Exposure In-Vivo with Panic Management for Agoraphobia: Treatment Rationale and Longterm Outcome

  • Iver Hand
  • Jörg Angenendt
  • Martina Fischer
  • Cornelia Wilke


During the 1970’s a series of international treatment studies, pioneered and led by British groups from London and Oxford, seemed to have established some of the best documented and validated, highly specific short-term treatments for a rather chronic illness in the whole field of psychotherapy research: exposure in-vivo for agoraphobia. Since the beginning of this decade, parallel to the introduction of DSM-III, an increasing amount of basic research and clinical studies on panic disorder, panic attacks and agoraphobia with panic attacks seems to question this empirical and experimental knowledge.


Social Anxiety Group Exposure Panic Attack Exposure Treatment Phobic Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Agras WS, Berkowitz R (1980) Clinical research in behavior therapy: Halfaway there? Behavior Therapy 9:472–487CrossRefGoogle Scholar
  2. Bandura A (1978) Self-efficacy: Toward a unifying theory of behavioral change. In: Francks CM, Wilson GT (eds) Annual Review of Behavior Therapy: Theory and Practice (Vol. 6) Brunner & Mazel, New YorkGoogle Scholar
  3. Barlow DH, Wolfe BE (1981) Behavioral approaches to anxiety disorders: A report on the NIMH-SUNY, Albany research conference. J Cons Clin Psychol 49:448–454CrossRefGoogle Scholar
  4. Chambless DL, Golstein AJ (1981) Clinical treatment of agoraphobia. In: Chambless DL, Goldstein AJ (eds) Phobia: Psychological and pharmacological treatment. Guilford, New YorkGoogle Scholar
  5. Cohen SD, Monteiro W, Marks IM (1984) Two-year follow-up of agoraphobics after exposure and imipramine. Br J Psychiatry 144:276–287PubMedCrossRefGoogle Scholar
  6. Emmelkamp PMG, Kuipers AC (1979) Agoraphobia: A follow-up study four years after treatment. Br J Psychiatry 134:352–355PubMedCrossRefGoogle Scholar
  7. Fahrenberg J (1975) Die Freiburger Beschwerdeliste, FBL. Zeitschrift für klinische Psychologie 4:79–100Google Scholar
  8. Fahrenberg J, Selg H, Hampel R (1973) Das Freiburger Persönlichkeitsinventar, FPI. Handanweisung. Hogrefe, GöttingenGoogle Scholar
  9. Fahrenberg J, Selg H, Hampel R (1984) Das Freiburger Persönlichkeitsinventar, FPI. Handanweisung der revidierten Fassung FPI-R und der teilweise geänderten Fassung FPI-A. Hogrefe, GöttingenGoogle Scholar
  10. Foa FB, Emmelkamp PMG (eds) (1983) Failures in behavior therapy. Wiley, New YorkGoogle Scholar
  11. Hafner RJ, Marks IM (1976) Exposure in vivo of agoraphobics: contributions of diazepam, group exposure and anxiety evocation. Psychol Med 6:71–88PubMedCrossRefGoogle Scholar
  12. Hallam RS, Hafner RJ (1978) Fears of phobic patients. Factor analyses of self-report data. Beh Res Ther 16:1–6CrossRefGoogle Scholar
  13. Hand I (1984) Verhaltenstherapie und Psychopharmaka bei Phobien? Welche Konsequenzen hat die „Entdeckung” der Panic Disorder wirklich für die verhaltenstherapeutische Praxis und Forschung? In: Götze P (ed) Leitsymptom Angst. Springer, BerlinGoogle Scholar
  14. Hand I (1986) Verhaltenstherapie und kognitive Therapie in der Psychiatrie. In: Kisker KP, Lanter H, Meyer J-E, Müller C, Strömgen E (eds) Psychiatrie der Gegenwart, Band 1, 3. Auflage. Springer, Berlin Heidelberg New YorkGoogle Scholar
  15. Hand I, Lamontagne Y (1976) The exacerbation of interpersonal problems after rapid phobia-removal. Psychotherapy: Theory, Research and Practice 13:405–411CrossRefGoogle Scholar
  16. Hand I, Lamontagne Y, Marks IM (1974) Group exposure (flooding) in vivo for agoraphobics. Br J Psychiatry 124:588–602PubMedCrossRefGoogle Scholar
  17. Hand I, Schröder G (1980) Die vago-vasale Ohnmacht bei der Blut-Verletzungs-Katastrophen (BVK)-Phobie und ihre verhaltenstherapeutische Behandlung. Therapiewoche 30:923–932Google Scholar
  18. Klein D (1981) Anxiety reconceptualized. In: Klein D, Rabkin J (eds) Anxiety: New Research and changing concept. Raven Press, New YorkGoogle Scholar
