Perspectives and Promises of Clinical Psychology

248 Pages·1992·22.058 MB·English

by  Anke Ehlers, Wolfgang Fiegenbaum, Irmela Florin, Jurgen Margraf

Perspectives and
Promises of
Clinical Psychology
APPLIED CLINICAL PSYCHOLOGY
Series Editors:
Alan S. BeHack, Medical College of Pennsylvania at EPPI, Philadelphia, Pennsylvania,
and Michel Hersen, University of Pittsburgh, Pittsburgh, Pennsylvania
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Perspectives and
Promises of
Clinical Psychology
Edited by
Anke Ehlers,
Wolfgang Fiegenbaum,
lrmela Florin, and
Jürgen Margraf
Christoph Dornier Foundation for Clinical Psychology
Marburg, Germany
Springer Science+Business Media, LLC
Llbrary of Congress Cataloglng-ln-Publlcatlon Data
Perspect1ves and promises of el inical psychology 1 ed1ted by Anke
Ehlers ... [et al.l.
p. cm. -- CApplled cllnical psychology>
Includes blbllographlcal references and 1ndexes.
1. Cl1n1cal psychology. 2. C11n1cal neuropsychology. 3. Mental
1 llness--Treatment. I. Ehlers. Anke, Ph. D. II. Ser1es.
[DNLM 1. Neurot1c Dlsorders--therapy. 2. Psychology, Clin1cal.
WM 170 P467)
RC467.P425 1992
616.89--dc20
DNLM/DLC
for L1brary of Congress 91-39351
CIP
ISBN 978-1-4899-3676-9 ISBN 978-1-4899-3674-5 (eBook)
DOI 10.1007/978-1-4899-3674-5
© 1992 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1992.
Softcover reprint of the hardcover 1s t edition 1992
AII rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Preface
Clinical psychology is a rapidly expanding field. Impressiveprogress has been
made in basic research and treatment of various psychological (e.g., anxiety
disorders) and somatic disorders (e.g., neurological disorders). The purpose of
this book is to illustrate recent achievements and to outline perspectives for
further applications of clinical psychology in research and treatment. The intro
duction by Florin and Piegenbaum demonstrates that the scope of clinical
psychology in research and application is much broader than previously
thought The subsequent contributions address three major misconceptions
about clinical psychology in the light of recent research:
Historically, clinical psychology has been identified with the study of
therapeutic interventions which were quite nonspecific for various disorders
and did not have a close connection with basic research. This has changed
dramatically within the last two decades. Clinical psychologists engage in basic
research designed to elucidate the physiological and cognitive mechanisms of
mental and organic disorders. These developments are exemplified by several
chapters of the present book: New data on the chemical senses and olfaction
in particular have direct implications for clinical phenomena such as organ
transplantations and pregnancy (see chapters by Ferstl and Eggert). Recent
research on the cognitive evaluation of body sensations in panic disorder has
led to specific and highly effective short-term interventions (chapters by Ehlers
and Margrat). Furthermore, a better and more reliable classification of mental
disorders should facilitate more specific treatments (chapters by Barlow and
Moras).
Clinical psychology uscd to be linked with the study of emotional disorders
such as anxiety or depression. Modem clinical psychology, however, can make
substantial contributions to the theory and treatment of medical disorders such
as infertility, epilepsy, and cardiovascular disease. These topics are addressed
in the present book. For example, evidence is provided suggesting that
decreasing interpersonal stress by couples therapy is an effective treatment for
organically healthy infertile men (chapters by Hellhammer and Kirschbaum),
V
vi Preface
that biofeedback may be a valuable treatment for epilepsy (chapter by
Birbaumer), and that behavioral processes are important for the etiology and
management of hypertension, one of the major risk factors for cardiovascular
disease (chapters by Steptoe and Molineux).
Clinical psychology has been equated with the study and treatment of less
severe psychological problems such as low self-esteem or shyness. Recent
research has demonstrated that psychological interventions are highly effective
in the treatment of some severe mental disorders. Thus, it has been shown that
