Marital Interactions as Predictors of Symptoms Severity in Panic Disorder with Agoraphobia

  •  Ghassan El-Baalbaki    
  •  Claude Bélanger    
  •  Steffany Fredman    
  •  Donald Baucom    
  •  Roger Marcaurelle    
  •  André Marchand    


Several studies showed associations among marital variables and panic disorder with agoraphobia (PDA)
symptomatology. However, very few explored this issue using behavioural coding of couples’ interactions. We conducted this study to investigate whether observed marital interaction patterns would predict PDA severity.
Cross-sectional, pre-treatment multi-center study of 65 married couples in which one spouse was diagnosed with
panic disorder with agoraphobia (PDA).
All participants completed seven self-reported PDA symptoms measures commonly used in PDA research and
two self-reported marital measures. Couples were observed during a 15-minute video-taped problem-solving task.
The spouses’ marital interactions were coded by two independent coders using two validated observational
coding systems.
After controlling for socio-economical variables, the presence of negative marital interaction patterns, namely
criticism and dominance behaviour, predicted higher symptom severity, whereas the presence of positive
interaction patterns, namely support and validation behaviours, predicted lower symptom severity . Emotional
over-involvement of the non-PDA partner, a manifestation of expressed emotions, failed to predict PDA severity.
Discord in the couple could exacerbate the PDA and maintain it. A therapist evaluating a married PDA client
may need to assess his or her client’s marital interaction patterns with his or her partner and adjust his
intervention accordingly.

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