Symptoms and cognitions during situational and hyperventilatory exposure in agoraphobic patients with and without panic

The purpose of this study was to explore the relationship between reported bodily symptoms and fearful cognitions in the anxiety episodes experienced by agoraphobic patients. Thirty-one inpatients, 16 with panic disorder (PD) with agoraphobia and 15 with agoraphobia without PD, performed a behavioral avoidance test (BAT) and a provoked hyperventilation test (PHT). The results of regression analyses indicated that feeling of unreality was related to number of reported thoughts concerning physical incapacitation during the BAT. On the PHT, shortness of breath was related to reported fears concerning physical incapacitation and loss of control. The results indicated that there were meaningful links between reported symptoms and catastrophic thoughts on both tests. Social/behavioral control fears were stable across the two tests, whereas physical fears, subjective anxiety increase, and number of symptoms reported showed no stability. More of the PD with agoraphobia patients than of the agoraphobia without PD patients reported fantasies of physical catastrophes associated with the BAT, whereas more of the agoraphobia without PD patients exhibited safety seeking behavior during the PHT.