Follow-up of Agoraphobic Patients Treated with Exposure in Vivo or Applied Relaxation

1986 ◽  
Vol 149 (4) ◽  
pp. 486-490 ◽  
Author(s):  
L. Jansson ◽  
A Jerremalm ◽  
L. G. Öst
Keyword(s):  
Treatment Results ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
Applied Relaxation ◽  
Response Systems ◽  
Exposure In Vivo ◽  
Clinically Significant ◽  
Made In

The present study describes the results of a 7-month and a 15-month follow-up of 32 agoraphobic patients treated with exposure in vivo or applied relaxation. During the followup period, all patients were given self-exposure instructions. Assessments were made in three response systems-subjective-cognitive, behavioural, and physiological-at the follow-up points. The study showed overall maintenance of treatment results in all three response systems for exposure-treated patients. For applied relaxation/self-exposure, there was a relapse on Δ heart-rate at 7 months for physiologically reactive patients, but the improvement was regained at the 15 month follow-up. Furthermore, a large proportion of the total improvement occurred during the follow-up period: 36% and 22% for exposure and applied relaxation/self-exposure respectively. The proportion of patients reaching a clinically significant improvement was 50% at the end of treatment and 66% at the 15 month follow-up.

scholarly journals A hybrid emotion-focused exposure treatment for chronic pain: A feasibility study

2014 ◽  
Vol 5 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Steven J. Linton ◽  
Alan E. Fruzzetti
Keyword(s):  
Chronic Pain ◽  
Emotion Regulation ◽  
Pain Intensity ◽  
Single Subject ◽  
Hybrid Treatment ◽  
Exposure In Vivo ◽  
Clinically Significant ◽  
Regulation Approach

AbstractBackground and aimsExposure in vivo for patients with fear-related chronic pain has a strong theoretical base as well as empirical support. However, the treatment does not work for every patient and overall the effect size is only moderate, underscoring the need for improved treatments. One possible way forward might be to integrate an emotion regulation approach since emotions are potent during exposure and because distressing emotions may both interfere with exposure procedures and patient motivation to engage in exposure. To this end, we proposed to incorporate an emotion-regulation focus into the standard exposure in vivo procedure, and delivered in the framework of achieving relevant personal goals. The aim of this study then was to test the feasibility of the method as well as to describe its effects.MethodWe tested a hybrid treatment combining an emotion-regulation approach informed by Dialectical Behaviour Therapy (DBT) with a traditional exposure protocol in a controlled, single-subject design where each of the six participants served as its own control. In this design participants first make ratings to establish a baseline from which results during treatment and the five month follow-up may then be compared. To achieve comparisons, participants completed diary booklets containing a variety of standardized measures including pain catastrophizing, pain intensity, acceptance, and function.ResultsCompared to baseline, all subjects improved on key variables, including catastrophizing, acceptance, and negative affect, at both post treatment and follow up. For 5 of the 6 subjects considerable gains were also made for pain intensity and physical function. Criteria were established for each measure to help determine whether the improvements were clinically significant. Five of the six participants had consistent results showing clinically significant improvements across all the measures. The sixth participant had mixed results demonstrating improvements on several variables, but not on pain intensity or function.ConclusionsThis emotion-regulation hybrid exposure intervention resulted in considerable improvements for the participants. The results of this study underscore the potential utility of addressing emotions in the treatment of chronic pain. Further, they support the idea that targeting emotional stimuli and using emotion regulation skills in conjunction with usual exposure may be important for obtaining the best results. Finally, we found that this treatment is feasible to provide and may be an important addition to usual exposure. However, since we did not directly compare this hybrid treatment with other treatments, additional research is needed before firm conclusions can be made.ImplicationsAddressing emotional distress in the treatment of patients suffering chronic pain appears to be quite relevant. Emotion regulation skills, employed together with exposure in vivo, hold the promise of being useful tools for achieving better results for patients suffering fear-related and emotionally distressing chronic pain.

In Vivo Sensitivity Test in Otitis Media: Efficacy of Antibiotics

PEDIATRICS ◽  
1985 ◽  
Vol 75 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Virgil M. Howie ◽  
Ruth Dillard ◽  
Barbara Lawrence
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Penicillin G ◽  
Treatment Results ◽  
Double Blind ◽  
Phenoxymethyl Penicillin ◽  
Procaine Penicillin ◽  
The Poor

