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This page intentionally left blank
The American Psychiatric Publishing

Textbook of
Anxiety Disorders

Edited by

Dan J. Stein, M.D., Ph.D.

Eric Hollander, M.D.

Washington, DC
London, England
Note: The authors have worked to ensure that all information in this book concerning drug dosages, schedules, and routes
of administration is accurate as of the time of publication and consistent with standards set by the U.S. Food and Drug
Administration and the general medical community. As medical research and practice advance, however, therapeutic
standards may change. For this reason and because human and mechanical errors sometimes occur, we recommend that
readers follow the advice of a physician who is directly involved in their care or the care of a member of their family. A
product’s current package insert should be consulted for full prescribing and safety information.
Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and
do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association.
Copyright © 2002 American Psychiatric Publishing, Inc.
ALL RIGHTS RESERVED
Manufactured in the United States of America on acid-free paper
05 04 03 02 4 3 2 1
First Edition
American Psychiatric Publishing, Inc.
1400 K Street, N.W.
Washington, DC 20005
www.appi.org
Library of Congress Cataloging-in-Publication Data
The American Psychiatric Publishing textbook of anxiety disorders / edited by Dan J. Stein, Eric Hollander. — 1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-88048-829-8 (alk. paper)
1. Anxiety. I. Stein, Dan J. II. Hollander, Eric, 1957-
[DNLM: 1. Anxiety Disorders. WM 172 T356 2001]
RC531 .T47 2001
616.85′223—dc21
2001022187
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
 Contents

Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii

PART
I
Approaching the
Anxiety Disorders
1 History of Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Michael H. Stone, M.D.
2 Classification of Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Timothy A. Brown, Psy.D.
3 Preclinical Models of Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Lotta Arborelius, Ph.D.
Charles B. Nemeroff, M.D., Ph.D.
4 Neural Circuits in Fear and Anxiety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
J. Douglas Bremner, M.D.
Dennis S. Charney, M.D.
5 Evolutionary Concepts of Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Myron A. Hofer, M.D.
6 Cognitive Concepts of Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Arthur Freeman, Ed.D., A.B.P.P.
Robert A. DiTomasso, Ph.D., A.B.P.P.
7 Psychodynamic Concepts of Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Barbara Milrod, M.D.
Arnold M. Cooper, M.D.
M. Katherine Shear, M.D.
8 Combined Treatment for Anxiety Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
James M. Ellison, M.D., M.P.H.
R. Harris G. McCarter, Ph.D.
 PART
II
Generalized Anxiety
Disorder
9 Phenomenology of Generalized Anxiety Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Laszlo A. Papp, M.D.
Marc S. Kleber, Ph.D.
10 Pathogenesis of Generalized Anxiety Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Thomas E. Brouette, M.D.
Andrew W. Goddard, M.D.
11 Pharmacotherapy for Generalized Anxiety Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135
Norman Sussman, M.D.
Dan J. Stein, M.D., Ph.D.
12 Psychotherapy for Generalized Anxiety Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Jonathan D. Huppert, Ph.D.
William C. Sanderson, Ph.D.

PART
III
Mixed Anxiety-
Depressive Disorder
13 Mixed Anxiety-Depressive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Rebecca P. Cameron, Ph.D.
Alan F. Schatzberg, M.D.

PART
IV
Obsessive-Compulsive
Disorder and Related
Disorders
14 Phenomenology of Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
Jane L. Eisen, M.D.
Steven A. Rasmussen, M.D.
15 Pathogenesis of Obsessive-Compulsive Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Scott L. Rauch, M.D.
Gabriela Corá-Locatelli, M.D.
Benjamin D. Greenberg, M.D., Ph.D.
16 Pharmacotherapy for Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
Wayne K. Goodman, M.D.
17 Psychotherapy for Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221
John H. Greist, M.D.
Lee Baer, Ph.D.

PART
V
Panic Disorder and
Agoraphobia
18 Phenomenology of Panic Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237
Mark H. Pollack, M.D.
Jordan W. Smoller, M.D., Sc.D.
Michael W. Otto, Ph.D.
Erin L. Scott, M.A.
Jerrold F. Rosenbaum, M.D.
19 Pathogenesis of Panic Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247
Jeremy D. Coplan, M.D.
Jack M. Gorman, M.D.
20 Pharmacotherapy for Panic Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
R. Bruce Lydiard, M.D., Ph.D.
21 Psychotherapy for Panic Disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273
David A. Spiegel, M.D.
Stefan G. Hofmann, Ph.D.

