Anxiety, 2nd Edition (Clinical Psychology: A Modular Course)

222 Pages·2004·1.25 MB·English

by  Stanley J. Rachman

ANXIETY
Second Edition

Anxiety
Second Edition
S. Rachman
University of British Columbia, Canada
Firsteditionpublished1998byPsychologyPressLtd
Secondeditionpublished2004byPsychologyPressLtd
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LibraryofCongressCataloging-in-PublicationData
Rachman,Stanley.
Anxiety/S.Rachman.– 2nded.
p.cm. – (Clinicalpsychology,amodularcourse,ISSN
1368-454X)
Includesbibliographicalreferencesandindex.
ISBN1-84169-515-7(hardback:alk.paper) – ISBN1-84169-516-5(pbk.
:alk.paper)
1.Anxiety.I.Title.II.Series.
RC531.R3342004
616.85'22–dc22
2004001276
ISBN 0-203-49094-0 Master e-book ISBN
ISBN 0-203-59540-8 (Adobe eReader Format)
ISBN1-84169-515-7(hbk)
ISBN1-84169-516-5(pbk)
ISSN1368-454X(ClinicalPsychology:AModularCourse)
Contents
Series preface vii
Preface ix
1 The nature of anxiety 1
Defining anxiety 3
The nature of fear 8
Fear, anxiety, and avoidance 12
Varieties of fear 19
The concept of anxiety disorders 24
Summary 26
2 Influences on anxiety 27
A model of anxiety 27
Anxiety, attention, perception, and memory 37
Anxiety and memory 47
Emotional processing 53
Affect and cognition 55
Summary 58
3 Theories of anxiety 61
Anxiety as the product of learning 61
Cognitive analyses of anxiety 67
Psychoanalytical explanations 69
Biological theories of anxiety 73
Summary 76
4 Specific phobias and the conditioning theory of fear 79
Evidence for the conditioning theory 79
The conditioning theory: Contrary evidence and
arguments 84
Neoconditioning theory 89
Specific phobias 92
Summary 93
CONTENTS v
5 Panic and anxiety 95
The experience of panic 99
The incidence of panic 100
The debate about panic 101
Treatment 119
Summary 122
6 Agoraphobia 123
Treatment 127
Summary 128
7 Obsessions and compulsions 129
Types of compulsive behaviour 135
Persistence 136
Obsessions 140
Compulsive hoarding 143
Relationship to anxiety 143
Treatment 143
Summary 145
8 Social anxiety 147
The definition of social anxiety 147
Cognitive theory of social anxiety 150
Social anxiety within the general framework of anxiety 156
Treatment 157
Summary 159
9 Generalized anxiety disorder (GAD) 161
The search for safety 164
Treatment 166
Summary 167
10 Post-traumatic stress disorder (PTSD) 169
Explanations for PTSD 171
Acute stress disorder (ASD) 179
Summary 180
Appendix 181
Suggested reading 183
References 185
Author index 201
Subject index 207
vi ANXIETY
Series preface
Clinical Psychology: A Modular Course was designed to overcome the
problemsfacedbythetraditionaltextbookinconveyingwhatpsycho-
logicaldisordersarereallylike.Allthebooksintheseries,writtenby
leading scholars and practitioners in the field, can be read as stand-
alonetext,buttheywillalsointegratewiththeothermodulestoforma
comprehensive resource in clinical psychology. Students of psychol-
ogy,medicine,nursing,andsocialwork,aswellasbusypractitioners
in many professions, often need an accessible but thorough intro-
duction to how people experience anxiety, depression, addiction, or
otherdisorders,howcommontheyare,andwhoismostlikelytosuffer
fromthem,aswellasup-to-dateresearchevidenceonthecausesand
available treatments. The series will appeal to those who want to go
deeper into the subject than the traditional textbook will allow, and
base their examination answers, research projects, assignments, or
practicaldecisionsonaclearerandmoreroundedappreciationofthe
clinicalandresearchevidence.
Chris R. Brewin
Other titles in this series:
Depression
Constance Hammen
Stress and Trauma
Patricia A. Resick
Childhood Disorders
Philip C Kendall
SERIES PREFACE vii
Schizophrenia
Max Birchwood and Chris Jackson
Addictions
Maree Teesson, Louise Degenhardt and Wayne Hall
viii ANXIETY
Preface
Surging advances in the understanding and treatment of anxiety
disordershavemadeitnecessarytoreviseandexpandthisbook.Signs
of impending change were evident in the research described in the
first edition but the progress made in the past 6 years has exceeded
expectations.Atleast 12newtheories ofpsychopathologyhavebeen
publishedinthisperiod,and7ofthemdealwiththeanxietydisorders.
Some of them are causal theories—unusual in clinical psychology—
and all of them incorporate cognitive concepts. The theories are
becoming increasingly specific and most provide platforms for the
derivationofequallyspecificmethodsoftreatment.Theevaluationof
theories and treatments is an unavoidably lengthy and demanding
process and definitive conclusions about particular theories, and the
generalpatternofthesedevelopments,issomewayoff.
The basic science deals with the psychology of anxiety but the
current emphasis on applied science, on the nature and treatment of
disordersofanxiety,overshadowsthebasicresearch.Thepreoccupa-
tion with anxiety disorders, and the pressures to master these dis-
tressingproblems,areunderstandablebuttheyhavetiltedthebalance
frombasictoappliedresearch.However,theinterplaybetweenbasic
andappliedresearchisatwo-wayprocessthatbenefitsboth.Advances
inunderstandingthephenomenaandmechanismsofanxietydisorders
help to illuminate fundamental psychological processes. The expan-
sionofunderstandingoftheemotionoffearwaslargelytheresultof
clinicalresearch.Anexcellentexampleoftheinterplayisnowtaking
placeincurrentanalysesoftheintriguingdisturbancesofmemorythat
aresoconspicuousinPTSD.Intensivestudiesoftheclinicalphenom-
ena have already begun to expand our conceptions of basic memory
processes.
S. Rachman,
Vancouver, 2003
PREFACE ix