Skip to main content

Biological vs. Psychological Treatments of Anxiety Disorders

  • Chapter
Perspectives and Promises of Clinical Psychology

Part of the book series: Applied Clinical Psychology ((NSSB))

  • 57 Accesses

Abstract

In my other chapter in this book (Biological vs. Psychological Perspectives on Anxiety Disorder) I presented a Table 1 listing some proposed etiologies of anxiety disorders and corresponding treatments. It would be wrong to infer from this table that the postulated causes were discovered first and the treatments followed as logical deductions. In many cases, a cause was inferred from the presumed mechanism of action of some treatment believed to be effective against anxiety. Treatments of mental disorders have always seemed more rooted in reality than theories of mental disorders. It is instructive, therefore, to examine outcome studies of purportedly successful biological and psychological treatments of anxiety disorders in order to determine how solid the factual bases of those inferences really are.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Agras, W.S., Teich, M.J., Taylor, C.B., Roth, W.T., and Brouillard, M.E. (1990). Imipramine and exposure therapy in agoraphobia: Untangling the actions and interactions. Submitted for publication.

    Google Scholar 

  • Ballenger, J.C., Burrows, G.D., DuPont, R.L., Lesser, I.M., Noyes, R, Jr., Pecknold, J.C, Rifkin, A., and Swinson, R.P. (1988). Alprazolam in panic disorder and agoraphobia: Results from a multicenter trial. I. Efficacy in short-term treatment. Archives of General Psychiatry, 45, 413–422.

    Article  PubMed  Google Scholar 

  • Clark, D.B., Taylor, C.B., Roth, W.T., and Agras, W.S. (1990) Surreptitious antianxiety medication use in a panic disorder study. American Journal of Psychiatry, 147, 507–509.

    PubMed  Google Scholar 

  • Cohen, S.D., Monteiro, W., and Marks, I.M. (1984). Two-year follow-up of agoraphobics after exposure and imipramine. British Journal of Psychiatry, 144, 276–281.

    Article  PubMed  Google Scholar 

  • Craske, M.G., Sanderson, W.C., and Barlow, D.H. (1987). How do desynchronous response systems relate to the treatment of agoraphobia: A follow-up evaluation. Behaviour Research and Therapy, 25, 117–122.

    Article  PubMed  Google Scholar 

  • Dilsaver, S.C., and Coffman, J.A. (1989). Cholinergic hypothesis of depression: A reappraisal. Journal of Clinical Psychopharmacology, 9, 173–179.

    Article  PubMed  Google Scholar 

  • Fiegenbaum, W. (1988). Long-term efficacy of ungraded versus graded massed exposure in agoraphobics. In I. Hand and H.-U. Wittchen (Eds.), Panic and Phobias 2. Treatments and Variables affecting Course and Outcome (pp. 83–88). Berlin: Springer-Verlag.

    Google Scholar 

  • Fisher, S., and Greenberg, R.P. (1989). A second opinion: Rethinking the claims of biological psychiatry. In S. Fisher and R.P. Greenberg (Eds.), The Limits of Biological Treatments for Psychological Distress. Comparisons with Psychotherapy and Placebo (pp. 309–336). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Frank, J.D. (1961). Persuasion and Healing. A Comparative Study of Psychotherapy. Baltimore: Johns Hopkins Press.

    Google Scholar 

  • Greenberg, R.P, and Fisher, S. (1989). Examining antidepressant effectiveness: Findings, ambiguities, and some vexing puzzles. In S. Fisher and R.P. Greenberg (Eds.), The Limits of Biological Treatments for Psychological Distress. Comparisons with Psychotherapy and Placebo (pp. 1–37). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Klein, D.F. (1980) Anxiety reconceptualized. Comprehensive Psychiatry, 21, 411–427.

    Article  PubMed  Google Scholar 

  • Klein, D.F., Zitrin, C.M., Woerner, M.G., Ross, D.C. (1983). Treatment of Phobias. II. Behavior therapy and supportive psychotherapy: Are there any specific ingredients? Archives of General Psychiatry, 40, 139–145.

    Article  PubMed  Google Scholar 

  • Klerman, G.I., Ballenger, J.C., Burrows, G.D., DuPont, R.L., Noyes, R., Jr., Pecknold, J.C., Rofkin, A., Rubin, R.T., and Swinson, R.P. (1989) In reply. [to Marks et al. (1989)]. Archives of General Psychiatry, 46, 670–672.

    Article  Google Scholar 

  • Margraf, J. (1989). Beiträge zur Diagnostik, Theorie und Therapie des Paniksyndroms. Habilitationsschrift, Fachbereich Psychologie der Philipps-Universität Marburg. Submitted 1989.

    Google Scholar 

  • Margraf, J., Ehlers, A., and Roth, W.T. (1986a). Panic attacks: Theoretical models ar 1 empirical evidence. In I. Hand and H.-U. Wittchen (Eds.), Panic and Phobias (pp. 31–43), Berlin: Springerf.

    Chapter  Google Scholar 

  • Margraf, J., Ehlers, A., and Roth, W.T. (1986b). Biological models of panic disorder and agoraphobia: A review. Behaviour Research and Therapy, 24, 553–567.