PART
VI
Social Phobia
22 Phenomenology of Social Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289
Denise A. Chavira, Ph.D.
Murray B. Stein, M.D., F.R.C.P.C.
23 Pathogenesis of Social Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301
Manuel E. Tancer, M.D.
Thomas W. Uhde, M.D.
24 Pharmacotherapy for Social Phobia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309
Carlos Blanco, M.D., Ph.D.
Franklin R. Schneier, M.D.
Michael R. Liebowitz, M.D.
25 Psychotherapy for Social Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323
Cynthia L. Turk, Ph.D.
Meredith E. Coles, M.A.
Richard G. Heimberg, Ph.D.

PART
VII
Specific Phobia
26 Specific Phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .343
Allison G. Harvey, Ph.D.
Ronald M. Rapee, Ph.D.

PART
VIII
Posttraumatic Stress
Disorder and Acute
Stress Disorder
27 Phenomenology of Posttraumatic Stress Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359
Alexander C. McFarlane, M.D.
28 Pathogenesis of Posttraumatic Stress Disorder and Acute Stress Disorder . . . . . . . . . . . . . . . . . . .373
Rachel Yehuda, Ph.D.
Cheryl M. Wong, M.D.
29 Pharmacotherapy for Posttraumatic Stress Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .387
Barbara A. Crockett, M.D.
Jonathan R. T. Davidson, M.D.
30 Psychotherapy for Posttraumatic Stress Disorder and Other Trauma-Related Disorders . . . . . . .403
Bessel A. van der Kolk, M.D.
Alexander C. McFarlane, M.D.
Onno van der Hart, Ph.D.

PART
IX
Anxiety Disorders in
Special Populations
31 Anxiety Disorders in Children and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .415
John S. March, M.D., M.P.H.
Anne Marie Albano, Ph.D.
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32 Anxiety Disorders in the Elderly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .429
Debra B. Kaminer, M.Psych.
Soraya Seedat, M.B., F.C.Psych., M.Med.(Psych)
Felix Potocnik, M.B., F.C.Psych.
Dan J. Stein, M.D., Ph.D.
33 Anxiety in the Context of Substance Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441
Leonard Handelsman, M.D.
34 Anxiety and Anxiety Disorders in Medical Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .449
Michael J. Raster, M.D.
Thomas N. Wise, M.D.
June Cai, M.D.

PART
X
Social Aspects of
Anxiety Disorders
35 Cultural and Social Aspects of Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .463
Dan J. Stein, M.D., Ph.D.
David R. Williams, Ph.D.
36 Economic Costs of Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .475
Robert L. DuPont, M.D.
Caroline M. DuPont, M.D.
Dorothy P. Rice, Sc.D. (Hon.)
37 Consumer Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .485
Jerilyn Ross, M.A., L.I.C.S.W.

Appendix: Internet Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .493

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .495
This page intentionally left blank
 Contributors

Anne Marie Albano, Ph.D. June Cai, M.D.

