CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS

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CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS

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CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS A Step-by-Step Treatment Manual FOURTH EDITION EDITED BY DAVID H BARLOW THE GUILFORD PRESS New York London To Beverly For love, loyalty, and dedication © 2008 The Guilford Press A Division of Guilford Publications, Inc 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Printed in the United States of America This book is printed on acid-free paper Last digit is print number: The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors, nor the editor and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information Readers are encouraged to confirm the information contained in this book with other sources Library of Congress Cataloging-in-Publication Data Clinical handbook of psychological disorders : a step-by-step treatment manual / edited by David H Barlow.—4th ed p ; cm Includes bibliographical references and index ISBN-13: 978-1-59385-572-7 (hardcover : alk paper) ISBN-10: 1-59385-572-9 (hardcover : alk paper) Behavior therapy—Handbooks, manuals, etc Medical protocols—Handbooks, manuals, etc I Barlow, David H [DNLM: Mental Disorders—therapy Psychotherapy—methods WM 420 C6415 2008] RC489.B4C584 2008 616.89′1—dc22 2007015429 About the Editor David H Barlow, PhD, is Professor of Psychology and Psychiatry and Founder and Director Emeritus of the Center for Anxiety and Related Disorders at Boston University He has published over 500 articles and chapters and close to 50 books and clinical manuals—some translated in over 20 languages, including Arabic, Chinese, and Russian—mostly in the area of emotional disorders and clinical research methodology Dr Barlow has been the recipient of numerous awards throughout his career, most recently the American Board of Professional Psychology’s Distinguished Service Award to the Profession of Psychology in 2006 He is past president of the Society of Clinical Psychology (Division 12) of the American Psychological Association and the Association for Advancement of Behavior Therapy (now the Associaton for Behavioral and Cognitive Therapies) and past editor of the journals Behavior Therapy, the Journal of Applied Behavior Analysis, and Clinical Psychology: Science and Practice Dr Barlow was chair of the American Psychological Association Task Force on Psychological Intervention Guidelines, a member of the DSM-IV Task Force of the American Psychiatric Association, and a cochair of the DSM-IV work group for revising the anxiety disorder categories He is a Diplomate in Clinical Psychology of the American Board of Professional Psychology and maintains a private practice v Contributors Michael E Addis, PhD, Department of Psychology, Clark University, Worcester, Massachusetts Laura B Allen, PhD, Center for Anxiety and Related Disorders and Department of Psychology, Boston University, Boston, Massachusetts Amy K Bach, PhD, Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island David H Barlow, PhD, Center for Anxiety and Related Disorders and Department of Psychology, Boston University, Boston, Massachusetts Aaron T Beck, MD, Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, and Beck Institute for Cognitive Therapy and Research, Bala Cynwyd, Pennsylvania Kathryn L Bleiberg, PhD, Department of Psychiatry, Weill Cornell Medical College, Cornell University, New York, New York Andrew Christensen, PhD, Department of Psychology, University of California, Los Angeles, California Zafra Cooper, DPhil, Department of Psychiatry, University of Oxford, Oxford, United Kingdom Michelle G Craske, PhD, Department of Psychology, University of California, Los Angeles, California Elizabeth T Dexter-Mazza, PsyD, Department of Psychology, University of Washington, Seattle, Washington vi Contributors Sona Dimidjian, PhD, Department of Psychology, University of Colorado, Boulder, Colorado Christopher G Fairburn, MD, Department of Psychiatry, Oxford University, Oxford, United Kingdom Edna B Foa, PhD, Department of Psychiatry and Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, Pennsylvania Martin E Franklin, PhD, Department of Psychiatry and Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, Pennsylvania Sarah H Heil, PhD, Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont Richard G Heimberg, PhD, Adult Anxiety Clinic and Department of Psychology, Temple University, Philadelphia, Pennsylvania Ruth Herman-Dunn, PhD, private practice, Seattle, Washington Stephen T Higgins, PhD, Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont Neil S Jacobson, PhD (deceased), Department of Psychology, University of Washington, Seattle, Washington Marsha M Linehan, PhD, Departments of Psychology and Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington Leanne Magee, MA, Adult Anxiety Clinic and Department of Psychology, Temple University, Philadelphia, Pennsylvania John C Markowitz, MD, Department of Psychiatry, New York State Psychiatric Institute, New York, New York Christopher R Martell, PhD, private practice, Seattle, Washington, and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington Barbara S McCrady, PhD, Center on Alcoholism, Substance Abuse, and Addictions, and Department of Psychology, University of New Mexico, Albuquerque, New Mexico R Kathryn McHugh, MA, Center for Anxiety and Related Disorders and Department of Psychology, Boston University, Boston, Massachusetts David J Miklowitz, PhD, Department of Psychology, University of Colorado, Boulder, Colorado Candice M Monson, PhD, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts Patricia A Resick, PhD, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts Shireen L Rizvi, PhD, Department of Psychology, New School for Social Research, New York, New York Jayne L Rygh, PhD, Cognitive Therapy Center of New York, New York, New York Roz Shafran, PhD, School of Psychology and Clinical Language Science, Reading University, Reading, United Kingdom vii viii Contributors Stacey C Sigmon, PhD, Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont Nicholas Tarrier, PhD, Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Manchester, United Kingdom Cynthia L Turk, PhD, Anxiety Clinic and Department of Psychology, Washburn University, Topeka, Kansas Arthur D Weinberger, PhD, Cognitive Therapy Center of New York, New York, New York Jennifer G Wheeler, PhD, private practice, Seattle, Washington G Terence Wilson, PhD, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey John P Wincze, PhD, Department of Psychiatry and Human Behavior and Department of Psychology, Brown University, Providence, Rhode Island Jeffrey E Young, PhD, Department of Psychiatry, Columbia University, and Cognitive Therapy Center of New York, New York, New York Preface Evidence-based practice (EBP) is one of those ideas that comes along occasionally and takes the world by storm Although some of the tenets of EBP have been around for decades (as has this Handbook), it is only in the past 10 years that EBP has been formally identified as a systematic method of delivering clinical care (Institute of Medicine, 2001; Sackett, Strauss, Richardson, Rosenberg, & Haynes, 2000) Since that time the “tipping point” (Gladwell, 2000) for EBP has clearly occurred, and health care policymakers and governments as well as professional societies around the world have collectively decided that the delivery of health care, including behavioral health care, should be based on evidence (APA Task Force on EvidenceBased Practice, 2006) Fulfilling this mandate comprises the goals of EBP, and has also been the goal of this book since the first edition was published in 1985 The fourth edition of this book continues to represent a distinct departure from any number of similar books reviewing advances in the treatment of psychological disorders from the perspective of EBP Over the past two decades we have developed a technology of behavior change that necessarily differs from disorder to disorder This technology consists of a variety of techniques or procedures with more or less proven effectiveness for a given disorder (and increasingly for classes of disorders) Naturally, we have more evidence of the effectiveness of these treatments for some disorders than for others It also has become more apparent since the earlier editions that considerable clinical skill is required to apply this technology most effectively Therefore, this book, in its fourth edition, is not another review of therapeutic procedures for a given problem with recommendations for further research Rather, it is a detailed description of actual treatment protocols in which experienced clinicians implement the technology of behavior change in the context of the most frequently encountered disorders ix x Preface In this edition, the originators of some of the best-known psychological treatment protocols have revised and updated the descriptions of their interventions to reflect the latest developments in an increasingly powerful