In this article we propose mechanisms that govern the processing of emotional information, particularly those involved in fear reduction. Emotions are viewed as represented by information structures in memory, and anxiety is thought to occur when an information structure that serves as program to escape or avoid danger is activated. Emotional processing is denned as the modification of memory structures that underlie emotions. It is argued that some form of exposure to feared situations is common to many psychotherapies for anxiety, and that confrontation with feared objects or situations is an effective treatment. Physiological activation and habituation within and across exposure sessions are cited as indicators of emotional processing, and variables that influence activation and habituation of fear responses are examined. These variables and the indicators are analyzed to yield an account of what information must be integrated for emotional processing of a fear structure. The elements of such a structure are viewed as cognitive representations of the stimulus characteristic of the fear situation, the individual's responses in it, and aspects of its meaning for the individual. Treatment failures are interpreted with respect to the interference of cognitive defenses, autonomic arousal, mood state, and erroneous ideation with reformation of targeted fear structures. Applications of the concepts advanced here to therapeutic practice and to the broader study of psychopathology are discussed.The last two decades have brought remarkable advances in the behavioral treatment of pathological fears and an abundance of data on treatment outcomes. This accumulation of data, however, has not been paralleled by theoretical understanding of the processes that relate interventions to outcome. In this article we examine the data on treatment of fear and offer a framework for organizing them. Within this framework we advance hypotheses about the mechanisms of therapeutic change and consider why treatment succeeds with some individuals and fails with others.The search for mechanisms of fear reduction can begin with recognition of some commonalities in how different schools of psychotherapy view anxiety and its treatment. Regardless of their theoretical persuasion, clinicians have long ascribed a central role to anxiety or other unpleasant affect in the etiology and maintenance of neurotic behavior. A basic assumption in psychodynamic approaches has been that neuroses reflect attempts to avoid disturbing experiences (Freud, 1956). In describing pathology, Perls (1969) asserted that, "If some of our thoughts, feelings are unacceptable to us, we want to disown them but only at the cost of disowning valuable parts of ourselves. . . . Your ability to cope with the world becomes less and less" (p.

This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), a psychometrically sound, theoretically driven, self-report measure. The revised OCI (OCI-R) improves on the parent version in 3 ways: It eliminates the redundant frequency scale, simplifies the scoring of the subscales, and reduces overlap across subscales. The reliability and validity of the OCI-R were examined in 215 patients with obsessive-compulsive disorder (OCD), 243 patients with other anxiety disorders, and 677 nonanxious individuals. The OCI-R, which contains 18 items and 6 subscales, has retained excellent psychometric properties. The OCI-R and its subscales differentiated well between individuals with and without OCD. Receiver operating characteristic (ROC) analyses demonstrated the usefulness of the OCI-R as a diagnostic tool for screening patients with OCD, utilizing empirically derived cutscores.

The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV} criteria and a measure of PTSD symptom severity. Twohundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of traumarelated psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.

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