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Our Anxiety Disorders Topic Center has been Updated!

Mark Dombeck, Ph.D. Updated: Jun 28th 2010

an anxious young man with his hand on his headI am pleased to announce that we have entirely refreshed and updated our Anxiety Disorders topic center.  This has been a major undertaking with a few false starts along the way.  It is good to finally get it out there. 

The rewrite - really we started over from scratch - was undertaken by four staff members of the Bio Behavioral Institute of Long Island, New York, a clinic that specializes in the treatment of Anxiety disorders.  We extend our sincere thanks to Matthew D. Jacofsky, PsyD., Melanie T. Santos, Psy.D.,
Sony Khemlani-Patel, Ph.D., and Dr. Fugen Neziroglu who have collectively done a really nice job. 

Anxiety is a fundamental human problem, touching every person to one degree or another.  It is a symptom of a wide variety of different mental disorders, but it also has its own family of anxiety disorders.  The DSM presently splits the anxiety disorders family into multiple sub-categories.  We have the Phobias (or fear disorders), many of which involve the phenomena of panic.  We have Obsessive Compulsive Disorder (OCD) which is turning out to be something of its own spectrum.  We have Post-Tramatic Stress Disorder (PTSD).  We have Generalized Anxiety Disorder (GAD).  All of these different presentations of anxiety disorders share the common core of anxiety being their central feature, but they are distinct and different as well. 

In the face of this complexity, we have opted to make this re-written topic center document an overview which describes the nature of anxiety and the nature of that core that links all the anxiety disorders together.  As we go forward, we will update our other topic centers that deal with the more specific types of anxiety with many references back to this document, and in that way, keep everything more compact.  No use reinventing the wheel each time you need to explain something. 

This new document is divided into 50 new pages on the website.  It is sub-divided into seven chapters:

The document starts by defining the nature of anxiety - an emotion related to fear.  After differentiating normal anxiety from problematic anxiety, it moves into a discussion of how problematic anxiety (e.g., anxiety disorders) occur; how they form and what keeps them going.  We lean heavily on the seminal work of David Barlow, Ph.D. in this explanation as his carefully argued and researched book on the subject (Anxiety and Its Disorders, Second Edition ) is to date the best and most influential description of how anxiety occurs.  It turns out that though the different forms of anxiety disorders are distinctive, they also all generally follow the pattern of anxiety disorders.  If you can understand this pattern in one context, you will have a good start at understanding how it functions in other contexts. 

After unfolding the theory of anxiety, we talk about the various anxiety disorders as understood through the lense of the DSM.  Following this brief discussion of disorders, we review the body of theory and research that provides the foundation for the modern understanding of anxiety.  This means we talk about learning theory, behavioral psychology and cognitive behavioral psychology, and the treatments that follow from these approaches, which include behavioral and cognitive behavioral forms of therapy, including exposure and response prevention and cognitive therapy (which boils down to cognitive restructuring and reframing).  We also discuss the use of medications in the treatment of anxiety. 

The discerning reader might note that we don't give space to the psychoanalytic theories that talk about anxiety disorders.  This is a deliberate choice, made on the grounds of utility and space.  We do think there are good insights into anxiety disorders that can be found within psychoanalytic formulations, but we don't see them as terribly important for informing the treatment of anxiety.  Behavioral and cognitive behavioral formulations have produced scientifically validated treatments that have high success rates.  Consequently, we discuss what we know works and stay within bounds by doing so.

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