family education and treatment prevent relapse in schizophrenia (chapter by
Hahlweg). Other research proves that cognitive behavioral therapy is effective
in the treatment of panic disorder (chapters by Ehlers and Margraf), agora
phobia (chapters by Roth), post-traumatic stress disorder (chapter by Foa), and
obsessive-compulsive disorder (chapters by Emmelkamp and Visser).
Publication of this book is part of the work of the Christoph-Dornier
Foundation for Clinical Psychology, Marburg, Germany. The purpose of the
foundation is to advance clinical and abnormal psychology in practice and
research. The foundation aims to establish opportunities to conduct psycholo
gical treatments, to ameliorate these treatments by pertinent basic and applied
research, and to make important results of clinical psychological research
accessible to the public. We hope to facilitate achieving this last goal by
including two types of contributions in the present book. In the first type of
paper ("overview" paper), leading experts give a short overview of the pro
gress that has been made in their research area and outline perspectives for
the future. Thus, these papers offcr the reader the possibility to gain a rapid
overview of recent developments. A more thorough understanding is offered
by the second type of paper ("studies" paper) in which the same experts
review empirical studies from their own work illustrating the points raised in
their overviews in greater detail.
We would like to express our gratitude to Gabriele Fünfstück, Dipl.-Psych.,
who organized the editorial work, translated some of the chapters, and pre
pared the manuscript for camera-ready publication. Without her, we would
not have been able to realize this book projcct. Furthermore, we acknowledge
the help of Gian-Paolo Caminiti, Anne Dessloch, Dipl.-Psych., Melissa Jenkins,
B.A., Kerstin Komischkc, Dipl.-Psych., and Christiane Zimmer, Dipl.-Psych.,
in preparing the manuscripts for publication. We would also like to thank
Eliot Wemer and Gregory Safford of Plenum Press for their adept editorial
support.
Preface vii
We acknowledge with appreciation the help of Monika Freitag, Dipl.-Psych.,
Bemd Frank, Dipl.-Psych., and Gabriete Fünfstück, Dipl.-Psych., in organizing
the syrnposium.
Last, but certainly not least we are grateful to Christoph Domier for bis
cornrnitrnent to the advancernent of clinical psychology.
Anke Ehlers
Wolfgang Piegenbaum
Irmela Florin
Jürgen Margraf
Contents
INTRODUCTION
Clinical Psychology: Its Successes and Perspectives . . . . 3
Irmela Florin and Wolfgang Fiegenbaum
PROGRESS IN BASIC RESEARCH:
IMPLICATIONS FOR TREATMENT
Diagnosis, DSM-IV, and Dimensional Approaches 13
David H. Barlow
Dimensional Approaches to Diagnosis and the
Problem of Anxiety and Depression . . . . . . . . . . . . . 23
Karla Moras and David H. Barlow
The Perception of Smell and Taste as a
Research Area of Clinical Psychology . . . . . . . . . . . . 39
Roman Ferstl
Production and Perception of Individual
Specific Body Odors: A New Area of Research in
Clinical Psychology . . . . . . . . . . . . . . . . . . . . 43
Roman Ferstl and Frank Eggert
Psychoendocrinology: The Brain, Hormones,
and Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Dirk Hellhammer
ix
X Contents
Cortisol and Behavior: The "Trier Mental
Challenge Test" (TMCT) - First Evaluation of a New
Psychological Stress Test . . . . . . . . . . . . . . . . . . . . 67
Clemens Kirschbaum, Oliver Diedrich, Jörg Gehrke, Stefan Wüst,
and Dirk Hellhammer
PROGRESS IN THE TREATMENT OF
SOMATIC DISORDERS
Clinicai-Psychological Treatment of Epileptic
Seizures: A Controlled Study . . . . . . . . . . . . . . . . . 81
Niels Birbaumer, 1l10mas Elbert, Brigitte Rockstroh, Irene Daum,
Peter Wolf, and Anthony Canavan
Clinical Health Psychology and Cardiovascular
Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Andrew Steptoe
Family History of Cardiovascular Disease,
Physical Fitness, and Psychophysiological
Reactivity to Mental Stress . . . . . . . . . . . . . . . . . . . 105
Andrew Steptoe and David Molineux
PROGRESS IN THE TREATMENT OF
MENTAL DISORDERS
Nature and Treatment of Panic Disorder ... 127
Jürgen Margraf and Anke Ehlers
Anxiety and Physical Symptoms: Recent
Findings on Panic Disorder . . . . . . . . . . . . . . . . . . . 135
Anke Ehlers and Jürgen Margraf