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R G Heimberg

Publications and source records attributed to R G Heimberg.

At least 73 records · Page 4Linked to original sources
PubMed1993

Specific issues in the cognitive-behavioral treatment of social phobia.

Cognitive-behavioral approaches to the treatment of social phobia are selectively reviewed. The review examines three specific questions of importance in the cognitive-behavioral treatment literature: (1) What is the role of cognitive techniques in the treatment of social phobia, especially in conjunction with behavioral techniques like in vivo exposure or social skills training? (2) Is there long-term maintenance of gains as a result of cognitive-behavioral treatment of social phobia? (3) How does cognitive-behavioral treatment of social phobia compare with pharmacologic treatment approaches? This review presents studies that address these questions, offers tentative answers, and outlines directions for future research on the cognitive-behavioral treatment of social phobia.

Atenolol↗
PubMed1992

Reaction time to threat stimuli in panic disorder and social phobia.

Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes.

Adult↗
PubMed1992

Personal and parental problem drinking: effects on problem-solving performance and self-appraisal.

This study examined the problem-solving performances and self-appraisals of problem-solving ability of college-age subjects with and without parental history of problem drinking. Contrary to our predictions, children of problem drinkers (COPDs) were rated as somewhat more effective in their problem-solving skills than non-COPDs, undermining prevailing assumptions about offspring from alcoholic households. While this difference was not large and was qualified by other variables, subjects' own alcohol abuse did exert a detrimental effect on problem-solving performance, regardless of parental history of problem drinking. However, a different pattern was evident for problem-solving self-appraisals. Alcohol-abusing non-COPDs saw themselves as effective problem-solvers while alcohol-abusing COPDs appraised themselves as poor problem-solvers. In addition, the self-appraisals of alcohol-abusing COPDs were consistent with objective ratings of solution effectiveness (i.e., they were both negative) while alcohol-abusing non-COPDs were overly positive in their appraisals, opposing the judgments of trained raters. This finding suggests that the relationship between personal alcohol abuse and self-appraised problem-solving abilities may differ as a function of parental history of problem drinking. Limitations on the generalizability of findings are addressed.

Adult↗
PubMed1992

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. We classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns = 10 and 10) and nongeneralized social phobics without APD (n = 10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with APD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information but the additional diagnosis of APD may simply identify a severe subgroup of social phobics.

Adult↗
PubMed1991

New developments in cognitive-behavioral therapy for social phobia.

Significant advances in cognitive-behavioral therapy for social phobia have occurred during the past 5 years. A new psychobiological model of social anxiety is described, and recent controlled clinical trials are reviewed. An effective cognitive-behavioral approach to therapy for social phobia developed in the authors' setting is described with case studies. Finally, future directions in cognitive-behavioral approaches to therapy for social anxiety, including clinical trials of interactive approaches that combine drug therapy with behavioral therapy and of intensive treatment of patients with avoidant personality disorder, are described briefly.

Adult↗
PubMed1990

DSM-III-R subtypes of social phobia. Comparison of generalized social phobics and public speaking phobics.

Social phobic patients who fear most or all social interaction situations are labeled generalized social phobics in DSM-III-R. Thirty-five patients who met this criterion were compared with 22 social phobic patients whose fears were restricted to public speaking situations. Generalized social phobics were younger, less educated, and less likely to be employed, and their phobias were rated by clinical interviewers as more severe than those of public speaking phobics. Generalized social phobics appeared more anxious and more depressed and expressed greater fears concerning negative social evaluation. They performed more poorly on individualized behavioral tests and differed from public speaking phobics in their responses to cognitive assessment tasks. The two groups showed marked differences in their patterns of heart rate acceleration during the behavioral test. The implications of these findings for the classification and treatment of social phobic individuals are discussed.

Adult↗
PubMed1989

An analysis of the significance of performance errors on the Trail Making Test in polysubstance users.

The Trail Making Test performance of a group of polysubstance users was evaluated in order to analyze the stability of performance errors between two administrations. Two categories of errors were identified: sequential (Part A) and sequential and/or perseverative (Part B). The general findings revealed statistically significant test-retest effects. The utility of performance errors as indicators of stable CNS dysfunction is discussed in view of these findings.

Journal Article↗
PubMed1988

Public and private self-consciousness and social phobia.

The relationship between public and private self-consciousness and self-report questionnaires, clinician ratings, and various measures derived from an individualized simulation of an anxiety-provoking situation was examined in a sample of men and women seeking treatment for social phobia. As predicted, public, not private, self-consciousness was generally related to self-report and naive observer ratings of anxiety and to behavioral disruption during the simulation. The predicted relationship between public self-consciousness and how accurately subjects evaluated their performance in the anxiety-provoking situation was marginally supported. Hypotheses regarding the relationship between private self-consciousness and self-reported anxiety during an anxiety-provoking situation, and between private self-consciousness and the correspondence between physiological assessment and self-report, were not supported. The discussion focuses on methodological issues and the theoretical implications of the relationship between self-consciousness and social anxiety.

