on young adults (i.e., [12][13][14][15]). One study reviews the applications of radial arm maze in both virtual and real versions (i.e., [16]), and the study by Zucchelli et al [17] shows how VR can be a proper differential diagnosis tool for mild agoraphobia disorders. The latter study highlights, through the use of VR, the presence of deficits in visuospatial working memory and navigation in people with agoraphobic-type anxiety disorders.…”

“…In contrast, the contribution by Zucchelli, Piccardi, and Nori [17] concerns the use of VR in treating the anxiety disorder agoraphobia, highlighting valuable findings for the differential diagnosis of the disorder even in its mild form. These authors used a virtual environment to study spatial memory in individuals with agoraphobia.…”