Assistant Professor, Department of Psychiatry, and Di- Clinical Associate, National Institute of Mental Health,
rector, Anxiety and Mood Disorders Clinical Research Bethesda, Maryland
Service, Child Study Center, New York University
School of Medicine, New York, New York Rebecca P. Cameron, Ph.D.
Postdoctoral Fellow, Department of Psychiatry and
Lotta Arborelius, Ph.D. Behavioral Sciences, Stanford University School of
Associate Professor, Department of Clinical Neuro- Medicine, Stanford, California
science, Karolinska Institutet, Stockholm, Sweden
Dennis S. Charney, M.D.
Lee Baer, Ph.D. Chief, Mood and Anxiety Disorders Research Pro-
Associate Professor of Psychology and Director, Psy- gram, National Institute of Mental Health, Bethesda,
chological Research, OCD Clinic and Research Unit, Maryland
Department of Psychiatry, Massachusetts General
Hospital, Charlestown, Massachusetts Denise A. Chavira, Ph.D.
Postdoctoral Research Fellow, Department of Psychia-
Carlos Blanco, M.D., Ph.D. try, University of California, San Diego, La Jolla, Cal-
Assistant Professor of Clinical Psychiatry, Department ifornia
of Psychiatry, Columbia University College of Physi-
cians and Surgeons, and the New York State Psychiat- Meredith E. Coles, M.A.
ric Institute, New York, New York Doctoral candidate, Adult Anxiety Clinic of Temple
University, Department of Psychology, Philadelphia,
J. Douglas Bremner, M.D. Pennsylvania
Associate Professor of Psychiatry and Radiology, Emo-
ry University School of Medicine, and Director, Emory Arnold M. Cooper, M.D.
Center for Positron Emission Tomography, Atlanta, Professor Emeritus of Consultation-Liaison Psychia-
Georgia; and Director of Mental Health research, At- try, Cornell University Medical College; and Training
lanta VA Medical Center, Decatur, Georgia and Supervising Psychoanalyst, Columbia University
Center for Psychoanalytic Training and Research, New
Thomas E. Brouette, M.D. York, New York
Attending Psychiatrist, Belmont Behavioral Health,
Philadelphia, Pennsylvania Jeremy D. Coplan, M.D.
Professor of Psychiatry, State University of New York–
Timothy A. Brown, Psy.D. Downstate Medical Center, Brooklyn, New York
Associate Director, Center for Anxiety and Related
Disorders; and Research Professor, Boston University,
Boston, Massachusetts

xi
 xii TEXTBOOK OF ANXIETY DISORDERS

Gabriela Corá-Locatelli, M.D. Wayne K. Goodman, M.D.

Adult OCD Unit, Laboratory of Clinical Science, Na- Professor and Chairman, Department of Psychiatry,
tional Institute of Mental Health, Bethesda, Maryland University of Florida College of Medicine, Gainesville,
Florida
Barbara A. Crockett, M.D.
Research Assistant Professor, Department of Psychia- Jack M. Gorman, M.D.
try, University of North Carolina School of Medicine, Professor of Psychiatry, Department of Psychiatry,
Chapel Hill, North Carolina College of Physicians and Surgeons, Columbia Univer-
sity, New York State Psychiatric Institute, New York,
Jonathan R. T. Davidson, M.D. New York
Director, Anxiety and Traumatic Stress Program, and
Professor, Department of Psychiatry and Behavioral Benjamin D. Greenberg, M.D., Ph.D.
Sciences, Duke University Medical Center, Durham, Associate Professor, Department of Psychiatry and Hu-
North Carolina man Behavior, Brown University, Providence, Rhode
Island; and Chief, Outpatient Services, Butler Hospital,
Robert A. DiTomasso, Ph.D., A.B.P.P. Providence, Rhode island
Professor, Vice-Chairman, and Director of Clinical
Research, Department of Psychology, Philadelphia John H. Greist, M.D.
College of Osteopathic Medicine, Philadelphia, Penn- CEO, Healthcare Technology Systems; and Clinical
sylvania Professor of Psychiatry, University of Wisconsin Med-
ical School, Madison, Wisconsin
Caroline M. DuPont, M.D.
Director of Clinical Research, Institute for Behavior Leonard Handelsman, M.D.
and Health, Inc., Rockville, Maryland Associate Clinical Professor, Department of Psychiatry
and Behavioral Sciences, Duke University Medical
Robert L. DuPont, M.D. Center, Durham, North Carolina
President, Institute for Behavior and Health, Inc.,
Rockville, Maryland; and Clinical Professor of Psychi- Allison G. Harvey, Ph.D.
atry, Georgetown University School of Medicine, University lecturer, Department of Experimental Psy-
Washington, D.C. chology, University of Oxford, Oxford, United King-
dom
Jane L. Eisen, M.D.
Assistant Professor, Department of Psychiatry and Hu- Richard G. Heimberg, Ph.D.
man Behavior, Brown University School of Medicine, Director, Adult Anxiety Clinic of Temple University,
Butler Hospital, Providence, Rhode Island Department of Psychology, Philadelphia, Pennsylvania

James M. Ellison, M.D., M.P.H. Myron A. Hofer, M.D.

