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PubMed1978

Taped vs. "live" desensitization and level of autonomic arousal.

Investigated whether variations in method of presentation of anxiety items (Es voice, E's taped voice, S's taped voice) will result in differences in autonomic arousal (as measured by self-report, galvanic skin responses, cardiac rate, blood pressure). Ss were 24 Naval Academy midshipmen. The procedure involved (1) training in deep muscle relaxation; and (2) measuring arousal after the presentation of anxiety-eliciting stimuli. Statistical analysis indicated that the influence of method of presentation was significant for galvanic skin response and self-reported anxiety. Comparison of cell means showed that verbal presentations were more effective in eliciting autonomic arousal than taped presentations. The results of this study provide partial evidence to support the conventional form of systematic desensitization as more effective than the newer automated or taped versions.

Anxiety↗
PubMed1979

A comparison of self-delivered consequences and desensitization in the treatment of fear of rats.

Exposed 52 rat phobic Ss to either group desensitization, self-delivered consequences imagined exposure, self-delivered consequences in-vivo exposure, or no treatment. Self-delivered consequences Ss conducted the treatment on their own and self-delivered preselected reinforcers contingent upon performance of the treatment exercises. All treatment groups improved significantly more than the no-treatment control group. The self-delivered consequences imagined exposure and the group desensitization treatments were equally effective. The self-delivered consequences in-vivo exposure treatment was significantly more effective than the self-delivered consequences imagined exposure and group desensitization treatments. The applicability of self-management techniques to the treatment of fear responses to specific stimuli and an extinction explanation of the effectiveness of systematic desensitization are discussed.

Adult↗
PubMed1979

Graded imagination and relaxation as components of experimental desensitization: a psychophysiological evaluation.

Studied the effects of aversive imagery gradation and muscular relaxation as procedural variables within desensitization by using (pre-vs. posttreatment) peripherally cued electrodermal responsivity as the dependent-variable measure of fear. There was no evidence that experimental desensitization or any of its procedural components yielded attenuated electrodermal responsivity to the peripheral fear cue. Because this result derives from a relatively well-done study, it poses a challenge to widespread notions about the vehicle of therapeutic effects from desensitization.

Arousal↗
PubMed1979

The desensitization derby: in vivo down the backstretch, imaginal at the wire?

Recontacted 17 Ss who had undergone successful imaginal or in vivo desensitization for snake phobia and had been evaluated pre- and posttreatment for a 9-month follow-up. Main findings were that: (a) overall treatment gains were maintained through the follow-up period; (b) differential gains in favor of the in vivo technique on one behavioral and two self-report snake-specific criteria were dissipated; and (c) imaginal Ss registered a reduction in self-rated fear during an approach task from posttesting to follow-up. Results are discussed in relation to the notion of cognitive rehearsal as a means of self-reinforcing treatment gains.

Adult↗
PubMed1979

Relaxation therapy, desensitization, and the treatment of anxiety-based disorders.

Evaluated systematic desensitization and relaxation training for the treatment of snake phobia and test anxiety as representatives of two classes of anxiety-based disorders. Treatment outcomes were assessed by examining situational and dispositional components of anxiety as related to these disorders and by behavioral measures of performance in relevant anxiety-provoking situations. Analyses of variance revealed that more pervasive anxiety reductions occurred for the more focalized animal phobia and that there was little difference in the effectiveness of desensitization and relaxation training. The generalizability of research findings based on the treatment of animal phobias was questioned, and the possible role of nonspecific factors in determining success was considered.

Anxiety↗
PubMed1980

Relaxation and distraction in experimental desensitization.

Compared experimental desensitization with a procedure that replaced relaxation with a distraction task and with an approach that combined both relaxation and distraction (N = 50). Each of these treatments reduced snake phobia to a greater extent than control procedures; desensitization generally was more effective than the other two procedures. The results are discussed in terms of their relevance for "distraction" or "attentional" accounts of desensitization.

Animals↗
PubMed1981

Stress management skill for nursing students.

Assessed the effectiveness of a 10-session, 5-week, group-administered stress management program for nursing students. The stress management group included sessions on progressive relaxation, deep muscle relaxation, autogenic training, visual imagery and modified systematic desensitization. Ten female nursing students participated in the stress management group. A second group of nursing students (7 female and 1 male) served as a control group. State and trait anxiety measures were taken before the group began and immediately prior to both mid-term and final examinations. The stress management group effectively reduced trait anxiety (p less than .05), while the control group's trait anxiety levels remained relatively unchanged. The experimental group showed a reduction in state (test-taking) anxiety from mid-semester to final examinations, while the control groups showed a slight increase from mid semester to final examination.