    Article  PubMed  Google Scholar 

  • Margraf, J., Ehlers, A., and Roth, W.T. (1986c) Sodium lactate infusions and panic attacks: A review and critique. Psychosomatic Medicine, 48, 23–51.

    PubMed  Google Scholar 

  • Margraf, J., Ehlers, A., and Roth, W.T. (1988) Mitral valve prolapse and panic disorder: A review of their relationship. Psychosomatic Medicine, 50, 93–113.

    PubMed  Google Scholar 

  • Marks, I.M. (1987). Fears, Phobias, and Rituals. Panic, Anxiety, and Their Disorders. Oxford: Oxford University Press.

    Google Scholar 

  • Marks, I.M., De Albuquerque, A., Cottraux, J., Gentil, V., Greist, J., Hand, L, Liberman, R.L., Relvas, J.S., Tobena, A., Tyrer, P, and Wittchen, H.-U. (1989). The ‘efficacy’ of alprazolam in panic disorder and agoraphobia: A critique of recent reports. Letter to the Editor. Archives of General Psychiatry, 46, 668–670.

    Article  PubMed  Google Scholar 

  • Marks, I.M., Gray, S., Cohen, D., Hill, R., Mawson, D., Ramm, E., and Stem, R. (1983). Imipramine and brief therapist-aided exposure in agoraphobics having self-exposure homework. Archives of General Psychiatry, 40, 153–162.

    Article  PubMed  Google Scholar 

  • Mavissakalian, M. (1988). The mutually potentiating effects of imipramine and exposure in agoraphobia. In I. Hand, and H.-U. Wittchen. Panic and Phobias 2. Treatments and Variables affecting Course and Outcome (pp. 36–43). Berlin: Springer-Verlag.

    Google Scholar 

  • Mavissakalian, M., and Michelson, L. (1982). Agoraphobia: Behavioral and pharmacological treatments, preliminary outcome, and process findings. Psychopharmacology Bulletin, 18, 91–103.

    PubMed  Google Scholar 

  • Mavissakalian, M., and Michelson, L. (1986). Relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine. Journal of Clinical Psychiatry, 143, 1106–1112.

    Google Scholar 

  • Mavissakalian, M., Michelson, L., and Dealy, R.S. (1983). Pharmacological treatment of agoraphobia: imipramine versus imipramine with programmed practice. British Journal of Psychiatry, 143, 348–355.

    Article  PubMed  Google Scholar 

  • Mellman, T.A., and Uhde, T.W. (1989). Electroencephalographic sleep in panic disorder. Archives of General Psychiatry, 46, 178–184.

    Article  PubMed  Google Scholar 

  • Overton, D.A. (1966). State-dependent learning produced by depressant and atropine-like drugs. Psychopharmacologia, 23, 373–385.

    Google Scholar 

  • Pecknold, J.C., Swinson, R.P., Kuch, K., and Lewis, C.P. (1988). Alprazolam in panic disorder and agoraphobia: Results from a multicenter trial. HI. Discontinuation effects. Archives of General Psychiatry, 45, 429–436.

    Article  PubMed  Google Scholar 

  • Rachman, S., Craske, M., Tallman, K., and Solyom, C. (1986). Does escape behavior strengthen agoraphobic avoidance? A replication. Behavior Therapy, 17, 366–384.

    Article  Google Scholar 

  • Telch, M.J., Agras, W.S., Taylor, C.B., Roth, W.T., and Gallen, C.C (1985). Combined pharmacological and behavioral treatment for agoraphobia. Behaviour Research and Therapy, 25, 325–335.

    Article  Google Scholar 

  • Vermilyea, J.A., Boice, R., and Barlow, D.H. (1984). Rachman and Hodgson (1974) a decade later: How do desynchronous response systems relate to the treatment of agoraphobia? Behaviour Research and Therapy, 22, 615–621.

    Article  PubMed  Google Scholar 

  • Weissman, M.M., Klerman, G.L., Markowitz, J.S., and Ouellette, R. (1989). Suicidal ideation and suicide attempts in panic disorder and attacks. New England Journal of Medicine, 321, 1209–1214.

    Article  PubMed  Google Scholar 

  • Zitrin, C.M., Klein, D.F., and Woemer, M.G. (1980). Treatment of agoraphobia with group exposure in vivo and Imipramine. Archives of General Psychiatry, 37, 63–72.

    Article  PubMed  Google Scholar 

  • Zitrin, C.M., Klein, D.G., Woemer, M.G., and Ross, D.C. (1983). Treatment of phobias. I. Comparison of imipramine hydrochloride and placebo. Archives of General Psychiatry, 40, 125–138.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer Science+Business Media New York

About this chapter

Cite this chapter

Roth, W.T. (1991). Biological vs. Psychological Treatments of Anxiety Disorders. In: Ehlers, A., Fiegenbaum, W., Florin, I., Margraf, J. (eds) Perspectives and Promises of Clinical Psychology. Applied Clinical Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3674-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-3674-5_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-3676-9

  • Online ISBN: 978-1-4899-3674-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics