Assessing cognitive aspects of anxiety. Stability over time and agreement between several methods

Comparison Between the Panic Disorder with Agoraphobia Patients and Normal Controls on the Basis of Cognitions Affect and Physiology

Research using ambulatory monitoring and cognitive sampling procedures has revealed the importance of negatively biased cognitions in panic attacks and panic disorder. However, the normal population has never been investigated on the basis of these procedures and it is still unclear how patients deviate from them on the basis of negative cognitions and their interaction with affect and physiology. The present study investigated these issues by comparing 15 panic disorder patients with an equal number of normal controls. The results revealed that, although the pattern of reporting cognitions was similar, the two groups differed on type and content of the cognitions. In general, there were significant differences between the two groups for neutral and negative cognitions. Patients experienced high anxiety levels that were associated with cognitions of negative affect. There was a low frequency of reported panic attacks in the patients group. Possible reasons for the limited number of panic attacks are discussed.

Cognition in childhood anxiety: conceptual, methodological, and developmental issues

Anxiety disorders are one of the most common psychiatric disorders in the general child population and can have significant impact on immediate and long-term functioning. Despite the common use of cognitive-behavioral interventions that target specific, negative thoughts in anxious children, it is unclear that the extant literature clearly documents cognitive aberrations among these children. In this review, conceptual and methodological issues related to the assessment of cognition in anxious children are highlighted and empirical data addressing these areas are evaluated. Furthermore, data addressing cognitive change as a function of treatment outcome is examined, and the impact of cognitive development as a moderating variable is discussed. Finally, areas for future research are presented.

Catastrophic cognitions in panic disorder with and without agoraphobia

The cognitive models of panic disorder with (PDA) or without (PD) agoraphobia are now widely recognised. These models propose that patients misinterpret external or internal cues in a catastrophic manner and as a result of these catastrophic cognitions the symptoms are maintained. There is now a large body of empirical evidence for this proposal and the aim of this paper is to systematically review the literature to evaluate whether the empirical evidence supports the contribution of catastrophic cognitions to PD and PDA. Empirical studies using different methodologies, such as interview, questionnaire, self-monitoring, and in vivo techniques are reviewed. The results indicate there is substantial empirical evidence in support of the central role of catastrophic cognition in cognitive models. Different methodologies provided convergent support for the importance of catastrophic cognitions in the maintenance of panic disorder and agoraphobia. Limitations in the interpretation of the existing research are highlighted and future research directions are proposed.

An investigation of anxious thought in patients with DSM-IV agoraphobia/panic disorder: rationale and design

Psychoanalysis as a profession is in difficulty because changes in the mental health field have exposed vulnerabilities inherent in psychoanalytic traditions. In this setting, scientific outcome studies of psychoanalytic treatment are a necessity. To enable such studies, certain preliminary research is required. In particular, a set of reliable diagnoses that recognize psychodynamic factors, in addition to "descriptive" criteria, must be developed. This paper outlines the rationale, significance, and design of a pilot study in the area of anxiety disorders, agoraphobia in particular, intended to provide a basis for recategorization of the currently predominant DSM system.

A longitudinal study of the intrusiveness of cognitions in test anxiety

Medical students who had to undergo an important set of examinations were asked to fill out two questionnaires, the first early in the term, the second 1 or 2 wk before the exams. Students whose anxiety increased substantially between the two questionnaire administrations reported that their thoughts had become more intrusive on a number of parameters including distress, frequency and dismissability. Subjects whose anxiety increased only moderately or not at all reported correspondingly smaller changes in intrusiveness. There was considerable stability in reported cognitions over time, but changes in anxiety were related to changes in reports of thought content. The perceived probability of negative outcomes did not vary over time. These results indicate that changes in anxiety levels over time are related to several parameters of intrusiveness as well as thought content.