array of psychological treatments Among these revisions to existing chapters, several deserve comment Patricia A Resick, Candice M Monson, and Shireen L Rizvi have updated their chapter on posttraumatic stress disorder with a new and tragic case fresh from the battlefields of Iraq Their successful treatment of this individual suffering from the unspeakable (and intolerable) trauma of war is one consequence of today’s headlines that seldom makes it into print Drug abuse continues as a scourge that ruins individual lives, the functioning of families, and the very fabric of society Stephen T Higgins, Stacey C Sigmon, and Sarah H Heil have expanded their chapter from a more narrow focus on cocaine to a broader focus on all serious drugs of abuse The body of evidence supporting interpersonal psychotherapy (IPT) has continued to grow in recent years, and for the first time in this edition two of the leading clinicians and teachers of IPT, Kathryn L Bleiberg and John C Markowitz, illustrate their fascinating approach to the treatment of depression in the context of an illuminating case In addition, there is much that appears for the first time in this edition, reflecting major developments in the past several years Four original treatment protocols make their appearance—two that focus on specific disorders and two that cut across disorders Chapter 8, by Sona Dimidjian, Christopher R Martell, Michael E Addis, and Ruth Herman-Dunn, describes the application of behavioral activation to depression A variety of new evidence suggests that this approach is one of the more exciting innovations in recent years, but because it is so new, few are aware of the intricacies of its application to depressed patients Chapter 11, by Nicholas Tarrier, presents the latest developments on psychological approaches to schizophrenia directed mostly at the “positive” symptoms of hallucinations and delusions Much of this work has been innovated in the United Kingdom, and is unfamiliar to many in North America despite the robust nature of evidence for efficacy Finally, there is growing consensus that the future of EBP will be to distill principles of effective change that cut across diagnostic conditions, making them more generally applicable Two of these “unified” or “transdiagnostic” protocols are presented for the first time in this edition Chapter presents our own unified approach to emotional disorders, and Chapter 14 describes a transdiagnostic approach to eating disorders by the originators, Christopher G Fairburn, Zafra Cooper, Roz Shafran, and G Terence Wilson As with all chapters, the nuts and bolts of clinical application are emphasized As with the previous editions, this book was motivated by countless clinical psychology graduate students, psychiatric residents, and other mental health professionals, either in training or in practice, asking, “But how I it?” Realizing that there is no single source in which to find step-by-step treatment protocols for use as a guide to practice, this book attempts to fill the void To accomplish this purpose, a number of specific topics are common to most chapters Each chapter begins with a brief review of our knowledge of the specific disorder (or class of disorders), followed by a description of the particular model or mini-theory that guides the technology utilized with the disorder in question This model, or mini-theory, typically answers the question, What particular facets of the disorder should be assessed and 708 Avoidance behavior (cont.) posttraumatic stress disorder, 66–67, 69–71 social anxiety disorder, 132–134, 137–138 See also Emotional avoidance Avoidance Hierarchy, 242, 242f, 243 Avoidant personality disorder panic disorder/agoraphobia outcome, 14 social anxiety disorder comorbidity, 124–125 subtypes, 124–125 Awareness of Emotions handout, 240, 241f Awareness training, schizophrenia, 474 Be Your Own Cognitive Coach (BYOCC), 143 Beck Anxiety Inventory–II, 22, 133–134, 227 Beck Depression Inventory–II (BDI-II) behavioral activation, 332 emotional disorders, 223, 227 substance abusers, 551–552 Behavior exchange, couples, 675 Behavioral activation activity scheduling, 338–339 versus antidepressant treatment, 331 assessment, 331–332 avoidance modification strategies in, 340–341 behavioral roots of, 329–330 case study, 343–362 client variables, 342–343 versus cognitive therapy, 259, 331 course of treatment, 332–343 current conceptualization, 330 depression treatment, 233, 328– 364 empirical context, 331 “functional analysis” in, 335 graded tasks in, 339–340 case study, 358 individualization of, 335–338, 343 key treatment points, 333t strategies, 338–341 therapist qualities, 342–343 therapy setting, 341–342 Behavioral Activation for Depression Scale (BADS), 332 Behavioral analysis alcohol use disorder, 534, 535f in dialectical behavior therapy, 395–396 case study, 403, 408–413 primary questions in, 395 Subject Index Behavioral avoidance, 231, 232t Behavioral couple therapy drug abuse and dependence, 555, 559–560 limitations, 663–665 See also Integrative behavioral couple therapy Behavioral experiments, schizophrenia, 476 Behavioral inhibition, 218 Behavioral model depression, 329–330 obsessive–compulsive disorder, 168–171 Behavioral rituals, obsessive– compulsive disorder, 165 Behavioral tests panic disorder/agoraphobia, 22– 23 social anxiety disorder, 134–135 Belief modification, schizophrenia, 475–476 Benzodiazepines as exposure safety signal, 31 panic disorder/agoraphobia, 16– 17 state-dependent learning drawback, 16–17 Benzoylecgonine, 562 Bereavement See Grief Binge eating analysis of, 608–610 cognitive-behavioral theory, 583 “dietary restraint” reaction, 607–608 function of, 609 Binge-eating disorder clinical features, 581 diagnosis, 580 presentation and course, 582 Biopsychosocial model, sexual dysfunction, 617, 620–627 Biosocial theory borderline personality disorder, 372–374 in case conceptualization, 371– 372 and emotion dysregulation, 372– 373 Bipolar disorder, 421–462 assessments, 435–438 in children and adolescents, 431, 435–436, 457 communication enhancement training, 442–444 comorbidity, 423–424 daily mood record, 436 diagnosis, 421–424, 435–436 changes in, 422–423 differential diagnosis, 423–424 drug treatment, 424–426 nonadherence, 426 outcome, 425 family and marital therapy outcome, 429–432 family assessment, 436–438 family stress model, 427–428 individual therapy outcome, 429 life-event stress, 426–427 problem-solving skills training, 444–446 psychoeducation, 438–442, 438t psychotherapy rationale, 426 reentry model, 438 resistance to illness concept, 441–442 treatment outcome studies, 428– 432 treatment process, 438–446 vulnerability–stress model, 426– 428, 427f Blame, PTSD case study, 97, 102 Body checking/avoidance, eating disorders, 603–605 Body dysmorphic disorder, 168 Body mass index, 596, 613n1 Body Sensations and Agoraphobia Cognitions Questionnaire, 22 Booster sessions, panic disorder/ agoraphobia, 33 Borderline personality disorder, 365–420 ancillary care, 386–388 assessment measures, 366 behavioral analysis, 395–396 case management strategies, 386–388 case study, 400–417 cognitive-behavioral therapies, 368–369 diagnosis, 366 dialectical behavior therapy, 365–420 treatment strategies, 388–400 exposure strategies, 398–399 individual therapy, 381–382 invalidation environments, 373– 374 modes of treatment, 381–388 pharmacotherapy, 368 problem solving, 394–395 psychodynamic therapy, 366–368 solution analysis, 396 suicidal behavior, 365–366 telephone consultation, 383–384 validation treatment strategy, 392–394 Borderline Symptom List (BSL), 366 Subject Index Breathing retraining current deemphasis of, 25 in vivo exposure comparison, 25 in panic treatment protocol, 36– 37, 40–42 rationale, 24 as safety signal, 424 Brief cognitive-behavioral therapy, panic disorder, 11–12 Brief Fear of Negative Evaluation Scale (BFNE), 133, 156– 157, 157f Brief Posttraumatic Diagnostic Scale, 228 Brief Social Phobia Scale (BSPS), 134 Bulimia nervosa, 578–614 assessment, 587–590, 592 clinical features, 580–581 cognitive-behavioral theory, 582– 584, 583f cognitive-behavioral therapy, 585–612 contraindications, 588–590 development and course, 581–582 diagnosis and classification, 578– 580, 579f protocol, 590–612 relapse prevention, 610–612 “transdiagnostic” approach, 582, 584–585, 585f See also Eating disorders The CAGE, 500, 500t Camberwell Family Interview, 427, 437 Cardiovascular reactivity, panic disorder, Catastrophic misappraisals, panic disorders, Catastrophizing as cognitive misappraisal, 230, 236 in panic treatment protocol, 40– 41 Category System for Coding Partner Interactions, 430, 437 Chain analysis, 395–396, 409 Challenging Beliefs Worksheet, 104, 105f, 108–110, 111f, 112–114 Challenging Questions Sheet, 100– 102, 101f, 106, 110 Changing EDBs monitoring form, 116f, 233 Checking rituals and home visits, 190 in vivo exposure, 189 pathology hypothesis, 170–171 Cheerleading strategies, 394, 414 Child abuse, assessment questions, 73 Child mode of responding, 256, 264f, 289 Childhood bipolar disorder diagnostic evaluation, 435–436 family psychoeducation, 