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Results for “Desensitization, Psychologic”

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PubMed2006

Effects of three PTSD treatments on anger and guilt: exposure therapy, eye movement desensitization and reprocessing, and relaxation training.

This study sought to investigate the efficacy of prolonged exposure, eye movement desensitization and reprocessing, and relaxation training on trait anger and guilt and on trauma-related anger and guilt within the context of posttraumatic stress disorder (PTSD) treatment. Fifteen PTSD patients completed each treatment and were assessed at posttreatment and at 3-month follow-up. All three treatments were associated with significant reductions in all measures of anger and guilt, with gains maintained at follow-up. There were no significant treatment differences in efficacy or in the proportion of patients who worsened on anger or guilt measures over the course of treatment. Between-treatment effect sizes were generally very small. Results suggest that all three treatments are associated with reductions in anger and guilt, even for patients who initially have high levels of these emotions. However, these PTSD therapies may not be sufficient for treating anger and guilt; additional interventions may be required.

Adult↗

PubMed2006

Combining pharmacotherapy with cognitive behavioral therapy: traditional and new approaches.

Given the ever-increasing sources of trauma both nationally and globally, it is imperative to develop new and better treatments for anxiety disorders such as posttraumatic stress disorder (PTSD). This review is a collection of presentations that seek to do just that, either by using pharmacotherapy to try to prevent or erase the formation of traumatic fear memories, or to enhance exposure-based cognitive-behavioral therapy using pharmacological agents that have been effective in enhanced extinction of fear in rodents.

Cognitive Behavioral Therapy↗

PubMed2006

Augmentation of sertraline with prolonged exposure in the treatment of posttraumatic stress disorder.

The present study was designed to determine whether augmenting sertraline with prolonged exposure (PE) would result in greater improvement than continuation with sertraline alone. Outpatient men and women with chronic PTSD completed 10 weeks of open label sertraline and then were randomly assigned to five additional weeks of sertraline alone (n = 31) or sertraline plus 10 sessions of twice-weekly PE (n = 34). Results indicated that sertraline led to a significant reduction in PTSD severity after 10 weeks but was associated with no further reductions after five more weeks. Participants who received PE showed further reduction in PTSD severity. This augmentation effect was observed only for participants who showed a partial response to medication.

Adult↗

PubMed2006

Dissemination of exposure therapy in the treatment of posttraumatic stress disorder.

Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive-behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these efficacious treatments is exposure therapy. Despite all the evidence for the efficacy of exposure therapy and other CBT programs, few therapists are trained in these treatments and few patients receive them. In this article, the authors review extant evidence on the reasons that therapists do not use these treatments and recent research on the dissemination of efficacious treatments of PTSD.

Chronic Disease↗

PubMed1996

Medical management of the multiple chemical sensitivity patient.

Multiple chemical sensitivity (MCS) is a complex, chronic disorder characterized by multisystemic symptoms occurring in response to a wide variety of chemical odors or low-level exposures. The etiology is unknown but likely multifactorial. Patient evaluation includes a comprehensive history with a review of past medical records and a physical examination with specific attention to the affected organ systems. Laboratory evaluation is dependent on past testing and patient symptoms. It should be individualized and, although standard baseline tests are helpful, exhaustive testing is not. The evaluation is primarily designed to exclude diseases requiring specific medical therapy. Treatment approaches vary considerably depending on the treating physician and patient responsiveness; many have been adapted from those used for similar chronic illness of unknown etiology. Therapies utilized in MCS patients include supportive care, behavioral techniques, including desensitization, psychotherapy, chemical avoidance, and clinical ecology regimens such as provocation-neutralization protocols. The advantages and disadvantages of these approaches are discussed and the use of clinical ecology regimens is discouraged. A multidisciplinary approach similar to those used in chronic pain patients may be beneficial. Regardless of the treatment chosen, the goal should be to decrease patient disability.

Behavior Therapy↗

PubMed1983

Behavioral treatment methods for alcoholism.

This chapter offers a review of the behavioral methodology directed to the treatment of alcoholism. Beginning with an outline of the theoretical bases of behavior therapy and assessment, a review with some historical perspective is undertaken of the chemical, electrical, and covert aversion treatments of alcoholism. Thereafter, the procedures of the social skills-training strategies (including marital skills and assertiveness training) are presented, followed by a discussion of the relaxation and desensitization techniques. The operant methodologies are illustrated by contingency contracting and the community-reinforcement approaches. Within the broad-spectrum procedures, a description of self-control training and an example of a broad-spectrum treatment study are offered. It is noted that although the merits of these various techniques are becoming widely recognized in the alcoholism treatment literature, the behavior therapeutic approaches to alcoholism have yet to receive widespread public acceptance. It is anticipated that future studies of treatment effectiveness will contribute to an increasing appreciation of the advantages of behavioral therapies to the management of alcohol abuse and dependence.

