title: Relationship of cognitions and symptoms of agoraphobia in Hong Kong Chinese: a combined quantitative and qualitative study.
abstract: OBJECTIVE
  The aim of this study was to explore and describe the subjective experiences of agoraphobia in Hong Kong Chinese.
  
  
  METHODS
  This was a cross-sectional descriptive study, using a combined qualitative-quantitative approach. In the qualitative part, two focus groups were held with nine participants suffering from DSM-IV panic disorder with agoraphobia, followed up in a regional hospital in Hong Kong. The audiotaped
  
  
  METHODS
  was transcribed and analysed into four main categories and 13 subcategories based on a grounded theory approach. One subcategory ('Fear of making others worried and being a burden to others') was identified as a novel, culture-specific concept in agoraphobia that was not reported in Western literature. In the quantitative part, this subcategory was redefined and measured by a two-item, self-rated questionnaire survey in another 35 participants suffering from DSM-IV defined panic disorder with agoraphobia.
  
  
  RESULTS
  Qualitative data showed that the clinical manifestations of agoraphobia were specifically related to the underlying corresponding catastrophic cognitions. An individual's agoraphobic cognitions and symptoms were highly related to the identity of the surrounding people during panic attacks in agoraphobic situations, which reflected the characteristic structure of the Chinese interpersonal network. Participants preferred reliance on self to cope with the anxiety first, then turned to their family members for help due to higher interpersonal trust. Participants also expressed fear of affecting others due to their illness. A new sub-theme of agoraphobia ('Fear of making others worried and being a burden to others') was extracted from the qualitative data. Its validity was confirmed by the quantitative description of this new theme using a self-rated questionnaire as a methodological triangulation.
  
  
  CONCLUSIONS
  The central theme to emerge from the qualitative data was that agoraphobia is a clinical condition that has a close relationship to Chinese cultural factors. 'Fear of making others worried and being a burden to others' is a new concept in agoraphobia worthy of further study.
authors.affiliation: Department of Psychiatry, Kowloon Hospital, Hong Kong.
authors.forename: Lung Kit
authors.initials: LK
authors.lastname: Hui
authors.forename: Roger M K
authors.initials: RM
authors.lastname: Ng
authors.forename: Lui
authors.initials: L
authors.lastname: Pau
authors.forename: K C
authors.initials: KC
authors.lastname: Yip
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D002681:China / Q000208:ethnology; D003071:Cognition; D017144:Focus Groups; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult