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Results for “Desensitization, Psychologic”

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PubMed1998

Virtual reality treatment of claustrophobia: a case report.

The efficacy of a treatment for claustrophobia using only Virtual Reality (VR) exposure was examined. The subject was a 43-year-old female who suffered from clinically significant distress and impairment and sought psychological therapy. Eight individual VR graded exposure sessions were conducted. All self-report measures were reduced following VR exposure and were maintained at one month follow-up. The necessity of a theoretical framework for this new medium for exposure therapy is discussed.

Adult↗

PubMedDate not supplied

Use of eye movement to reduce stress after trauma.

In 1987 an accidental discovery revealed an association between certain eye movements and reduced levels of distress resulting from traumatic memories. The result was a new psychological intervention, eye movement desensitisation and reprocessing (EMDR). The treatment consists of generating rapid and rhythmic eye movements while simultaneously holding traumatic images, thoughts and emotions in the active memory. This paper describes the experiences of one psychotherapist in using EMDR to treat people with post-traumatic stress disorder. Six case studies illustrate aspects of this complex treatment.

Desensitization, Psychologic↗

PubMed2000

Self-focused attention before and after treatment of social phobia.

It has been hypothesized that effective psychological treatment for social phobia changes the person's representation of the self in a more positive direction. In order to test this hypothesis, we analyzed 506 thoughts that were endorsed by 23 social phobic individuals while anticipating socially stressful situations before and after exposure therapy. Treatment efficacy was assessed with the Social Phobia and Anxiety Inventory (SPAI) [Turner, S. M., Beidel, D. C., Dancu, C. V., & Stanley M. A. (1989) An empirically derived inventory to measure social fears and anxiety: the Social Phobia and Anxiety Inventory. Psychological Assessment, 1, 35-40)]. Subjects endorsed significantly fewer negative self-focused thoughts after treatment (on average 8.7% of the thoughts) than before treatment (26.5%, p < 0.005). These changes were highly correlated with pre-post difference scores in the social phobia subscale of the SPAI (r = 0.74, p < 0.0001). Implications of the results for the cognitive model of social phobia will be discussed.

Adult↗

PubMed1993

Attentional bias and spider phobia: conceptual and clinical issues.

Experimental evidence indicates that anxious subjects show an attentional bias for threat-relevant information. Foa and McNally (1986) (Cognitive Therapy and Research, 10, 477-485) and Watts et al. (1986) (British Journal of Psychology, 77, 97-108) reported that behaviour therapy can eliminate this attentional bias. A replication study was carried out in order to increase the evidence for exposure being the crucial component in reducing attentional bias. Moreover, in this study some conceptual and clinical issues are explored. The theoretical and clinical implications of the results are discussed.

Adult↗

PubMed1982

Multiple approaches to the reduction of dental fear.

Participant modeling, symbolic modeling, and graduated exposure were compared with each other and with two control treatments for effectiveness in reducing fear of dentistry in 33 adults who had avoided dental treatment for from 1 to 10 yr. Assessment of in-chair psychological responsiveness and overt behavior showed no significant pre-post change for any group although all of them reported significant reduction in state anxiety and expected pain. During the 24 months following treatment, from 50 to 87.5% of the subjects were able to return to regular dental care with the highest "return" rate appearing in the participant modeling condition.

Adult↗

PubMed2001

A VR-based multicomponent treatment for panic disorders with agoraphobia.

Agoraphobia consists of a group of fears of public places such as going outside, using public transportation and being in public places, which cause serious interference in daily life. Many studies demonstrated the effectiveness of a multicomponent cognitive-behavioral treatment strategy for panic disorder with agoraphobia. The traditional protocol involves a mixture of cognitive and behavioral techniques which are intended to help patients identify and modify their dysfunctional anxiety-related thoughts, beliefs and behavior. Emphasis is placed on reversing the maintaining factors identified in the cognitive and behavioral patterns. We use Virtual Reality (VR) to support Panic Disorder treatment. The preliminary treatment protocol for Panic Disorder and Agoraphobia, named Experiential-Cognitive Therapy (ECT), was developed at the Applied Technology for Neuro-Psychology Lab of Istituto Auxologico Italiano, Verbania, Italy, in cooperation with the Psychology Department of the Catholic University of Milan, Italy. The actual version included the efforts of researchers from the Center for Advanced Multimedia Psychotherapy, California School of Professional Psychology, San Diego (CA), USA, and from the Seoul Paik Hospital, Inje University, Seoul, Korea. The goal of ECT is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms. The characteristics of the approach will be presented through the description of the clinical protocol.

Agoraphobia↗

PubMed1994

Memory functions, alprazolam and exposure therapy: a controlled longitudinal study of agoraphobia with panic disorder.

