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At least 145 records · Page 8Linked to original sources
PubMed2005

Clinical management of dental anxiety: what works for whom?

This paper aims to provide an overview of the current knowledge regarding the management of adult dentally anxious patients. Furthermore, an attempt is made to formulate a number of preliminary clinical guidelines, based on the available literature. The findings are discussed in the light of the following four problem areas or types of patients, those with: 1) a mild form of fear or anxiety, 2) a phobia of specific dental procedures or situations, 3) interfering psychiatric symptoms and/or 4) a high treatment need. The literature suggests that particularly the implementation of a high level of predictability during treatment, the training of patients in the use of coping skills, and the application of in vivo exposure to anxiety provoking stimuli are the most appropriate options for the management of anxious dental patients and the reduction of their anxiety level.

Adaptation, Psychological↗
PubMed2003

Early intervention with traumatized children.

With the events of September 11th, childhood trauma has come to the forefront of national attention. One of the common psychiatric outcomes of trauma is Posttraumatic Stress Disorder (PTSD). Despite the fact that certain vulnerabilities may contribute to the development of PTSD in traumatized youth, the existence of an identifiable stressor provides a unique opportunity for early intervention. Cognitive Behavioral Treatment (CBT) interventions are considered by many to be the mainstay of treatment of children and adolescents with PTSD. More severe cases of PTSD are often treated with medications in the community. In this article we present a CBT program--developed by our site--STAIR--and provide useful guides and rationales for clinicians to work with when treating this population. We will also briefly review the available literature on the psychopharmacologic interventions to help guide the physician when confronted with such treatment decisions.

Adaptation, Psychological↗
PubMed1978

Setting generality of blood pressure reductions and the psychological treatment of reactive hypertension.

The setting generality of treatment effects was examined for a client with 3 years' history of essential hypertension. Self-control progressive relaxation training led to durable normotensive blood pressures (BP) in the natural environment and psychology clinic, although medical setting BP remained elevated. Further assessment indicated that this latter problem was a function of conditioned anxiety to medical setting stimuli. Systematic desensitization led to reductions in medical setting BP to normotensive levels, and laboratory psychophysiological assessments confirmed the elimination of the anxiety response. The present case study raises the issue of to what extent such reactive hypertension is a problem for other individuals similarly diagnosed and demonstrates the importance of the assessment of generality of treatment effects for essential hypertension.

Adult↗
PubMed1993

Levels of trauma: a multidimensional approach to the treatment of PTSD.

The historical course of professional interest in psychological trauma in the 20th century parallels the cycle of intrusion and denial characteristic of traumatized individuals, in which periods of recognition and concern alternate with times of forgetfulness and neglect (Glass et al. 1966; Ingraham et al. 1986). The inclusion of the diagnostic category of posttraumatic stress disorder (PTSD) in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III-1980) inescapably confronted the mental health community with the problem of psychic trauma and catalyzed the quest for a deeper understanding of the disorder. This has led to a variety of explanatory models from such distant fields as neurobiology (Krystal et al. 1989; Pitman 1989; van der Kolk et al. 1985), psychophysiology (Kolb 1987), learning theory (Keane et al. 1985), psychoanalysis (Krystal 1978; Laufer 1988), cognitive psychology (Janoff Bulman 1985), and existential-humanistic philosophy (Lifton 1988).

Adaptation, Psychological↗
PubMed2004

[Does approach using "mindfulness" meditative exercises have a role to play?].

Mindfulness is the fundamental attentional stance underlying all streams of Buddhist meditative practice. It has been described as "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally." During the last years, mindfulness practice has been evaluated and introduced into several mental health treatments (Mindfulness Based Stress Reduction; Dialectical Behavior Therapy; Mindfulness Based Cognitive Therapy). In this paper, the author considers the mechanisms that may explain how mindfulness skills can lead to symptom reduction and behavior change in different emotional disorders and in anxiety disorders.

Adaptation, Psychological↗
PubMed1992

Spouse-aided therapy with agoraphobics.

Sixty agoraphobics were treated by behavioural therapy (self-exposure in vivo) either with their partner involved in all aspects of treatment or without their partner. The two treatment formats were about equally effective. Behavioural treatment directed at the agoraphobia resulted in improvement irrespective of marital quality and partner involvement in the therapy. The effects of treatment led neither to a deterioration of the marriage nor to adjustment problems in the partner. Avoidance behaviour, intropunitivity and overprotection were found to predict treatment response. The partners of agoraphobics were not found to have psychological problems themselves.

Adult↗
PubMed1997

Behaviour therapy for obsessive-compulsive disorder: a decade of progress.

