Editing Agoraphobia (section)

== Diagnosis ==
Most people who present to mental health specialists develop agoraphobia after the onset of panic disorder.<ref>[[American Psychiatric Association]], 1998</ref> Agoraphobia is best understood as an adverse behavioral outcome of repeated panic attacks and subsequent anxiety and preoccupation with these attacks that leads to an avoidance of situations where a panic attack could occur.<ref>{{cite book | year = 1988 | author = Barlow DH | title= Anxiety and its disorders: The nature and treatment of anxiety and panic | publisher = Guilford Press }}</ref> Early treatment of panic disorder can often prevent agoraphobia.<ref>{{cite web|url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001921/|title=Agoraphobia – National Library of Medicine|last=pmhdev|access-date=25 January 2017|url-status=live|archive-url=https://web.archive.org/web/20140330112146/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001921/|archive-date=30 March 2014}}</ref> Agoraphobia is typically determined when symptoms are worse than panic disorder, but also do not meet the criteria for other mental disorders such as depression.<ref>{{cite web|last1=Kenny|first1=Tim|last2=Lawson|first2=Euan|title=Agoraphobia|url=http://www.patient.info/health/agoraphobia-leaflet|website=Patient.info|access-date=8 December 2014|url-status=dead|archive-url=https://web.archive.org/web/20150607021823/http://patient.info/health/agoraphobia-leaflet|archive-date=7 June 2015}}</ref>

=== Agoraphobia without history of panic disorder ===
'''Agoraphobia without a history of panic disorder''' (also called '''primary agoraphobia''') is an [[anxiety disorder]] where the individual with the diagnosis does not meet the [[DSM-5]] criteria for panic disorder. Agoraphobia typically develops as a result of having panic disorder. In a small minority of cases, however, agoraphobia can develop by itself without being triggered by the onset of [[panic attack]]s. Agoraphobia can be caused by [[Trauma (psychology)|traumatic]] experiences, such as bullying or abuse. Historically, there has been debate over whether agoraphobia without panic genuinely existed, or whether it was simply a manifestation of other disorders such as panic disorder, [[generalized anxiety disorder]], [[avoidant personality disorder]] and [[social phobia]]. One researcher said: "out of 41 agoraphobics seen (at a clinic) during a period of 1 year, only 1 fit the diagnosis of agoraphobia without panic attacks, and even this particular classification was questionable...Do not expect to see too many agoraphobics without panic".<ref>Barlow, D. H. & Waddell, M. T. (1985) Agoraphobia. Ch 1 in Barlow, D. H. (Ed) ''Clinical handbook of psychological disorders: A step-by-step treatment manual.'' New York: Guilford.</ref> In spite of this earlier skepticism, current thinking is that agoraphobia without panic disorder is indeed a valid, unique illness which has gone largely unnoticed, since those with the condition are far less likely to seek clinical treatment.{{citation needed|date=May 2024}}

According to the [[DSM-IV-TR]], a widely-used manual for diagnosing [[mental disorder]]s, the condition is diagnosed when agoraphobia is present without panic disorder where symptoms are not caused by or are unreasonable to an underlying medical problem or pharmacological influence.<ref name=BehaveNet>{{cite book |title=Diagnostic and Statistical Manual of Mental Disorders |edition=4th, text revision ([[DSM-IV-TR]]) |author=American Psychiatric Association |year=2000 |isbn=0-89042-025-4 |chapter=Diagnostic criteria for 300.22 Agoraphobia Without History of Panic Disorder |chapter-url=https://www.behavenet.com/diagnostic-criteria-30022-agoraphobia-without-history-panic-disorder |access-date=2007-06-28 |publisher=<!-- pacify Citation bot --> |location=<!-- pacify Citation bot --> }}</ref> The DSM-5 decoupled agoraphobia and panic disorder, making them separate disorders that can be [[Comorbidity|diagnosed together]].<ref>{{cite web |last=Administration |first=Substance Abuse and Mental Health Services |date= June 2016|title=Table 3.10, Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5 |url=https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t10/ |access-date=2023-11-04 |website=ncbi.nlm.nih.gov |language=en}}</ref>