During a 10-year period, antibiotics were assigned in random, double-blind fashion in six combinations to treat 948 episodes of otitis media in children. Exudate from the middle ear of all patients was cultured before treatment. Three follow-up visits were conducted; the first follow-up visit was three to five days after the start of therapy, and the second and third visits were 14 and 31 days after onset of treatment. Exudates were recultured for 75% of the patients on the first follow-up visit. Comparison of treatment results showed that triple sulfonamide combined with either phenoxymethyl penicillin, or benzathine and procaine penicillin G given intramuscularly (IM) was as effective as was ampicillin or amoxicillin. Phenoxymethyl penicillin and cyclacillin alone were usually effective against pneumococci but relatively ineffective against Haemophilus influenzae. Cefaclor and trimethoprim-sulfamethoxazole produced unsatisfactory results in about half the cases caused by pneumococci or H influenzae. Although production of β-lactamase by some otitis-causing Haemophilus and Staphylococcus species may explain the ineffectiveness of some treatments, the percentage of organisms positive for β-lactamase was too small to be responsible for the poor results with certain drugs.

scholarly journals Improving the Recording of Diagnoses in Primary Care with Team Incentives: A Controlled Longitudinal Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Tuomo Lehtovuori ◽  
Timo Kauppila ◽  
Jouko Kallio ◽  
Anna M. Heikkinen ◽  
Marko Raina ◽  
...  
Keyword(s):  
Primary Care ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Follow Up Study ◽  
Primary Care Teams ◽  
Before And After ◽  
Quasi Experimental ◽  
Clinically Significant ◽  
Made In

Introduction. We studied whether primary care teams respond to financial group bonuses by improving the recording of diagnoses, whether this intervention leads to diagnoses reflecting the anticipated distribution of diseases, and how the recording of a significant chronic disease, diabetes, alters after the application of these bonuses. Methods. We performed an observational register-based retrospective quasi-experimental follow-up study with before-and-after setting and two control groups in primary healthcare of a Finnish town. We studied the rate of recorded diagnoses in visits to general practitioners with interrupted time series analysis. The distribution of these diagnoses was also recorded. Results. After group bonuses, the rate of recording diagnoses increased by 17.9% (95% CI: 13.6–22.3) but not in either of the controls (−2.0 to −0.3%). The increase in the rate of recorded diagnoses in the care teams varied between 14.9% (4.7–25.2) and 33.7% (26.6–41.3). The distribution of recorded diagnoses resembled the respective distribution of diagnoses in the former studies of diagnoses made in primary care. The rate of recorded diagnoses of diabetes did not increase just after the intervention. Conclusions. In primary care, the completeness of diagnosis recording can be, to varying degrees, influenced by group bonuses without guarantee that recording of clinically significant chronic diseases is improved.

Cognitive-Behavioral Therapy for Paruresis: A Case Report

1998 ◽  
Vol 83 (1) ◽  
pp. 187-196 ◽  
Author(s):  
Jan P. C. Jaspers
Keyword(s):  
Behavioral Therapy ◽  
Single Case ◽  
Treatment Model ◽  
Cognitive Approach ◽  
Social Phobias ◽  
Cognitive Interventions ◽  
Cognitive Components ◽  
Exposure In Vivo

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.

Treatment of Obsessive-Compulsive Neurosis with History of Childhood Autism

1977 ◽  
Vol 130 (6) ◽  
pp. 592-597 ◽  
Author(s):  
Peter Lindley ◽  
Isaac Marks ◽  
Robin Philpott ◽  
John Snowden
Keyword(s):  
Social Skills Training ◽  
Skills Training ◽  
Childhood Autism ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
History Of Childhood ◽  
History Of ◽  
Made In

SummaryA young man was followed-up over three years who had severe obsessive-compulsive rituals and ruminations, interpersonal deficits, complicating depression and a history of childhood autism. Intensive behavioural treatment was given in an operant framework, with exposure in vivo, modelling, response prevention and social skills training. Compulsive rituals improved markedly and lastingly, but ruminations and social defects persisted. When intercurrent depression occurred dothiepin facilitated behavioural treatment. Adjustment remained fragile. Minimum maintenance treatment in the community could not be adequately arranged, so that gains made in hospital were partly lost at follow-up, despite continuing improvement in rituals.

Cognitive-Behavioural Problem Solving in the Treatment of Patients who Repeatedly Attempt Suicide a Controlled Trial

1990 ◽  
Vol 157 (6) ◽  
pp. 871-876 ◽  
Author(s):  
Paul M. Salkovskis ◽  
Chris Atha ◽  
David Storer
Keyword(s):  
Problem Solving ◽  
High Risk ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Behavioural Problem ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
One Year

In a controlled trial, 20 patients at high risk of repeated suicide attempts were randomly allocated to either cognitive-behavioural problem solving or a ‘treatment-as-usual’ control condition. The group practising problem solving improved significantly more than controls on ratings of depression, hopelessness, suicidal ideation and target problems at the end of treatment and at follow-up of up to one year, and there was evidence of an effect on the rates of repetition over the six months after treatment.

