Agoraphobia: A study of the syndrome and its treatment.

The basis of the thesis is a treatment outcome study of agoraphobia which took place over a 4 year period. 132 subjects met inclusion criteria and 100 completed a trial of treatment using a standard exposure in vivo programme with follow-up to 1 year. Of the 32 subjects who refused or dropped out, 21 subjects were followed up to 1 year. Chapter One of the thesis reviews the literature on the nature of agoraphobia. Chapter Two reviews the literature on exposure treatment and describes the outcome of such treatment with the study population. Also included was a comparison of treatment base (home or out-patient clinic) and an assessment of the relationship between marital satisfaction and outcome and some other minor variables. Chapter Three reviews the relevant literature on treatment failure and describes a study of the 60 treatment failures in the study (i.e. drop outs, treatment refusers, treatment non-responders and treatment relapsers). This was effected by statistical analyses of the measures used in Chapter Two and additional questionnaire data. Chapter Four reviews the relevant literature on cognitive variables and describes a study of cognitive processing in 12 of the study subjects. The principal measures used were those of subjective probability and value of aversive outcome, rated over treatment for six target behaviours for each subject. Chapter Five reviews the relevant literature on sex role variables and describes a study of the differential outcome of the 102 females and 30 male subjects, and of the subjects' responses to a measure of sex role stereotyping. The thesis concludes with a summary which attempts to integrate the findings of the various chapters.