Adult↗
PubMed1988

A comparison of the trail making test, symbol digit modalities test, and the Hooper Visual Organization Test in an inpatient substance abuse population.

Ninety inpatients from a substance abuse treatment facility each completed the Symbol Digit Modalities Test, the Trail Making Test and a novel, group-administered form of the Hooper Visual Organization Test. Patients exhibited varying degrees of impairment on all three instruments compared to available norms. The correlations among the tests were all statistically significant. The lowest inter-test correlations were obtained on the Hooper Visual Organization Test. The utility of global neuropsychological screening instruments with inpatient substance abusers' is discussed in light of these findings.

Journal Article↗
PubMed1985

Evaluations and consequences of assertive behavior.

Male and female high assertive and low assertive subjects observed videotaped scenes of actors exhibiting assertive, empathic-assertive, and nonassertive behavior in response to unreasonable requests made by acquaintances. Subjects provided evaluative ratings of actors in the different scenes and rated the likelihood of various consequences that might follow from the actors' behaviors. Generally, empathic-assertive behavior was more positively received than assertive behavior. Empathic assertion received high ratings on dimensions of competence and likeability and was associated with expectations of positive consequences of a social (i.e. requestor's reactions to the actor's behavior) or personal (i.e. the actor's own feelings) nature. In contrast, both empathic-assertion and assertion were believed to result in more negative long-term consequences (i.e. the effect the actor's responses will have on the relationship in the long run) than nonassertive behavior. These effects were modified by the sex of the requestor and the sex and assertiveness of the subject, but unaffected by the sex of the actor. Implications of these findings for research and training of assertive behavior are discussed.

Assertiveness↗
PubMed1985

Treatment of social phobia by exposure, cognitive restructuring, and homework assignments.

Seven patients who experienced clinically significant anxiety in situations involving public speaking or heterosexual performance and who had received a DMS-III diagnosis of social phobia participated in a 14-week program of cognitive-behavioral treatment. Treatment was conducted in a group format and consisted of: imaginal exposure, in which patients visualized their own participation in phobic events; performance-based exposure, in which patients enacted simulated phobic situations during sessions; cognitive restructuring, in which patients' cognitions experienced during exposure situations were assessed and analyzed; and systematic homework assignments involving the confrontation of environmental events previously simulated in the group. Self-report, behavioral, and physiological measures of anxiety were collected weekly during baseline and treatment periods, and additional measures were collected before and after treatment. After treatment, most patients demonstrated significant gains, and improvements were maintained at 3-month and 6-month follow-ups.

Adult↗
PubMed1983

Dry bed training without a urine alarm: lack of effect of setting and therapist contact with child.

Three variations in the mode of delivery of Dry Bed Training as a treatment for nocturnal enuresis were investigated. Twenty-three children, ranging in age from 4 to 14, received dry bed training without the additional use of a urine alarm. Treatment variations included: (a) in-home training of parents and child, (b) office based training of parents and child, and (c) office based training of parents only. An additional 7 children served as a waiting list control during the first 8 weeks of the study. A wide variety of outcome measures showed improvement for the entire sample regardless of specific mode of delivery. Implications for the treatment of enuresis using dry bed training and a number of critical methodological issues are discussed.

Adolescent↗
PubMedDate not supplied

Relationship between ADIS clinician's severity rating and self-report measures among social phobics.

Although global clinical rating scales have been a mainstay of clinical research, little is known about the relationship between these measures and other assessment modalities. The present study examined the Clinician's Severity Rating (CSR) from the Anxiety Disorders Interview Schedule in a sample of 186 social phobics. It was hypothesized that the CSR would be related to higher fear of negative evaluation, behavioral avoidance, social anxiety, and dysphoria, and that four self-report measures reflecting each of these common features of social phobia would contribute individually to predict clinicians' judgments of clinical severity using the CSR. Multiple regression analyses supported these hypotheses, accounting for nearly 33% of the variance in the CSR. The role of subtype of social phobia was also investigated. Overall, these results support the utility of the CSR for use with social phobics, but the relatively low proportion of variance accounted for raises further questions. Directions for future research are also discussed.

Adolescent↗
PubMedDate not supplied

Quality of life in social phobia.

The person's perception of his or her quality of life has been neglected in studies of mental health in general and anxiety disorders in particular. However, the judgement of the impact of a mental disorder based on symptomatic distress while ignoring one's overall quality of life is incomplete. In the present study, we examined social phobic patients' judgments of their satisfaction with various domains of life they deem important using the Quality of Life Inventory (QOLI; Frisch, unpublished). Social phobics judged their overall quality of life lower than Frisch's (unpublished) normative sample. Quality of life was inversely associated with various measures of severity of social phobia (especially social interaction anxiety), functional impairment, and depression. It was not, however, related to performance anxiety or trait anxiety. Quality of life also varied across combinations of subtype of social phobia and the presence/absence of avoidant personality disorder, and as a function of marital status. Patients showed significant improvement in quality of life scores after completion of cognitive-behavioral group therapy for social phobia.

Adult↗