SEARCH · PubMed Health

Results for “SUFFOCATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources

PubMedDate not supplied

[Hereditary angioedema in organs of the head and neck as an indication for emergency tracheotomy].

INTRODUCTION: Angioedema (angioneurotic edema) is often associated with urticaria, but edema is located deeper in the skin and mucous membranes. There are limited, painless, soft and medium hard swellings. Lack of general symptoms is evident, except if mucous membranes of the gastrointestinal system are affected and pain appears. It is particularly dangerous if located in the brain or larynx when there is a risk of suffocation. In 20% cases with laryngeal involvement intubation or tracheotomy is necessary. CASE REPORT: This is a case report of a patient hospitalized at the Clinic, having a swelling at the front side of neck, lower lip and difficulties with deglutition. Occasionally the patient had similar difficulties in the main joints whereas periodical swellings are characteristic for his father, sister, and sister's daughter. Clinical check-up indicated a greyish swelling, of the oropharynx structure, with 1 cm respiratory space. Larynx was not visible due to swelling of epiglottis. The patient received intravenous steroid therapy, followed by infusion of physiologic solution with calcium. As his condition become very bad half an hour after admittance he was transported to the operation room. He received adrenaline but within the excepted time his respiration did not improve. Emergency tracheotomy was performed and afterwards his respiration and skin colour became normal. Regarding family anamnesis, clinical picture and laboratory results, hereditary angioedema was diagnosed. DISCUSSION: Hereditary angioedema is a rare form of angioedema which is an inherited autosomal dominant disorder. The disease is a result of deficit in C esterase inhibitor, which is a serum glycoprotein of SERPIN family (serum protease inhibitors), that is usually synthesized in hepatocytes. All the diseased are heterozygotes. There are two genetic variantions of the disease: I--patients with decreased quantity of inhibitor level in serum due to decreased synthesis and II--patients that have normal protein concentrations, but with abnormal protein, which is functionally inactive. Laryngeal edema can very soon cause narrowing of respiratory space, and if tracheotomy is not performed on time, suffocation occurs. Tracheotomy is one of the most urgent surgical interventions with the purpose to make patient's breathing easier to prevent suffocation and sometimes to save thr patient from certain death. CONCLUSION: In differential diagnosis of laryngeal edema, hereditary angioedema should be considered. Therapy of acute hereditary angioedema attacks should involve antihistamines, corticosteroids and adrenaline, as well as administration of fresh frozen plasma or infusion of C 1 inhibitor concentrate. Hereditary angioedema of the head and neck causing airway obstruction, is an indication for emergency tracheotomy.

Adult↗

PubMed2003

Trends in postneonatal mortality attributable to injury, United States, 1988-1998.

OBJECTIVE: Half of all postneonatal mortality (PNM; deaths among infants aged 28-364 days) in the United States is caused by potentially preventable causes such as sudden infant death syndrome, infections, and injuries. A detailed analysis of PNM attributable to injury has not been conducted and may provide useful data in prioritizing prevention strategies and targeting high-risk populations. METHODS: The authors used US infant death certificate data to analyze trends in PNM caused by injury during 1988-1998. Attending physicians, medical examiners, or coroners report cause of death on death certificates using a format specified by the World Health Organization and endorsed by the Centers for Disease Control and Prevention. The major causes of PNM by type of injury were evaluated, and trends were compared over time. Injury-related deaths per 100 000 live births were examined by race and region of residence. Rate ratios between black and white infants also were calculated. RESULTS: Among major causes of PNM during the study period, injury mortality declined the least (13.0% decline; from 29.6 to 25.7 per 100 000 live births). All types of unintentional injury deaths declined except for mechanical suffocation rates, which increased from 4.8 to 7.1. Homicide rates increased slightly (8.5%) from an 11-year low in 1988 and accounted for a greater proportion of all PNM caused by injury by 1998 (27.5% in 1998, 22.1% in 1988). Overall, PNM rates attributable to injury declined less among blacks (8.7%) than whites (13.6%) during the study period, and rates were on average 2.6 times higher among black infants (range: 2.4-3.0). Unintentional injury declined less among blacks (15.4%) than among whites (24.9%), in part because of an increase in motor vehicle crash-related mortality rates among black infants. Although black infants were more than 3 times as likely to be a victim of homicide than white infants (range: 3.0-4.4), increases in homicide rates were similar among black infants (9.9%) and white infants (10.6%) from 1988 through 1998. Racial disparities in PNM attributable to injury varied by region. PNM rates attributable to injury increased only among black infants residing in the Midwest (10.2%) and West (27.7%) as a result of increases in unintentional injury (ie, motor vehicle crash-related deaths in the West and mechanical suffocation in the Midwest) and homicide rates in these regions. Homicide rates increased among all infants regardless of race, except for infants residing in the Northeast. CONCLUSIONS: Overall PNM rates attributable to injury declined, yet rates of mechanical suffocation increased and large regional and racial disparities persisted. Death certificates have limited information to help explain the observed differences. Because injuries are frequently preventable, prevention strategies should encourage formation of infant and child death review teams to help identify community and system factors that may contribute to injury deaths. Health care providers can assist parents in providing a safe environment for infants by counseling on age-appropriate injury prevention as part of their anticipatory guidance and serving as child advocates. Additional studies should examine regional differences in death investigation practices, case ascertainment, and reporting of deaths attributed to intentional injuries.