Clinical Director, Geriatric Psychiatry Program, and Di- Sackler Institute Professor of Developmental Psycho-
rector, Ambulatory Service, McLean Hospital, Belmont, biology, Department of Psychiatry, Columbia Univer-
Massachusetts; and Associate Clinical Professor in Psy- sity College of Physicians and Surgeons, New York,
chiatry, Harvard Medical School, Boston, Massachusetts New York

Arthur Freeman, Ed.D., A.B.P.P. Stefan G. Hofmann, Ph.D.

Professor and Chairman, Department of Psychology, Assistant Professor, Center for Anxiety and Related
Philadelphia College of Osteopathic Medicine, Phila- Disorders, Boston University, Boston, Massachusetts
delphia, Pennsylvania
Eric Hollander, M.D.
Andrew W. Goddard, M.D. Professor of Psychiatry, Mount Sinai School of Medi-
Associate Professor, Yale University School of Medi- cine, New York, New York
cine, Connecticut Mental Health Center, New Haven,
Connecticut
 Contributors xiii

Jonathan D. Huppert, Ph.D. Charles B. Nemeroff, M.D., Ph.D.

Assistant Professor of Psychology in Psychiatry, Center Professor of Psychiatry, Department of Psychiatry and
for the Treatment and Study of Anxiety, University of Behavioral Sciences, Emory University School of Med-
Pennsylvania School of Medicine, Philadelphia, Penn- icine, Atlanta, Georgia
sylvania
Michael W. Otto, Ph.D.
Debra B. Kaminer, M.Psych. Director, Cognitive-Behavioral Therapy Program,
Lecturer, Department of Psychology, University of Massachusetts General Hospital, Boston, Massachu-
Cape Town, Rondebosch, South Africa setts; and Professor of Psychiatry, Harvard Medical
School, Boston, Massachusetts
Marc S. Kleber, Ph.D.
Instructor in Clinical Psychology, Department of Psy- Laszlo A. Papp, M.D.
chiatry, College of Physicians and Surgeons, Columbia Associate Professor of Psychiatry, Department of Psy-
University; and the Biological Studies Unit, New York chiatry, College of Physicians and Surgeons, Columbia
State Psychiatric Institute, New York, New York University; Director, Biological Studies Unit, New
York State Psychiatric Institute, New York, New York;
Michael R. Liebowitz, M.D. and Director, Anxiety Disorders Research Program,
Professor of Clinical Psychiatry, Department of Psy- Hillside Hospital, Glen Oaks, New York
chiatry, Columbia University College of Physicians and
Surgeons, and the New York State Psychiatric Insti- Mark H. Pollack, M.D.
tute, New York, New York Director, Anxiety Disorders Program, Massachusetts
General Hospital, Boston, Massachusetts; and Associ-
R. Bruce Lydiard, M.D., Ph.D. ate Professor, Department of Psychiatry, Harvard
Professor of Psychiatry, Medical University of South Medical School, Boston, Massachusetts
Carolina, Charleston, South Carolina; and Director,
SouthEast Health Consultants, Charleston, South Felix Potocnik, M.B., F.C.Psych.
Carolina Researcher and Clinician, South African Memory Re-
source Centre, Department of Psychiatry, University
John S. March, M.D., M.P.H. of Stellenbosch, Cape Town, South Africa
Professor of Psychiatry and Director, Program in Child
and Adolescent Anxiety Disorders, Departments of Ronald M. Rapee, Ph.D.
Psychiatry and Psychology: Social and Health Sciences, Professor, Department of Psychology, Macquarie Uni-
Duke University Medical Center, Durham, North versity, Sydney, Australia
Carolina
Steven A. Rasmussen, M.D.
R. Harris G. McCarter, Ph.D. Associate Professor, Department of Psychiatry and Hu-
Private Practice, Cambridge, Massachusetts; and In- man Behavior, Brown University School of Medicine,
structor in Psychology, Harvard Medical School, Bel- Butler Hospital, Providence, Rhode Island
mont, Massachusetts
Michael J. Raster, M.D.
Alexander C. McFarlane, M.D. Director of Consultation-Liaison Psychiatry, Wauke-
Professor of Psychiatry, Adelaide University, Queen sha Memorial Hospital, Waukesha, Wisconsin
Elizabeth Hospital, Adelaide, Australia
Scott L. Rauch, M.D.
Barbara Milrod, M.D. Associate Professor of Psychiatry, Harvard Medical
Assistant Professor, Department of Psychiatry, Cornell School; and Director of Psychiatric Neuroimaging Re-
University Medical College, New York, New York search, Departments of Psychiatry and Radiology,
Massachusetts General Hospital, Boston, Massachu-
setts
 xiv TEXTBOOK OF ANXIETY DISORDERS

Dorothy P. Rice, Sc.D. (Hon.) Jordan W. Smoller, M.D., Sc.D.

