What avoidance behavior in a patient supports the diagnosis of panic disorder?

The behavior of avoiding traveling more than five miles from home is indicative of panic disorder because it reflects a significant level of anxiety regarding the possibility of experiencing a panic attack away from a perceived safe environment. Patients with panic disorder often develop agoraphobia, which is the fear of being in situations where escape might be difficult or help unavailable in the event of a panic attack. By limiting travel to within a specific distance from home, the patient is demonstrating a classic avoidance behavior associated with this condition—refraining from situations that could trigger anxiety or a panic attack, thereby attempting to maintain a sense of safety and control.

In contrast, while avoiding crowds does indicate a fear associated with panic attacks, the specific behavior of restricting travel suggests a more pervasive impact on the patient's life by limiting their ability to engage in day-to-day activities. The other options, like avoiding the outdoors due to contamination fears or accompanying a spouse to work due to the fear of losing them, reflect different anxieties or conditions not specifically tied to panic disorder. These behaviors align more closely with obsessive-compulsive disorder or separation anxiety than with the characterized avoidance seen in panic disorder.