Panic Disorder: Cognitive Behavioral and Pharmacological Treatment Strategies

The past decade has seen significant advances in both psychosocial, notably cognitive behavioral (CBT), and pharmacological treatments for panic disorder. Given the widely acknowledged efficacy of both forms of treatment, it is reasonable to consider that the combination of approaches should yield an extremely potent strategy to treating panic disorder. The present report summarizes scientific evidence for the singular and combined treatment approaches to panic disorder. Data across studies indicate that combined treatments yield immediate and short-term benefits above those provided by either pharmacologic treatment or CBT alone. In the long-term, however, these benefits disappear. In fact, the combination of benzodiazepines and CBT appears to produce poorer end-state functioning than CBT alone. Other data indicate that the sequencing of pharmacotherapy and CBT may be useful for benzodiazepine fading. Although these data are preliminary, combined treatments do not appear to be the treatment of choice for patients with panic disorder. Treatment algorithms are suggested based on existing data.     

Psychosocial management of glioma patients treated with combined therapy

Based on an empirical study it is pointed out that psychosocial care of patients with glioma differs in some points from that of other cancer patients. The first essential difference is that the emotional involvement of the care staff is not as intensive as those of other cancer patients. Other differences concern some illness- and therapy related effects such as family problems or monotony problems resulting from the longterm therapy. These specific problems are described in detail.     

Semantic expectancy effects on word access

Summary Access to word-representations in memory was studied in an experiment that used a lexical decision task: Ss had to decide whether a string of letters was a word or a nonword. Independent variables were context-similarity and semantic expectancy. The former is defined in terms of the categorical relationship that holds between a set of context words and the subsequently presented test word. The second refers to the cue-value given to subjects as to the likelihood with which related or unrelated test words would be presented. Cue-values did not provide information on the likelihood with which word or nonword decisions were required, but only on the most probable semantic relationship holding among context and test words. In theory, Meyer and Ellis' (1970) race model for word access was extended for the present purpose. It is shown that the two search processes assumed to mediate lexical access interfere on the basis of limited processing capacity, at least under the special conditions prevailing during the experiment. Furthermore, it is shown that Ss effectively manage to control the point in time at which they decide to issue a nonword response. Cuing for related test words tends to produce faster nonword decisions than cuing for unrelated words.This paper reports work that was conceived and begun at Stanford University, Calif., USA, where the author spent a year as a post-doctoral fellow. This fellowship was made possible by the Deutsche Forschungsgemeinschaft, Bad Godesberg, Federal Republic of Germany, Grant Schm 350/1. I am grateful to R.C. Atkinson, S. Monsell, P. Matthews, and D. Vorberg for supporting this research in a number of ways.     

An auditory evoked potential study of consonant perception in different vowel environments

Auditory evoked responses (AER) to series of consonant—vowel syllables were recorded from temporal and parietal scalp locations from 20 right-handed female college students. Averaged AERs were submitted to principal components analysis and analysis of variance. Seven components of the group's AERs were found to reflect various aspects of the stimulus parameters. One component reflected changes over only the left hemisphere to different consonants independent of the following vowel sound. A second component changed systematically over both hemispheres in response to only consonant changes. A third component systematically changed for the different consonants depending on the following vowel.     

Assessing stereomotion thresholds with a high-resolution computer monitor

We investigated the feasibility of a computer-graphics-based method of assessing stereomotion thresholds (Silicon Graphics Stereoview stereoscopic system). Stereomotion thresholds for a rectangle oscillating in depth were determined with the use of a dual randomly interleaved staircase design. In a group of 31 naive observers, the average thresholds of 5.97′ of arc forcrossed stereomotion and 6.00′ of arc foruncrossed stereomotion were comparable to those assessed in earlier work done with optics-based techniques. By assessing the thresholds for a rectangle that was defined either by lateral motion or by changing size, in a group of experienced observers, we were able to show that any potential residual translational motion present in the display would not have influenced the stereomotion thresholds. Our findings suggest that this computer-graphics-based technique may be a reasonable alternative to optics-based methods of assessing stereomotion thresholds.     

Book reviews

Pseudo‐Problems. How Analytic Philosophy Gets Done, Roy Sorensen, 1993. London, Routledge xi + 291 pp., hb £37.50, ISBN: 0–415–09464X

Changing Tools: Case Studies in the History of Scientific Methodology, Marta Feher, 1995. Adademiai Kiado £23.17, ISBN: 9630567288

Evolutionary Naturalism, Michael Ruse, 1995, London, Routledge pp. 316, hb £35, ISBN 0–415–08997–2

Knowledge and the Body‐Mind Problem: in Defence of Interaction, Sir Karl Popper, 1994 London, Routledge ix+ 158 pp., hb £25; £10.99 pb, ISBN: 0–415–11504–3

Whys and Ways of Science, Peter J. Riggs, 1992 Melbourne University Press ix + 235 pp., £11.95, ISBN: 0522844715

Rethinking Objectivity, Aixan Megill, Ed., 1994 Durham and London, Duke University Press ix +342pp., £43.50, ISBN: 0822314797

Projective Probability, James Logue, 1995 Clarendon Press xiii+ 171 pp., £24.75, ISBN: 0198239599

Self‐motion: from Aristotle to Newton, M. L. Gill & J. G. Lennox (Eds), 1994 Princeton, New Jersey, Princeton University Press xxi + 367 pp., £36.50, ISBN: 0–691–03235–1