elevated posttreatment AS is among the best predictors of relapse (chaps. 10 and 14). This suggests that it would be important to assess AS levels at the end of treatment and provide additional, AS-focused treatment to people with elevated AS. An important question is whether such an intervention is able to substantially reduce the risk of relapse over the long term (i.e., years). A further question is whether elevated posttreatment AS predicts relapse for other disorders, such as substance abuse or dependence, depression, and chronic pain. Answers to these and other questions raised in this section should greatly enhance our understanding of how the assessment and reduction of AS can be used to improve clinical practice.
This volume has reviewed the many important developments in the theory and assessment of AS. This construct has been the subject of a good deal of research, and the body of empirical work continues to grow at a rapid pace. AS has been implicated in several disorders, although it appears to be most important in panic attacks and panic disorder. Much remains to be learned about the causes, consequences, and clinical implications of AS. This volume will have served its purpose if it stimulates further research on these important issues.
Preparation of this chapter was supported in part by a grant from the British Columbia Health Research Foundation.
American Psychiatric Association. ( 1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Barlow D. H., & Craske M. G. ( 1994). Mastery of your Anxiety and Panic II. New York: Psychological Corporation.
Burstein A. ( 1985). "Posttraumatic flashbacks, dream disturbance, and mental imagery". Journal of Clinical Psychiatry, 46, 374-378
Clark D. M. ( 1986). "A cognitive approach to panic". Behaviour Research and Therapy, 24, 461-470
Davidson J. R. T., & Foa E. B. ( 1991). "Diagnostic issues in posttraumatic stress disorder: Considerations for DSM-IV". Journal of Abnormal Psychology, 100, 346-355
Jones J. C., & Barlow D. H. ( 1990). "The etiology of posttraurnatic stress disorder". Clinical Psychology Review, 10, 299-328
Kagan J., Reznick J. S., & Snidman N. ( 1988). "Biological bases of childhood shyness". Science, 240, 167-171