What Cognitions Differentiate Panic Disorder from Other Anxiety Disorders?

Abstract

Phobias, characterized by intense anxiety to circumscribed stimuli and a strong tendency to their avoidance, have attracted much attention by learning theorists and behavior therapists. Interestingly, neither the early theoretical formulations nor the treatment procedures have distinguished among types of pathological fear. Thus, for example, the most popular theory of the acquisition and maintenance of phobias, Mowrer’s (1939) two-stage theory, was adopted by Dollard and Miller (1950) to explain obsessive-compulsive symptoms. In the same vein, systematic desensitization (Wolpe 1958), the first behavioral procedure aiming at reduction of phobic fear, was employed not only with simple phobics but also with agoraphobics and with obsessive-compulsives, as it was expected to have similar effects on all manifestations of neurotic anxiety. Consonant with this assumption, many of the early behavior therapy outcome studies employed samples of mixed phobias (e.g., Gelder et al. 1967; Marks et al. 1968), again reflecting the belief that all neurotic fears are governed by the same mechanisms and, thus, will respond similarly to therapy.

Preparation of this manuscript was supported in part by NIMH Grant No RO1MH40865-01 awarded to the author.