Michelle G. Craske’s research while affiliated with University at Albany, State University of New York and other places

The goal of this study was to examine the role of panic-expectancy in patterns of avoidance. Twenty-eight individuals with Panic Disorder with moderate to severe avoidance underwent individualized behavioral testing. Dependent variables were assessed immediately prior to attempting the behavioral test item. They included, in addition to actual levels of reported fear and avoidance, predicted probability of panic, predicted intensity, discomfort and harm from the physical sensations of panic, predicted negtive consequences of panicking, and predicted level of fear tolerance. Number of months since last attempt to approach the behavioral test item was also recorded. The probability of panic and fear tolerance levels were related significantly to avoidance across individuals. The predicted probability of panic was the variable of most significance for within individual patterns of avoidance, although ratings of the physical symptoms of panic and fear tolerance levels related to some extent. Correlational coefficients suggested that the predicted probability of panic was situationally specific in comparison to the relative stability of predictions relating to negative consequences of panicking. Treatment implications are considered.

The hypothesis that high heart rate and low perceived skill would be associated with greater return of fear than low heart rate and high perceived skill was investigated in a group of 63 anxious musical performers. Musicians were taught progressive muscle relaxation and attention-focusing skills over the course of four weekly sessions. Return of subjective fear was assessed between training programme sessions and at a three-month follow-up assessment. Performance quality ratings served as the behavioural measure, anticipatory heart rate as the physiological measure, and subjective units of distress scales as the subjective measure. Four classification groups (high heart rate, low perceived skill; high heart rate, high perceived skill; low heart rate, low perceived skill; and low heart rate, high perceived skill) were formed on the basis of median splits of heart rate and perceived skill pre-assessment levels. Each group demonstrated subjective fear reduction, while heart rate reduced in the high heart-rate subjects, and performance quality improved overall at post-assessment. Follow-up return of fear was apparent in high heart-rate subjects, regardless of their perceived skill status. High heart-rate subjects reported more anxious thoughts than did low heart-rate subjects. Perceived skill was not clearly associated with return of fear. Post-hoc comparisons indicated that subjects who demonstrated follow-up return of fear had higher heart rate, lower perceived skill, more anxious thoughts, less performance skill and fewer performances over the follow-up interval than subjects who did not demonstrate a return of fear. However, initial heart rate was the only significant predictor of follow-up fear levels.

Responses to the Mobility Inventory for Agoraphobia and the Cognitions Questionnaire were compared from samples of agoraphobics, social phobics, senior citizens, students, and students'' relatives. The data illustrate the occurrence of avoidant behavior and panic in groups other than agoraphobics. The Mobility Inventory was shown to have good discriminative power, but the Cognitions Questionnaire failed to discriminate between agoraphobics and social phobics. The relationship of panic to mobility and cognitions is considered.

In an attempt to find out whether escape behavior strengthens agoraphobic avoidance, two groups of agoraphobic patients were given 8 sessions of individually administered exposure treatment. The patients in the no-escape group were exposed progressively to selected fear-evoking situations in the standard manner. The patients in the escape group were also exposed progressively but were instructed to escape when their fear reached a preset level of 70 on a scale of 0–100. Both groups of patients showed significant and equivalent improvements on all measures of agoraphobia, and these changes were still evident 3 months later. The patients in the escape condition reported greater control and less fear than those in the no-escape condition. Escapes were not followed by increases in fear, or in estimates of danger, nor by decreases in estimates of control or safety. The presession estimates of control and safety were reduced on treatment sessions that followed a panic. It is concluded that escape behavior does not necessarily strengthen agoraphobic avoidance.