Patterns of Personality Pathology in Patients with Generalized Anxiety Disorder, Panic Disorder with and without Agoraphobia, and Social Phobia

Dyck, Ingrid R.; Phillips, Katharine A.; Warshaw, Meredith G.; Dolan, Regina T.; Shea, M. Tracie; Stout, Robert L.; Massion, Ann O.; Zlotnick, Caron; Keller, Martin B.

doi:10.1521/pedi.15.1.60.18643

Cited by 84 publications

(63 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We see this as a strength of the study in spite of the fact that epidemiological data show that up to 50% of GAD patients also fulfil criteria for depression, other anxiety disorders and somatization disorders [7, 8, 9, 10]. Our goal was to test the efficacy of CBT in GAD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

Lindén¹,

Zubraegel²,

Baer³

et al. 2004

Psychother Psychosom

View full text Add to dashboard Cite

Background: Generalized anxiety disorders (GAD) are amongst the most prevalent mental disorders. Recent studies have suggested that cognitive behaviour therapy (CBT) is an effective treatment for GAD. A controlled clinical trial was done to evaluate the efficacy of CBT treatment in outpatients with pure GAD who were treated by a therapist working in routine care. Methods: Seventy-two outpatients, fulfilling GAD criteria according to DSM-IV, were included in the study. From this group, 36 patients (CBT-A) were randomly assigned to 25 sessions of CBT and the other 36 formed a contact control group (CCG). After the contact control period (CC period), these patients were also treated with CBT (CBT-B), allowing not only a parallel group comparison but also an A-B comparison. Therapists were licensed full-time psychologists who worked routinely in outpatient care and had a professional training in CBT. Treatment was done in accordance with a manual, and treatment conformity was controlled by several methods. Results: The reduction in the score on the Hamilton Anxiety Observer Rating Scale was 6.4% (1.5 points) in the CCG, 35.4% (9.5 points) in the CBT-A and 47.3% (10.3 points) in the CBT-B. In the self-rating Spielberger State-Trait Anxiety Inventory, a reduction of 2.7% was seen in CCG, 14.6% in CBT-A, and 11.6% in CBT-B. According to the Clinical Global Impression Rating, 65.6% of patients were still at least moderately ill at the end of the CC period, while this rate was 33.4% at the end of CBT-A, or 15.7% at the end of CBT-B. All these differences between treatment and control group are statistically highly significant. The clinical improvement remained stable over a follow-up period of 8 months. Conclusions: CBT is an effective method of treatment for GAD. Differences between control and treatment group are comparable to or larger than those reported in studies on antidepressant drugs.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This type of disorder has gained increasing scientific interest in recent years [2, 3]. Epidemiological studies have shown that GAD is one of the most frequent mental disorders, with co-morbidity rates of up to 50% [4, 5, 6, 7, 8, 9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

Lindén¹,

Zubraegel²,

Baer³

et al. 2004

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…These findings are inconsistent with a simple severity hypothesis. Data from several recent studies [125][126][127] also challenge the severity hypothesis. In sum, although SAD typically is more comorbid with AVPD than with other PDs and AVPD more comorbid with SAD than with other anxiety disorders, in neither case is the relationship at all exclusive, nor close enough to support a simple severity hypothesis.…”

Section: Social Anxiety Disorder Versus Avoidant Personality Disordermentioning

confidence: 99%

“…Relatively few studies have examined long-term outcomes or diagnostic course for either SAD or AVPD, but the existing data indicate that both disorders (like many others) have relatively early onsets and a persistent course, albeit with variability in severity over time. [155,168] Both the Collaborative Longitudinal Personality Study [127] and Harvard/Brown Anxiety Research Project [125] found significant but not exclusive overlap in the longitudinal courses of SAD and AVPD. Moreover, the longitudinal courses of AVPD and OCD also overlapped, although not as strongly.…”

Section: Social Anxiety Disorder Versus Avoidant Personality Disordermentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

