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Biomedical subjects

L G Ost

Publications and source records attributed to L G Ost.

At least 19 recordsLinked to original sources
PubMed2002

Attentional and memory bias for emotional information in crime victims with acute posttraumatic stress disorder (PTSD).

A combined emotional Stroop, implicit memory (tachistoscopic identification) and explicit memory (free recall) task with three types of words (trauma-related, positive, and neutral) and two exposure conditions (subliminal and supraliminal) was administered to 39 crime victims with acute posttraumatic stress disorder (PTSD) and 39 age- and sex-matched controls. PTSD subjects showed supraliminal Stroop interference for trauma-related words and a similar effect on positive words. A specific explicit memory bias was found for trauma-related words among the PTSD subjects, but no preattentive bias on the subliminally presented words, nor any implicit memory bias. Findings suggest that acute PTSD subjects have an attentional and memory bias for threat-related material. Methodological limitations of the study are reviewed, and it is proposed that further studies are needed in order to elucidate whether acute PTSD Ss display a preattentive and implicit memory bias for trauma-related material.

Attention↗
PubMed2001

Cognitive-behavior therapy vs exposure therapy in the treatment of PTSD in refugees.

The present study investigated the efficacy of cognitive-behavior therapy (CBT) and exposure therapy (E) in the treatment of post-traumatic stress disorder (PTSD) in refugees. Sixteen outpatients fulfilling the DSM-IV criteria for PTSD were randomized to one of the two treatments. Assessor and self-report measures of PTSD-symptoms, generalized anxiety, depression, quality of life and cognitive schemas were administered before and after treatment, and at a 6-month follow-up. The patients were treated individually for 16-20 weekly sessions. The results showed that both treatments resulted in large improvements on all the measures, which were maintained at the follow-up. There was no difference between E and CBT on any measure. E and CBT led to a 48 and 53% reduction on PTSD-symptoms, respectively, a 49 and 50% reduction on generalized anxiety, and a 54 and 57% reduction on depression. The results were maintained at the 6-month follow-up. The conclusion that can be drawn is that both E and CBT can be effective treatments for PTSD in refugees.

Adult↗
PubMed2001

One vs five sessions of exposure and five sessions of cognitive therapy in the treatment of claustrophobia.

Forty-six patients fulfilling the DSM-IV criteria for claustrophobia were assessed with behavioral, physiological, and self-report measures. They were randomly assigned to four conditions: (1) one-session (E1); or (2) five-sessions of exposure (E5); (3) five-sessions of cognitive therapy (C5); and (4) Wait-list for 5 weeks. The first condition consisted of a single 3 h session of massed exposure, and condition 2 and 3 of 5 h of gradual treatment, which was done individually by very experienced therapists. The results showed that treatment was significantly better than the wait-list condition, and the three treatments did equally well with no differences between them. At post-treatment 79% of treatment patients vs 18% of the wait-list controls had improved to a clinically significant extent. When the three treatments were compared 80% in the E1-group, 81% in the E5-group, and 79% in the C5-group were clinically improved. At the 1 year follow-up the corresponding figures were 100%, 81%, and 93%, respectively. The implications of these results are discussed.

Adolescent↗
PubMed2001

One-Session treatment of specific phobias in youths: a randomized clinical trial.

Sixty children, ages 7-17 years, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis for various specific phobias were randomized to (a) 1-session exposure treatment alone, (b) 1-session treatment with a parent present, or (c) wait-list control group for 4 weeks. After the waiting period, the wait-list patients were rerandomized to the active treatments. The patients' phobias were assessed with behavioral approach tests (approach behavior, experienced anxiety, and physiological reactions), whereas general anxiety, depression, phobic tendencies, and anxiety sensitivity were assessed with self-report inventories. Assessments were done pre-, post-, and 1-year following treatment. Results showed that both treatment conditions did significantly better than the control condition, whereas the treatment groups did equally well on most measures, and the effects were maintained at follow-up. The implications of these results are discussed.

Adolescent↗
PubMed2000

Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder.

