This book is a collection of 31 chapters, grouped into four sections, written by well known faculty members of Columbia University. As the authors state, this book ‘could just as well be called The Columbia Guide to Understanding and Treating Anxiety Disorders’. After reading it, another alternate title came to mind: What you have always wanted to know about anxiety (but were afraid to ask). This book indeed provides a very comprehensive overview of pathological anxiety in the simplest and clearest manner.
The first section focuses on different conceptual frameworks within which anxiety has been studied. It is interesting to note that in our contemporary scientific world, since the advent of DSM and its non-theoretical framework, there is much less debate about possible competing frameworks and researchers and clinicians often tend to work within their usual framework without leaving their comfort zone. This section speaks to that, by covering a broad range of theoretical frameworks and their implications in anxiety nosography. Thus, it expands, for example, upon the psychodynamic and evolutionary concepts of the development of anxiety.
The second section addresses the issues surrounding the diagnosis of pathological anxiety. Again, many of the chapters in this section address recent controversies in anxiety research beyond DSM-IV framework. After 17 years, the reign of this version of DSM is about to come to an end. However, a whole generation of (relatively) young psychiatrists and psychologists has been trained to think within this particular framework. This section, by addressing issues such as the relationships between Axis I and II or tapping into concepts outside the DSM framework such as cultural syndromes or health anxiety provides the readers with some insight to further develop their critical thinking.
The third section draws on the various potential approaches to understand the aetiology of anxiety disorders. From genetic methods to concepts of separation anxiety, this section covers all main recent advances in this field. Although a few chapters are more specialized and might not be relevant to the lay reader, various pieces of interesting state-of-the-art research are presented.
Finally, the last section is a more conventional description of the treatment of anxiety disorders. However, several chapters tackle less typical subjects such as complementary and alternative approaches or brain stimulation as treatments for anxiety.
Overall, this book is a very appealing collection of interesting and diverse chapters, often underdeveloped in other textbooks and very few criticisms can be directed at it. The different chapters have in common the fact that they have been written by faculty members of Columbia University Department of Psychiatry and New York State Psychiatric Institute. Thus, some chapters might appear somewhat out of place, as the topic may have been dictated more by the availability of an expert in the field rather than the overall coherence of the work. Furthermore, there is also some overlap between chapters but this is minimal and does not interfere with the readability. Finally, another possible shortcoming is the relative lack of consistency between the different sections. For example, while cross-cultural issues are developed in the diagnostic section, their relevance is not discussed in terms of aetiology and treatment in the subsequent sections. However, I believe, this relative lack of consistency is the downside of the diversity of approaches.
To conclude, I would recommend this book to anyone (psychiatrist, psychologist, social worker or student) who has a interest in or is curious about anxiety in general and pathological anxiety in particular. This book brings valuable insights on issues often omitted from curricula. At a time when the scientific arena (and funding agencies) are placing researchers under increasing pressure to achieve a high level of specialization, it is difficult to keep updated in all domains of the field of anxiety research. This book, by presenting up-to-date general knowledge on anxiety disorders combined with findings from the latest research, provides a favourable setting for the emergence of new ideas for both research and clinical care. By drawing upon recent advances on the classification, aetiological pathways and treatment of pathological anxiety with different conceptual approaches, this book fulfils the authors' self-proclaimed aim of capturing ‘the ferment of science as it exists today’ … well, at least at Columbia University.