Cause of Death↗

PubMedDate not supplied

[Mortality due to lesions in accidents and violence in children under 20 years of age].

Given the importance of injury's associated mortality in children, the total number of deaths caused by injuries in subjects under 20 years of age along years 1982 through 1987 in Chile, were studied. The Annals of Mortality and Causes of Death of the Chilean National Institute of Statistics were reviewed for that period. The average annual injury's death rate was 21.95 per 100,000 inhabitants younger than 20 years. Suffocation, motor vehicle accidents, burning and drowning were the leading causes of death by injuries. In infants, the main reported cause of death was suffocation (90.1% of the total deaths). Motor vehicle accidents were the leading cause of death for children aged 5 to 19 years. Fifty percent of the total deaths occurred in children aged less than one year. The total injury death rate trend remained stable over the analyzed period. The same occurred for deaths due to motor vehicle accidents in 5 to 19 years old. The trend for deaths by suffocation in children aged less than one year has clearly increased during the period, as is also the case for the proportion due to this same cause over the total number of deaths.

Accidents↗

PubMed1999

Review of hazards associated with children placed in adult beds.

OBJECTIVES: To identify and assess dangers associated with placing children younger than 2 years to sleep in adult beds. This article focuses on overlying, wedging, and strangulation hazards and the relationship of these hazards to children's sleeping environments. DESIGN: A retrospective review and analysis of data collected by the US Consumer Product Safety Commission on deaths of children younger than 2 years in standard adult beds, daybeds, and waterbeds. The review included incident data from January 1990 through December 1997. RESULTS: The 8-year records showed a total of 515 deaths of children younger than 2 years who were placed to sleep on adult beds. Of these deaths, 121 were reported to be due to overlying of the child by a parent, other adult, or sibling sleeping in bed with the child and 394 were due to entrapment in the bed structure. Most of these deaths seem to have resulted from suffocation or strangulation caused by entrapment of the child's head in various structures of the bed. CONCLUSIONS: Placing children younger than 2 years to sleep in adult beds exposes them to potentially fatal hazards that are generally not recognized by the parent or caregiver. These hazards include overlying by a parent, sibling, or other adult sharing the bed; entrapment or wedging of the child between the mattress and another object; head entrapment in bed railings; and suffocation on waterbeds. Parents and caregivers should be alerted to these avoidable hazards.

Adult↗

PubMed2006

Evidence for respiratory and nonrespiratory subtypes in panic disorder.

Recently researchers have posited a "respiratory" subtype of panic disorder (PD), which differs from "nonrespiratory" subtypes in phenomenology and perhaps treatment response. This study was designed to further examine evidence for the existence of a respiratory subtype in PD. Individuals with PD with prominent respiratory symptoms (PD-R; n=10) and without prominent respiratory symptoms (PD-NR; n=23), as well as healthy controls (n=27), underwent a standardized 5% CO(2) rebreathing challenge. Ventilatory response and subjective sensation of suffocation were continuously recorded. The PD-R group exhibited greater subjective suffocation levels, rates of respiration, and propensity to terminate the procedure voluntarily than did the other two groups, which in turn did not differ on these measures. Findings are consistent with the existence of a respiratory subtype of PD, which differs from nonrespiratory subtypes in CO(2) sensitivity.

Adult↗

PubMed1988

[Incidence and forensic value of liver cell hydrops in external asphyxia and sudden infant death].