431 research, 457 Childhood sexual abuse and borderline personality disorder, 374 cognitive processing therapy, 84 as invalidating environment, 374 STAIR/MPR treatment, 79, 82 Cholecytokinin–B receptor gene, panic disorder, Chronic depression general characterization, 255 schema therapy, case study, 287– 297 treatment research, 255–256 Chronic schizophrenia, CBT for psychosis, 465, 467 Cialis See Erectile dysfunction medications Classical conditioning, PTSD, 69 Client variables alcoholism treatment outcome predictors, 527–528 and behavioral activation, 342– 343 cognitive therapy, 266 dialectical behavior therapy, 388 eating disorders, 586 family-focused treatment, 433 integrative behavioral couple therapy, 677 interpersonal psychotherapy, 310 posttraumatic stress disorder, 84–87 sex therapy, 628–629 Clinical Impairment Assessment (CIA), 588 Clinician-Administered PTSD Scale, 73 Clomipramine versus exposure/ritual prevention, 176–177 in obsessive–compulsive disorder, 176 CO2 inhalation, 28 Cocaine abuse and alcohol use, disulfiram therapy, 571–572 behavioral couple therapy, 559– 560 case study, 566–575 community reinforcement approach, 555–566 709 functional analysis, 556–557, 557f Job Club, 559 refusal skills, 557–558, 558t self-help groups, 558 self-management planning, 557– 558 time management, 558–559 vocational counseling, 559, 559t voucher program, 562–564 Cocaine Dependency Self-Test, 551 Cognitive appraisals, in emotional disorders, 230–231, 236– 237 Cognitive avoidance strategies, 231–232, 232t Cognitive-behavioral analysis system of psychotherapy, 255–256 Cognitive behavioral group therapy See Group cognitive-behavioral therapy Cognitive-behavioral model alcohol abuse case conceptualization, 497 and drug use/dependence, 554– 566 eating disorders, 582–585 versus exposure/ritual prevention, 175–176 obsessive–compulsive disorder, 170 social anxiety disorder, 126–128, 127f Cognitive-behavioral therapy bipolar disorder, 429 borderline personality disorder, 368–369 eating disorders, 585–612 contraindications, 588–590 protocol, 590–612 panic disorder and agoraphobia, 10–17 components, 24–32 efficacy, 32–33, 50 maintenance of response, 32– 33 protocol, 33–50 posttraumatic stress disorder, 78–79, 86 See also specific aspects Cognitive-behavioral therapy for psychosis (CBTp), 463–491 acute schizophrenia, 465 basic clinical principles, 466–467 case study, 477–484 in chronic schizophrenia, 465 context of, 469–471 coping–recovery model, 471–476 depression, 250–305 710 Cognitive-behavioral therapy for psychosis (cont.) development of, 464 early intervention, 465 Manchester model, 471–477 patient variables, 470 procedure, 471–477 relapse prevention, 465 research evidence, 464–465 schizophrenia, 464–489 therapist variables, 470–471 Cognitive models depression, 259–265 obsessive–compulsive disorder, 168–171 posttraumatic stress disorder, 70–71 schizophrenia, 465–466 Cognitive processing therapy (CPT) efficacy, 82, 84 posttraumatic stress disorder, 79, 82, 84 protocol, 79 Cognitive reappraisal See Antecedent cognitive reappraisal Cognitive rehearsal, and depression, 270 Cognitive restructuring alcohol abuse relapse prevention 499 versus exposure treatment, 26 panic disorder and agoraphobia, 25–27, 38–42 posttraumatic stress disorder, 78, 80, 83–84 in sex therapy, 641–642 social anxiety disorder, 125–126, 139–143 Cognitive therapy versus behavioral activation, 331 depression, 250–305 behavioral versus cognitive aspects, 258–259 versus drugs, 252, 256–258 posttraumatic stress disorder, 78, 80–81, 83 See also Cognitive-behavioral therapy; Schema therapy Collaborative empiricism in cognitive therapy, 268 case study, 280 Collaborative relationship behavioral activation treatment, 334 in cognitive therapy, 266–268 “Collaborative set,” couple therapy, 670 “Collaborative weighing,” 596 Colorado Family Project, 433 Subject Index “Columbo technique,” 466 Combat Exposure Scale, 73 Combat veterans case study, 87–115 multiple traumatization, 86 PTSD prevalence, 68–69 therapist variables, 85 Command hallucinations, 488 Communication analysis case study, 321–322 in interpersonal psychotherapy, 314, 321–322 Communication enhancement training (CET) bipolar disorder, 442–444 case study, 451–454 and demand–withdraw pattern, 451–452 in family-focused treatment, 442–444 Communication training couples, 675–677 significant others, panic– agoraphobia, 45 sexual dysfunction, 646–648, 648f Communicative deviance, bipolar disorder, 438 Community clinics, panic disorder and agoraphobia, 33 Community reinforcement and family training (CRAFT) model, 501 Community reinforcement approach and alcoholism, 523 case study, 566–575 cocaine dependence, 555–566 voucher program, 562, 564 drug abuse/dependence treatment, 548 general characteristics, 556 Comorbidity alcohol use disorders, 494 bipolar disorder, 423–424 “general neurotic syndrome” pattern, 219 mood disorders and anxiety, 219 obsessive–compulsive disorder, 166–167 panic disorder and agoraphobia, 14–15 unified protocol for, 211–222 “Completion tendency,” PTSD theory, 69–70 Compliance See Noncompliance Complicated bereavement, 315– 323 Compulsions, definition, 164–165 Computer-assisted therapy, 11, 265 Conditioned stimulus, and exposure therapy, 31–32 Conflict Tactics Scale–Revised, 507, 669, 669t Confrontational techniques, alcoholism treatment, 504, 526 Conscious processing, PTSD memories, 71 Consolidation of learning, and exposure, 30 Constructivist theories, PTSD model, 70 Consultation team in dialectical behavior therapy, 384–386, 385t primary functions, 385 Context effects, exposure therapy, 31–32 Contingency contracts, alcoholism, 523 Contingency management in behavioral activation treatment, 335–339 in depression behavioral models, 329–330 in dialectical behavior therapy, 395–399 drug use disorders efficacy, 555 and vouchers, 562–564 and functional analysis, 335–336 in integrative behavioral couple therapy, 665–666 assessment, 670–671 and reciprocal communication, 399 suicidal behavior and hospitalization, 401–403 case study, 401–403, 409–410 Continuation-phase cognitive therapy (C-CT), 254 Control feelings/beliefs PTSD case study, 112 schizophrenia, 476 Controlled drinking protocol, 572 Coping–recovery model, schizophrenia, 471–476 Coping skills, stress inoculation training, 77 “Core appraisal”, 230, 237 Core beliefs case study, 154–155 social anxiety disorder, 143, 154–155 “Core psychopathology,” eating disorders, 600–610 Cost-effectiveness, antidepressants versus CBT, 16, 257–258 Cotherapists, in family-focused treatment, 434–435 Subject Index Couple distress, 662–689 assessment, 669–672 components, 667–668 etiology, 666–667 See also Integrative behavioral couple therapy Couple therapy alcoholism, 512, 524 definition, 663 See also Integrative behavioral couple therapy Covert modeling, stress inoculation training, 77 Cues, and alcoholism, 523 Cultural factors, sexual dysfunction, 625 Cyclothymic disorder, differential diagnosis, 424 Daily mood chart, bipolar disorder, 436, 436f Daily Mood Record, panic monitoring, 20, 21f, 24 Daily Record of Dysfunctional Thoughts, 272–273, 272f Daily self-recording card, 505–506, 507f, 513, 532 Dearousing techniques, schizophrenia, 474–475 Decatastrophizing, panic treatment, 41 Decision analysis, interpersonal psychotherapy, 314 Decisional Balance Sheet, 505, 506f, 513 Defense system social anxiety disorder link, 127– 128 social order mechanism, 127 “Delayed eating,” 597 Delusional disorder, OCD differential diagnosis, 168 Delusions case formulation, 480–484 case study, 477–484 cognitive-behavioral therapy for psychosis, 466, 473–477 cognitive process modification, 476–477 coping–recovery model, 471 intervention, 473–477 origins and maintenance of, 471, 472f Demand–withdraw communication pattern, 451–452 Depression acute phase treatment research, 251–253 antidepressants versus CBT, 252 antidepressants versus CBT, 252, 256–258 anxiety overlap, 219 behavioral activation treatment, 233, 328–364 empirical context, 331 behavioral models, 329–330 cognitive model, 259–265 cognitive therapy, 250–305 “early maladaptive schemas,” 260 and eating disorders, 588–589, 599 interpersonal psychotherapy, 306–327 medical model, 309, 318, 323 and obsessive–compulsive disorder treatment, 184–185 and panic disorder/agoraphobia outcome, 14 prevalence, 250, 307 schema therapy, 255–256 and sexual dysfunction, 624 symptom reduction, 270–278 Depressive and Bipolar Support Alliance, 446 Depressive rumination See Rumination Derogatis Sexual Functioning Inventory (DSFI), 635 Detoxification, alcohol dependence, 509 Devil’s advocate technique, 391, 405–408 Diabetes, and sexual dysfunction, 621 Diagnostic and Statistical Manual of Mental Disorders See DSM-IV-TR Diagnostic Interview for DSM-IV Personality Disorders, 366 Dialectical behavior therapy ancillary care, 386–388 behavioral analysis in, 395–396 in binge-eating disorder, 370 biosocial theory, 372–374 borderline personality disorder, 365–420 case conceptualization, 371–372 case management strategies, 386–388 case study, 400–417 client variables, 388 cognitive modification, 398 consultation team, 384–386, 