Bruce A. Thyer

Ages of onset of DSM-III anxiety disorders

Abstract The Diagnostic and Statistical Manual (DSM-III) contains little specific information pertaining to the ages of onset of anxiety disorders. Such information is of clinical and research value in understanding the natural history of mental illnesses, in determining which of several possible etiologies for a given diagnosis may be relevant for a particular patient, and in testing theories of psychopathology or pathophysiology. Age-of-onset data is presented for 423 psychiatric outpatients seen at a University Hospital—based anxiety disorders program. All adult anxiety disorders are represented except posttraumatic stress disorder. The relevance of this information is discussed in terms of past research on ages of onset of the anxiety disorders, and in its bearing on the psychiatric diagnosis of these conditions.

Endocrine and Cardiovascular Responses During Phobic Anxiety

&NA; In vivo exposure therapy for phobias is uniquely suited for controlled studies of endocrine and physiologic responses during psychologic stress. In this study, exposure therapy induced significant increases in subjective anxiety, pulse, blood pressure, plasma norepinephrine, epinephrine, insulin, cortisol, and growth hormone, but did not change plasma glucagon or pancreatic polypeptide. Although the subjective and behavioral manifestations of anxiety were consistent and intense, the magnitude, consistency, timing, and concordance of endocrine and cardiovascular responses showed considerable variation.

Evidence-Based Practice and Social Work

Abstract The essential features of contemporary evidence-based practice (EBP) are outlined, with specific reference to the applications of this model to various areas of social work, micro through macro. EBP is seen as a welcome addition to our field, representing a fuller and more comprehensive development of earlier and related positions such as empirical clinical practice within social work, and the delineation of empirically-supported therapies within psychology. Social work should proactively adopt EBP as its preferred conceptual model, reorient BSW and MSW training programs along the lines advocated by EBP, and inculcate these principles into the delivery of social work services. This is seen as both a professional and ethical imperative necessary for the survival of the field.

Blood-injury-illness phobia: A review

The empirical literature that pertains to phobias of blood, injury, or illness (BII) is surveyed. BII phobia is selectively associated with a vasovagal fainting response upon exposure to phobic stimuli, and the clinical entity may represent an exaggeration of a response that is relatively prevalent in the general population. Clinical, demographic and etiological information obtained from a series of 15 BII phobics is presented, and the suggestion is made that this disorder warrants a diagnostic category separate from simple phobia.

Autonomic correlates of the subjective anxiety scale

The subjective anxiety scale is an assessment tool commonly used in behavioral research and therapy to quantify verbal report of private events, usually states of fear. An investigation was undertaken to determine the extent of relationship between the subjective anxiety scale and two concurrent measures of autonomic arousal, peripheral vasoconstriction and heart rate. Measures were recorded during baseline, surgical film and second baseline phases for 20 subjects. The subjective and autonomic measures indicated increased anxiety during the film phase and significant correlations were found between subjective report of anxiety and the two physiological indices. The results support the continued use of the subjective anxiety scale as a clinical assessment tool. Practice and research implications are discussed.

The quest for evidence- based practice: A view from the United States

• Summary: This article describes how a reliance upon social and behavioral science research is the feature distinguishing modern professional social work from prior non-professional efforts at providing social care. A number of formal efforts that attempted to more closely link science and practice are described, including the empirical clinical practice movement, the empirically supported treatments initiative, and, most recently, evidence-based practice (EBP). • Findings: EBP is correctly seen as a process of inquiry intended to help practitioners and their clients make important decisions about the services the clients receive. EBP is a process, a verb, not a noun. There is no such thing as evidence-based practices, since in EBP one decides what services to provide by taking into account not only research evidence but also client preferences and values, situational circumstances, professional ethics, the practitioner’s existing skills, and available resources. • Applications: From this perspective it is a misuse of the term EBP to refer to specific interventions or assessment methods as evidence-based. At best, interventions or techniques may be labeled as empirically supported or research-supported. The current status of EBP within American social work is seen as healthy and growing, although misconceptions regarding this process are common.

What Is the Role of Theory in Research on Social Work Practice

The social work profession suffers from a dearth of empirically based studies of practice outcomes. One reason for this is the message conveyed in research texts, doctoral program standards, and disciplinary guidelines that research should build and test theory, rather than solve applied problems. Since many legitimate forms of empirical, scientific research do not involve theory testing, social work should consider itself less an academic discipline that advances social and behavioral science knowledge and more an applied profession that finds solutions to psychosocial problems. Research inquiries along these lines may or may not involve direct theory testing or development.

A comparison of panic disorder and agoraphobia with panic attacks

Abstract The validity of distinguishing between the diagnoses of panic disorder and agoraphobia with panic attacks was examined in a study of 20 patients with each disorder. Comparison of demographic, psychometric, and clinical features of the two groups revealed few differences. Agoraphobics scored higher on ratings of interpersonal sensitivity, phobic anxiety, paranoid ideation, and alcohol use. Panic disorder patients more frequently reported periods of remissions from anxiety symptomatology. These results support the validity of conceptualizing agoraphobia with panic attacks and panic disorder as subcategories of a core endogenous anxiety disorder.

Evaluating Distance Learning in Social Work Education: A Replication Study

Fifty-seven MSW students enrolled in two different practice courses were exposed to approximately equal amounts (five 4-hour sessions) of live, in-class instruction and two-way interactive televised instruction. Separate post-course evaluations of both teaching methods, using a previously published measure of instructional quality, significantly favored live instruction over televised distance learning. More empirical research demonstrating the potential benefits of distance learning technology is urgently needed prior to the widespread adoption of these methods.

Alcohol abuse among clinically anxious patients

Abstract Of 156 patients meeting DSM-III criteria for either agoraphobia with panic attacks, panic disorder, simple or social phobia, or generalized anxiety disorder, 27 (17.3%) were found to score in the alcoholic range (⩾ 5) on the Michigan Alcoholism Screening Test. This pattern of alcohol abuse was primarily associated with the diagnosis of agoraphobia. Agoraphobic patients with a concurrent affective disorder were especially prone to abuse alcohol.