The present study investigated the efficacy of a coping-technique, applied relaxation (AR) and cognitive therapy (CT), in the treatment of generalized anxiety disorder. Thirty-six outpatients fulfilling the DSM-III-R criteria for generalized anxiety were assessed with independent assessor ratings and self-report scales before and after treatment and at a 1 yr follow-up. The patients were randomized and treated individually for 12 weekly sessions. The results showed that both treatments yielded large improvements, which were maintained, or furthered at follow-up. There was no difference between AR and CT on any measure. The drop-out rate was 12% for AR and 5% for CT. The proportions of clinically significantly improved patients were 53 and 62% at post-treatment and 67 and 56% at follow-up for AR and CT, respectively. Besides affecting generalized anxiety the treatments also yielded marked and lasting changes on ratings of worry, cognitive and somatic anxiety and depression. The conclusion that can be drawn is that both AR and CT have potential as treatments for generalized anxiety disorder but they have to be developed further in order to increase the efficacy to the level usually seen in panic disorder, 80-85% clinically improved.

Adult↗
PubMed2000

Probability ratings in claustrophobic patients and normal controls.

Forty-nine DSM-IV diagnosed claustrophobics and 49 sex- and age-matched community controls, without any current or past psychiatric disorder, were asked to estimate the probability that three types if events would occur if they were in the described situations. The events were claustrophobic, generally negative, and positive in nature. The results showed that claustrophobics significantly overestimated the probability of events they specifically feared, i.e. the claustrophobic events, while there was no difference between the groups regarding generally negative events and positive events. This finding remained when the higher scores for claustrophobics on the Claustrophobia scale and the Anxiety Sensitivity Index were covaried out. The conclusion that can be drawn is that claustrophobics' probability ratings are characterized by distortions that are specifically connected to anxiety-arousing events and not negative events in general. The hypothesis is proposed that this may be explained by an exaggerated use of simplified rules-of-thumb for probability estimations that build on availability in memory, simulation, and representativity.

Adult↗
PubMed1999

Cognitions in generalized anxiety disorder and panic disorder patients. A prospective approach.

Self-observations of cognitions during episodes of anxiety were examined in 38 patients with generalized anxiety disorder and 36 patients with panic disorder. Two independent observers who where blind to the diagnoses categorised the cognitions. The inter-rater reliability was high (mean kappa 0.82). The GAD-patients had significantly more cognitions in the following categories: interpersonal confrontation, competence, acceptance, concern about others and worry over minor matters, while the PD-patients had significantly more cognitions in the physical catastrophe category. Furthermore, GAD-patients with a comorbidity of social phobia reported more cognitions regarding social embarrassment than did GAD-patients with other or no (axis-I) comorbidity. The results of this study support the cognitive theory regarding the cognitive specificity of anxiety disorders. The implications of these results are discussed, along with the issues of reliability and validity of the instrument used.

Adolescent↗
PubMed1999

Perfectionism and self-consciousness in social phobia and panic disorder with agoraphobia.

Social phobics were compared to patients with panic disorder with agoraphobia and normal controls on perfectionism and self-consciousness. On concern over mistakes and doubts about action, social phobics scored higher than patients with panic disorder. Social phobics also demonstrated a higher level of public self-consciousness than patients with panic disorder and when this difference was controlled for the significant differences on perfectionism disappeared. Within each patient group, however, perfectionism was more robustly related to social anxiety than was public self-consciousness, which replicates the findings of Saboonchi and Lundh [Saboonchi, F. & Lundh, L. G. (1997). Perfectionism, self-consciousness and anxiety. Personality and Individual Differences, 22, 921-928.] from a non-clinical sample. The results are discussed in terms of public self-consciousness being a differentiating characteristic of the more severe kind of social anxiety which is typical of social phobia.

Adult↗
PubMed1999

Preattentive bias for emotional information in panic disorder with agoraphobia.