387t commitment session, 385t contingency procedures, 397–398 core strategies, 392–394 in depression, 370 711 and dialectical dilemmas, 374f, 374–377 dialectical treatment strategy, 389f, 389–392 efficacy, 369–370 exposure strategies, 398–399 function of treatment, 380 modes of treatment, 381–388 orienting and commitment stage, 378 philosophical basis, 370–372 problem solving, 394–399 skills training groups in, 382– 383, 397 stages of, 377–380 stylistic strategies, 399–400 telephone consultations, 383–384 therapist variables, 388 therapy-interfering behaviors, 379 treatment goals, 377–380 treatment strategies, 388–400 validation in, 392–394 Dialectical thinking, therapy goal, 378 Dialectics, 370–372 Diaphragmatic breathing, 37–38, 40–41 Diary cards, in dialectical behavior therapy, 381–382 Diatheses, triple vulnerability theory, 217–218 Diathesis–stress model, 372 Dietary restraint adverse effects, 607–608 eating disorders, 607–608 relapse prevention, 611 treatment, 608 Direct therapeutic exposure, PTSD, 77 Discrete predictions, in panic treatment, 38 Disease model, alcohol abuse, 499 Disputing questions, in social anxiety, 140 Dissociation borderline personality, 401–402 and PTSD psychophysiologic reactivity, 76 Distraction, exposure practice effects, 29 Distress tolerance skills, 383 Distressing Event Questionnaire (DEQ), 74 Disulfiram contract, 560, 561f Disulfiram therapy, 560, 571–572 Domestic violence, assessment, 669 “Double depression,” 323 “Downward arrow technique” in panic treatment protocol, 38, 47 social anxiety disorder, 143 712 Drink refusal skills, 520–521 Drinker Inventory of Consequences, 504 Drinking feedback sheet, 513, 514f Drinking Patterns Questionnaire (DPQ), 505 Drug abuse and dependence, 547– 577 assessment, 549–554 behavioral couple therapy, 555, 559–560 case study, 566–575 clinical supervision of treatment, 566 cognitive-behavioral therapies, 554–566 community reinforcement approach, 555–566 diagnosis and course, 548–550 DSM-IV-TR criteria, 548, 549t, 550t functional analysis, 556–557, 557f motivational interviewing, 555 overview, 547–548 principles of effective treatment, 548, 548t refusal skills, 557–558, 558t self-help groups, 558 treatment plan, 564–566 voucher program, 562, 564 Drug-refusal training, 557–558, 558t Drug treatment See Medication DSM-IV-TR alcoholism diagnostic criteria, 493 bipolar disorder, 421–422 borderline personality disorder, 366 eating disorders, 578–580 and emotional disorders latent st5ructure, 218 obsessive–compulsive disorder, 164–165 “partner relational problem,” 662 posttraumatic stress disorder, 65 sexual dysfunction, 617–620 substance abuse/dependence, 548, 548t, 550t versus “transdiagnostic” approach, 612 Dual-representation theory, PTSD, 71–72 Duration of exposure obsessive–compulsive disorder, 173 in optimizing learning, 29–30 panic disorder and agoraphobia, 29–30 Subject Index Dyadic Adjustment Scale, 22, 506– 507, 635, 669, 669t Dysfunctional Parent modes, 256, 265f, 289 Dyspareunia, 620, 645–646, 646t Dysthymia, interpersonal psychotherapy, 312 Early maladaptive schemas development of, 256 defining characteristics, 260, 264 Early intervention, schizophrenia, 465 Early Signs Scale, 487 Eating Disorder Examination (EDE), 588 Eating Disorder Examination Questionnaire (EDE–Q), 588 Eating disorders, 578–614 assessment, 587–590, 592 body checking/avoidance, 603– 605 classification and diagnosis, 578– 580, 579f clinical features, 580–581 cognitive-behavioral theory, 582– 585 cognitive-behavioral therapy– enhanced, 585–612 contraindications, 588–590 protocol, 590–612 “core psychopathology,” 600 depression comorbidity, 588– 589, 599 development and course, 581– 582 establishing regular eating,” 597–598 “feeling fat” interventions, 605– 607 homework, 610 patient education, 596 problem-solving intervention, 609–610 progress review, 599 real-time self-monitoring, 593, 594f, 595f relapse prevention, 610–612 self-evaluation treatment stage, 600–610 “transdiagnostic” protocol, 578– 614 “transdiagnostic” theory, 582, 584–585, 585f weekly weighing, 591, 592, 595– 596 Eating disorder NOS assessment, 587–590, 592 clinical features, 580–581 cognitive-behavioral therapyenhanced, 585–612 contraindications, 588–590 protocol, 590–612 development and course, 582 diagnosis and classification, 578– 580, 579f “transdiagnostic” theory, 584– 585, 585f EBAC (experience–belief–action– confirmation) cycle, 472, 473f, 483 Education See Psychoeducation Emergent fears/rituals, OCD, 207 Emotion-driven behaviors (EDBs), 224, 226f, 233–234, 235t Emotion dysregulation biosocial theory, 372–373 borderline personality disorder, 372–373 Emotion exposures, 233–234, 238– 239, 243–244 Emotion vulnerability, 374f, 375 Emotional acceptance in integrative behavioral couple therapy, 665–666, 672–675 strategies, 672–675 “Emotional avoidance” borderline personality disorder, 377 categories of, 231–232, 232t “Emotional awareness training,” 232–233, 240–241, 241f Emotional disorders, 216–249 assessment, 222–229 broad effect of treatments, 219– 220 case study, 222–229 functional analysis, 228–229 latent structure, 218–219 overlap among disorders, 219 self-monitoring, 224–225, 225f– 226f “spectrum” approach, 217 treatment components, 229–234 treatment variables, 220–222 “triple vulnerability theory,” 217–218 unified protocol, 216–249 detailed description, 234–245 Emotional expression, social anxiety treatment, 135–136 Emotional reactivity, panic disorder, Empathy couple therapy process, 673, 683–685 therapist quality, alcoholism, 526 Entering the paradox technique, 390 Subject Index Environmental factors in behavioral activation, 329, 347 dialectical behavior therapy, 386–388 Environmental Reward Observation Scale (EROS), 332 Erectile dysfunction DSM-IV-TR description, 618 prevalence, 616, 618 sensate focus approach, 642– 644, 643t Erectile dysfunction medications antidepressant combination, premature ejaculation, 644 challenge to sex therapy, 638 cognitive-behavioral treatment integration, 644 integration with sex therapy, 616 side effects, 616 Erection Quality Scale (EQS), 635 Esteem module, PTSD case study, 112–114 Ethnicity, and posttraumatic stress disorder, 85 Exercise, and panic disorder/ agoraphobia, 28 Expectancies and exposure practice length, 29 outcome factor, social anxiety, 137 Experience–belief–action– confirmation (EBAC) cycle, 472, 473f, 483 Exposure and ritual prevention case study, 192–205 choice of treatment, 184–185 versus cognitive therapies, 175– 176 complications, 205–208 contraindications, 185, 191–192 family involvement effects, 174– 175 home visits, 189–190 homework, 188 individual versus group format, 174 information gathering sessions, 185–188 case study, 192–199 intensive program, 185–192 maintenance period, 190 noncompliance problem, 205–206 in obsessive–compulsive disorder, 171–177 patient variables, 191–192 and relapse prevention, 176 versus serotonergic medications, 176–177 therapeutic setting, 190 therapist assistance, 173, 209 therapist variables, 191 treatment period, 188–189 treatment plan, 188 treatment rationale, 186 treatment variables, 171–174 Exposure therapy borderline personality disorder, 398–399 duration of, 29–30, 173 eating disorders, body avoidance, 605 obsessive–compulsive disorder, 172–174 panic disorder and agoraphobia, 10–32 posttraumatic stress disorder, 77–84 sexual aversion disorder, 645, 646t social anxiety disorder, 125–126, 129–130, 140–143, 141t outcome research, 125–126 See also In vivo exposure; Interoceptive exposure Expressed emotion assessment, 437 bipolar disorder link, 427–428 “Extended formulation,” 602, 602f “Extending” technique, 391 External fear cues, OCD, 178–180 Extinction, and PTSD mechanism of change, 70 Extramarital affairs, and sex therapy, 638 Eye movement desensitization and reprocessing (EMDR), 79–80 efficacy, 81–82 lateral eye movements component, 82 protocol, 79–80 PTSD treatment, 79–82 “False alarm,” initial panic attack, Family assessment, bipolar disorder, 436–438 Family factors alcohol abuse, 498, 522–524 and obsessive–compulsive disorder, 174–175, 207–208 Family-focused treatment (FFT) bipolar disorder, 430–431 case study, 446–457 client variables, 433 communication enhancement training, 442–444 concurrent drug treatment, 433– 434 713 objectives, 432t, 432–435 outcome, 430–432 pretreatment assessments, 435–438 problem-solving skills training, 444–446 rationale, 445 psychoeducational component, 428, 432, 438–442, 438t resistance in, 441–442, 456 setting, 433 structure, 432–435 termination, 446 therapist variables, 434–435 Family interventions, schizophrenia, 470 Family stress, bipolar disorder link, 427–428 Family therapy, alcoholism, 512 Fear and avoidance hierarchy, sex therapy, 645, 646f Fear of fear, 6–10 Fear of Negative Evaluation (FNE) scale, 133 Fear structure, PTSD theory, 69 Feedback couple distress, 672, 680–682 social anxiety disorder, 134 Feedback sheet, alcoholism, 513, 514f “Feeling fat,” 605–607 Female orgasmic disorder DSM-IV-TR description, 619 treatment, 644–645, 645t Female sexual arousal disorder DSM-IV-TR definition, 618–619 sensate focus approach, 642– 644, 