View full text Add to dashboard Cite

Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a ''predominantly performance'' variety of SAD. A specifier based on ''fear of showing anxiety symptoms'' (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010. Key words: DSM-V; social anxiety disorder; social phobia; subtypes; classification; interpersonal; performance; test anxiety; selective mutism; avoidant personality disorder INTRODUCTIONThis review evaluates several issues pertaining to the diagnostic criteria for social phobia or social anxiety disorder (SAD) (Table 1), in light of empirical evidence gathered since DSM-IV. The review was guided by questions posed in the DSM-IV Sourcebook (Vol. 2), chapters titled ''Social phobia'' [1] and ''Social phobia subtypes,''[2] a review conducted as part of the DSM-V Stress Induced and Fear Circuitry Disorders Workgroup Conference, titled ''Social Phobia: Towards DSM V, '' [3] by questions posed by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group and by issues raised by consulted experts and advisors. The main issues to be addressed are the generalized specifier and its alternatives, the overlap with avoidant personality disorder, and developmental issues including the relationship that SAD shows in childhood with selective mutism (SM) and test anxiety. STATEMENT OF THE ISSUESThis review addresses the following questions, using the validators provided by the DSM-V Task Force: (1) What is the evidence/utility of the DSM-IV generalized specifier? If there is insufficient evidence/utility for a generalized specifier, what is the utility/evidence for alternative sub...

show abstract

“…It is associated with deterioration in education, work, and social relationships as well as with comorbid mental disorders, especially other anxiety disorders, depression, alcohol abuse and personality disorder. Social phobia is generally found to have the highest degree of comorbid personality disorders among the anxiety disorders (Dyck et al, 2001;Sanderson, Wetzler, Beck & Betz , 1994). It is estimated that only about 5-10 % among persons with social phobia seeks treatment for their condition and, if they do, they do so, on average, more than 15 years after its appearance (Keller, 2003).…”

Section: A Social Phobiamentioning

confidence: 99%

A Novel Group Therapeutic Format in Cognitive Behavioral Treatment for Clients with Social Phobia in a Training Setting: A Case Study of One Treatment Group with Nine Clients

Hougaard

Madsen²,

Hansen³

et al. 2008

PCSP

View full text Add to dashboard Cite

This case study pilot-tests a novel, cognitive behavioral treatment (CBT) program for social phobic clients in an Anxiety Clinic run by the Department of Psychology of the University of Aarhus, Denmark. The core of the program was an intensive therapy group lasting for 5 consecutive days during one week, from 9:00 am to 2:00 pm each day. The group was composed of 9 clients and 8 student therapists in training, who were present throughout the total 25 hours, and two supervising psychologists, who were present during the first 2 hours of each day. Each client was also assigned to one of the student therapists, seeing the therapist for 2-4 individual sessions before the intensive group-week, and 6 weekly 2-hour group sessions after the intensive group experience. The groups were composed of 4 (or 5) clients and 4 students with the students on their own in charge of the therapy. Individual therapy was also provided when clinically indicated after the end of the group therapy. Treatment was evaluated within an embedded case study design with one group and 9 clients via both qualitative information and quantitative measures that assessed the clients' presenting problems and therapeutic progress over the entire course of therapy and at follow-up. The results show that the intensive group treatment was therapeutically valuable for the clients. Specifically, almost all the clients appreciated the intensive group treatment format, and most achieved fast symptomatic declines over the week. Outcomes of the full treatment program for the whole group were in line with results from studies on psychotherapy for social phobia provided by experienced therapists. The educational value of the program is commented on in the discussion.

show abstract

Patterns of Personality Pathology in Patients with Generalized Anxiety Disorder, Panic Disorder with and without Agoraphobia, and Social Phobia

Cited by 84 publications

References 28 publications

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

Social anxiety disorder: questions and answers for the DSM-V

A Novel Group Therapeutic Format in Cognitive Behavioral Treatment for Clients with Social Phobia in a Training Setting: A Case Study of One Treatment Group with Nine Clients

Contact Info

Product

Resources

About