Benzodiazepines (BZs) produce transient anterograde amnesia when given to normal subjects. The present longitudinal study assessed whether BZs impair memory functions in a clinically anxious group. Eighty-two agoraphobics with panic disorder were randomly allocated to one of four treatment groups resulting from a combination of two drug treatments (alprazolam or placebo) and two psychological treatments (exposure or relaxation). Of these, 38 subjects were assessed on a range of objective and subjective indices of memory and mood at three time points: before treatment, after 8 weeks of treatment and again at 24 weeks when patients had been free of medication from 5-8 weeks. Alprazolam produced pronounced impairments on a word recall task. At the 24-week medication-free follow-up, alprazolam patients were still impaired on the task compared with placebo patients. Alprazolam did not impair performance on an implicit memory task and did not affect digit span. Differences between psychological treatments emerged mainly in subjective memory effects. Findings are discussed in terms of the specificity of BZ-induced amnesia and differential tolerance to the varying effects of BZs. Implications are drawn out for the patient's ability to function optimally in daily life while taking alprazolam.

Adult↗

PubMed1997

New hope for a disabling condition. Cognitive-behavioral approaches to panic disorder.

1. Panic disorder, which encompasses both biological and psychological dimensions, is a common anxiety-related problem that can result in significant disability. 2. Cognitive-behavioral approaches to panic disorder are effective in 70% to 80% of patients treated, and generally involve a combination of patient education, relaxation training, exposure, and cognitive restructuring. 3. Mental health nurses can benefit their panic disorder patients by becoming aware of cognitive-behavioral treatment options, and should consider adding these methods to their repertoire of therapeutic skills.

Cognitive Behavioral Therapy↗

PubMed1993

Psychological treatment of panic: work in progress on outcome, active ingredients, and follow-up.

Initial interest in the causes and treatment of panic disorder was triggered by biological theories and investigators. More recently, however, research on newly developed psychological approaches for panic has advanced our understanding of the disorder and has led to the development of specific treatment programs. Typically, these programs consist of a range of treatment components that more or less directly target panic attacks and the fears and behaviors associated with them. The paper reviews four studies evaluating these programs that have recently been completed or are close to completion in different centers in the United States (Albany, New York; Austin, Texas) and Europe (Oxford, England; Marburg, Germany). Conforming to strict methodological standards, these studies report consistently high success rates and temporal stability of the treatment gains. About 80% or more of the patients receiving combined cognitive-behavioral treatments achieved panic free status as well as strong and clinically significant improvement in general anxiety, panic-related cognitions, depression, and phobic avoidance. Furthermore, these gains were maintained at follow-ups of up to 2 years. The success of these psychological treatments compares favorably with the outcome for the established pharmacological treatments. In addition, the studies provide new insights into the active ingredients that may operate in cognitive-behavioral treatments for panic disorder and show the feasibility of group treatments. Together, these studies underscore the fact that cognitive-behavioral treatments rest on firm experimental evidence that justifies their application in everyday practice as well as continued research into their mechanisms of action.

Arousal↗

PubMed1976

Personality, expectancies and group psychotherapy.

The paper reports an extension of work into the relevance of personality and pre-treatment expectancies for allocation and response of patients to group psychotherapy. The results show that subjects who are internally directed in interest and who have a liberal attitude to a variety of social issues and a "psychological" set to treatment are more responsive to group psychotherapy as seen by their therapists as well as by themselves. Those who are externally directed in interest and who have a conservative attitude to life and a more "medical-physical" set to treatment are more likely to be referred for behaviour therapy; if referred for group psychotherapy they are likely either to drop out or to show very limited response to treatment.

Adult↗

PubMed2000

[Psychopathology and treatment of traumatic mental disorders--on the vicissitude and controversy around theory and practice].

Recently, among advanced nations, including the United States, there have been growing interest in trauma related psychopathology. Regarding Japan, since Hanshin Awaji Great Earthquake and Sarin gas terrorism by Aum Shinrikyo, interest for psychological trauma has grown high. It is only about twenty years since active research and discussion around these issues started. Therefore, there are still hot dispute around psychopathology of these disorders. Also, therapeutic method is ever progressing. Regarding psychotherapy, there remain a lot of dispute and no general agreement has been made. In this paper, I would like to summarize the literature on psychological trauma and trauma-related psychopathology historically and provide current overview about the theory and practice of this pathology. The summary of the overview is as follows: 1. Psychological trauma is defined as a state caused by traumatic event described in DSM-IV, not as a traumatic event itself. Traumatic mental disorder should be understood as a spectrum of disorders, ranging from phobias and panic reactions related to distinct traumatic events to personality disorders, where intense and chronic traumatic experience is integrated into the personality organization. 2. Historically speaking, traumatic disorders were studied from two directions; war neuroses and etiology of hysteria. Each is corresponds to physioneurosis model and memory processing disturbance model, respectively, which is thought to be two major etiological models of this disorder. 3. Regarding treatment, although corresponding therapeutic idea for each model is provided, currently, most promising treatments are pharmacotherapy using SSRI and novel cognitive-behavioral techniques such as PE (prolonged exposure treatment), SIT (stress inoculation training) and EMDR (eye movement desensitization and reprocessing). As for psychotherapy, hot arguments has been done as to how authentic recovered traumatic memories are and how to deal with them. Regardless of these disputes, it is essential to establish empathic therapeutic bond with the patients.

