Download Prof. Millie Roqueta - ISS 1161 Chapter 15 Summary

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Prof. Millie Roqueta
CHAPTER 15 SUMMARY
Chapter 15
PSYCHOLOGY AND PHYSICAL HEALTH
LEARNING OBJECTIVES
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Describe and evaluate the medical model of abnormal behavior.
Explain the most commonly used criteria of abnormality.
Discuss the history of the DSM system and describe the five axes of DSM-IV.
Summarize data on the prevalence of various psychological disorders.
List and describe four types of anxiety disorders.
Discuss the contribution of biological factors and conditioning to the etiology of anxiety
disorders.
Discuss the contribution of cognitive factors, personality traits, and stress to the etiology of
anxiety disorders.
Describe three types of somatoform disorders.
Summarize what is known about the causes of somatoform disorders.
Describe three types of dissociative disorders.
Summarize what is known about the causes of dissociative disorders.
Describe the two major mood disorders and discuss their prevalence.
Explain how genetic and neurochemical factors may be related to the development of mood
disorders.
Explain how cognitive processes may contribute to mood disorders.
Explain how interpersonal behavior and stress may contribute to mood disorders.
Describe the prevalence and general symptoms of schizophrenia.
Describe four schizophrenic subtypes.
Explain the distinction between positive and negative symptoms in schizophrenia.
Identify factors related to the prognosis for schizophrenic patients.
Summarize how genetic vulnerability and neurochemical factors may contribute to the etiology
of schizophrenia.
Discuss the evidence relating schizophrenia to structural abnormalities in the brain and
neurodevelopmental insults to the brain.
Summarize how expressed emotion and stress may contribute to schizophrenia.
Explain the reasoning underlying the insanity defense, and how often it is used.
Explain the legal grounds for involuntary commitment.
Abnormal Behavior: Myths and Realities
The Medical Model
Applied to
Abnormal
Behavior
1. Medical model: proposes that it is useful to think of
abnormal behavior as a disease.
2. Basis for many of the terms used to refer to abnormal
behavior (e.g., mental illness, psychological disorder).
3. Prior to 18th century, people who behaved strangely were
believed to be possessed by demons, to be witches in league
with the devil, or to be victims of God’s punishment. Their
disorders were treated with chants, rituals and exorcisms.
Mentally ill individuals were often chained, confined to
dungeons, tortured, and killed.
4. The rise of the medical model (in 18th, 19th centuries)
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brought improvements in treatment. Inasmuch as people
were thought to be ill, they were afforded more sympathy and
conditions began to improve. It was not until the 20th century,
however, that the mentally ill acquired rights.
5. Problems with the medical model
a. Thomas Szasz suggests that abnormal behavior
usually involves a deviation from social norms rather
than an illness
b. Results in derogatory labels being applied to people
with disorders
6. Putting the model in perspective
a. Model is useful as an analogy.
b. Diagnosis involves distinguishing one illness from
another.
c. Etiology refers to the apparent causation and
developmental history of an illness.
d. Prognosis is a forecast about the probable course
of an illness.
Criteria of
Abnormal
Behavior
1.
Criteria of abnormal behavior
a. Three criteria are most frequently used in
determining abnormal behavior:
1) Deviance – behavior must deviate from what
the individual’s society considers acceptable.
What constitutes normality varies somewhat
from one culture to another.
2) Maladaptive behavior – the person’s
everyday adaptive behavior must be
impaired. The behavior must begin to
interfere with the person’s social or
occupational functioning.
3) Personal distress – frequently, the
diagnosis of a psychological disorder is
based on an individual’s report of great
personal distress.
b. Although two or three criteria may apply in a
particular case, people are often viewed as
disordered when only one criterion is met.
c. Antonyms such as normal versus abnormal and
mental health versus mental illness imply that
people can be divided neatly into two distinct
groups: those who are normal and those who are
not. In reality, it is often difficult to draw a clear line
between normality and abnormality. Behavior thus
is considered abnormal when it becomes extremely
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2.
3.
Psychodiagnosis:
The Classification
of Disorders
1.
2.
3.
The Prevalence of
Psychological
Disorders
1.
2.
3.
deviant, maladaptive, or distressing.
The cultural bounds of normality
a.
There is considerable continuity across cultures in
regard to what is considered abnormal.
b.