A histological examination was carried out in 108 cases of asphyxia, 28 cases of SIDS, and 33 cases with other causes of death to assess the occurrence of liver-cell hydrops. In almost all cases of violent suffocation of newborns and children up to 10 years of age hydrops of the hepatocytes were found, whereas these results could be verified only exceptionally after violent suffocation of adults. Eighteen cases or 64.3% of SIDS showed a diffuse distribution of liver-cell hydrops over each liver lobule. Liver-cell hydrops seems to represent a frequent morphological equivalent of acute oxygen deficiency in asphyxia in childhood and is a common finding in SIDS.

Adult↗

PubMed1989

[Comparative histologic studies of the origin of petechial thymus hemorrhage].

Systematic histological investigations were carried out on the thymus with regard to the incidence and genesis of petechial thymus hemorrhages in 145 cases of death (fetuses from pregnancy terminations and stillbirth, mature and immature neonates, SIDS cases, other baby deaths, deaths during infancy and childhood). Petechial thymus hemorrhages were most frequently found in SIDS cases (87%). Even though distinguishable, a distribution pattern similar to that of thymus hemorrhages in SIDS cases (including hemorrhages mainly in the cortical zone of the lobes) could be detected in the group of fetuses from pregnancy terminations and stillbirth, as well as in mature and immature neonates. Histologically, deaths in babies and infants without extrinsic suffocation showed a different histological bleeding pattern (irregular hemorrhages of varying size in the cortex and medulla of the lobes). In violent extrinsic suffocation of babies and infants, thymus hemorrhages were much rarer and less pronounced in quantitative terms. Acute and subacute or chronic forms of asphyxia, the cause of death and the duration of the death struggle are discussed as pathogenetic factors to explain the different patterns of the findings.

Asphyxia↗

PubMed2004

Three subsequent infanticides covered up as SIDS.

Within a period of 9 years a young woman lost 3 daughters during infancy and each time death was attributed to the sudden infant death syndrome. The children had different fathers and died at the ages of 11 weeks, 7 weeks and 2 weeks, respectively. A fourth daughter survived and lives separated from the mother together with her father and is healthy. At autopsy the last of the three deceased infants did not reveal any pre-existing pathological organ findings, except for acute pulmonary emphysema and extensive intra-alveolar bleeding. As a consequence the strong suspicion of mechanical suffocation arose. Subsequent police investigations produced incriminating clues that the first two children had also been suffocated. On confrontation with the autopsy findings and investigation results, the woman confessed that she herself had killed the first two infants by pressing a cushion on their faces. In the case of the third death the baby had been smothered by the child's father who in agreement with the mother put a plastic film on mouth and nostrils.

Adult↗

PubMed1992

General and specific fears in referred and self-referred adult patients with extreme dental anxiety.

The levels of, and relationships between, dental fear and general fears and phobias were studied in 109 adult patients at a specialized dental fear clinic using two dental fear scales (the Dental Anxiety Scale and the Dental Fear Survey) together with the Fear Survey Schedule II (FSS-II) and some additional fear items. Referred and self-referred fearful dental patients answered mailed questionnaires in conjunction to being put on a 1 yr waiting list for treatment. Among feared objects and situations the separate item 'pain' revealed the highest mean scores for both men and women, followed by fear of suffocating, death of a loved one and sharp objects among women, and death of a loved one, suffocating and hypodermic needles among men. With few exceptions, women scored higher than men. The frequencies of extreme fears (6 and 7 on a 7-point scale) were high and 92.7% of the patients reported at least one extreme fear. Half of the subjects (49.5%) reported five fears or more. It was also shown that a number of FSS-II items correlated to dental fear indicating a relationship between general and dental fear. These results indicated that a large proportion of these dentally fearful individuals were prone to fear-associated reactions and behaviors, which has previously been shown to negatively influence the prognosis of treatment.

Adult↗

PubMed1993

The reduction of claustrophobia--II: Cognitive analyses.

A clinical experiment comparing methods of fear reduction in claustrophobia was used as the basis for analysing the relationships between a number of cognitive variables and the reduction of claustrophobia. Both the number and believability of negative cognitions present were associated with fear reduction and return of fear; this was also found when considering the number of body sensations experienced. High fear and panic were always accompanied by these phenomena whilst zero fear was never reported in the presence of believable cognitions and body sensations. An absence of believable cognitions post-test was accompanied by an absence of claustrophobia in 10/13 subjects. Specifically, removal of belief in any of the cognitions "I will be trapped", "I will suffocate" and/or "I will lose control" was associated with removal of belief in all the other cognitions and a dramatic reduction in claustrophobia. Belief in one of these central cognitions was associated with the maintenance of fear. We conclude that it is possible to conceptualize claustrophobia as comprising a number of cognitions centred on key thoughts of trappedness, suffocation and loss of control.