A combined emotional Stroop and implicit memory (tachistoscopic identification) task with 3 types of words (panic-related, interpersonal threat, and neutral words) and 2 exposure conditions (subliminal, supraliminal) was administered to 35 patients with panic disorder and 35 age- and sex-matched controls. The patients showed Stroop interference for panic-related words both sub- and supraliminally and a similar but not equally robust effect on interpersonal threat words. On the tachistoscopic identification task, the patients identified more panic-related words than the controls did but showed no implicit memory bias effect. The patients' subliminal Stroop interference for panic-related words was found to correlate with trait anxiety and depression, although not with anxiety sensitivity.

Adult↗
PubMed1998

A clinical study of spider phobia: prediction of outcome after self-help and therapist-directed treatments.

The present clinical study was aimed at investigating predictors of treatment success, attrition and the extent of treatment needed to achieve clinically significant improvement in spider phobic patients. A total of 103 patients were included in the study after a detailed screening interview. There were four treatment conditions; self-help manual, video, group, and individual treatment, which the patients received in a hierarchical order providing they were not clinically significantly improved after the previous treatment. Pre and post each treatment the patients went through a behavioral approach test and filled in a number of self-report questionnaires. The results showed that 38 patients dropped out during the manual treatment, and 59 fulfilled the treatments to become clinically improved. The patients achieving clinical improvement after the two self-help treatments were significantly predicted, as was the extent of treatment needed. The significant predictors were credibility of the manual treatment and motivation for psychotherapy in general.

Adult↗
PubMed1998

Recognition bias for safe faces in panic disorder with agoraphobia.

Panic patients with agoraphobia were compared with normal controls on tasks of face recognition. The subjects were presented with 20 photos, and were required to make a judgement of the persons on the photos; shortly afterwards they were unexpectedly presented with a recognition task. In the first study, one task was to judge whether the persons on the photos were critical or accepting: unlike social phobics (Lundh and Ost, 1996b, Behaviour Research and Therapy, 34, 787-794), panic patients showed no bias for critical vs accepting faces on the recognition task. In a secondary study, the task was to judge whether the persons on the photos were 'safe' or 'unsafe', i.e. whether they could be relied on if the subject would need help in some situation. The results showed a recognition bias for safe vs neutral faces in panic patients. The index of recognition bias for safe faces correlated with avoidance of feared situations when accompanied by others, as measured by the Mobility Inventory. The possibility that memory bias in emotional disorders is a function of basic concern, or functional importance, rather than positive/negative valence is discussed. The results are also discussed in terms of degree of elaboration, exposure duration of the stimuli, and the generality of the findings.

Adult↗
PubMed1997

Explicit and implicit memory bias in social phobia. The role of subdiagnostic type.

Fourty-five patients with social phobia and 45 normal controls were compared on explicit memory (cued recall) and implicit memory (word stem completion) for positive, neutral, social threat, and physical threat words. Although there were no significant differences between the social phobics and the normal controls, the subgroup of patients with non-generalized social phobia showed an implicit memory bias for social threat words. The results are discussed in terms of a critical analysis of the concept of implicit memory bias, which is operationalized as the difference between a bias on primed and unprimed words, and where the latter represents a "baseline bias". In the present study, this baseline word completion bias for social threat words showed a strong negative correlation (r = -0.72) with the implicit memory bias for social threat words, and showed positive correlations with several psychopathology-related measures among the social phobics. It is suggested that future research should consider results on both implicit memory bias and its corresponding baseline bias. The possibility is discussed that implicit memory bias and baseline bias may serve as indexes of externally and internally generated priming effects, and that the relative contributions of external and internal priming may differ in different subtypes of social phobia.

Adult↗
PubMed1997

One-session group therapy of spider phobia: direct versus indirect treatments.

Forty-six patients with spider phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to three group treatment conditions: (1) direct treatment; (2) direct observation; and (3) indirect observation. All treatments were carried out in large groups of eight patients, and consisted of one 3 hr session of massed exposure and modelling. The results showed that on the behavioral test, measures and the specific self-report measures of spider phobia the direct treatment was significantly better than direct observation and indirect observation, which did not differ. On the physiological measures and the psychopathology self-report measures there were significant pre-post improvements, but no differences between the groups. The effects were maintained or furthered at the one year follow-up assessment. The proportion of clinically significantly improved patients were, at post-treatment, 75% in the direct treatment, 7% in the direct observation, and 31% in the indirect observation group. At follow-up, the corresponding figures were 75, 14, and 44%, respectively. The conclusion that can be drawn is that direct treatment is the treatment of choice.