Anxiety↗
PubMed1984

Desensitization of test anxious urban community-college students and resulting changes in grade point average: a replication.

Ninety-seven self-referred students applied for enrollment in a behavior modification program to reduce test anxiety. Those whose free time coincided with the workshop times served as the experimental group (N = 42), while the remainder served as the control group (N = 55). At the end of the treatment semester, results indicated that students who participated in the program had improved their academic averages more than the control group, as measured by Mann-Whitney U test. After the workshop series, the experimental group reported less debilitating anxiety than the control group, as measured by the Alpert-Haber Test Anxiety Questionnaire. There was no comparable finding for facilitating anxiety. These results support those reported by Hudesman and Wiesner (1979) on a similar sample.

Achievement↗
PubMed2002

Treatment of late-onset OCD following basal ganglia infarct.

Current consensus on the treatment of obsessive-compulsive disorder (OCD) includes cognitive behavior therapy (CBT) in the form of exposure and response prevention (ERP). However, the generalizability of these methods to elderly populations remains largely undocumented. This clinical case study examines the effectiveness of medications and intensive, inpatient ERP in an elderly patient with onset of OCD following basal ganglia infarcts. There was a dramatic reduction from baseline to follow-up in both obsessions and compulsions with Yale-Brown Obsessive-Compulsive Scale [YBOCS; Goodman et al., 1989] total scores decreasing by over 20 points. These gains were maintained up to 1 year post-treatment. Age-specific issues and the application of standard therapeutic methods to elderly clients are discussed.

Aged↗
PubMed2007

Sequential cognitive-behavioral therapy for children with obsessive-compulsive disorder with an inadequate medication response: a case series of five patients.

Few data have been reported on the efficacy of cognitive-behavioral therapy (CBT) for youth with obsessive-compulsive disorder (OCD) who have not responded to prior treatment with medication. Given this, we report an open trial of CBT for children who have remained symptomatic following medication trials. Five children with OCD who had an inadequate response to psychotropic medications (e.g., limited response and/or unable to be titrated to a complete dose due to side effects) received treatment in a 3-week intensive CBT program. Assessments were conducted at baseline and after treatment. All participants were classified as treatment responders (much improved or very much improved) and the severity of clinician-rated OCD symptoms and impairment significantly decreased after the intervention. Although a number of limitations of this preliminary report exist, this study provides preliminary support for the utility of an intensive intervention for youth with OCD who have had an inadequate response and/or adverse side effects.

Adolescent↗
PubMed2002

Body image treatment within an inpatient program for anorexia nervosa: the role of mirror exposure in the desensitization process.

OBJECTIVE: This pilot study examined the role of mirror confrontation in the desensitization process of a body image treatment within an inpatient program for anorexia nervosa. METHOD: A within-subjects design was used. It compared the impact of two modes of group body image treatment on body dissatisfaction, anxiety, and avoidance behaviors. Both treatments followed a set format of exposure exercises and homework, but the modified treatment also included mirror confrontation as an exposure exercise. RESULTS: Standard treatment did not produce any significant changes. Modified treatment produced a significant and sustained improvement in body dissatisfaction and a significant reduction in body anxiety and avoidance behaviors. DISCUSSION: Mirror confrontation is a more effective form of exposure because of the strong emotional response it elicits. Patients' pronounced emotional response to this exercise allowed easier identification of the affective and behavioral components of body dissatisfaction and more cogent links into a developmental body image timeline.

Adult↗
PubMed2002

Cue reactivity as a predictor of outcome with bulimia nervosa.

The present study sought to evaluate specific hypotheses concerning the relation between cue reactivity and outcome among women with bulimia nervosa. Participants were 135 women aged between 17 and 45 years with a current, primary diagnosis of bulimia nervosa who participated in a randomized clinical trial evaluating the additive efficacy of exposure and nonexposure-based behavior therapy, to a core of cognitive behavior therapy (CBT). Physiological, self-report, and behavioral measures of cue reactivity to individualized high-risk binge foods were obtained at pretreatment and posttreatment. Primary, secondary, and tertiary outcome measures are reported for posttreatment and six-month follow-up. Self-report measures of cue reactivity at posttreatment were significantly positively associated with symptomatology at posttreatment. Cue reactivity at posttreatment was significantly positively associated with symptomatology at 6-month follow-up. However, cue reactivity at posttreatment did not contribute to the prediction of outcome at follow-up over and above posttreatment outcome. The notion that pretreatment cue reactivity may predict which treatment modality will be most beneficial (exposure or nonexposure-based treatment), as measured by reductions in symptomatology at posttreatment could not be supported. Implications for future research are discussed.