643t Fight–flight reaction, 24, 66 Fixed beliefs, in OCD, 181–182 Flooding, PTSD treatment, 77 Fluoxetine See Antidepressants Fluvoxamine, in OCD, 177 FORM–90, 504 “Formulation” couple distress, 667–668 eating disorders, 592–593, 599– 602 FRAMES acronym, 497 Frequency of exposure, OCD, 173 Functional analysis alcohol abuse, 498 assessment, 505–506, 507f in behavioral activation therapy, 335 cocaine abuse, 556–557, 557f couple distress, 670–671 drug abuse and dependence, 554–555 panic disorder and agoraphobia, 23–24 Functional validation, 394 714 Gender differences/factors panic disorder and agoraphobia, PTSD prevalence, 67–69 PTSD treatment, 84–85 “General neurotic syndrome,” 219–220 Generalized anxiety disorder, 167 Generalized social anxiety disorder, 124–125 Genetics panic disorder, social anxiety psychoeducation, 138 Goal choice questionnaire, 505, 506f Graded exposure agoraphobia, 27 versus intensive exposure, 27 obsessive–compulsive disorder, 172–173 Graded tasks in behavioral activation, 339– 340 case study, 281 Graduated abstinence, 516 Grief case study, 315–323 interpersonal psychotherapy, 310–311 Group cognitive-behavioral therapy versus individual CBT, 11 panic disorder and agoraphobia, 11 psychosis, 470 PTSD efficacy, 83 social anxiety disorder, 125–126, 130 treatment outcome literature, 125–126 Group exposure/ritual prevention, 174 Group treatment alcoholism, 512 borderline personality disorder, 382–383 posttraumatic stress disorder, 86–87 Guided activation, 345–355 Guided mastery exposure, 10 Guilt PTSD case study, 98, 99, 102 PTSD diagnosis, 67 Habituation and duration of exposure, OCD, 173 OCD treatment mechanism, 187 PTSD mechanism of change theory, 70 Subject Index Hallucinations See Auditory hallucinations Hamilton Anxiety Rating Scale (HARS), 224 Hamilton Depression Rating Scale (HDRS), 224, 352 Health Anxiety Inventory, 228, 245 Healthy Adult mode, 264 Heart rate, and panic attacks, 8–9 HIV/AIDS education, drug abusers, 560, 561t Home treatment, schizophrenia, 469 Home visits mental health professionals, 478–479 obsessive–compulsive disorder, 189–190 Homework behavioral activation treatment, 334, 338–339 in cognitive therapy, 268, 274– 276 rationale, 274–275 eating disorders, 610 emotional disorders, 235 exposure and ritual prevention, 188, 200–202 interoceptive exposure, 46 obsessive–compulsive disorder, 188, 200–202 PTSD case study, 90, 93 schizophrenia, 485–486 sex therapy, 638 social anxiety disorder, exposure, 143 social anxiety disorder outcome predictor, 158 Hospitalization, and OCD therapy, 190 Hyperarousal, PTSD diagnosis, 66 Hyperventilation breathing retraining rationale, 24 homework practice, 46 and interceptive exposure, 241 in panic treatment protocol, 37, 46–47 Hypervigilance PTSD diagnosis, 66 social anxiety disorder, 128 Hypoactive sexual desire disorder case study, 648–655 DSM-IV-TR definition, 617–618 treatment, 646, 647t Hypochondriasis case study, 223 OCD differential diagnosis, 168 Hypomania, 422, 435 Hypothesis testing, automatic thoughts, 273–274 If–then relationships See Contingency management Imagery, urges to drink control, 517, 519 Imaginal exposure depressive reactions to, 207 emotional disorders, case study, 244 obsessive–compulsive disorder, 172, 188–189 corrective mechanism, 170, 186–187 PTSD treatment, 78, 80–81, 83 efficacy, 80–81, 83 Impact of Event Scale (IES), 74 Impact Statement, PTSD case study, 91 Impotence See Erectile dysfunction In-session exposures ease of graduation advantage, 129 social anxiety disorder, 129–130, 140–143 In-session weighing, eating disorders, 591–592, 595– 596 In vivo exposure obsessive–compulsive disorder, 170, 188–189 case study, 201–203 panic disorder and agoraphobia, 10, 12–13, 27–32 medication drawbacks, 16–17 panic treatment protocol, 42– 50 posttraumatic stress disorder, 77–78 social anxiety disorder, 125–126, 143, 151–153 treatment outcome literature, 125–126 Individual therapy alcoholism, 512 bipolar disorder, 429 borderline personality disorder, 381–382 dialectical behavior therapy, 381–382 Informants, eating disorders, 587 Information processing theory, PTSD model, 69, 71 Inhibited grieving, 374f, 376–377 “Inside–out” approach, 353 Integrative behavioral couple therapy (IBCT), 663–687 assessment, 669–672 case study, 678–680 case study, 678–686 “change” techniques, 675–677 client variables, 677 Subject Index communication training 675–677 contingency-shaped behavior approach, 665 development of, 664–666 efficacy, 677–678 emotional acceptance in, 665– 666, 672–675 emphasis on “themes,” 665 “formulation,” 667–668 problem-solving training, 675– 677 stages of, 668–677 therapist variables, 677 versus traditional behavioral therapy, 664–665 Intensive treatment programs, alcoholism, 512 Internal dialogue, schizophrenia intervention, 474 Internal fear cues, OCD, 180–181 International Index of Erectile Function (IIEF), 635 International Personality Disorders Examination (IPDE), 366 Internet See Computer-assisted therapy Interoceptive awareness, panic disorder, Interoceptive conditioning panic disorder maintenance, 8–9 patient education protocol, 35 Interoceptive exposure, 27–28 CO2 inhalation method, 28 comparative studies, 28 emotional disorders, 241 exercises, 45–46 homework practice, 46 implementation, 28 “naturalistic” form of, 48–49 panic disorder and agoraphobia, 27–28, 43, 45–50 Interpersonal and social rhythm therapy (IPSRT), 429 Interpersonal effectiveness skills, 383 “Interpersonal inventory,” 312– 313, 317 Interpersonal problems, 311–312 Interpersonal psychotherapy, 306– 327 case study, 315–323 characteristics, 308–309 common problems in, 323–324 depression model, 308 development of, 307–308 eating disorders, 585 grief treatment, 310–311 initial phase, 312–314 interpersonal deficits treatment, 311–312 major depression, 306–327 middle phase, 314 predictors of response, 324–325 process of treatment, 312–315 role disputes treatment, 311 termination phase, 314–315 treatment contract, 313–314 Intimacy module, PTSD case study, 114 Intrusions, PTSD diagnosis, 67 Invalidating environments and borderline personality disorder, 373–374 primary characteristics, 373–374 The Inventory of Drinking Situations, 505 Iraq war veterans, PTSD prevalence, 68–69 Irreverent communication, 399– 400, 403, 412, 415 Job Club, 559, 573 Keane PTSD Scale, 74 “Lapse,” versus relapse, alcoholism, 499 Lateral eye movements, EMDR, 82 Learning, and exposure techniques, 29–30, 42 Learning theory, PTSD model, 69 Lemonade out of lemons strategy, 392, 411 Length of exposure in optimizing learning, 29–30 panic disorder and agoraphobia, 29–30 Level of care, alcohol abuse, 507– 509, 508t Levitra See Erectile dysfunction medications Leyton Obsessional Inventory, 178 Liebowitz Self-Rated Disability Scale, 134 Liebowitz Social Anxiety Scale (LSAS), 134, 145, 145t Life event stress, bipolar disorder, 426–427 Life Events Checklist, 73 Life Events Survey, 439–440 Limit setting, dialectical behavior therapy, 398 “Limited reparenting role,” 256, 295 Lithium, in bipolar disorder, 424– 425 Long-term treatment alcoholism, 524–525 Low self-esteem, schizophrenia, 484–487 Lynfield Obsessional/Compulsive Questionnaire, 178 715 Maintenance of response CBT versus drugs, depression, 254, 258 eating disorders, 611–612 obsessive–compulsive disorder, 190–191, 209 panic disorder and agoraphobia, 32–33 Major depression See also Depression diagnosis, 307 interpersonal psychotherapy, 306–327 Maladaptive coping modes, 256, 265f, 289 Male erectile disorder DSM-IV-TR description, 618 sensate focus approach, 642– 644, 643t Male orgasmic disorder DSM-IV-TR description, 619 treatment, 644–645, 645t Managed care, pharmacotherapy bias, 257 Manic episode diagnosis, 421–422 drug treatment, 424–426 Manual-assisted cognitive treatment (MACT), 369 Manualized treatment eating disorders, 612–613 misconceptions, 612 social anxiety disorder, 131, 135–136 flexibility emphasis, 136 and “transdiagnostic” approach, 612 “Manufactured” emotions, PTSD case study, 89–90 Marijuana use, case study, 573–574 Marital Happiness Scale, 22 Marital Status Inventory, 669, 669t Massed exposure effectiveness, agoraphobia, 29 versus spaced exposure, 30 Masturbation exercises, 638 “Maudsley method,” 585 McLean Screening Instrument for Borderline Personality Disorder, 366 Medical comorbidity, panic disorder, 14–15 Medical evaluation emotional disorders, 224 panic disorder and agoraphobia, 19 Medical model and depression, 309, 318, 323 interpersonal psychotherapy, 309, 318 716 Medical Outcomes Study SF–36, 227 Medications bipolar disorder, 424–426 nonadherence, 426 borderline personality disorder, 424–426 depression, 252, 256–258 factors in bias toward, 257 obsessive–compulsive disorder, 176–177, 184–185 panic disorder and agoraphobia, 15–17 and relapse, 222 as safety signal, 31 sexual side effects, 622–623, 633 social anxiety disorder issues, 131 state-dependent learning drawback, 16–17 in unified treatment protocol, 222 See also specific medications Meditation, skills training, 383 Memory deficits, and checking behavior, 170–171 Memory disturbances, and PTSD, 70–72 Mental representations, social