  19. Lambert MJ, Bergin AE (1978) The evaluation of therapeutic outcome. In: Garfield SC, Bergin AE (eds) Handbook of psychotherapy and behavior change: An empirical analysis. Wiley, New YorkGoogle Scholar
  20. Mahoney M (1983) Cognition, consciousness and processes of personal change. In: Craig K, McMahon R (eds) Advances in clinical behavior therapy. Brunner & Mazel, New YorkGoogle Scholar
  21. Marks IM (1970) The classification of phobic disorders. Br J Psychiatry 116:337–380CrossRefGoogle Scholar
  22. Marks IM (1971) Phobic disorders four years after treatment: A prospective follow-up. Br J Psychiatry 118:683–688PubMedCrossRefGoogle Scholar
  23. Marks IM (1975) Behavioral treatment of phobic and obsessive-compulsive disorders: a critical appraisal. In: Hersen M, Eisler R, Miller P (eds) Progress in behavior modification. Academic Press, New YorkGoogle Scholar
  24. Marks IM (1983) Panic attacks in phobia: treatment studies. Arch Gen Psychiatry 40:1151Google Scholar
  25. Mathews AM, Teasdale J, Munby M, Johnston D, Shaw P (1977) A home based treatment program for agoraphobia. Behavior Therapy 8:915–924CrossRefGoogle Scholar
  26. Mathews A, Gelder M, Johnston D (1981) Agoraphobia. Nature and treatment. Guilford Press, New YorkGoogle Scholar
  27. Mavissakalian M, Michelson L, Dealy S (1983) Pharmacological treatment of agoraphobia: Imipramine versus Imipramine with programmed practice. Br J Psychiatry 143:348–355PubMedCrossRefGoogle Scholar
  28. McPherson FM, Brougham L, McLaren S (1980) Maintainance of improvement in agoraphobic patients treated by behavioral methods - a four year follow-up. Behav Res Ther 8:150–152CrossRefGoogle Scholar
  29. Munby M, Johnston DW (1980) Agoraphobia: The long-term follow-up of behavioral treatment. Brit J Psychiatry 137:418–427CrossRefGoogle Scholar
  30. Nie NH, Hull CM, Jenkins K, Bent DH (1980) SPSS - Statistical Package for the Social Sciences. McGraw Hill, New YorkGoogle Scholar
  31. Priebe S (1980) Die Bedeutung von Kohäsion und Angstfluktuation bei Kurzzeitübungs-Gruppen von Agoraphobikern. Unveröffentlichte Dissertation. Universität HamburgGoogle Scholar
  32. Sheehan D, Ballenger J, Jacobsen G (1980) Treatment of endogenous anxiety with phobic hysterical and hypochondrieal symptoms. Arch Gen Psychiatry 37:51–59PubMedGoogle Scholar
  33. Shipley R, Boudewyns P (1980) Flooding and implosive therapy: Are they harmful? Behavior Therapy 11:503–508CrossRefGoogle Scholar
  34. Strian F (1983) Angst. Grundlagen und Klinik. Springer, BerlinGoogle Scholar
  35. Teaman BH, Telch MJ (1984) Phobic disorders. In: Adams HE, Sutker PB (eds) Comprehensive handbook of psychopathology. Plenum Press, New York LondonGoogle Scholar
  36. Teasdale JD, Walsh PA, Lancashire M, Mathews AM (1977) Group exposure for agoraphobics: A replication study. Brit J Psychiatry 130:186–193CrossRefGoogle Scholar
  37. Thorpe G, Burns L (1983) The Agoraphobic syndrome. Wiley, New York ChichesterGoogle Scholar
  38. Thorpe GL, Burns LE, Smith PJ, Blier MJ (1984) Agoraphobia: Research developments and clinical implications. In: Franks CM (ed) New developments in behavior therapy from research to clinical application. The Haworth Press, New YorkGoogle Scholar
  39. Watson JP, Marks IM (1971) Relevant and irrelevant fear in flooding - a crossover study of phobic patients. Behavior Therapy 2:275–293CrossRefGoogle Scholar
  40. Zaworka W, Hand I, Jauernig G, Lünenschloβ K (1983) Das Hamburger Zwangsinventar (HZI) Manual and Fragebogen. Beltz, WeinheimGoogle Scholar
  41. Zerssen von DV, Koeller D-M (1976) Klinische Selbstbeurteilungsskalen (KSb-S) aus dem Münchener psychiatrischen Informationssystem. Beltz, WeinheimGoogle Scholar
  42. Zitrin C, Klein D, Woerner M (1980) Treatment of agoraphobia with group exposure in vivo and imipramine. Arch Gen Psychiatry 37:63–72PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • Iver Hand
  • Jörg Angenendt
  • Martina Fischer
  • Cornelia Wilke

There are no affiliations available

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