Antidepressive Agents, Tricyclic↗

PubMed2005

A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders.

OBJECTIVE: To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD). METHOD: Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed. RESULTS: Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness. CONCLUSION: Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders.

Cognitive Behavioral Therapy↗

PubMed1998

From toy to tool: the development of immersive virtual reality environments for psychotherapy of specific phobias.

Virtual Reality (VR) entered the mental health field some years ago. While the technology itself has been available for more than ten years now, there is still a certain amount of uncertainty among researchers and users as to whether VR will one day fulfill all it's promises. In this chapter we are giving an overview of the implementation of the technology in our mental health research facility in Basel, Switzerland. The development of two applications for use with claustrophobic and acrophobic patients perspectively serves just as an example within this context. Some may say, the chapter is too much based on technical considerations. Strictly speaking, VR is pure technology, even knowing that this special form of technology has sensory, psychological and even philosophical implications not known from other human computer interfaces so far. As far as we are concerned, the development of the technology for use within the mental health sector has merely just begun. As today's mostly used immersive output devices (Head-mounted Displays, shutter glasses) do not have a satisfactory resolution, do restrict movements and prevent multi-user-capabilities, there will be a soar of mental health applications the day some or at least the most important of these obstacles have been overcome.

Computer Simulation↗

PubMed1983

Some current treatment options for symptoms of anxiety.

The psychologic (i.e., psychotherapeutic or behavioral) and pharmacologic approaches available for the treatment of anxiety are reviewed. Accurate diagnosis and consideration of patient characteristics are essential in choosing among the numerous treatment options. Nonpharmacologic methods are generally the first treatment choice in situational and nonincapacitating anxiety. When anxiety is severe and prolonged, adjunctive drug treatment is appropriate, with antidepressants for phobic and panic states and anxiolytics for generalized anxiety disorder and mixed anxiety and depression. Benzodiazepines are currently the anxiolytics of choice; newer nonbenzodiazepine compounds may provide increased safety.

Aged↗

PubMed1989

Accident simulation as a new therapy technique for post-traumatic stress disorder. A case study.

Data are presented from clinical interviews and psychological tests of a helicopter pilot who had survived a helicopter crash. Within a week, the pilot developed severe stress reactions after the crash, dominated by guilt feelings, nightmares and fear of not being able to fly. Helicopter-accident training simulating a helicopter crashing into the water was used as part of the treatment. The therapeutic value and limitations of this type of treatment are discussed. The main benefit seemed to be the extinction of traumatic helplessness and the reestablishment of a positive response-outcome expectancy. Existential conflicts were not covered by the simulator training.

Accidents, Aviation↗

PubMed2001

"Echo attributions" and other risks when publishing on novel therapies without peer review.

A special series on Thought Field Therapy in the Journal of Clinical Psychology provides an opportunity for psychologists to learn about techniques and theories outside the mainstream of our field. Unfortunately, by publishing this series of manuscripts without meeting the standards of peer review, the Journal also provides an avenue for the misuse of its good reputation and the improper promotion of untested methods. "Echo attributions" can be made whereby an author attributes the source of his own words to the professional journal in which the text appears. Historical examples illustrate that such misuse of scientific journals and institutions occurs. A formal statement of guidelines is needed to instruct authors on appropriate versus unethical representations of their publications.

Advertising↗

PubMed2000

In-patient treatment for resistant obsessive-compulsive disorder.

Obsessive Compulsive Disorder is one of the increasing psychological disorders. If not detected early and treated properly, obsessive-compulsive disorder usually becomes an incapacitating illness adversely affecting almost all aspects of the patient's life. Outpatient behavioral and pharmacotherapies frequently fail. This is a report on a severe case of obsessive-compulsive disorder that was treated as an in-patient with both behavior and pharmacotherapies, she was then followed up for 5 years with no relapse. The case reflects the importance and the need for in-patient units for severe resistant obsessive compulsive cases especially in Saudi Arabia where we have an increasing number of such cases.

Adult↗

PubMed2002

Perseveration of traumatic re-experiencing in PTSD; a cautionary note regarding exposure based psychological treatments for PTSD when head injury and dysexecutive impairment are also present.

This case study describes the psychological treatment of a man with co-existing PTSD, head injury and mild dysexecutive impairment. It describes the detrimental consequences when the re-experiencing of a traumatic event appears to have become a perseverated response. In this case, the perseveration meant that the most distressing part of the traumatic event became unavoidable and lead to it being continuously re-experienced without remittance over a very prolonged period (7-10 days). This type of re-experiencing has not been reported before. It potentially has significant implications for the treatment of PTSD in such circumstances. It may also have implications for behavioural models of PTSD in general.

Acute Disease↗