Leahy et al. - Anxiety Disorders - Oxford Textbook Of Psychotherapy.pdf

Ovid: Oxford Textbook of Psychotherapy Pagina 1 di 74
Editors: Gabbard, Glen O.; Beck, Judith S.; Holmes, Jeremy
Title: Oxford Textbook of Psychotherapy, 1st Edition
Copyright ©2005 Oxford University Press
> Table of Contents > Section II - Psych otherapy in psychiatric disorders > 13 - Anxiety
disorders
13

Anxiety disorders
Robert L. Leahy
Lata K. McGinn
Fredric N. Busch
Barbara L. Milrod
Introduction
Anxiety disorders are one of the mon psychological disorders found in
national surveys of the prevalence of psychiatric problems. Many anxiety
disorders are persistent rather than episodic, with a large percentage of
patients with generalized anxiety, social anxiety disorder (SAD), or obsessive-
compulsive disorder (OCD) reporting difficulties lasting years. In many cases,
the existence of an anxiety disorder will precede the emergence of a later
depressive disorder, perhaps because there is mon diathesis or because
the demoralization of having a long-lasting anxiety disorder contributes to
self-criticism, withdrawal, loss of rewards, and general feelings of helplessness
and hopelessness. Indeed, many individuals suffering from these anxiety
disorders rely on alcohol or other drugs as anxiety management, thereby
complicating their problems.
In this chapter we have brought to the reader two quite different theoretical
and clinical orientations to understanding and treating anxiety
disorders—specifically, cognitive-behavioral therapy (CBT) and
psychodynamic therapy. We attempt to provide theoretical models and clinical
strategies drawn independently from these models. Because of the differences
in these models, we have chosen to let them stand independently from one
another and leave it to the reader to explore the possibility of clinical
integration.
Cognitive-behavioral theory and model of anxiety
disorders
The behavioral and cognitive models of phobia and