I n d e x 617
Empirical Hypothesis-Testing Form, 231, 247
Encapsulation, in fear module, 25–26
Environmental triggers; see also Triggers
in assessment of fear activation, 137, 138t
in cognitive model, 42–43
Escape, controlled, versus endurance, 243–244
Escape behavior, 146; see also Avoidance
disadvantages of, 194
Ethnicity; see also Cultural factors
GAD and, 395–396
PTSD and, 503
Evidence gathering
form for, 228
in OCD, 480
in panic disorder therapy, 318
procedure and case illustration, 201–205
in PTSD, 540–541
in social phobia, 373
Ex-consequentia reasoning, in negative interpretation
of anxiety, 75–76
Executive function, fear response and, 21
Expanded Physical Sensations Checklist, 167–168
Expectancies, threat-related, 88
Explicit memory bias, threat elaboration and, 88–90
Exposure, spontaneous, clinical questions about, 152t
Exposure and response prevention, for OCD, control
trials of, 484–486
Exposure hierarchy, in social phobia, 241t
Exposure Hierarchy Form, 268
Exposure interventions, 238–251; see also In vivo
exposures
anxiety management during, 245–246
attention versus distraction, 243
collaboration and client-oriented control in, 244
controlled escape versus endurance, 243–244
flooding/abrupt, in imaginal versus in vivo
interventions, 248–249
frequency and duration of, 242–243
graduated versus intense, 241
guidelines for, 239–246
imaginal, 238–239
intensive, massed, for panic disorder, 242
internal, 238–239
naturally occurring versus therapeutic, 239, 240t
postexposure evaluation of, 247
purpose of, 239t
recommendations for enhancing effectiveness of, 243
safety signals and partner-assisted exposure in,
244–245
within sessions versus between sessions, 240
situational, 238–239
therapeutic implications of, 238
types of, 238–239
in vivo (see In vivo exposures)
Exposure Practice Record, 269
Expressive writing, 221–222
Eye contact, avoidance of, 146
Eye movement desensitization and reprocessing, for
PTSD, 550–551
fFainting, 146
False alarms, 7
Fear
adaptive value of, 192
defining, in client education, 191
normalizing, 186–187
Fear acquisition, cognitive processes in, 27
Fear activation, assessment and case formulation of,
135–147
behavioral observation in, 136
cognitive processing errors in, 147
first apprehensive thoughts/images in, 141–144
immediate inhibitory responses in, 146–147
perceived autonomic arousal in, 144–145
primary questions in, 136
situational analysis in, 137–141
Fear imagery script, 249–250
Fear memories, exposure interventions and, 238
Fear module, 25–26
definition and characteristics, 25–26
Fear of Negative Evaluation Scale, 363
Fear response
amygdala’s role in, 19–21
versus anxiety, 5–6
anxiety and, 4–10
in classical conditioning theory, 23
clinician guidelines for, 5, 7–8
as cognitive appraisal, 5
conscious cognitive processes in alteration of,
27–28
conscious cognitive processing in, 20–21
defining, 4–6
dysfunctional cognition and, 6
higher order cortical regions and, 28–29
immediate (see also Threat mode activation)
case formulation for, 135–147, 157–160
hypotheses pertaining to, 58–72
secondary reappraisal of, 160
treatment goals for, 160
impaired functioning and, 6–7
LeDoux’s dual pathway of, 19, 20f
neurobiological basis of, 19
noncognitive view of, 26–27
nonspecificity of amygdala activation and, 28
normal versus abnormal, 6–9
stimulus hypersensitivity and, 7
working/declarative memory and, 20–21
“Fight-or-flight” response, 192
First apprehensive thoughts/images
assessment of, 141–144
methods for accessing, 142–143
Flight behavior, 146
Flooding exposures, in imaginal versus in vivo
interventions, 248–249
Freezing, 146
Functional impairment, in PTSD, 493, 494t, 504–
505