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At least 469 records · Page 26Linked to original sources
PubMed1995

Dismantling cognitive-behavioral group therapy for social phobia.

The efficacy of Heimberg's (1991) Cognitive-Behavioral Group Therapy (CBGT) [Unpublished manuscript] for social phobia has been demonstrated in several studies in recent years. However, little is known about the mechanisms underlying the treatment's success. In order to determine whether the cognitive restructuring component of CBGT is essential, this study compared CBGT to an exposure-based treatment without formal cognitive restructuring. A wait-list control was also included. In general, Ss in the active treatment conditions improved and control Ss did not improve on a variety of self-report, clinician, and behavioral measures. Limited evidence indicated that Ss in the non-cognitive treatment may have made somewhat greater gains on some measures. Although CBGT Ss reported more improvement than exposure-alone Ss in subjective anxiety during an individualized behavioral test at posttreatment, this difference disappeared at 6-month follow-up. Surprisingly, CBGT was less effective than in previous controlled trials, and possible reasons for this are discussed. Implications of the results for cognitive theory and cognitive-behavioral therapy for social phobia are addressed.

Adolescent↗
PubMed1995

One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia.

Fifty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to five different treatment conditions: (1) one session therapist-directed exposure (maximum 3 hours), (2) specific manual-based treatment in the home, (3) specific manual-based treatment at the clinic, (4) general manual-based treatment in the home and (5) general manual-based treatment at the clinic. The results show that therapist-directed one-session treatment was significantly more effective than three of the manual-based treatments, both at the post-treatment and follow-up stages. Specific manual-based treatment at the clinic was significantly more successful than the other manual-based treatments, but only at follow-up. The proportion of clinically significant improved patients at follow-up was 80% in the therapist-directed group compared to 63% for the specific manual-based treatment at the clinic, 10% for specific manual-based treatment in the home, 9% for general manual-based treatment in the home, and 10% for general manual-based treatment at the clinic. The conclusion that can be drawn is that one-session therapist-directed treatment is the treatment of choice for spider phobia but manual-based treatment is a good alternative in some cases.

Adolescent↗
PubMed1996

Cognitive and performance-based treatments for panic attacks in people with varying degrees of agoraphobic disability.

Compared the effectiveness of cognitive therapy and performance-based exposure as treatments for panic attacks. Subjects were 48 panicky individuals selected without regard to agoraphobic disability, and who varied widely in that respect. Subjects were assigned randomly to either cognitive treatment, performance-based exposure treatment, a combined cognitive/performance treatment, or a no-treatment control condition. All three treatments led to marked and enduring improvements in panic, and did not differ from one another in effectiveness, whereas the control condition produced little benefit. However, on several measures of phobia and panic-related cognitions, performance exposure was significantly more effective than cognitive therapy. Degree of agoraphobic disability had a significant bearing on panic treatment effectiveness. Whereas 94% of the low agoraphobia Ss were free of panic after treatment, only 52% of the high agoraphobia Ss became panic-free. The findings suggest that when panic treatment research excludes people with serious phobias, as it has routinely done in recent years, an overly positive estimate of panic treatment effectiveness can result.

Adolescent↗
PubMed1996

Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobia.

The aim of this study was to assess the rate of change on clinical, behavioral and cognitive variables during exposure therapy and cognitive restructuring in the treatment of panic disorder with agoraphobia. A total of 28 Ss who received a diagnosis of panic disorder with agoraphobia were randomly assigned to either of two treatment conditions: exposure therapy or cognitive restructuring. Treatment conditions were kept as distinct as possible from each other. Subjects were assessed on five occasions: pretreatment, after 5, 10, and 15 (posttreatment) sessions of treatment and at a 6-month follow-up. Analyses of outcome data revealed strong and significant time effects on all measures. However, no group x time interaction reached statistical significance, suggesting that both strategies operate at the same pace. Furthermore, power analyses suggest that any difference that might exist in the rate of improvement between exposure and cognitive restructuring in the treatment of panic disorder with agoraphobia is marginal.

Adult↗
PubMedDate not supplied

Prediction of outcome in the treatment of specific phobia. A cross validation study.