Alcoholism↗

PubMed1978

Behavioral treatment parameters with primary dysmenorrhea.

Fourteen women with primary dysmenorrhea were administered four sessions of systematic desensitization (SD) by either a male or a female therapist. The following measures were taken during the flow periods before and after treatment and at a 6-month follow-up: menstrual symptom checklist, medication usage, invalid hours, and menstrual attitudes. At pretreatment, menstrually distressed women had significantly higher scores on all measures compared to a normative group and an explicitly nondistressed group. At posttreatment, treated women's scores on the dependent variables were significantly reduced. All indices were reduced to a "nondistressed level" at posttreatment and at 6-month follow-up. Type of dysmenorrhea (congestive vs. spasmodic), trait anxiety level, and therepist sex did not predict differential responsiveness to SD. SD did not affect frontailis EMG, peripheral blood flow, or pain threshold. A Retrospective Symptom Scale of menstrual distress was found to be highly reliable, valid, and sensitive.

Adolescent↗

PubMed1976

Proxemics, locus of control, anxiety, and type of movement in emotionally disturbed and normal boys.

In order to determine the interpersonal distancing requirements for emotionally disturbed and normal children and in order to investigate the relationship of locus of control and anxiety to interpersonal space, 20 emotionally disturbed and 20 normal boys were randomly required to approach an object person and to let the object person approach them until they felt uncomfortable. Results indicated that emotionally disturbed boys required more space than normals; that subjects would approach closer than they would allow the object person to approach them; and that externals required more space than internals. There were no significant differences between high and low anxious subjects, nor between emotionally disturbed children diagnostically classified as overanxious reaction and those with other diagnosis. Finally, neither anxiety nor locus of control explained the significant normal-emotionally disturbed differences in space requirements. Theoretical and practical implications were discussed as well as the relationship between the present and previous research.

Affective Symptoms↗

PubMed1989

Stress management and Gilles de la Tourette's syndrome.

Tourette's syndrome is a lifelong disorder characterized by multiple motor and verbal tics. The present study examined relaxation training and desensitization training as a method of reducing the frequency and intensity of tics and the distress they caused in a young adult diagnosed with Tourette's syndrome. After a period of symptom monitoring the subject underwent 3 weeks of intensive training in relaxation skills and 5 weeks of desensitization training with situational cues previously identified as eliciting Tourette's symptoms. According to self-report monitoring, the experience of symptoms was decreased across 3 global dimensions: distress (48%), frequency (48%), and intensity (50%), and an hourly symptom count (50%). Collateral parental symptom report agreed with an observed decreased across distress (40%), frequency (41%), and intensity (40%). Inspection of data suggests that both components of stress management added to total treatment efficacy.

Adult↗

PubMed1993

Modifying the behavior of the violent patient.

Different behavioral techniques are briefly described for treating the violent patient in a hospital setting. Emphasis is placed on doing a careful assessment of the situation and behavior before attempting a behavioral intervention. It is also emphasized that all staff members involved be adequately trained, otherwise the procedures tend to fail. Techniques include strategies for changing the environment, as well as using relaxation procedures, systematic desensitization, differential reinforcement schedules, token economies, response cost, time out, and social skills training. Multi-component programs are also briefly mentioned. The paper emphasizes that violent behavior can be greatly reduced if approached in a systematic way, using procedures based on sound research methodology.

Behavior Therapy↗

PubMed1976

Group desensitization of dissimilar anxieties.

Group desensitization is an effective, efficient anxiety-reduction therapy that, nonetheless, is not applicable in most mental health settings. This paper outlines several procedural modifications that make possible the desensitization of diverse anxieties within a single group and thus make group desensitization a more practical strategy.

Anxiety↗

PubMed1975

Systematic desensitization of erectile impotence: a controlled study.

Results of a study conducted to assess the therapeutic effectiveness of systematic desensitization of erectile impotence are described. Three groups of eight patients each were formed. They were treated with systematic desensitization or conventional medication and general advice, or put on a waiting list. Therapeutic effects were investigated on the behavioral, subjective, and physiological levels. There were no significant differences among the three groups except on the subjective level. On this level, after therapy the systematic desensitization group rated feelings in sexually arousing situations as associated with significantly less anxiety than the other two groups. Systematic desensitization used alone as a treatment for erectile impotence shows only limited therapeutic effect. The unimproved patients were later treated using a modification of the Masters and Johnson technique. Early results suggest that this technique may be superior to systematic desensitization alone.

