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Bulimia nervosa: group behavior therapy with exposure plus response prevention.

Exposure plus response prevention has been demonstrated to be effective in the treatment of bulimia nervosa. However, when done individually, it is labor intensive and cost-ineffective. In the present study exposure plus response prevention was used in the context of a 6-wk., 12-session behavioral group. In addition to the exposure plus response-prevention component, other techniques included self-monitoring, cognitive restructuring, eating-habit stabilization and problem-solving. Eight bulimic women, vomiting a minimum of five times per week for at least a year, participated in the group. At the end of treatment significant reductions in bingeing and vomiting behaviors were reported by all but one subject, substantiated by significantly lower depression scores (Beck Depression Inventory) and binge-eating scores (Binge Eating Scale). At 6 mo. and 1 yr. posttreatment, 6 of 8 subjects reported averaging less than one binge-purge episode per week, one subject continued unchanged, and one subject had relapsed. A group of wait-list control subjects reported essentially no change in binge-purge frequency over the treatment period. Exposure plus response prevention conducted in a behavioral group context appears to be a cost-effective alternative to individual treatment.

Adolescent↗

The status of expectancy-arousal theory: comparative credibility of systematic desensitization and rational-emotive therapy in the treatment of anxiety about study.

96 university students were asked to imagine that they were suffering from study anxiety to the point of wishing to receive help with the problem. They were then asked to read a booklet detailing either (a) the rationale for systematic desensitization or Rational-Emotive Therapy and (b) told that counselling lasted for 5 or 15 weeks. They then assessed the credibility of the therapy using Borkovec's credibility rating method. Meta-analysis has shown that systematic desensitization has superior outcomes when compared to other treatments, but this could be attributed to the different expectations of benefit that the therapies arouse. This notion has been called the expectancy-arousal hypothesis. Results from the present experiment did not support Shapiro's 1981 findings that systematic desensitization was more credible than Rational-Emotive Therapy, which disconfirms the expectancy-arousal hypothesis, but the basis for this remains unclear.

Adult↗

Evaluation of the one-session Eye-movement Desensitization Reprocessing procedure for eliminating traumatic memories.

Eye-movement Desensitization Reprocessing (EMDR) is a relatively new therapy technique originally reported to eliminate traumatic memories (rape, catastrophes) in one session. Early published research has tended to support the technique. However, there is controversy and at least one unpublished recent study by Rothbaum who reported only about one-half of her cases had successful outcomes. The present study was conducted as a preliminary evaluation in 1990. Our results were judged to be unsuccessful in five of eight cases and successful in three cases. Further, the cases with the most pathology improved the least. The techniques, cases, and outcomes are presented to provide additional data on this new and controversial therapeutic technique.

Adult↗

Operant learning (R-S) principles applied to nail-biting.

The principles of R-S learning were applied to a 32-yr.-old Caucasian woman to reduce the frequency and duration of fingernail-biting activity in a reversal-replication (ABAB) research design. The undesirable behavior, fingernail-biting which included frequency and duration, antecedents, and setting events, was recorded during a 28-day study. Self-monitoring recordings indicated that anxiety was the most prevalent antecedent. Through the use of a preliminary questionnaire and interview, increase in self-awareness was judged to be most effective in the extinction of the undesired behavior. The systematic desensitization techniques of deep muscle relaxation and Transcendental Meditation were used during the treatment phase.

Adult↗

Cognitive-behavioral therapy for paruresis: a case report.

This article reviews directive interventions for paruresis, the inability to urinate in the proximity of others. As in treatments for other anxiety disorders, historical interventions have included the use of paradoxical intention and several different forms of exposure. The results of pharmacological treatment have not proven promising. Although a multidimensional treatment model has been recommended, little attention has been paid to treating cognitive components of the problem. In this paper, a single case is described in which cognitive components of the problem of paruresis were evident. A cognitive approach and exposure in vivo were applied. Measures of successful trials were obtained over 18 weeks. The combination of cognitive interventions and gradual exposure was effective in reducing paruresis. At follow-up 6 mo. later results had been maintained. The results of this case suggest more attention to the cognitive components is appropriate in the treatment of paruresis, as was stated previously for other specific social phobias.

Adolescent↗

Homosexuality treated adventitiously in a stuttering therapy program: a case report presenting a heterophobic orientation.

The heterophobic orientation toward treatment of homosexuality is discussed. A case report is presented where homosexuality apparently "spontaneously remitted" and heterosexuality was instated while the patient underwent treatment for stuttering. The change in sexual orientation is interpreted as possibly adventitiously induced through generalization effects from treatment of the relevant phobic aspects of the stuttering problem to the associated social aspects of the sexual problem.

Adult↗