OBJECTIVE: To review the last decade of behaviour therapy research in obsessive-compulsive disorder (OCD). METHOD: The most salient research was analyzed. RESULTS: Many studies confirmed that exposure and ritual prevention (ERP) effectively reduced compulsive rituals and obsessive thoughts in most patients in all age groups, although a minority of the patients did not complete treatment. Gains persisted to follow-up 2 to 6 years later in several countries. Improvement after ERP generalized to obsessive-compulsive beliefs, mood, work, and social adjustment, and was accompanied by reduction in cerebral blood flow in the right caudate nucleus. Teaching patients how to prevent relapse seems to reduce the risk of recurrence. ERP yields slightly more improvement than does appropriate antidepressant medication and is followed by far less relapse after treatment has stopped, so ERP may be more cost-effective in the long term. Antidepressant medication is a useful adjunct to ERP when OCD is accompanied by comorbid depression. The therapist now tends to teach patients how to carry out self-exposure and self-imposed ritual prevention, rather than to impose ERP on them. Self-help manuals help patients to do this, and computer aids to allow patients to learn how to do ERP at home have been valuable in pilot studies. Cognitive therapy without ERP was as useful as ERP. CONCLUSION: ERP is of lasting value for OCD. Long-term cost-effectiveness comparisons are needed of self-administered ERP versus cognitive therapy and versus medication. Studies are also needed of brief psychological treatment for depression comorbid with OCD.

Adult↗
PubMedDate not supplied

Rehabilitation of post MI depression and psychological invalidism: a pilot study.

The majority of survivors of myocardial infarction experience an array of psychological and emotional reactions. Often, persistent anxiety and depression impair recuperation and rehabilitation. A behaviorally based treatment approach is utilized which consists of a combination of deep muscle relaxation, imagery based desensitization, social reinforcement, stress management, activity scheduling and shaping technics. The spouse is utilized as a facilitator/co-therapist. This approach is shown to be effective in increasing adaptive function, decreasing depressive symptomology and facilitating return to acceptable premorbid levels of activity.

Behavior Therapy↗
PubMed1990

Is the match/mismatch model based on a statistical artefact?

In the match/mismatch model, recently formulated by Rachman and coworkers, it is stated that incorrectly predicted aversive experiences are generally followed by an immediate adjustment of the predictions concerning aversiveness of the next experience. This model can be considered to reflect a psychological process of the formation of expectations. In the present article it is argued that a simple H0 model, assuming that predictions are completely randomly generated by the subject, may account for the same effects. This H0 model is used in a stringent test of empirical data to determine if there are any effects of the discrepancy between prediction and experience on next prediction that exceed the effects explained by the H0 model. Although the H0 model produces effects very similar to the empirically observed effects, there is clear support for the hypothesized influence of the discrepancy between prediction and experience. Therefore, the model appears to reflect 'real' psychological processes and not chance findings.

Agoraphobia↗
PubMed2001

Psychological treatment of malignant vasovagal syncope due to bloodphobia.

A 17-year-old boy with frequent faints due to blood-injury phobia was studied. During cardiovascular reflex investigation in our syncope unit, 50 seconds of asystole were recorded. He was treated using systematic desensitization with muscular tension and cognitive techniques by the Pediatric Psychosocial Department and has not experienced syncopal events again.

Adolescent↗
PubMed2002

Assessing the anxious patient.

Dental anxiety is a problem for many adults and children and for many patients anxiety acts as a barrier to treatment: avoidance of treatment, irregular attendance or attendance for emergency treatment only being typical ways of dealing with the problem. For the dental team a patient's anxiety poses major management problems, as an anxious patient may require more time for treatment, is very likely to miss appointments and may have raised pain thresholds. A major cause of stress for clinicians is the management of anxiety in their patients.

Adaptation, Psychological↗
PubMed1988

Recognizing and treating fears in general practice.

Recognizing and treating dental fears requires attention to the behavioral, physiologic, and cognitive manifestations of anxiety. This article provides questions to ask and strategies to employ to identify and use in assisting the fearful patient in general practice.

Adaptation, Psychological↗
PubMed1992

Prenatal care and delivery in an agoraphobic woman. A case report.

Agoraphobia is a psychiatric illness that can cause patients to become functionally homebound. Although the obstetric care of women with agoraphobia has not been described previously, it is likely that the problem is more prevalent than recognized. A pregnant woman initially believed she would be unable to travel to the hospital for delivery. She was given prenatal care and psychotherapy at home; a safe hospital delivery was achieved. The management plan included the in-depth involvement of two physicians, physician preparation for a potential home delivery, patient education about obstetric risks and the harmlessness of agoraphobic panic attacks, and psychologic and marital therapy. Strategies for minimizing medicolegal risks were employed.

Adult↗
PubMed1983

Differential treatment of phobias: use of imipramine for panic attacks.

The core disorder in agoraphobia and mixed phobia typically is the "spontaneous" panic attack, which may be due to various psychologic and physiologic triggering mechanisms. The panics tend to lead to anticipatory anxiety and, consequently, avoidance behavior. Tricyclics and MAO inhibitors suppress the spontaneous panics. Once this is accomplished, psychotherapeutic intervention helps patients overcome their phobias. Supportive psychotherapy, imaginal desensitization and in vivo exposure appear to be equally effective. Phobics who do not experience spontaneous panics are unaffected by these drugs but improve with psychotherapeutic techniques.

Adult↗