anxiety disorder, 128 Mental rituals, in OCD, 165 Mentalization therapy, borderline personality disorder, 367 Metacommunication skills, therapist, 277 Metaphors, in dialectical behavior therapy, 390–391, 415 Michigan Alcoholism Screening Test (MAST), 551 Mind reading PTSD case study, 106 social anxiety disorder, 140 Mindfulness practices borderline personality disorder, 383 in relapse prevention, depression, 254 rumination therapy, 341 in therapist consultation meetings, 386 Mini-ADIS–IV, 223, 245 Mini-SPIN, 133 “Minnesota model,” alcoholism treatment, 512–513 Minnesota Multiphasic Personality Inventory (MMPI), 74 Mirror use, eating disorders, 604 Subject Index Misappraisals cognitive restructuring, 26–27 patient education, protocol, 35 Mississippi Scale for CombatRelated PTSD, 74 Mixed mania, diagnosis, 422 Mobility Inventory, agoraphobia, 22 Moderate Management drinking guidelines, 513 Moderation goal, versus abstinence, 515–516, 571–572 Monoamine oxidase inhibitors, social anxiety, 126 Mood chart, bipolar disorder, 436, 436f Mood disorders See Emotional disorders Mood stabilizers in bipolar disorder, 424–425, 433–434 and family-focused treatment, 433–434 Motivation alcoholism treatment, 497–498, 500–504 assessment, 505 eating disorders therapy, 591 OCD patients, 191 Motivational interviewing alcoholism, 513 drug use disorders, 555 and schizophrenia, 489 Motor vehicle accidents cognitive behavioral therapy, 82 cognitive therapy efficacy, 83 physiological reactivity, 75 PTSD rate, 68 Mowrer’s two-stage theory, OCD, 168–169 Multiple-task paradigm, social anxiety disorder, 128 “Mutual trap,” couple distress, 668, 682 Myth, in dialectical behavior therapy, 390–391 Myths of sexuality, 639–640 Narrative exposure therapy, PTSD, 82–83 National Comorbidity Survey, PTSD prevalence, 68 National Vietnam Veterans Readjustment Study, 68 “Natural” emotions, PTSD case study, 89–90, 96, 98 “Naturalistic” interoceptive exposure activity exercises, 49 definition, 48 in panic–agoraphobia treatment protocol, 48–49 Negative affect in alcoholism, coping, 521–522 emotional disorders latent structure, 218 measures of, 227 panic disorder, “Negative affect syndrome,” 220 Negative feedback exposure, 153– 154 Negative psychotic symptoms, 464 Negative reinforcement and avoidant behavior, depression, 336, 351 emotional disorders function, 235 Negative self-schema cognitive therapy, 485–487 schizophrenia, 484–487, 485f Negative states of mind, 126 Neuroticism emotional disorders latent structure, 218 and panic disorder, NIMH Treatment of Depression Collaborative Research Program, 252 “No lethal drugs for lethal people” protocol, 416–417 Nocturnal panic, 2, 32 Nocturnal penile tumescence, 618, 636 “Noncognitive panic,” Noncompliance bipolar disorder, medications, 426, 429 OCD response prevention, 205– 206 panic attack monitoring, 20–21 self-monitoring, panic disorder, 20–21 sex therapy homework, 638 Nongeneralized social anxiety disorder, 124–125 Nonsuicidal self-injurious behavior (NSSI) borderline personality disorder, 365 case study, 400–417 communication function, 409– 410 dialectical behavior therapy, 370, 381–382 Numbing symptoms function, 66 PTSD diagnosis, 66–67 theories of, 69–71 Subject Index Obsessions, definition, 164–165 Obsessive–compulsive disorder, 164–215 assessment, 177–178 case study, 192–205 choice of treatment, 184–185 cognitive and behavioral models, 168–171 comorbidity, 166–167 definition, 164–165 and depression, treatment, 184– 185 differential diagnosis, 167–168 exposure and ritual prevention, 171–177, 185–192 versus medication, 176–177 noncompliance problem, 205– 206 external fear cues, 178–180 family reactions, 207–208 feared consequences in, 181 history of main complaint, 183 initial interview, 178–185 intensive treatment program, 185–192 internal fear cues, 180–181 pharmacotherapy, 176–177 choice of, 184–185 prevalence and course, 165–166 relapse prevention, 176, 209 social functioning, 183–184 strength of belief factor, 181–182 treatments, 171–177 “with poor insight” subtype, 165 Obsessive–Compulsive Inventory– Revised (OCI–R), 178, 228 Operant conditioning in drug abuse and dependence, 554 posttraumatic stress disorder model, 69 Orgasmic disorders DSM-IV-TR description, 619 treatment, 644–645, 645t Overaccommodation, PTSD case study, 89, 91, 99 Overcoming Binge Eating (Fairburn), 596, 609, 611, 612 Overestimation errors, 38–39 Overgeneralizing, PTSD case study, 103 PANDAS (pediatric autoimmune neuropsychiatric disorders), 166 Panic Attack Record, 20, 21f, 24 Panic attacks definition, education about, 24 “false alarm” aspect, nonclinical form of, 2–3 self-monitoring, 19–21, 21f Panic disorder and agoraphobia, 1– 65 anxiety sensitivity, 6–7 behavioral tests, 22–23 case study, 17–23, 33–50 client variables, 14–15 childhood abuse history, cognitive-behavioral therapy, 10– 17, 24–51 efficacy, 32–33 comorbidity effects, 14–15 etiological factors, 5–10 exposure therapy, 27–32 functional analysis, 23–24 maintenance factors, 9–10 medical evaluation, 19 versus panic attacks, 2–3 pharmacotherapy, 15–17 presenting features, 4–5 prevalence, psychophysiology, 23 self-monitoring, 19–22 self-report inventories, 22 social phobia differential diagnosis, 19, 20f therapist variables, 13–14 triple vulnerability theory, 5–10 twelve-session treatment protocol, 33–50 Panic Disorder Severity Scale–SelfReport (PDSS-SR), 228 Paradox, in dialectical behavior therapy, 390 Paradoxical interventions bipolar disorder, 441 panic disorder and agoraphobia, 25–26 Paranoia case formulation, 480–484 case study, 477–484 coping–recovery model, 471–472 Paroxetine, in panic disorder, 16– 17 “Partner relational problem,” 662 Passive avoidance, OCD, 182–183, 206 Patient characteristics See Client variables Patterns of Problematic Thinking Sheet, 102–103, 103f, 104, 106–107, 110 Penn State Worry Questionnaire (PSWQ), 223, 228 Perceived Criticism Scale, 437 “Peritraumatic dissociation,” 76 Personal scientist model, 26, 34 717 Personality disorders, and panic disorder outcome, 14 Pharmacotherapy See Medication Phenelzine, in social anxiety, 126 Physical attraction, and sexual functioning, 626 Pleasant Events Schedule, 332 “Point–counterpoint” technique, 285–286 “Polarization process,” couple distress, 668, 682 Positive affect emotional disorders latent structure, 218 measures, 227 The Positive and Negative Affect Scale (PANAS), 227 Positive expectancies, social anxiety, 137 Positive feedback, in communication training, 443 Positive psychotic symptoms assessment, 473 cognitive-behavioral therapy for psychosis, 464 Positive reinforcement depression behavioral model, 329 problematic aspects, depression, 336 Positive states of mind, 126 Posttraumatic Stress Diagnostic Scale (PDS), 74 Posttraumatic stress disorder, 65– 122 assessment, 72–76 case study, 87–115 client treatment variables, 84–87 cognitive-behavioral therapy, 78– 79 cognitive therapy, 78, 80–81, 83 combination treatments, 78–79, 82 diagnosis, 65–67 dialectical behavior therapy, 380 exposure techniques, 77, 80–84 group treatment, 86–87 multiply traumatized, 86 OCD comorbidity, 167 prevalence, 67–69 psychophysical assessment, 75– 76 self-report instruments, 74 response bias assessment, 75 stress inoculation training, 77, 80 structured diagnostic interview, 73–74 718 Posttraumatic stress disorder (cont.) suicide risk, 76 theoretical models, 69–72 therapist variables, 84–87 treatment, 76–87 violence risk assessment, 76 Potential Stressful Events Interview, 73 Power/Control module, PTSD case study, 112 Practical Needs Assessment Questionnaire, 553 Predictors of response alcohol use disorder, 541–542 interpersonal psychotherapy, 324–325 Premature ejaculation DSM-IV-TR description, 619 treatment, 644 Primary Care PTSD Screen (PCPTSD), 75 Primary care settings, panic disorder, CBT, 33 Primary emotions, PTSD models, 71–72 Probability overestimation case study, 236–237 as cognitive misappraisal, 230, 236 Problem-oriented stance, cognitive therapy, 268 Problem solving in avoidance modification, 340– 341 bipolar disorder, families, 432– 433, 444–446 case study, 454–455 couple therapy, 675–677 in dialectical behavior therapy, 394–399 eating disorders, 609–610 in family-focused treatment, 444–446 rationale, 445 procedures, 396–399 Prodromal schizophrenia cognitive-behavioral therapy for psychosis, 465, 467, 468t and relapse prevention, 487 signs and symptoms of, 487 Progressive muscle relaxation, 25 Project MATCH, 497, 511 Prolonged exposure efficacy, 80–84 PTSD treatment, 77–84 Protocols See Unified treatment protocol Psychodynamic therapy, borderline personality disorder, 366– 368 Subject Index Psychoeducation bipolar disorder, 428, 431–432, 438–442, 438t case study, 448–451 emotional disorders, 229 panic disorder and agoraphobia, 15, 24, 34–36 sexual dysfunction, 630, 639, 641 case study, 650–651 social anxiety disorder, 136–139 case study, 146–147 Psychophysiology panic disorder and agoraphobia, 23 posttraumatic stress disorder, 75–76 Psychotic disorders, 463–491 Psychotic Symptom Rating Scale (PSYRATS), 473 Psychotic symptoms assessment, 472–473 case formulation, 480–484 coping