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.It should also be noted that Marks and Mataix-Cols do not includeobsessive–compulsive disorder (OCD) in their classification of phobias,even though this disorder shares many behavioural (avoidance, forexample) and cognitive symptoms with phobias.In a cognitive perspective,it can be mentioned that studies of attention find hypervigilance to specific threat words in OCD subjects (e.g.[23]) and a memory bias in terms ofbetter retrieval of threat material (e.g.[24]).To conclude, a behavioural perspective remains of essential importancein the definition of a taxonomy of phobic disorders, as well as in thecomprehension and treatment of these subtypes of anxiety disorders.Nonetheless, the cognitive approach to phobias, which stresses theimportance of information processing biases in these disorders, is currently extending the knowledge of the underlying mechanisms associated withthese syndromes.We think, therefore, that a combined perspective shouldbe taken into account when defining a future taxonomy of anxietydisorders.However, although research studies have confirmed theexistence of information processing biases as well as a relative specificity in their modalities in the different anxiety and phobic disorders, furtherresearch is still needed to investigate the different patterns of thesemechanisms as well as their impact on the genesis and persistence ofphobias.58 ____________________________________________________________________________________________ PHOBIASREFERENCES1.McNally R.J., Reiman B.C., Kim E.(1990) Selective processing of threat cues in panic disorder.Behav.Res.Ther., 28: 407–412.2.Ehlers A., Bruer P.(1992) Increased cardiac awareness in panic disorder.J.Abnorm.Psychol., 101: 371–382.3.Coles M.E., Heimberg R.G.(2002) Memory biases in the anxiety disorders:current status.Clin.Psychol.Rev., 22: 587–627.4.McNally R.J., Foa E.B.(1987) Cognition and agoraphobia: bias in theinterpretation of threat.Cogn.Ther.Res., 11: 567–581.5.Baptista A., Figuiera M.L., Lima M.L., Matos F.(1990) Bias in judgement in panic disorder patients.Acta Psiqiatr.Portug., 36: 25–35.6.Harvey J.M., Richards J.C., Dziadosz T., Swindell A.(1993) Misinterpretation of ambiguous stimuli in panic disorder.Cogn.Ther.Res., 17: 235–248.7.Stopa L., Clark D.M.(1993) Cognitive processes in social phobia.Behav.Res.Ther., 31: 255–267.8.Stopa L., Clark D.M.(2000) Social phobia and interpretation of social events.Behav.Res.Ther., 38: 273–283.9.Hope D.A., Rappee R.M., Heimberg R.G., Dombeck M.J.(1990) Representationsof the self in social phobia: vulnerability to social threat.Cogn.Ther.Res., 14: 177–189.10.Mattia J.I., Heimberg R.G., Hope D.A.(1993) The revised Stroop color-naming task in social phobics.Behav.Res.Ther., 31: 305–313.11.Spector I.P., Pecknold J.C., Libman E.(2002) Selective attentional bias related to the noticeability aspect of anxiety symptoms in generalized social phobia.J.Anxiety Disord., 17: 517–531.12.Musa Z.C., Le´pine J.-P., Clark D.M., Mansell W., Ehlers A.(2003) Selective attention in social phobia and the moderating effect of a concurrent depressive disorder.Behav.Res.Ther., 41: 1043–1054.13.Chen Y.P., Ehlers A., Clark D.M., Mansell W.(2002) Patients with generalized social phobia direct their attention away from faces.Behav.Res.Ther., 40: 677–687.14.Clark D.M., McManus F.(2002) Information processing in social phobia.Biol.Psychiatry, 51: 92–100.15.Watts F.N., McKenna F.P., Sharrock R., Trezise L.(1986) Colour naming ofphobia related words.Br.J.Psychol., 77: 97–108.16.O¨ hman A., Soares J.J.F.(1994) Unconscious anxiety: phobic responses tomasked stimuli.J.Abnorm.Psychol., 103: 231–240.17.Thorpe S.J., Salkovskis P.M.(1997) Information processing in spider phobics: the Stroop colour naming task may indicate strategic but not automaticattentional bias.Behav.Res.Ther., 35: 131–144.18.Thorpe S.J., Salkovskis P.M.(2000) Recall and recognition memory for spider information.J.Anxiety Disord., 14: 359–375.19.Sawchuk C.N., Meunier S.A., Lohr J.M., Westendorf D.H.(2002) Fear, disgust, and information processing in specific phobia application of signal detection theory.J.Anxiety Disord., 16: 495–510.20.Bryant R.A., Harvey A.G.(1995) Processing threatening information inposttraumatic stress disorder.J.Abnorm.Psychol., 104: 537–541.21.Vrana S.R., Roodman A., Beckham J.C.(1995) Selective processing of traumarelevant words in post-traumatic stress disorder.J.Anxiety Disord., 9: 515–530.DIAGNOSIS AND CLASSIFICATION OF PHOBIAS: COMMENTARIES ____________ 5922.Amir N., McNally R.J., Weigartz P.D.(1996) Implicit memory bias for threat in post-traumatic stress disorder.Cogn.Ther.Res., 20: 625–636.23.Tata P.R., Leibowitz J.A., Prunty M.J., Cameron M., Pickering A.D.(1996)Attentional bias in obsessional compulsive disorder.Behav.Res.Ther., 34: 53–60.24.Randomsky A.S., Rachman S.(1999) Memory bias in obsessive–compulsivedisorder (OCD).Behav.Res.Ther., 37: 605–618.1.11Diagnosis and Classification of Phobias and Other Anxiety Disorders:Quite Different Categories or Just One Dimension?Miguel R.Jorge1Phobias achieved a separate diagnostic status in psychiatric classifications soon after the Second World War, probably because of their frequentoccurrence in soldiers at the battlefront.One of the main questionsregarding their classification is related to a major issue among nosologists nowadays, at least for some classes of mental disorders such as anxietydisorders: are they better represented by diagnostic categories ordimensions?Costello [1] pointed out that research on symptoms may be more fruitfulthan research on categories or syndromes because of: (a) the questionablevalidity of psychiatric diagnostic systems; (b) the requirement to assesslarge number of different types of symptoms rather than adequatelymeasure individual items; (c) the uncertainty about whether there is a true cut off between a psychiatric syndrome and normality; and (d) symptoma-tological overlap between diagnostic groups.In contrast, Mojtabai andRieder [2] found little evidence in support of the thesis that: (a) symptoms have higher reliability and validity compared to diagnostic categories; (b) underlying pathological mechanisms are symptom specific; and (c)elucidation of the process of symptom development will lead to thediscovery of the causes of syndromes.Ten years before the publication of the DSM-III and the boom ofneuroscience research, Robins and Guze [3] proposed five phases forestablishing diagnostic validity in psychiatric diagnosis: clinical description, laboratory studies, delimitation from other disorders, follow-up study, and family study.Until the causes of mental illnesses are identified,measuring psychopathology probably will require a combination of acategorical and a dimensional approach [4].As Marks and Mataix-Cols1 Department of Psychiatry, Federal University of Sa˜o Paulo, Rua Antonio Felıćio 85, 04530-060 Sa˜o Paulo, Brazil60 ____________________________________________________________________________________________ PHOBIASpoint out, ‘‘certain quantitative changes along dimensions can also meanqualitative categorical changes [ Pobierz całość w formacie PDF ]

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