Adaptation, Psychological↗

PubMed2005

Gender makes a difference in the description of dyspnoea in patients with chronic heart failure.

BACKGROUND: Dyspnoea is a common symptom of chronic heart failure (CHF). In the community setting, patients with CHF are most often women. AIM: To examine the impact of gender on the description of dyspnoea and to explore which clinical variables support a diagnosis of CHF. METHODS: From four primary health care centres, 158 patients with CHF were included. Patients were examined with echocardiography and a cardiologist assessed the diagnosis of CHF. The patients filled in a questionnaire containing 11 descriptors of dyspnoea. RESULTS: A diagnosis of CHF was confirmed in 87 (55%) patients (47 males and 40 females). One descriptor, I feel that I am suffocating, was significantly scored higher in CHF patients (p=0.014) as compared to non-CHF patients. Three descriptors, My breath does not go in all the way (p=0.006), I feel that I am suffocating (p=0.040), and I cannot get enough air (p=0.0327) were significantly scored higher among men with CHF, compared to no descriptor among women with CHF. Being male (OR=2.7; CI: 1.3-5.6, p=0.008), having diabetes (OR=5.6; CI: 1.7-18.2, p=0.004), IHD (OR=3.3; CI: 1.3-8.5, p=0.014), and a borderline significance for age (OR=1.04; CI: 0.99-1.08, p=0.058) predicted a confirmed diagnosis of CHF. CONCLUSION: Three descriptors of dyspnoea were associated with CHF among men, whereas no such association was found among women. Our results suggest that gender is an important factor and should-together with age, underlying heart disease, and diabetes-be taken into account when symptoms are evaluated in the diagnosis of CHF in primary care.

Age Factors↗

PubMed2006

Identification of novel genes expressed in hypoxic brain condition by fluorescence differential display.

Fluorescence differential display (FDD) and comparative RT-PCR have been used extensively to detect differentially expressed genes. We investigated hypoxia-induced gene expression in the brain by FDD-PCR and comparative RT-PCR. Mice were anaesthetized after which hypoxia was induced by neck ligation for 1 min or 25 min, then were killed by decapitation, and the brains were dissected either immediately or 30 min after death (Group A1-0, Group A25-0, Group A1-30 and Group A25-30). Control mice without ligation of the neck were killed by decapitation under anaesthesia immediately (Group C-0) or 30 min after death (Group C-30). FDD-PCR, sequence analysis and comparative RT-PCR revealed that mitochondrial thymidine kinase 2, Rab6, selenoprotein T and two novel cDNAs were enhanced in Group A25-0 and Group A25-30 compared with the other groups. In Group A25-30, only RAP2 interacting protein and another novel cDNA were induced. In Group A25-0, one novel gene was detected. These findings were consistent with the results of statistical analysis by ANOVA. No differences of band pattern were observed among Groups A1-0, A1-30, C-0 and C-30. The genes exhibiting altered expression were associated with vital cellular functions, e.g., intracellular signaling and mitochondrial metabolism. In addition, we identified four novel genes, expressed after extended hypoxic conditions in mouse brain with suffocation. These results may contribute to clarify the pathophysiology of asphyxia in the brain and aid in the diagnosis of suffocation.

Animals↗

PubMed2006

Extensive thyroidectomy in Graves' disease.

