Handbook of Interpersonal Psychology: Theory, Research, Assessment and Therapeutic Interventions

By Leonard M. Horowitz; Stephen Strack | Go to book overview

26
INTERPERSONAL PROCESSES
IN THE ANXIETY DISORDERS

Lynn E. Alden

Marci J. Regambal

In this chapter we examine the role of interpersonal processes in the anxiety disorders, a group of clinical conditions marked by persistent and severe physiological arousal and worry. While anxiety is a ubiquitous human experience, in the anxiety disorders anxiousness exceeds any objective danger and results in debilitating distress and impairment. Our current classification system, the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR), distinguishes a number of anxiety syndromes, including social anxiety disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and specific phobia (American Psychiatric Association [APA], 2000).

Anxiety disorders have plagued mankind throughout history. In 400 B.C., Hippocrates described cases of “men who fear that which need not be feared,” that match the clinical picture we see in anxious individuals today. One such case involved a man who never went to parties or the theatre for fear he would say something unacceptable and disgrace himself, an early depiction of social phobia. Another experienced terror in open spaces, a common fear in individuals suffering from agoraphobia (Saul, 2004). Indeed, the term panic was derived from Pan, the Greek man-goat god who inspired sudden, groundless terror in lonely places (Papakostas, Eftychiadis, Papakostas, & Christodoulou, 2003). Phobia derives from Phobos, the Greek god who embodied fear, particularly in battle, and whose likeness was painted on the shields of Greek warriors (Berrios, Link, & Clark, 1995). Descriptions of panic and anxiety weave through writings over the centuries, reflecting the zeitgeist of each era, to arrive at our psychological conceptualizations today.

Contemporary theories of anxiety disorders emphasize biological and cognitive processes. The biological literature clearly shows that genetic vulnerabilities and innate temperament, for example, behavioral inhibition and negative affectivity, increase the risk of developing an anxiety disorder (e.g., Brown, 2007; Fox, Henderson, Marshall, Nichols, & Ghera, 2005; Hettema, Prescott, Myers, Neale, & Kendler, 2005; Kagan, Reznick, Snidman, Gibbons, & Johnson, 1988). Cognitive theorists emphasize the way in which selective processing of threat information biases the individual’s interpretation of events and

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