Acquisition of agoraphobia, mode of onset and anxiety response patterns

The ways in which 80 agoraphobic patients had acquired their phobia were investigated. The patients were requested to answer a questionnaire concerning: (a) the origin of the phobia, with items relevant for conditioning experiences, vicarious experiences and experiences of negative information/instruction; (b) physiological reactions; (c) anticipatory anxiety; (d) negative thoughts while in the phobic situation. In addition, data on mode of onset, precipitating factors, family history of phobias, marital and occupational status and severity of the phobia were obtained. The reported anxiety reaction was conceptualized in terms of the Three-Systems Model of fear and anxiety, i.e. anxiety as composed of a physiological, cognitive and behavioral component. The results showed that a large majority (81%) of the patients attributed their phobias to conditioning experiences, while 9% recalled vicarious learning, none recalled instruction/information and 10% could not recall any specific onset circumstances at all. In another classification 46% of the patients had a rapid, 36% a gradual and 18% a slow onset of their phobias. There was no relationship between either the ways of acquisition, or the modes of onset, and the anxiety components, nor did the conditioning and the indirect groups differ in severity of phobic reactions.