Adult↗
PubMed1997

Explicit and implicit memory bias in panic disorder with agoraphobia.

Thirty patients with a diagnosis of panic disorder with agoraphobia and 30 normal controls were compared on explicit memory (cued recall) and implicit memory (word stem completion) for positive, neutral, social threat, and physical threat words. The panic patients showed an explicit memory bias, but no implicit memory bias, for physical threat words. The index of explicit memory bias for physical threat words was found to correlate with anxiety sensitivity and degree of agoraphobic fear and avoidance. The index of baseline bias for threat words on the word completion task, on the other hand, correlated with trait anxiety. Although there were no correlations between explicit and implicit memory bias for physical threat words, explicit memory bias for physical threat words correlated with explicit memory bias indexes for positive words and social threat words. The results are discussed in terms of the functional role of an explicit memory bias for physically threatening events in panic disorder. The negative results on implicit memory bias are discussed in relation to earlier studies, the use of different implicit memory tasks, and the role of baseline bias on implicit memory tasks. Finally, the hypothesis is suggested that explicit and implicit memory bias for emotional information may represent two different styles of information processing, which serve as vulnerability factors for different emotional disorders.

Adult↗
PubMed1997

One versus five sessions of exposure in the treatment of flying phobia.

Twenty-eight patients with flying phobia, fulfilling the DSM-IV criteria for specific phobia, were assessed with behavioral, and self-report measures. They were randomly assigned to two treatment conditions: (1) 1-session, or (2) 5-sessions of exposure and cognitive restructuring. The first condition consisted of a single 3 hr session of massed treatment, and the second condition of 6 hr of gradual treatment. Treatment was done individually by very experienced therapists. The results showed that the two treatment conditions did equally well and there were no differences between them. At post-treatment 93% of the 1-session group and 79% of the 5-session group managed to take an unaccompanied return fight. At the 1-yr follow-up assessment the effects were maintained on all measures except the behavioral test; in both groups 64% of the patients took the flight. The most plausible reason for this deterioration is that during the follow-up year the subjects who relapsed didn't have the opportunity to fly as a job requirement with the employer paying the expenses. The implications of these results are discussed.

Adult↗
PubMed1997

Misinterpretation of body sensations in panic disorder.

Cognitive accounts of panic predict that panic disorder patients will be particularly prone to misinterpret autonomic sensations. Several studies have produced results consistent with this prediction, but each is open to alternative interpretation. To clarify matters, 2 studies administered the Body Sensations Interpretation Questionnaire (BSIQ) to panic patients and controls. Panic patients were more likely to interpret ambiguous autonomic sensations as signs of immediately impending physical or mental disaster and were more likely than other anxiety disorder patients and nonpatients to believe these interpretations. In a 3rd study, a brief version of the BSIQ was shown to have satisfactory test-retest reliability, to change with treatment, and to discriminate treatments that varied in their effects on panic.

Adult↗
PubMed1996

One versus five sessions of applied tension in the treatment of blood phobia.

Thirty patients with blood phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to 3 different conditions: (1) 5 sessions of applied tension; (2) 1 session of applied tension (maximum 2 h); and (3) I session of tension-only (maximum 2 h). The results showed that the patients in the 3 treatments were all significantly improved at post-treatment and the effects were maintained at the 1 yr follow-up. At post-treatment and follow-up the proportions of clinically improved patients were: AT5 50 and 60%, AT1 0 and 70%, and T1 30 and 60%, respectively. The conclusion that can be drawn is that I-session therapist-directed applied tension or tension-only is the treatment of choice for blood phobia, but completed with a maintenance program of self-exposure.

Adolescent↗