hardpanic disorderagoraphobiaPDSSparoxetineCBTinteroceptive exposureavoidance behaviortreatment response
A 27-year-old female with panic disorder and agoraphobia has been on paroxetine 40 mg daily for 14 weeks and has completed 10 sessions of cognitive behavioral therapy incorporating interoceptive exposure and graduated in-vivo exposure. Her baseline Panic Disorder Severity Scale (PDSS) score was 22. At today's visit, her PDSS is 9. She reports she has not had a full panic attack in five weeks, though she experiences occasional limited-symptom episodes with heart pounding and derealization lasting two to three minutes. She has resumed driving independently and grocery shopping but continues to avoid highway driving and crowded indoor venues such as concerts and movie theaters. She no longer carries a PRN benzodiazepine in her purse but reports significant anticipatory anxiety before attempting new situations. Her catastrophic cognitions about panic attacks causing cardiac arrest have resolved. The PMHNP is evaluating the overall treatment response and residual symptom burden. Which of the following best represents the appropriate evaluation?