But judgments of abnormality are influenced to
some extent by cultural norms and values, which
can change over time.
c. Key point is that diagnoses of psychological
disorders almost always involve value judgments.
Normality and abnormality as a continuum
a. Normality/abnormality is a matter of degree, not an
either-or proposition.
First version of Diagnostic and Statistical Manual of Mental
Disorders (DSM) published in 1952 by American Psychiatric
Association.
Current version, DSM-IV introduced in 1994:
a. The multiaxial system
1) Axis I -- clinical syndromes
2) Axis II -- personality disorders
3) Axis III -- general medical conditions
4) Axis IV -- psychological and environmental
problems
5) Axis V -- global assessment of functioning
Controversies surrounding the DSM
a. Validity of the diagnostic categories.
b. Inclusion of everyday problems not traditionally
thought of as mental illnesses (e.g., extreme
clumsiness in children).
Epidemiology: study of the distribution of mental or
physical disorders in a population.
Prevalence: the percentage of a population that exhibits
a disorder during a specified time period.
Estimates suggest that psychological disorders are more
common than most people realize:
a. Recent studies suggest that one-third of population
may be affected during their lifetimes.
b. Most common disorders include anxiety disorders,
substance use disorders, and mood disorders.
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Anxiety Disorders
Generalized
Anxiety Disorder
1.
2.
Phobic Disorders
1.
2.
3.
Panic Disorder
and Agoraphobia
1.
2.
Anxiety disorders: a class of disorders marked by
feelings of excessive apprehension and anxiety.
a. Four principal types, not mutually exclusive:
generalized anxiety disorder, phobic disorder,
obsessive-compulsive disorder, and panic disorder.
b. People with anxiety disorders also exhibit elevated
rates of depression.
c. Quite common, occurring in about 17% of the
population.
Generalized anxiety disorder (marked by a chronic, high
level of anxiety that is not tied to any specific threat).
a. Sometimes called "free-floating anxiety".
b. People with this disorder worry constantly about
yesterday’s mistakes and tomorrow’s problems. In
particular, they worry about minor matters related to
family finances, work, and personal illness. They often
dread decisions and brood over them endlessly.
c. Frequently accompanied by physical symptoms (e.g.,
trembling, muscle tension, etc.).
d. Tend to have a gradual onset and is seen more
frequently in females.
Phobic disorder (marked by a persistent and irrational
fear of an object or situation that presents no realistic
danger).
Mild phobias are extremely common. People are said to
have a phobic disorder only when their fears seriously
interfere with everyday behavior.
Common phobias include agoraphobia (fear of places of
assembly, crowds, open spaces), acrophobia (fear of
heights), claustrophobia (fear of enclosed places),
hydrophobia (fear of water).
Panic disorder: characterized by recurrent attacks of
overwhelming anxiety that usually occur suddenly
and unexpectedly.
Agoraphobia: a fear of going out to public places.
a. A common complication of panic disorders. More
common in women.
b. More similar to panic disorder than phobic disorder.
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ObsessiveCompulsive
Disorder
Etiology of
Anxiety Disorders
1.
Obsessive-compulsive disorder (OCD) is marked by
persistent, uncontrollable intrusions of unwanted
thoughts (obsessions) and urges to engage in
senseless rituals (compulsions).
a. Typical age of onset is early adulthood.
b. Obsessions often center on fear of contamination,
inflicting harm on others, suicide, or sexual acts.
c. Compulsions usually involve stereotyped rituals that
temporarily relieve anxiety.
d. Prevalence (roughly 2% of population) seems to be
increasing, but may be due to changes in clinicians’
and researchers’ diagnostic tendencies.
1. Biological factors
a. There may be a weak genetic predisposition.
b. Associated with inhibited temperament in infants.
c. Anxiety sensitivity may make people vulnerable to anxiety
disorders. That is, some people are very sensitive to the
internal physiological symptoms of anxiety and are prone
to overreact with fear when they experience these
symptoms.
d. Has been linked to neurochemical activity in brain:
1) Neurotransmitters: chemicals that carry
signals from one neuron to another.
2) Disturbances in neural circuits using GABA may
play role.
2. Conditioning and learning
a. Many anxiety responses may be acquired through
classical conditioning, maintained through operant
conditioning.
b. Martin Seligman's concept of preparedness helps explain
the tendency to develop phobias of certain objects:
1) Suggests that people may be biologically
prepared to acquire some fears more easily than
others (e.g., snakes, spiders).