BACKGROUND: The best surgical treatment for hyperthyroidism caused by Graves' disease remains a controversial subject. METHODS: Seven hundred fourteen consecutive patients underwent total or near-total thyroidectomy for Graves' disease in a 13-year period. In a first analysis, postoperative rates of suffocating hematoma, wound infection, recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, and persistence or recurrence of hyperthyroidism, were studied and compared with the same parameters in 4,426 patients who underwent bilateral thyroid gland resection for other conditions. A second analysis identified factors associated with postoperative complications among Graves' disease patients. RESULTS: Comparing Graves' disease patients with patients who had bilateral thyroid resection for other conditions, the transient morbidity rate was 13.3% versus 8.2% (p < 0.0001), with 10.2% versus 5.0% (p < 0.0001) hypoparathyroidism, 2.2% versus 1.7% (p = 0.35) RLN palsy, 1.7% versus 0.9% (p < 0.05) suffocating hematoma, and 0.3% versus 0.4% (p = 0.67) wound infection, respectively. Permanent morbidity rate was 2% versus 2.2% (p = 0.72), including 0.4% versus 0.6% RLN palsy and 1.5% versus 1.7% hypoparathyroidism. Among the Graves' disease patients, univariate analysis revealed that those who experienced postoperative complications had a higher weight resected thyroid gland (odds ratio = 1.5; 95% CI, 1.0-2.3) and a higher rate of total thyroidectomy (24.4% versus 19.5%, odds ratio = 2.2; 95% CI, 1.4-3.4) than patients without complications. In the multivariable model, these two factors remained independent. There was no recurrence of hyperthyroidism with a median followup of 6.7 years (interquartile range 4.1 to 10.1 years). Persistent hyperthyroidism developed in three patients. CONCLUSIONS: Total or near-total thyroidectomy is an effective and safe treatment for Graves' disease when performed by an experienced surgeon.

Adult↗

PubMed2007

The epidemiology of infant injuries and alarming health disparities.

PURPOSE: Injury epidemiology is the underappreciated foundation of injury prevention and control strategies. Given the substantial disparity of infant injury-related mortality between African Americans (AA) and whites in our region, we sought to better understand the epidemiology of infant injury-related mortality rates. METHODS: Our trauma database was reviewed for all infant injuries over a 10-year period. The mortality rates were analyzed based on race, mechanism, and health insurance type. RESULTS: From 1995 to 2004, 1270 infants were identified. Sixty-nine percent were white, 26% AA, and 5% were other. Overall mortality was 4.8%. There were significant disparities in mortality comparing AA to whites: overall, 9.6% vs 2.8%*; abuse, 15% vs 4%*; suffocation, 100% vs 55%* (*P < .05). Although 75% of AA vs 40% of whites were insured by Medicaid, when separated by insurance type, the disparity in mortality rates between races remained significant. CONCLUSIONS: African-American infants have 3.5 times increased risk of death from preventable injuries compared to white infants. This disparity persists despite controlling for type of health insurance, a surrogate for socioeconomic status. Understanding these disparities and developing injury-prevention programs targeting high-risk mechanisms of injury such as abuse and suffocation among AA is critical toward eventually eliminating these preventable deaths.

Black or African American↗

PubMed2005

Novel hypothesis for the cause of panic disorder via the neuroepithelial bodies in the lung.

Panic disorder (PD) is a complex condition that is further complicated by its numerous inducers, which include hypercapnia, hypoxia, sodium lactate, caffeine and cholecystokinin. It seems unlikely that there are specific suffocation receptors for each of these inducers in the brain. The pulmonary neuroepithelial bodies (NEBs), which are situated at the bifurcation point of the small bronchi, act as storage cells for 5-hydroxytryptamine (5-HT) and sensors for suffocation. If we suppose that PD might represent an inflammation of the NEBs, bradykinin (BK) which augments the airway hyper-response to diverse indcers might cause these cells to release 5-HT along with peptides and panneuroendcrine markers from their dence-core secretory granules. It was revealed that BK with 5-HT could cross the blood-brain barrier (BBB). When 5-HT released from these cells along with BK cross the BBB, the release of 5-HT at the axonal terminals in the serotonergic neurons in the brain will be inhibited, since the 5-HT1 autoreceptor have a higher affinity for 5-HT than do the 5-HT2 receptors. The inhibition of 5-HT at the axonal terminal causes to suppress the periaqueductal gray matter, which inhibits flight reactions to impending danger, pain or asphyxia. In short, this serotonergic situation might bring about PD. According to this theory, the type of inducer that the PD patient is exposed to is unimportant as long as it stimulates the NEBs, and through the effect of 5-HT and BK, PD would be revaluated as a somatic disease that directly and reversibly affects the brain.

Anxiety↗

PubMed2004

Beta-amyloid precursor protein immunohistochemistry in the evaluation of pediatric traumatic optic nerve injury.