strategies, 473–476 intractable cases, 488 origins and maintenance of, 471–478, 472f, 473f See also Schizophrenia PTSD Checklist (PCL), 74, 75 PTSD Checklist–C (PCL-C), 75 PTSD Checklist–M (PCL-M), 75 PTSD Checklist–S (PCL-S, 75 The PTSD Symptom Scale– Interview (PSS-I), 74 The PTSD Symptom Scale–SelfReport (PSS-SR), 74 Purdue PTSD Scale–Revised,74 Quality of Life Inventory, 134, 145, 145t, 227 Questioning, in cognitive therapy, 274 RAND MOS-SF–36, 227 Rape trauma behaviorally-oriented assessment, 73 male therapist variables, 84–85 prevalence, 67 psychophysiological reactivity, 76 time course, 66–67 “Rapid cycling” diagnosis, 422–423 family-focused treatment, 433 “Readiness programs,” OCD, 184, 209 Readiness to Change Questionnaire, 505 Real-time self-monitoring, 593, 594f, 595f Reality testing, schizophrenia, 476 Reattributions intervention depression, 274, 284 schizophrenia, 474 Reciprocal communication case study, 414 in dialectical behavior therapy, 399, 414 “Reciprocal determinism,” 372 Reconcilable Differences (Christensen & Jacobson), 670, 672 Recovery model, schizophrenia, 471–476 Reexperiencing symptoms, PTSD, 65–66 Reframing, in communication training, 444 Reinforcement strategies alcoholism treatment, 523 drug abuse and dependence, 554 See also Contingency management Relapse, and panic disorder, 32 Relapse prevention alcohol abuse, 498–499, 524– 525 model, 524 and behavioral activation therapy, 341 bipolar disorder, 440–441 case study, 450 CBT versus medications, depression, 253–254 CBT for psychosis results, 465 treatment method, 467, 468t drug abuse and dependence, 555 eating disorders, 610–612 obsessive–compulsive disorder, 176, 209 in schizophrenia, prodromal signs, 487 Relapse signature, schizophrenia, 487 Relaxation techniques, 231 See also Progressive muscle relaxation Resistance in bipolar disorder, 441–442, 457 PTSD clients, 86 Respiratory disturbance, panic disorder, Response-contingent relationships See Contingency management Response delay, and urges to eat, 610 Responsibility role, in OCD, 169 Revised Conflict Tactics Scale, 507, 669, 669t Subject Index Revised Diagnostic Interview for Borderlines (DIB-R), 366 RigiScan monitor, 636 Ritual prevention versus exposure, OCD, 171–172 implementation, 172 intensive program, 185–192 monitoring of, 187 noncompliance problem, 205– 206 See also Exposure and ritual prevention Rituals, in obsessive–compulsive disorder, 182–183, 186 Role disputes, interpersonal psychotherapy, 311 Role-playing in drug-refusal training, 558 in family-focused treatment, 442–444 functions of, 270–271 interpersonal psychotherapy, 314, 321–322 case study, 321–322 social anxiety behavioral test, 135 social anxiety disorder exposure, 142–143 in stress inoculation training, 77 Role reversal, 271 Role transitions, interpersonal psychotherapy, 311 “Rule-governed” strategies, 665 Rumination behavioral activation approach, depression, 341 case study, 344, 355–357, 358–360 OCD differential diagnosis, 167 social anxiety disorder, 129 The Safety module, PTSD, 107– 109 Safety signals/behaviors and arousal decline, 31 breathing skills as, 42 in CBT for psychosis, 466 as emotional avoidance strategy, 232, 232t exposure detrimental effects of, 31 medication as, 31 in naturalistic interoceptive exposure, 49 removal of, in exposure, 27 significant others as, 44–45 social anxiety disorder, 128– 129 in-session exposure effects, 129–130 Safety system, social order mechanism, 127–128 Schedule for Affective Disorders and Schizophrenia for School-Age Children–PL, 435 Scheduling, exposure practices, 30 Schema Mode Questionnaire, 289 Schema modes, 260, 261f–263f, 265 Schema Questionnaire, 255, 289 Schema therapy borderline personality disorder, 369 chronic depression treatment, 255–256 case study, 287–297 cognitive model, 260 and modes of responding, 256, 264f–265f Schemas definition, 260 PTSD case study, 88–89 PTSD model, 69 in schizophrenia, 484–487, 485f tripartite approach to, 287 Schizoaffective disorder, 424 Schizophrenia, 463–491 alcohol and substance use comorbidity, 489 assessment, 472–473 associated features, 467, 468t, 469 bipolar disorder differential diagnosis, 424 case formulation, 480–484 case study, 477–484 cognitive-behavioral therapy for psychosis, 464–489 clinical model, 471–476 research evidence, 464–465 cognitive process modification, 476–477 coping strategies, 473–476 engagement, 478–480 home visits, 478–479 intractable psychotic symptoms, 488 low self-esteem, 484–487 cognitive therapy, 485–487 OCD differential diagnosis, 168 patient variables, 470 phases of, treatment aims, 467, 468t relapse prevention, 487 suicide/self-harm risk, 488–489 therapist variables, 470–471 thought disorder, 487–488 Schizophrenia and Affective Disorders Schedule–Lifetime Version, 19 719 Schizotypal personality disorder, 192 Screening, alcohol abuse, 500–501 Secondary emotions, in PTSD theory, 71–72 Secular Organizations for Sobriety/ Save Ourselves (SOS), 511– 512 Self-blame, PTSD case study, 97, 102 Self-directed exposure, indications, 10–11 Self-disclosure, in dialectical behavior therapy, 399 Self-esteem cognitive–behavioral therapy for psychosis, 467 PTSD case study, 112–114 in schizophrenia, 467, 484–487, 495f cognitive therapy, 485–487 Self-evaluation domains of, 600–603, 601f eating disorders, 600–610 Self-exposure, OCD, 173–174 Self-hate, borderline personality disorder, 375 Self-help groups alcoholism, 511–512 role of, 525–526 drug abuse and dependence, 558 Self-image, social anxiety disorder, 128 Self-Management and Recovery Training (SMART), 511 Self-management planning alcohol abuse, 537 and cocaine abuse, 557 drug refusal training in, 557–558 Self-management planning sheet, 537, 537f, 557f Self-management skills, dialectical behavior therapy, 383 Self-monitoring and behavioral activation treatment, 338–339 cognitive-behavioral therapy component, 24 eating disorders, 593, 594f, 595f emotions, 235–236 function of, 19–20 noncompliance problem, 20–21 OCD ritualistic behavior, 187– 188 case study, 199 panic disorder and agoraphobia, 19–22, 24 in panic treatment protocol, 35– 36 in sex therapy, 641 720 Self-recording cards alcohol abuse, 505–506, 507f, 513, 532 case study, 532 case vignette, 513 Self-reliance training, 270 Self-schema, schizophrenia, 484– 487, 485f Self-statements intervention, schizophrenia, 474 Semistructured interviews emotional disorders, 220 panic disorder and agoraphobia, 18–19, 20f social anxiety disorder, 131–132 substance abuse and dependence, 553–554 Sensate focus technique, 642–644, 643t, 652–655 Sequential combination strategies, 16 Serotonergic medications See Antidepressant drugs Sex therapy, 637–657 case studies, 648–657 challenges, 638 goals, 637 methods, 637–648 pharmacology integration, 616 process issue, 637–638 Sexual abuse, assessment, 75 Sexual assault, 84–85 Sexual aversion disorder case study, 655–657 DSM-IV-TR definition, 618 treatment, 645–646, 646t Sexual dysfunction, 615–658 assessment, 629–637, 633f process issues, 630–631 biological risk factors, 620–624 biopsychosocial model, 617–627 case formulation, 636–637 case studies, 648–657 causal/risk factors, 620–627 clinical interview, 631–634, 633f communication training, 646– 648, 648f couples versus individual treatment, 628 DSM-IV-TR descriptions, 617, 620 myths, 639–640 patient outcome variables, 628– 629 pharmacology, 616 prevalence, 615–616 psychoeducation, 639–641 psychophysiological assessment, 635–636 psychosocial risk factors, 624– 627 Subject Index setting of treatment, 627 treatment approach, 629–648 treatment spacing and length, 627–628 See also Sex therapy Sexual fantasies, and sex therapy, 642, 654 Sexual Opinion Survey (SOS), 635 Sexuality myths, 639–640 Shame, PTSD diagnosis, 67 “Shattered” assumptions, PTSD, 70, 107 “Short-fuse” families, 444 Short Inventory of Problems, 504 “Sick role” case study, 316 in interpersonal psychotherapy, 312 Significant others and agoraphobia therapy, 13, 27 alcoholism treatment involvement, 522–524 communication training, 45 eating disorders involvement, 598–599 and in vivo exposure, 27 panic/agoraphobia treatment protocol, 44–45 as safety signal, 44–45 “Situationally accessed memories”(SAMs), 71 Skills training borderline personality disorder, 382–383, 397 cocaine abuse, 559 dialectical behavior therapy procedures, 397 Sleep–wake cycles, bipolar disorder, 426–427 SMART program, alcoholism, 511 Smoking, and sexual dysfunction, 623–624 Sobriety strategies, case vignette, 517–521 Social anxiety disorder, 123–163 anger as treatment failure predictor, 158 appropriate treatment clients, 130–131 assessment, 131–135 avoidant personality disorder comorbidity, 124–125 behavioral assessment, 134–135 case study, 144–158 clinical interview, 131–132 cognitive-behavioral model, 126– 128, 127f cognitive restructuring, 125–126, 139–143 comorbidity, 124 exposure therapy, 140–143 case study, 149–154 group versus individual treatment, 130 homework adherence and outcome, 158 in-session exposures, 129–130, 140–143 individual cognitive-behavioral therapy, 135–144 protocol, 135–144 medication issues, 131 outcome predictors, 158 prevalence, 123–124 