2) Only modest research support.
c. Conditioning models have a number of problems.
3. Cognitive factors
a. Certain styles of thinking may make some people
vulnerable to anxiety disorders.
b. Theorists suggest these people tend to:
1) Misinterpret harmless situations as threatening.
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2)
3)
Focus excessive attention on perceived threats.
Selectively recall information that seems
threatening.
4. Personality
a. Neuroticism correlated with an elevated prevalence of
anxiety disorders. People who score high in neuroticism
tend to be self-conscious, nervous, jittery, insecure, guilt
prone, and gloomy.
b. Mechanisms underlying association are subject of
debate.
5. Stress
a. Anxiety disorders may be stress related.
b. High stress may help precipitate onset of anxiety
disorders.
Somatoform Disorders
Somatization
Disorder
1.
2.
3.
Psychosomatic diseases versus somatoform disorders
a. Psychosomatic diseases: genuine physical
ailments caused in part by psychological factors,
especially emotional stress.
b. Recorded on DSM axis for physical problems (Axis III).
Somatoform disorders: physical ailments with no
authentic organic basis that are due to psychological
factors
a. Although their symptoms are more imaginary than real,
victims of somatoform disorders are not simply faking
illness. Include maladies such as ulcers, asthma, high
blood pressure.
b. Deliberate feigning of illness for personal gain is
called malingering.
Somatization disorder is marked by a history of diverse
physical complaints that appear to be psychological in
origin.
a. Occur mostly in women, and often in conjunction with
depression or generalized anxiety disorder.
b. Victims report an endless succession of minor physical
ailments that seem to wax and wane in response to the
stress in their lives.
c. Over the years, they report a mixed bag of
cardiovascular, gastrointestinal, pulmonary,
neurological and genitourinary symptoms. Diversity of
victims' complaints is distinguishing feature.
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Conversion
Disorder
1.
2.
3.
Hypochondriasis
1.
2.
3.
Etiology of
Somatoform
Disorders
1.
2.
Conversion disorder is characterized by a significant
loss of physical function, with no apparent organic
basis, usually in a single organ system.
Common symptoms include loss of vision, hearing,
paralysis, seizures, vomiting, and loss of feeling or function
in limbs.
People with conversion disorders are usually troubled by
more severe ailments than people with somatization
disorders.
Hypochondriasis: (more widely known as hypochondria)
is characterized by excessive preoccupation with health
concerns and incessant worry about developing
physical illnesses.
People tend to over-interpret every conceivable sign of
illness.
Frequently coexists with other psychological disorders,
especially anxiety disorders, depression.
Inherited aspects of physiological functioning may predispose
some people to somatoform disorders.
a. Personality factors
 Often associated with histrionic personality
characteristics. The histrionic personality tends to
be self-centered, suggestible, excitable, highly
emotional, and overly dramatic. Such people thrive
on the attention that they get when they become ill.
 Neuroticism may also play a role.
b. Cognitive factors
 Cognitive theorists assert that some people focus
excessive attention on their internal physiological
processes and amplify normal bodily sensations into
symptoms of distress.
 Recent evidence suggests that people with
somatoform disorders tend to draw catastrophic
conclusions about minor bodily complaints. They
also seem to apply a faulty standard of good health,
equating health with a complete absence of
symptoms and discomfort, which is unrealistic.
The sick role
a.
Some people grow fond of role associated with being sick,
which gets them attention and helps them avoid life's
challenges.
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Dissociative Disorders
Dissociative
Amnesia and
Fugue
1.
2.
Dissociative
Identity Disorder
1.
2.
3.
4.
Dissociative disorders (a class of disorders in which
people lose contact with portions of their consciousness
or memory, resulting in disruptions in their sense of
identity).
Dissociative amnesia and fugue
a. Dissociative amnesia: a sudden loss of memory for
important personal information that is too
extensive to be due to normal forgetting.
 Memory loss may occur for single traumatic event,
or for extended period of time surrounding the
event.
 Cases have been observed as a result of
disasters, accidents, combat stress, physical
abuse, etc.
b. Dissociative fugue: people experience extensive
amnesia and confusion about their identity, coupled
with unexpected travel away from their customary
home.
 People forget their name, their family, where they
live, and where they work. They typically wander
away from their home area.