OBJECTIVE: The pathologic markers of nonaccidental injury (NAI) of the central nervous system (CNS) of infants and young children include subdural, subarachnoid, and retinal hemorrhages. Immunohistochemical staining for beta-amyloid precursor protein (betaAPP) has been used to investigate traumatic axonal injury of the brain, brain stem, and spinal cord injuries, and has potential as an additional indicator of traumatic head injury. A single study has reported that betaAPP immunostaining of the optic nerve in CNS NAI reveals axonal damage. The purpose of our study was to explore further the utility of betaAPP immunostaining of optic nerves for the detection of traumatic axonal injury. METHODS: We used hematoxylin-eosin and betaAPP immunostaining to evaluate the eyes and optic nerves in 18 cases of CNS nonaccidental blunt force head injury, 4 cases of homicidal blunt force abdominal injury (BFAI), 1 homicidal suffocation, 1 case of sudden infant death syndrome, 1 near-drowning, 1 overlay (clinical history: "found under sleeping mother in bed"), 1 motor vehicle accident, and 6 natural deaths in children < or =5 years of age. RESULTS: Evaluation of the cases of CNS NAI revealed 17 of 18 (94%) with subdural hemorrhage; 15 of 18 (83%), subarachnoid hemorrhage; 17 of 18 (94%), retinal hemorrhage; 16 of 18 (88%), perioptic nerve hemorrhage; and 6 of 18 (33%), optic nerve betaAPP immunoreactive axonal swellings. The only nontraumatic case that demonstrated betaAPP immunoreactive axonal swellings was the near-drowning. No cases of BFAI, suffocation, overlay, or natural deaths revealed any retinal or perioptic nerve hemorrhage or significant optic nerve betaAPP immunoreactivity. Global hypoxic-ischemic injury was present in 21 cases, of which 19 had evidence of brain swelling, and 7 demonstrated betaAPP immunoreactive axonal swellings. CONCLUSIONS: These findings confirm the presence of optic nerve axonal injury in some cases of fatal pediatric CNS NAI.

Amyloid beta-Protein Precursor↗

PubMed1998

Pulmonary function and dyspnea/suffocation theory of panic.

This article presents a brief discussion of pulmonary function and panic attacks in the context of respiratory psychophysiology. Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) earlier dyspnea/suffocation theory of panic is contrasted with Klein's (Archives of General Psychiatry, 50, 306-316, 1993) later false suffocation alarm theory. The distinction between "dyspnea" (the sensation of difficulty in breathing) and "suffocation" (a condition that sometimes gives rise to dyspnea) is emphasized. The brief discussion is followed by a critical comparison of two recent studies on pulmonary function and panic. Asmundson and Stein (Journal of Anxiety Disorders, 8, 63-69, 1994) reported an association between forced expiratory flow rate (a measure of pulmonary function) in panic disorder patients and the severity of panic-related symptoms. They interpreted their findings as support for the dyspnea/suffocation theory of panic since severity of dyspnea is a consequence of pulmonary function. Spinhoven et al. (Behaviour Research and Therapy, 33, 457-460, 1995) failed to replicate the findings of Asmundson and Stein. The present paper provides a critical analysis of the study by Spinhoven et al. and concludes that the failed attempt to replicate may have been a consequence of a flawed methodology (the subjects of the two studies are not comparable on a crucial pulmonary test) and a statistical anomaly (disproportionately small differences between means that exceed predictions based on sampling error). A recommendation is made that future attempts to replicate should pay special care to avoid the possibility of experimenter-demand effects.

Asphyxia↗

PubMed2002

The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation.

We examined the effects of safety-seeking behavior and guided threat focus and reappraisal on fear reduction during exposure. Participants (N=46) displaying marked claustrophobic fear were randomized to one of three 30-min exposure conditions: (a) guided threat focus and reappraisal; (b) safety-behavior utilization; or (c) exposure only control. Tripartite outcome assessments during a behavioral approach test, along with measures of suffocation and restriction fears were obtained at pre- and post-treatment, and at a 2-week follow-up. Treatment process measures were collected throughout treatment and consisted of indices of fear activation; within and between-trial fear habituation; and suffocation and entrapment expectancies. Measures of safety behavior utilization and attentional focus were also collected to assess the integrity of the experimental manipulations. Consistent with prediction, those encouraged to utilize safety-behaviors during exposure showed significantly more fear at post-treatment and follow-up relative to those encouraged to focus and reevaluate their core threat(s) during exposure. Moreover, growth curve analyses of treatment process data analyses revealed that safety-behavior utilization exerted a detrimental effect on between-trial habituation; whereas guided threat reappraisal enhanced between-trial habituation.

Adaptation, Psychological↗