By David A. Clark PhD, Aaron T. Beck MD
Updating and reformulating Aaron T. Beck’s pioneering cognitive version of hysteria issues, this groundbreaking paintings is either authoritative and hugely useful. The authors synthesize the most recent pondering and empirical facts on nervousness therapy and supply step by step guide in cognitive evaluate, case formula, cognitive restructuring, and behavioral intervention. they supply evidence-based mini-manuals for treating the 5 commonest nervousness problems: panic ailment, social phobia, generalized nervousness ailment, obsessive–compulsive sickness, and posttraumatic rigidity affliction. undemanding positive aspects contain bright case examples, concise “Clinician guidance” that toughen key issues, and over 3 dozen reproducible handouts and types. (20100401)
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Extra resources for Cognitive Therapy of Anxiety Disorders: Science and Practice
In sum it would appear that important psychophysiological features of anxiety such as elevated basal arousal level, slower habituation, and diminished autonomic flexibility might contribute to the misinterpretation of threat that is the core cognitive feature of anxiety. However, a different physiological response pattern may distinguish phobia, panic disorder, and GAD, which prevents generalizing research findings across the anxiety disorders. Furthermore, it is unclear whether the anxiety state is primarily an excess of SNS activation and a withdrawal of vagal activity, or if SNS activity is depressed and PNS activity remains normal under the conditions of daily living (see Mussgay & Rüddel, 2004, for discussion).
At the same time anxiety is often acquired through the organism’s interaction with the environment even though this learning process may occur outside awareness and beyond rational consideration. And yet cognitive mediation such as expectancies, interpretations, beliefs, and memories play a critical role in the development and persistence of anxiety. As a subjective experience, anxiety may feel like a storm that surges and recedes throughout the day. Relief from this state of personal turmoil can be a potent motivator even when it elicits response patterns, such as escape and avoidance, that are ultimately counterproductive to the vital interests of the individual.
It has multiple output projections via the central nucleus to the hypothalamus, hippocampus, and upward to various regions of the cortex, as well as downward to various brainstem structures involved in autonomic arousal and neuroendocrine responses associated with stress and anxiety like the periaqueductal gray region (PAG), the ventral tegmental area, the locus ceruleus, and the raphe nuclei (Barlow, 2002). All of these neutral structures have been implicated in the experience of anxiety, including the bed nucleus of the stria terminalis (BNST; Davis, 1998), which may be the most important neural substrate of anxiety (Grillon, 2002).