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R Hoekstra

Publications and source records attributed to R Hoekstra.

66 records · Page 4Linked to original sources

Conditioning experiences and phobias.

A retrospective study was conducted to examine the extent to which phobias are associated with a conditioning pathway to fear. The Phobic Origin Questionnaire (Ost and Hugdahl, Behav. Res. Ther. 19, 439-477, 1981) was administered to a sample of 91 phobic outpatients (patients with panic disorder with agoraphobia, social phobics, simple phobics). Results show clearly that conditioning experiences occur more frequently than either vicarious or informational, learning experiences, which confirms the findings previously reported by Rimm, Janda, Lancaster, Nahl and Dittmar (Behav. Res. Ther. 15, 231-238, 1977) and by Ost and Hugdahl (1981; Behav. Res. Ther. 21, 623-631, 1983). Yet, conditioning experiences consist mainly of panic attacks in confirmed environments. The findings also suggest that a considerable number of phobias are based on a combination of different pathways to fear.

Adult↗

Personality disorders do not influence the results of cognitive and behavior therapy for obsessive compulsive disorder.

This study examined whether categorical or dimensional personality disorder variables affected treatment outcome in a sample of 52 patients with obsessive compulsive disorder who followed a standardized cognitive behavior therapy program. Treatment consisted of 12 weekly sessions and was completed by 43 patients. The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was taken before the start of treatment by an independent rater. The treatment outcome measures included questionnaires and a Behavioral Assessment Test. Measurements were taken before and after treatment, and at 1 and 6 month follow-up tests. After the first follow-up test, further treatment was provided if clinically indicated. Neither categorical, nor dimensional personality disorder variables affected treatment outcome significantly. The inclusion of drop-outs in the analyses, did not change these results. Therefore, patients with obsessive compulsive disorder and concomitant personality disorder pathology should not be excluded from cognitive or behavior therapy for their obsessive compulsive complaints. Attributing therapy failure to concomitant Axis II pathology should be approached with caution.

Adolescent↗

Hyperventilation is not diagnostically specific to panic patients.

It has been claimed that hyperventilation is a cause of panic attacks in patients suffering from panic disorder (PD), and various studies have, in fact, documented low resting CO2 in PD patients. However, most comparisons have been made using non-psychiatric controls. Since increased ventilation is a common concomitant of distress, the relevance of using healthy/non-anxious control groups may be questioned. Respiratory peculiarities of PD patients may actually just reflect background anxiety rather than a diagnostically specific feature. In order to explore the possible diagnostic specificity of hyperventilation, as well as increased respiratory rate and respiratory variability, to PD patients, capnographic patterns were analyzed from PD patients, non-panic disorder anxiety patients, and healthy controls. Capnographic data were obtained while subjects were resting, watching an exciting film, relaxing, and being exposed to idiosyncratically relevant fearful imagery. Findings were robust. As found in most studies, PD patients had lower resting CO2 than healthy controls; however, that of non-panic disorder anxiety patients was just as low as PD patients. The exciting film and fearful imagery produced consistent increases in distress and concomitant increases in respiratory rate, variability of end-tidal CO2, and decreases in end-tidal CO2. However, this was similar in all three groups. Data suggest that hyperventilation is not specific to PD patients.

Adult↗