Dissociative identity disorder (the disorder formerly
known as multiple-personality disorder or MPD)
involves the coexistence in one person of two or more
largely complete, and usually very different,
personalities.
Various personalities are often unaware of each other and
may be different in age, race, gender, and sexual
orientation.
Most DID patients also have a history of anxiety, mood, or
personality disorders.
It is a rare disorder, however, it has shown a dramatic
increase since the 1970s. It appears that a handful of
clinicians have begun over-diagnosing the disorder.
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Etiology of
Dissociative
Disorders
1.
2.
Dissociative amnesia, fugue usually attributed to excessive
stress.
a. Relatively little is known about why such an extreme
reaction occurs in tiny minority of people.
b. Speculation that certain personality traits may make
some people more susceptible (e.g., fantasy
proneness).
Causes of MPD are obscure.
a. Some skeptics suggest that people fake the disorder.
b. Although some faking occurs, most theorists believe at
least some cases are authentic.
c. May be associated with severe emotional trauma in
childhood.
Mood Disorders
Major Depressive
Disorder
1.
2.
Mood disorders: a class of disorders marked by
emotional disturbances that may spill over to disrupt
physical, perceptual, social, and thought processes
a. Tend to be episodic in nature.
b. Episodes of disturbance vary greatly in length;
typically last several months.
c. Click here for Dr. Ivan’s Depression Central, a
website that is considered a great resource
regarding depression. Also view the American
Psychological Association’s Help Center site on
depression, along with the many other articles
maintained by the APA about specific issues
related to depression.
Major depressive disorder is marked by persistent
feelings of sadness and despair and a loss of interest
in previous sources of pleasure
a. Negative emotions main symptom.
b. Other symptoms include reduced appetite,
insomnia, lack of energy.
c. A relatively common disorder.
 Recent studies indicate that as many as 17%
of Americans endure a depressive disorder
at some time. Prevalence is increasing,
particularly for people born since WW II.
 About twice as common in women as in men.
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Bipolar Disorder
1.
2.
3.
4.
Etiology of Mood
Disorders
1.
2.
3.
4.
Bipolar disorders (formerly known as manic-depressive
disorders) marked by the experience of both depressed
and manic periods.
Manic episodes characterized by elevated mood, high selfesteem, optimism, energy.
Much less common than unipolar depression.
Seen equally often in men and women.
Genetic vulnerability
a. Evidence indicates genetic factors influence likelihood
of developing disorder.
b. Concordance rate: the percentage of twin pairs or
other pairs of relatives that exhibit the same
disorder.
 Twin studies, which compare identical and
fraternal twins, suggest that genetic factors are
involved.
 Concordance rates average around 67% for
identical twins, 15% for fraternal twins.
Neurochemical factors
a. Correlations found between mood disorders and
levels of two neurotransmitters in brain
(norepinephrine, serotonin).
b. Drug therapies are fairly effective in treatment.
Cognitive factors
a. Explanatory styles may play a role; pessimistic
explanatory style, learned helplessness or a sense of
hopelessness may be cognitive styles that contribute
to elevated vulnerability to depression.
b. Research indicates that people who consistently tend
to make internal, stable, and global attributions are
more prone to depression.
c. Depressed people who ruminate about their
depression have elevated rates of depression and
tend to stay depressed longer.
Interpersonal roots
a. Inadequate social skills may put people on road to
depression.
b. Depressed people tend not to be enjoyable
companions: they are often irritable and pessimistic,
they complain a lot, and as a result they court
rejection from those around them. In turn, rejection
and lack of social support may aggravate and depend
a person’s depression.
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Prof. Millie Roqueta
5.
Precipitating stress
a. Evidence indicates a moderately strong link between
stress and onset of mood disorders.
b. Stress may also affect how people with mood
disorders respond to treatment.
c. Stress may trigger mood disorders in people who are
vulnerable.
Schizophrenic Disorders
General
Symptoms
1.
2.
Subtypes
1.
2.
3.
Schizophrenic disorders: a class of disorders marked
by disturbances in thought that spill over to affect
perceptual, social, and emotional processes.
a.
Estimates suggests it occurs in about 1-1.5% of
population (about 4 million people in the U.S.)
b.
A severe, debilitating disorder.
General symptoms
a.
Irrational thought
 Delusions: false beliefs that are
maintained even though they clearly are
out of touch with reality.
