Assessing the Effectiveness of Xanax Based on Cognitive Style

Roughly translated, cognitive style encompasses an individual’s approach to the world and all of its stimuli. It’s the set of mental tools and preconceived notions that each individual brings into daily life. People who blow small events out of proportion and always fear the worst outcomes are said to “catastrophize” their lives. Not surprisingly, those with a catastrophic worldview are far more likely to have a mood disorder. Specifically, people with a distinctly anxiety-prone cognitive style are at greater risk for a number of anxiety disorders, including panic disorder.

According to the Mayo Clinic, panic disorder is characterized by repeated panic attacks—acute episodes of irrational fear—and an ever-present heightened level of anxiety. A recent study published in Depression and Anxiety uncovered new details about how cognitive style affects both the short-term response and long-term outcome for patients with panic disorder. In the study, a total of 26 adults with panic disorder consented to an 8-week course of treatment with Xanax (alprazolam). The dosage was gradually scaled for the first 4 weeks. Participants kept a diary for recording both their daily state of mind and any panic events. At weekly intervals, each participant was put through a battery of tests and psychological performance measures. The results were encouraging but left many questions.

Initial scores on the Anxious Thoughts and Tendencies Questionnaire in no way predicted the response to Xanax treatment. High-scoring (extremely anxious) persons responded just as well as those with lower scores. Throughout the study, participants showed steady and significant improvement on nearly all measures of anxiety. Participants did show a decline in motor skills, due either to the sedative effects of Xanax or a growing boredom with the regimen. Most surprisingly, self-reported feelings of anxiety did not significantly change throughout the study. This argues strongly that therapy must always be part of the treatment for panic disorders.

The results of this study demonstrate that even for patients who have a tendency toward anxiety, Xanax and cognitive behavioral therapy can work together toward a positive outcome. Even when person scores highly on the standardized tests for anxiety, this particular medication shows substantial effectiveness. As with all drugs in its class, however, Xanax cannot be seen as a permanent solution to the underlying condition because of the risks of tolerance and dependence.


  1. Panic attacks and panic disorder. (2010). Mayo Clinic. Retrieved February 29, 2012, from
  2. Uhlenhuth, E. H., Starcevic, V., Qualls, C., Antal, E. J., Matuzas, W., Javaid, J., et al. (2008). Cognitive style, alprazolam plasma levels, and treatment response in panic disorder. Depression and Anxiety, 25, E18-E26.

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