Exposure in vivo vs applied relaxation in the treatment of blood phobia

1984 ◽  
Vol 22 (3) ◽  
pp. 205-216 ◽  
Author(s):  
Lars-Göran Öst ◽  
Inga-Lena Lindahl ◽  
Ulf Sterner ◽  
Anita Jerremalm
Keyword(s):  
Applied Relaxation ◽  
Exposure In Vivo

The Use of Rescripting Imagery for People with Psychosis Who Hear Voices

2013 ◽  
Vol 42 (2) ◽  
pp. 129-142 ◽  
Author(s):  
Rebecca Ison ◽  
Luigi Medoro ◽  
Nadine Keen ◽  
Elizabeth Kuipers
Keyword(s):  
Visual Imagery ◽  
Treatment Approach ◽  
Behavioural Therapy ◽  
Community Services ◽  
Adult Mental Health ◽  
Cognitive Behavioural ◽  
Health Community ◽  
Imagery Rescripting ◽  
Clinically Significant

Background: Image rescripting can be helpful in reducing the distress associated with intrusive images or memories across a range of disorders. Existing studies using imagery rescripting with people with psychosis have not included people who hear voices. Aims: This study aimed to explore the use of image rescripting with people with psychosis who have intrusive images or memories and hear voices. Method: This study used a one-off image rescripting session, using an A-B design with four participants with psychosis who were attending adult mental health community services. Results: Clinically significant reductions in distress, negative affect and reduced conviction in the beliefs associated with the imagery were reported at 1-week follow-up and maintained for three of the four participants at 1-month follow-up. Conclusions: The study offers early indications that image rescripting can be used as a treatment approach for people with psychosis. Exploring visual imagery and rescripting visual memories where appropriate may be a useful extension of cognitive behavioural therapy for psychosis (CBTp).

scholarly journals Cognitive–behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis

2015 ◽  
Vol 45 (13) ◽  
pp. 2793-2804 ◽  
Author(s):  
S. Young ◽  
M. Khondoker ◽  
B. Emilsson ◽  
J. F. Sigurdsson ◽  
F. Philipp-Wiegmann ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Randomized Controlled ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
Over Time

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by high rates of co-morbid psychopathology. Randomized controlled trials of multimodal interventions, combining pharmacological and psychological treatments, have shown a robust treatment effect for ADHD symptoms but outcomes for co-morbid symptoms have been mixed. This may be accounted for by the type of intervention selected and/or by methodological problems including lack of follow-up and low power. The current study addressed these limitations in a parallel-group randomized controlled trial conducted in Iceland.MethodA total of 95 adult ADHD patients who were already being treated with medication (MED) were randomly assigned to receive treatment as usual (TAU/MED) or 15 sessions of cognitive–behavioural therapy (CBT/MED) using theR&R2ADHDintervention which employs both group and individual modalities. Primary measures of ADHD symptoms and severity of illness, and secondary measures of anxiety, depression and quality of life were given at baseline, end of treatment and 3-month follow-up. Primary outcomes were rated by clinicians blind to treatment condition assignment.ResultsCBT/MED showed overall (combined outcome at end of treatment and 3-month follow-up) significantly greater reduction in primary outcomes for clinician-rated and self-rated ADHD symptoms. Treatment effect of primary outcomes was maintained at follow-up, which suggests robust and lasting findings. In contrast to the primary outcomes, the secondary outcomes showed significant improvement over time.ConclusionsThe study provides evidence for the effectiveness ofR&R2ADHDand demonstrates that there are differential effects over time for ADHD symptomsversusco-morbid problems, the latter taking longer to show positive effects.

Cognitive-Behavioural Treatment of Posttraumatic Stress Disorder Following Awareness under Anaesthesia: A Case Study

2005 ◽  
Vol 34 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Richard A. Bryant ◽  
Michelle L. Moulds
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Cognitive Restructuring ◽  
Behavioural Treatment ◽  
Cognitive Behavioural Treatment ◽  
Cognitive Behavioural

The aim of the current paper is to describe the tailoring of cognitive-behavioural treatment for a female client who developed posttraumatic stress disorder (PTSD) subsequent to awareness under anaesthetic during an emergency caesarean procedure. Treatment consisted of prolonged and in vivo exposure, and cognitive restructuring over eight sessions. Assessment was conducted prior to treatment, immediately after treatment, and at 6- and 24-month follow-up. Follow-up at 24 months demonstrated good outcome, with the client no longer meeting criteria for PTSD.

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