Adult↗

PubMed1984

The role of anxiety in sexual dysfunctions: a review.

Studies are reviewed which (a) compare anxiety and other measures of psychopathology between normals and dysfunctionals ; (b) evaluate the effectiveness of anxiety reduction procedures for treating sexual dysfunctions; and (c) try to identify anxiety-related stimuli that alter sexual arousal. The studies, in general, suggest that (a) anxiety is common among people with sexual dysfunctions, but that the level and nature of the anxiety may vary greatly between individuals; (b) anxiety reduction procedures improve some, but probably not all, aspects of sexual dysfunctions; and (c) recent research has begun to identify some anxiety-related factors that can disrupt sexual arousal.

Anxiety↗

PubMed1978

Effects of group systematic desensitization on female orgasmic dysfunction.

This study investigated the impact of group systematic desensitization (SD) on varied aspects of sexual functioning in primary and secondary nonorgasmic women. After serving as their own controls, 22 women (eight primary, 14 secondary) received 15 sessions of group SD using four common hierarchies of sexual scenes. The measures were administered to each subject and her regular sex partner at each of the testing periods. Significant positive treatment effects were found on measures of general and specific sexual adjustment and in extracoital orgasmic frequency. Treatment also enhanced sexual communication among subjects and their partners, increased the females' acceptance of their mates as being satisfactory sexual partners, and increased the females' self-acceptance as sexual beings. All but one of the treatment effects (degree of pleasure experienced during extracoital stimulation) were maintained at the 6-week follow-up. Secondary subjects reported significantly greater pleasure from coital and extracoital stimulation and significantly increased frequency of orgasm in response to extracoital stimulation than primary subjects. Primary and secondary subjects did not differ in their evaluation of the experiment. The need for controlled comparative treatment investigations is stressed.

Adult↗

PubMed1995

Change in rape narratives during exposure therapy for posttraumatic stress disorder.

This paper presents a coding system developed to explore changes in narratives of rape during therapy for posttraumatic stress disorder (PTSD) involving repeated reliving and recounting of the trauma. Relationships between narrative categories hypothesized to be affected by the treatment and treatment outcome were also examined. As hypothesized, narrative length increased from pre- to post-treatment, percentage of actions and dialogue decreased and percentage of thoughts and feelings increased, particularly thoughts reflecting attempts to organize the trauma memory. Also as expected, increase in organized thoughts was correlated negatively with depression. While indices of fragmentation did not significantly decrease during therapy, the hypothesized correlation between decrease in fragmentation and reduction in trauma-related symptoms was detected.

Adolescent↗

PubMed1992

Systematic desensitization of oral hypersensitivity in a patient with a closed head injury.

A 36-year-old man who had sustained a closed head injury displayed extreme fear of being stimulated in the oral cavity, of being presented with foods, and of swallowing. The patient's fear increased his muscle tone and hypersensitivity in the facial and oral area, thereby preventing assessment of his dysphagia. We describe the use of systematic desensitization to alleviate the patient's fear thus allowing successful completion of a videofluoroscopic barium swallow examination.

Adult↗

PubMed2002

[Pharmacological support of exposure therapy in anxiety disorders. Animal experiment studies].

The fear-potentiated startle paradigm (i.e., the enhancement of the startle response in the presence of an aversive conditioned stimulus) is a valuable cross-species model for the study of the neuronal mechanisms underlying fear and anxiety as well as of the cognitive control of those aversive states. Walker et al. present data from a study in rats indicating that extinction of fear in the fear-potentiated startle paradigm is enhanced by the partial agonist of the N-methyl-D-aspartate receptor D-cycloserine (DCS). The authors therefore suggest tests of DCS in clinical trials as a potential pharmacotherapeutic adjuvant for exposition therapies in fear and anxiety disorders.

Animals↗

PubMed2003

[Treatment of acrophobia in a virtual environment].

Specific phobias are one of the most frequent mental health problems and can lead to years of personal suffering. The most effective treatment is exposure therapy. Our aim was to proof the feasibility and efficacy of virtual environments in treating acrophobia patients using a manually guided exposure therapy. Our pilot study was designed as a crossover intervention with a waiting list condition as a control group. After treatment, our results show that exposure in virtual environments is a feasible technique, can provoke anxiety, and leads to a therapeutic effect.

Adult↗