Change in danger cognitions in agoraphobia and social phobia during treatment

Cognitive theories of anxiety emphasise the differences in anxious concerns and symptomatology across the anxiety disorders. The nature and extent of danger appraisal in social phobics and agoraphobics was examined and compared with that of a non-phobic group of adult stutterers. All groups were measured before, during and after treatment. Results showed that the form of danger appraisal was related to the fears exhibited, reductions in the particular appraisals of danger were associated with reductions in specific fears, and specific patterns of danger appraisal emerged. Agoraphobics' concerns with physical and loss of control danger normalized during treatment. Despite considerable and significant improvement, social phobics continued to have social evaluation danger scores significantly higher than the control group at the end of treatment. While cognitive behavioural therapy does change relevant fear cognitions, it appears that the intransigence of social phobic concerns about negative evaluations may require extra time and/or therapy.