 Thinking becomes chaotic.
b.
Deterioration of adaptive behavior
c.
Distorted perception
 Hallucinations: sensory perceptions that
occur in the absence of a real, external
stimulus or that represent gross
distortions of perceptual input.
 Auditory hallucinations are most common.
d.
Disturbed emotion
 Some victims show flattening of emotions.
 Others show inappropriate emotional
responses.
 Some become emotionally volatile.
Paranoid schizophrenia: dominated by delusions of
persecution, along with delusions of grandeur.
Catatonic schizophrenia: marked by striking motor
disturbances, ranging from muscular rigidity to random
motor activity.
Disorganized schizophrenia: marked by a particularly
severe deterioration of adaptive behavior.
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4.
5.
Course and
Outcome
1.
2.
3.
Etiology of
Schizophrenia
1.
2.
3.
4.
Undifferentiated schizophrenia: marked by idiosyncratic
mixtures of schizophrenic symptoms.
Some researchers have proposed an alternative approach to
sub-typing based on predominance of negative versus
positive symptoms.
a. Negative symptoms involve behavior deficits (e.g.,
flattened emotions, social withdrawal).
b. Positive symptoms involve behavioral excesses or
peculiarities (e.g., hallucinations, delusions).
Disorders usually emerge during adolescence, early
adulthood.
Emergence may be sudden or gradual.
Factors related to favorable prognosis:
a. Onset was sudden rather than gradual.
b. Onset occurred at later age.
c. Patient was well adjusted prior to onset.
d. Patient has healthy, supportive family to return to.
Genetic vulnerability
a. Much evidence for role of hereditary factors.
b. People seem to inherit genetically transmitted
vulnerability to schizophrenia.
Neurochemical factors
a. Associated with changes in neurotransmitter activity in
brain.
b. Excess dopamine activity implicated, although evidence
is riddled with inconsistencies.
Structural abnormalities in brain
a. Problems with attention suggest that disorders may be
caused by neurological defects.
b. Evidence suggests association between enlarged brain
ventricles and chronic schizophrenia. This appears to be
particularly true for male patients.
c. Researchers currently intrigued by finding that thalamus
is smaller and shows less metabolic activity in
schizophrenic patients.
The Neurodevelopmental Hypothesis
a.
Schizophrenia is produced by a series of disruptions in
the normal development of the brain.
b.
Suspected causes are prenatal exposure to viruses,
malnutrition, and obstetrical complications.
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5.
Expressed Emotion Theory
a. Expressed emotion is degree to which relatives are highly
critical, emotionally over-involved.
b. Relapse rates are much greater for patients returning to
families high in expressed emotion.
c. Patients suffering from mood disorders whose families
are high in expressed emotion also show elevated
relapse rates.
Precipitating stress
a. Stress seems to play role in triggering the disorder.
b. High stress may also trigger relapses.
6.
Psychological Disorders and the Law
Insanity
Involuntary
Commitment
1.
Insanity is a legal status indicating that a person cannot
be held responsible for his or her actions because of
metal illness.
a. This is an issue because criminal acts must be
intentional.
b. There is no simple way to establish insanity.
c. Most people with psychological diagnoses would not
qualify as insane.
d. The most widely used rule for establishing insanity is
the M’naghten rule, which states that insanity exists
when a mental disorder makes a person unable to
distinguish between right and wrong.
e. People tend to vastly overestimate the use of the
insanity defense, it is rarely used, and when used,
rarely succeeds.
1.
2.
In involuntary commitment people are hospitalized in
psychiatric facilities against their will. In order for this to
occur, a mental health professional and legal authority must
certify that the person is:
a.
A danger to his or her self
b.
A danger to others
c.
In need of treatment due to severe disorientation
In emergencies, mental health professionals can order a
temporary commitment, but extensive involuntary
hospitalization requires court proceedings. Florida’s statute
is known as the “Baker Act”, which allows involuntary
commitment for 72 hours when the patient is a risk to
him/herself or others. Click here to read the Florida Statute.
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Prof. Millie Roqueta
Discussion
Questions
1. What do you think of Thomas Szasz’s criticisms of the medical model of
psychological disorders? Do you think it makes sense to treat
psychological disorders the same way we treat diseases? Why or why
not?