The purpose of this study was to investigate possible predictors of treatment outcome in specific phobia at 1 week after treatment, and at I year follow-up. The subjects (n = 138) came from four studies (two on spider phobia, one on blood phobia and one on injection phobia), and all had been diagnosed with simple phobia according to DSM-III-R. The dependent variable was clinically significant improvement in three different factors; avoidance behavior in a behavior test, self-rated anxiety during the test, assessor rating of phobic severity or fainting behavior. Fourteen variables covering self-report, demographic and physiological variables, and data from the behavior test were used as prognostic variables. Multiple regression analyses were used in a cross validation procedure. The results showed that diastolic blood pressure at pretest was a predictor at post-treatment for one sample and credibility was found as a predictor for the other sample both at post-treatment and at 1 year follow-up. Analyses were made for the diagnoses and the treatments but the results were inconclusive. Despite the large sample size and the cross validation procedure no stable predictors were found for short- and long-term outcome. The few significant predictors should be considered as chance findings.

Adolescent↗
PubMedDate not supplied

Treatment of generalized social phobia: results at long-term follow-up.

This study investigated the long-term follow-up effectiveness of (cognitive-) behavioural group and individual treatments for generalized social phobia. Patients were reassessed 18 months after they had finished one of the following treatment packages: (1) exposure in vivo; (2) cognitive therapy followed by exposure in vivo; or (3) a cognitive-behavioural treatment in which both strategies were integrated from the start. Half of the patients were individually treated, the other half in a group. Self-report assessments were held before and after treatment and at 3-month and 18-month follow-ups. Repeated measures MANOVAs on the patients who completed the long-term follow-up (n = 50) demonstrated significant time effects, indicating lasting improvement compared with the pretest. Between the posttest and the 18-month follow-up no significant changes were observed. ANCOVAs either with the pretest or the posttest as covariate showed a significant interaction at 18-month follow-up between treatment package and treatment modality on three of the four compound outcome variables. The group treatment with exposure in vivo alone had been the most effective in the longer term, the integrated group treatment the least effective, while the individual treatments had given improvements in-between. Results are qualified in view of numbers of dropouts, additional treatments in the respective treatment conditions, and clinical relevance.

Cognitive Behavioral Therapy↗
PubMed1996

One-session group treatment of spider phobia.

Forty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to two group treatment conditions: (1) small groups of three to four patients, and (2) large groups of seven to eight patients. They received one 3-hr session consisting of exposure and modeling. The results showed that both conditions yielded significant improvements on almost all measures, and these were maintained or furthered at the 1-yr follow-up. With one exception, there was no difference between the conditions, but on most measures there was a trend for the small group condition to yield better effects. The proportions of clinically significantly improved patients at post-treatment were 82% in the small group and 70% in the large group. At follow-up the corresponding figures were 95% and 75%, respectively. The conclusion that can be drawn is that one-session group treatment is a feasible alternative to individual treatment, yielding almost as good effects.

Adolescent↗
PubMedDate not supplied

DSM-II personality characteristics of panic disorder with agoraphobia patients in stable remission.

The Personality Diagnostic Questionnaire (PDQ), a self-rating scale designed to assess DSM-III axis II personality disorders (PD), was administered to 12 panic disorder with agoraphobia patients during a 6-month stable and virtually symptom-free remission period with the aim of assessing the personality characteristics of these patients in the best possible approximation of the not-ill condition in clinical reality. The personality profile of the sample remained unchanged during remission and was predominated by avoidant PD traits. In a finer grain analysis, the stable and commonly endorsed individual PDQ items were compared with previously reported panic disorder and normal control subjects, which showed that the present sample was more like the panic patients in their tendency to see themselves as rather unassertive, indecisive, self-critical, and emotional individuals who are easily frustrated and feel rejected when criticized by others. These results suggest that avoidant behavioral and attitudinal patterns may be enduring personality characteristics of panic disorder with agoraphobia patients.

Adult↗
PubMed1993

Combined behavioral therapy and pharmacotherapy of agoraphobia.

There are few controlled studies of combined behavioral-pharmacological treatments of agoraphobia with panic. This review of the empirical evidence from studies using exposure in vivo as the behavioral modality and imipramine as the pharmacological agent suggests that these treatments have mutually potentiating effects in this disorder.

Agoraphobia↗