Professor Emeritus, Institute for Health and Aging, Director, Psychiatric Genetics Program in Mood and
University of California, San Francisco Anxiety Disorders, Outpatient Division of Psychiatry,
Massachusetts General Hospital, and Assistant Profes-
Jerrold F. Rosenbaum, M.D. sor of Psychiatry, Harvard Medical School, Boston,
Professor of Psychiatry, Harvard Medical School, Bos- Massachusetts
ton, Massachusetts; Chief of Psychiatry (Interim), and
President and Executive Director, MGH Mood and David A. Spiegel, M.D.
Anxiety Disorders Institute (MADI), Massachusetts Research Professor, Center for Anxiety and Related
General Hospital, Boston, Massachusetts Disorders, Boston University, Boston, Massachusetts

Jerilyn Ross, M.A., L.I.C.S.W. Dan J. Stein, M.D., Ph.D.

President and CEO, Anxiety Disorders Association of Director, Medical Research Council Unit on Anxiety
America, Rockville, Maryland; and Director, The Ross Disorders, University of Stellenbosch, Cape Town,
Center for Anxiety and Related Disorders, Washing- South Africa; and University of Florida, Gainesville
ton, D.C.
Murray B. Stein, M.D., F.R.C.P.C.
William C. Sanderson, Ph.D. Professor of Psychiatry, Department of Psychiatry,
Associate Professor of Psychology and Director, Cog- University of California, San Diego, La Jolla, Califor-
nitive-Behavioral Treatment Program for Anxiety and nia
Depression, Department of Psychology, Graduate
School of Applied and Professional Psychology, Rut- Michael H. Stone, M.D.
gers University, Piscataway, New Jersey Professor of Clinical Psychiatry, Columbia College of
Physicians and Surgeons, New York, New York; Re-
Alan F. Schatzberg, M.D. search Coordinator, Mid-Hudson Forensic Psychiatric
Professor of Psychiatry, Department of Psychiatry and Hospital, New Hampton, New York; and Consultant,
Behavioral Sciences, Stanford University School of Personality Disorder Institute, New York Hospital–
Medicine, Stanford, California Westchester Division, White Plains, New York

Franklin R. Schneier, M.D. Norman Sussman, M.D.

Associate Professor of Clinical Psychiatry, Department Clinical Professor of Psychiatry, Department of Psy-
of Psychiatry, Columbia University College of Physi- chiatry, New York Hospital, New York, New York
cians and Surgeons, and the New York State Psychiat-
ric Institute, New York, New York Manuel E. Tancer, M.D.
Associate Professor of Psychiatry, Departments of Psy-
Erin L. Scott, M.A. chiatry and Behavioral Neurosciences and Pharmacol-
Department of Psychology, Temple University, Phila- ogy, Wayne State University School of Medicine,
delphia, Pennsylvania Detroit, Michigan

Soraya Seedat, M.B., F.C.Psych., M.Med.(Psych) Cynthia L. Turk, Ph.D.

Director, Posttraumatic Stress Disorder Unit, Medical Associate Director, Adult Anxiety Clinic of Temple
Research Council Unit on Anxiety Disorders, Univer- University, Department of Psychology, Philadelphia,
sity of Stellenbosch, Cape Town, South Africa Pennsylvania

M. Katherine Shear, M.D. Thomas W. Uhde, M.D.

Professor of Psychiatry, Western Psychiatric Institute Professor of Psychiatry, Departments of Psychiatry and
and Clinic, Pittsburgh, Pennsylvania Behavioral Neurosciences and Pharmacology, Wayne
State University School of Medicine, Detroit, Michi-
gan
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