2. What do you think of the process of "labeling" people with psychological
disorders? Do you think pinning a potentially derogatory label on a
person may do more harm than good? Why do you think psychiatrists
and psychologists generally support the use of some classification system
for psychological disorders?
3. Recent editions of the DSM include everyday problems that are not
traditionally thought of as mental illnesses (e.g., developmental
coordination disorder, nicotine dependence disorder). Do you think it's
appropriate for these kinds of problems to be included among severe
psychological disorders such as multiple-personality disorder and
schizophrenia?
4. The textbook mentions transvestic fetishism as an example of a deviant
behavior. Why do you think it's acceptable in our society for a woman to
dress in men's clothing, but not vice versa?
5. If a person does not pose a threat to anyone else and is not unhappy with
his or her behavior, but is socially deviant (e.g., a transvestite), should
that person be considered abnormal and mentally ill?
6. What do you think of the notion that normality and abnormality exist on a
continuum of behavior? Do you think most people view abnormal
behavior as quantitatively or qualitatively different from normal behavior?
7. Many people experience some degree of anxiety when they see a snake
or a spider, or when they find themselves in high places. What
distinguishes this kind of anxiety from a full-fledged phobia? (Note: This
question could be combined with question number 3 above in a
discussion focusing on normal versus abnormal behavior.)
8. According to your textbook, the vast majority of people who suffer from
panic disorder or agoraphobia are women. Why do you think this is the
case? How might an evolutionary psychologist explain this difference?
9. Recent research indicates that infants who show evidence of an inhibited
temperament may be at a greater risk of developing anxiety disorders
later in life. This finding suggests that the tendency to develop an anxiety
disorder may be inborn. What do you think of this notion? Do you think
it’s possible for infants with this temperament to grow into normal, anxietyfree adults?
10. Given that instances of multiple-personality disorder are relatively rare,
why do you think it is that this disorder is so frequently portrayed in books
and movies?
11. Researchers have suggested that the prevalence of depression is about
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Prof. Millie Roqueta
twice as high in women as it is in men. Why do you think this is the case?
Do you think it’s possible that women are simply more likely than men to
report instances of depression?
12. According to your textbook, some theorists suggest that inadequate social
skills can lead to the development of depression. Do you think it’s
possible that poor social skills may be a symptom of depression, rather
than a cause? Can you think of a study that could be done that would
help resolve this issue?
13. Do you think a person diagnosed with schizophrenia who commits a
serious crime (e.g., murder) should be considered not guilty due to
“insanity”? Why or why not? Discuss how your view of the insanity plea
has been affected by the information you have learned in the course.
14. There is a common misconception that multiple-personality disorder is the
same thing as schizophrenia. Can you think of any explanations for this
misconception?
15. Some researchers have suggested that eating disorders are particularly
common among college women. Why do you think this is the case?
16. Given that cultural values play a predominant role in the prevalence of
eating disorders, what steps could we take as a society to reduce the
likelihood of young women developing these disorders?
17. It is not uncommon for students in abnormal psychology classes to begin
to feel that they have signs of many of the disorders themselves. Did you
experience this feeling as you read the material in Chapter 15? Why do
you think students tend to have this reaction?
Chapter Summary References:
Adapted by Roqueta, M. (2002), from Weiten, W., & Lloyd, M. A. (2003), Psychology
applied to modern life: Adjustment in the 21st Century. Belmont, CA:
Wadsworth/Thomson Learning.
Table References:
Tables and PowerPoint Slides adapted by Roqueta, M. (2002) from Hutchens PowerPoint
Series for Weiten, W., & Lloyd, M. A. (2003), Psychology applied to modern life: Adjustment in
the 21st Century. Belmont, CA: Wadsworth/Thomson Learning.
Websites:






http://www.mentalhealth.com This site contains comprehensive information regarding all areas of
abnormal behavior and clinical psychology.
http://www.vanguard.edu/faculty/ddegelman/amoebaweb/index.cfm?doc_id=859 This site contains
a large number of links to sites dealing with psychological disorders.
http://www.pendulum.org/ A web site featuring resources related to Bipolar disorder.
http://www.schizophrenia.com/ Resources for people with schizophrenia and their families.
http://www.baltimorepsych.com/anxiety.htm Commercial web site for a psychiatry practice, but has a
lot of good information on anxiety disorders and is worth checking out.
http://www.nami.org/index.html Official home page of the National Alliance for the Mentally Ill.
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