Adolescent↗
PubMed2003

Cue exposure in the treatment of resistant bulimia nervosa.

OBJECTIVE: It was hypothesized that binge eating (bulimia nervosa [BN]) may be caused by the anticipatory and immediate anxiety associated with certain types of food. Consequently, an extinction schedule should reduce binge eating. METHODS: Cue exposure was carried out with 6 bulimic women who had responded poorly or not at all to the usual pharmacologic or cognitive-behavioral treatments. RESULTS: Binge eating and vomiting were almost totally suppressed in the 6 patients. Symptom suppression was maintained at two follow-ups, one at 4-20 months and another at 2.5-3 years. DISCUSSION: Cue exposure may be effective with BN that is resistant to conventional treatments. The anxiety associated with food plays an important role in provoking and/or maintaining binge eating. Motivation to change is likely to be an important mediator.

Adolescent↗
PubMed2002

Treatment of PTSD: stress inoculation training with prolonged exposure compared to EMDR.

The effectiveness of Stress Inoculation Training with Prolonged Exposure (SITPE) was compared to Eye Movement Desensitization and Reprocessing (EMDR). Twenty-four participants who had a diagnosis of Post Traumatic Stress Disorder (PTSD) were randomly assigned to one of the treatment conditions. Participants were also their own wait-list control. Outcome measures included self-report and observer-rated measures of PTSD, and self-report measures of depression. On global PTSD measures, there were no significant differences between the treatments at the end of therapy. However on the subscale measures of the degree of intrusion symptoms, EMDR did significantly better than SITPE. At follow-up EMDR was found to lead to greater gains on all measures.

Adult↗
PubMed2002

Eye Movement Desensitization and Reprocessing (EMDR): information processing in the treatment of trauma.

Eye Movement Desensitization and Reprocessing (EMDR) is an efficacious and efficient treatment for posttraumatic stress disorder (PTSD). This article provides a brief overview of the findings of 20 controlled-outcome studies and describes Shapiro's Adaptive Information Processing model. This model posits that pathology results when distressing experiences are processed inadequately and hypothesizes that EMDR accelerates information processing, resulting in the adaptive resolution of traumatic memories. A detailed description of the eight phases of treatment highlights the procedures, assumptions, and clinical observations that currently guide EMDR clinical practice. A case study, with an in-session transcript, illustrates the application of EMDR to address the past events that have laid the groundwork for dysfunction, the present circumstances that elicit distress, and skills acquisition needed for adaptive functioning.

Adult↗
PubMed2002

Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex posttraumatic stress disorder.

This article reviews the complexity of adaptation and symptomatology in adult survivors of childhood neglect and abuse who meet criteria for the proposed diagnosis of Complex Posttraumatic Stress Disorder (Complex PTSD), also known as Disorders of Extreme Stress, Not Otherwise Specified (DESNOS). A specific EMDR protocol, Resource Development and Installation (RDI), is proposed as an effective intervention in the initial stabilization phase of treatment with Complex PTSD/DESNOS. Descriptive psychometric and behavioral outcome measures from two single case studies are presented which appear to support the use of RDI. Suggestions are offered for future treatment outcome research with this challenging population.

Adult↗
PubMed2002

Efficacy of eye movement desensitization and reprocessing in the treatment of specific phobias: Four single-case studies on dental phobia.

A series of single-case experiments was used to evaluate the application of Eye Movement Desensitization and Reprocessing (EMDR) to traumatically induced dental phobia. Following two to three sessions of EMDR treatment, three of the four patients demonstrated substantially reduced self-reported and observer-rated anxiety, reduced credibility of dysfunctional beliefs concerning dental treatment, and significant behavior changes. These gains were maintained at six weeks follow-up. In all four cases, the clinical diagnosis present at pretreatment was not present at posttreatment at a clinical level. All patients actually underwent the dental treatment they feared most within three weeks following EMDR treatment. The findings support the notion that EMDR can be an effective treatment alternative for phobic conditions with a trauma-related etiology.

Adult↗