psychoeducation, 136–139 safety behaviors, 128 self-image, 128 self-report instruments, 132–134 subtypes, 124 therapeutic relationship, 135– 136 outcome link, 136 treatment outcome literature, 125–126 treatment rationale, 129–130 Social Anxiety Session Change Index (SASCI), 133, 156, 157f Social avoidance See Avoidance behavior Social-cognitive theories in dual-representation theory, 71–72 PTSD model, 69–72 Social dysfunction obsessive–compulsive disorder, 183–184 schizophrenia coping, 475 Social Interaction Anxiety Scale (SIAS), 132, 145, 228 Social learning theory, and drug abuse, 554 Social networks, and drug abuse, 558 Social phobia agoraphobia differential diagnosis, 19, 20f versus panic, case vignette, See also Social anxiety disorder Social Phobia and Anxiety Inventory (SPAI), 132–133 Social Phobia Inventory (SPIN), 133 Social Phobia Scale (SPS), 132, 145 Social skills training, drug abuse, 555 Social support alcohol abuse treatment link, 498, 510, 524 cocaine abuse, case study, 573 Subject Index SOCRATES scale, 505, 551 The Socrates study, 465 Socratic questioning in cognitive restructuring, 26–27, 39 in panic treatment protocol, 39 and PTSD, 79, 98 SOS (Secular Organizations for Sobriety/Save Ourselves), 512 SPAARS, PTSD model, 72 Spaced exposures, 30 Specific phobias, 167–168 “Spectrum” approach, emotional disorders, 217 “Splitting” dialectical behavior therapists, 387 and dialectics, 371 Spousal/partner involvement, alcoholism treatment, 522– 524 SSRIs See Antidepressant drugs Stages of Change Readiness and Treatment Eagerness Scale See SOCRATES scale STAIR protocol, 79, 82 State-dependent learning, pharmacotherapy drawback, 16–17 State–Trait Anxiety Inventory, 22 States of mind model, 126 Stepped-care model, alcoholism, 507–508 Stimulus control, and sobriety, 517 Storytelling, in dialectical behavior therapy, 390–391 Strength of belief, in OCD, 181– 182 Stress inoculation training, in PTSD, 77, 80 Structured Clinical Interview for DSM-IV (SCID), 19, 73, 223, 332, 435, 504 Structured Clinical Interview for DSM-IV Axis II Personality Disorders, 332 Structured Interview Guide for the Hamilton Anxiety Rating Scale, 223–224, 245 Structured Interview Guide for the Hamilton Depression Rating Scale, 224, 245 Subjective Units of Discomfort Scale (SUDS) and exposure, 142–143, 150–152 and obsessive–compulsive disorder, 179, 202–203 and social anxiety disorder, 139, 142–143 Submissiveness, social anxiety disorder, 128 Substance abuse See Drug abuse and dependence Suicidal ideation/behavior borderline personality disorder, 365–366 case study, 400–417 contingent hospitalization reinforcement, 401–403 dialectical behavior therapy, 370, 381–382 priority of, 379 telephone consultation, 384 eating disorders, 588 and interpersonal psychotherapy, 324 in PTSD assessment, 76 and schizophrenia, 488–489 Supportive psychotherapy, borderline personality disorder, 367 Sustained exposure in optimizing learning, 29–30 panic disorder and agoraphobia, 29–30 Symptom Checklist 90–Revised (SCL-90-R), 74, 552 Symptom-specific measures, emotional disorders, 227– 228 Systematic desensitization, in PTSD, 77 Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) outcome, 431 therapist variables, 434 Telephone consultation contingency management principles, 384 in dialectical behavior therapy, 383–384 and suicidal behavior, 384 target hierarchy, 383–384 Telephone-guided treatment, agoraphobia, 10 Temperament, panic disorder, Termination family-focused treatment, bipolar disorder, 446 case study, 455–456 social anxiety disorder treatment, 143–144 Testosterone levels, and sexual dysfunction, 622 “Theme,” in couple distress, 667– 668 Therapeutic reactance sign, 277 721 Therapeutic relationship alcohol abuse treatment, 497, 526 in dialectical behavior therapy, 371, 388 social anxiety disorder, 135–136 See also Collaborative relationship Therapist-directed exposure panic disorder and agoraphobia, 10–11 versus self-exposure, OCD, 173, 209 Therapist–patient relationship difficulties cognitive therapy, 276–277 interpersonal psychotherapy, 324 Therapist variable alcohol use disorder, 526–527 behavioral activation, 342 cognitive therapy, depression, 265–267 community reinforcement approach, 556 dialectical behavior therapy, 388 eating disorders, 586–587 integrative behavioral couple therapy, 677 interpersonal psychotherapy, 310 interpersonal qualities, 266–267 obsessive–compulsive disorder, 191 panic disorder and agoraphobia, 13–14 posttraumatic stress disorder, 84–87 social anxiety disorder, 131 sex therapy, 629 in unified protocol, 221 vicarious traumatization, 85–86 Therapy envelope, 465 Therapy-interfering behaviors dialectical behavior therapy, 379 and therapist consultation meeting, 386 “Thinking errors,” 139–140 Thought–action fusion (TAF), 169– 170, 180 Thought disorder, schizophrenia, 487–488 Tics, 167–168 Time management cocaine abusers, 558–559 in social anxiety disorder treatment, 136 Time sampling, in activity monitoring, 336 Timeline Follow-Back Interview (TLFB), 504, 528–529, 553 Tolerance building, couples, 674, 683, 685 722 Tourette syndrome, 167–168 Traditional behavioral couple therapy (TBCT) limitations, 663–665 “rule-governed” strategies, 665 Training of therapists, 13–14, 131 Trait Meta-Mood Scale (TMMS), 227 Transactional model, 372 “Transdiagnostic” approach, 578– 614 eating disorders, 582, 584–585, 585f implications, 613 Transference-focused therapy borderline personality disorder, 367 versus schema therapy, 369 target hierarchy, 367 Transportability, cognitivebehavioral therapy, 33 TRAP/TRAC acronym, 340–341, 361–362 Trauma Events Scale, 73 Trauma History Questionnaire, 73 Trauma Symptom Inventory (TSI), 75 Traumatic Life Events Questionnaire, 73 Traumatic Stress Schedule, 73 Treatment contract interpersonal psychotherapy, 313–314 social anxiety disorder, 134 Treatment dropouts, schizophrenia, 470 Treatment for Adolescents with Depression Study (TADS), 252 Treatment setting See under specific disorders “Triggers” sheet, 532, 533f “Triple vulnerability theory” emotional disorders, 217–218 panic disorder and agoraphobia, 5–10 in treatment protocol, 34 Subject Index Trust module, PTSD case study, 109 12-step programs alcoholism, 511, 525–526 disease model treatment approach, 499 Two-stage theory, and OCD, 168– 169 UCLA Life Stress Interview, 220 “Ultrarapid cycling,” 423 Uncontrollability, panic disorder factor, Ungraded exposure, 27 Unified treatment protocol, 216– 249 assessment, 222–229 case study, 222–229 client variables, 221–222 detailed description of, 234–245 emotional disorders, 216–249 format, 221 functional analysis in, 228–229 rationale, 217–220 self-monitoring, 224–225, 225f– 226f therapist variables, 221 treatment components, 229–234 University of Rhode Island Change Assessment Scale, 505 Urge to eat, coping strategies, 610 Urges to drink, coping strategies, 517, 519 Urinalysis, cocaine abuse, 562, 569–570 Vaginismus, 620 “Valence” errors, 38 Validation strategies in dialectical behavior therapy, 392–394 case study, 408–410 essence of, 393 “Verbally accessible memories” (VAMs), 71 Viagra See Erectile dysfunction medications Vicarious traumatization, 85–86 Vietnam veterans physiological reactivity, 75 PTSD prevalence, 68 violence risk, 76 Violence, in trauma victims, 76 Virtual reality, PTSD treatment, 77 “Visions,” 484 Vocational counseling, cocaine abuse, 559, 559t Vouchers cocaine abuser program, 562–563 case study, 566–575 and contingency management, 555, 562 Vulnerability–stress model, bipolar disorder, 426–428, 427f, 439–440 Washing rituals case study, 192–205 and home visits, 190 in vivo exposure, 189 Weekly Activity Schedule, 270, 271f Weekly Record of Anxiety and Depression (WRAD), 224, 225f Weekly weighing, eating disorders, 591–592, 595–596 Withdrawal symptoms, alcohol dependence, 509 Work and Social Adjustment Scale (WSAS), 227 Workbooks, in social anxiety disorder, 135 Worry, as emotional avoidance strategy, 231–232 Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), 177–178 Yohimbine, extinction facilitation, 30 Zeitgebers, 426–427 Zeitstorers, 426 Zen practice, 369, 383 ... Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont Nicholas Tarrier, PhD, Division of Clinical Psychology, School of Psychological Sciences, University of Manchester,... target fear of bodily sensations and associated agoraphobic situations is well established In addition to presenting an up-to-date review CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS NATURE OF PANIC... extent of agoraphobia that emerges is highly variable (Craske & Barlow, 1988) Various factors have been investigated CLINICAL HANDBOOK OF PSYCHOLOGICAL DISORDERS as potential predictors of agoraphobia

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Mục lục

  • Front Matter

  • Chapter 1

  • Chapter 2

  • Chapter 3

  • Chapter 4

  • Chapter 5

  • Chapter 6

  • Chapter 7

  • Chapter 8

  • Chapter 9

  • Chapter 10

  • Chapter 11

  • Chapter 12

  • Chapter 13

  • Chapter 14

  • Chapter 15

  • Chapter 16

  • Author Index

  • Subject Index

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