ABSTRACT
The search for a parsimonious set of psychological treatment procedures that may be efficacious across the emotional disorders must necessarily begin with an understanding of how much these disorders overlap in terms of their occurrence and etiology. We know that disorders characterized by high levels of emotional dysregulation and inappropriate emotional responding, particularly anxiety and unipolar depressive disorders, are common. These disorders are also chronic and extremely costly, begin in late childhood and continue through adulthood, and tend to co-occur at high rates (Angold, Costello, & Erklani, 1999; Barlow, 2002; Kovacs & Devlin, 1998). As noted by Orvaschel, Lewinsohn, and Seeley (1995), experience of a childhood or adolescent anxiety disorder may not only predict the presentation of later anxiety symptomatology, it may also be associated with the development of a mood disorder. These authors found that roughly two-thirds (64.5%) of adolescents with a primary anxiety disorder diagnosis later developed a diagnosis of a depressive disorder. Similarly, rates of current and lifetime comorbidity between emotional disorders in adulthood are very high. Brown, Campbell, Lehman, Grisham, and Mancill (2001) indicate that of 1,127 patients carefully assessed for anxiety and depressive disorders using the Anxiety Disorders Interview Schedule for the DSM—IV, Lifetime Version (ADIS-IV-L, 1994), 55% presented with a principal mood or anxiety disorder and at least one additional mood or anxiety disorder at the time of assessment, even with conservative DSM—IV hierarchical diagnostic rules applied. When lifetime prevalence rates were calculated, this figure increased to 76% of patients experiencing an additional anxiety or mood disorder sometime in their lifespan (Brown et al., 2001).
