Validity study of the Anxiety Symptoms Interview.

The Anxiety Symptoms Interview (ASI) is a diagnostic instrument designed to identify agoraphobia (with and without panic attacks), panic disorder, social phobia, and obsessive compulsive disorder according to DSM-III criteria. The present study evaluated the diagnostic validity of this instrument by examining the extent to which ASI diagnoses assigned to 73 clinic patients agreed with diagnoses determined by clinicians. Most kappa coefficients and other concordance indicators were in the acceptable range or above, a finding that held for diagnoses overall and for specific diagnoses of agoraphobia with panic attacks, social phobia, and obsessive compulsive disorder. However, none of the 73 patients had clinician-assigned diagnoses of panic disorder (that is, without agoraphobia) or agoraphobia without panic. Limitations and applications of the ASI are discussed.

A qualitative review of psychosocial treatments for bulimia.

This review covers 32 individual and group therapy studies of the psychosocial treatment of bulimia published between 1976 and 1986. Using 14 criteria to assess the quality of experimental methodology, three studies were rated as high, 17 as medium, and 12 as low. Common methodological problems included the failure to use a control group or to specify the experience level of the therapist, overreliance on self-report outcome measures, and small sample sizes. Great variability was found among studies in inclusion criteria, treatment length, and length of follow-up. Thirty-eight percent of patients in group therapy and 41.5% of those in individual therapy were totally abstinent from bingeing and purging at follow-up. Although most studies used behavioral or cognitive-behavioral strategies, no modality of treatment has shown clear superiority. The results are discussed in terms of their implications for treatment, training, and future research.

Inpatient treatment of complicated agoraphobia and panic disorder.

Despite recent advances in the treatment of agoraphobia and panic disorder, some patients do not respond to standard outpatient regimens of biological and psychosocial intervention and may require more intensive, closely supervised care. The authors describe a specialized inpatient program that integrates pharmacotherapy, intensive levels of exposure and other behavioral therapies, a structured and strategically reinforcing environment, panic and anxiety management strategies, and other interventions designed specifically for patients with complicated panic-based disorders. Outcome data for 25 patients indicate that after a mean stay of 35 days, 19 patients were significantly improved. These preliminary results suggest that appropriately designed inpatient programs offer an effective treatment option for some patients with refractory conditions of agoraphobia or panic disorder.