Cardiophobic persons repeatedly present with complaints of chest pain and heart palpitations accompanied by fears of having a heart attack and of dying. They focus attention on their heart when experiencing stress and arousal, perceive its function in a phobic manner, and continue to believe they suffer from an organic heart problem despite repeated negative medical tests. To reduce anxiety, they seek continuous reassurance, make excessive use of medical facilities, and avoid activities believed to bring on symptoms. This article analyses the evidence for viewing cardiophobia as a phobic disorder in its own right rather than merely a problem of non-organic chest pain with some overlay of anxiety and depression. Despite some overlapping symptoms shared with persons who suffer from panic disorder, illness phobia, and extreme health anxiety, a number of central and defining features of cardiophobia are identified to differentiate cardiophobia from other anxiety disorders. An integrative model for understanding the origin and maintenance of cardiophobia (Eifert, 1990) is summarised and some treatment recommendations are derived from this model to target the central problems of persons with cardiophobia. Directions for future research are also discussed.

Twenty-eight non-clinical subjects, scoring either high or low on a variety of anxiety measures, were asked to match their perceived heart rate to a series of tones produced by a metronomal device, both at rest and during a period of mild exercise. Actual heart rate was measured concurrently with an electrocardiogram. No differences were found between groups in the accuracy with which they were able to monitor their heart rates and, in fact, all subjects markedly underestimated their heart rate. Also, no significant correlations were found between heart rate awareness and any of the measures of anxiety, except for a negative relationship between awareness and scores on the Anxiety Sensitivity Index. Theories of anxiety, and methodological considerations, are discussed.

Despite their significance, childhood anxiety disorders, compared to those of adults, have been neglected by researchers. However, recent years have witnessed increasing research on childhood anxiety disorders. Normative and developmental aspects of fear and anxiety are briefly discussed and we examine the classification and diagnostic reliability of childhood anxiety disorders. In relation to assessment, we focus on some recent research developments on self-report instruments and behavioural avoidance tests. An integrative behavioural treatment model is presented in which the need for age-appropriate intervention is emphasised. Also, data on the social validity of fear reduction procedures are presented. Finally, we outline several directions for future research.

This study investigated the relationship between the level of combat exposure and army status (regular army soldiers vs national servicemen) and the subsequent development of combat-related post-traumatic stress disorder (PTSD). Sixty-four Australian infantrymen who were exposed to combat stress in Vietnam were used in this study. They were divided into four groups based on combat exposure and status as a regular or conscripted soldier. Subjects were assessed 23 years after their tour of duty in Vietnam for PTSD and psychiatric symptomatology using a PTSD inventory based on DSM-III-R criteria, the Self-report Checklist 90 (SCL-90), the Beck Depression Inventory (BDI), the Impact of Events Scale (IES), the Mississippi Scale for Combat-related PTSD (Mississippi Scale), the State and Trait Anxiety Inventory (STAI), and a demographic questionnaire. Results showed that 29.85% of the veterans have a positive diagnosis of PTSD according to self-report of symptoms based on the DSM-III-R criteria, while 54.89% of the remaining veterans suffer major symptoms of this disorder. MANOVA results show that neither the level of combat exposure nor the army status of the veterans had any significant effect on their psychiatric symptomatology as measured by the SCL-90, the BDI, the IES, and the STAI.