Stress and the onset of agoraphobia

Abstract

Recent investigations have suggested that agoraphobia develops in response to stress. The present controlled study was undertaken in order to evaluate the assertion that psychosocial and/or physical stressors precede the development of agoraphobia with panic attacks. Data on life events, chronic stressors, and physiological distrubances were collected from 51 agoraphobics with panic attacks who had had the disorder for between 1 and 5 years. The life event data was then compared with matched controls drawn from doctors' surgeries. Agoraphobics reported twice the number of life events in the year prior to onset, and significantly more life events in six areas including threats to primary relationships, health, and financial security. Agoraphobia generally developed in a climate of chronic stress extending across many areas of life, with the onset of panic attacks often preceded by a deterioration in health. Despite these stresses, the vast majority of sufferers reported being “totally baffled” by the onset of the disorder. The significance of these events for the development of agoraphobia is discussed with reference to personality and individual differences.