Efficacy of interoceptive exposure therapy combined with trauma-related exposure therapy for posttraumatic stress disorder: A pilot study

Wald, Jaye; Taylor, Steven

doi:10.1016/j.janxdis.2006.10.010

Cited by 75 publications

(36 citation statements)

References 20 publications

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“…We also found that IE may indirectly involve some degree of imaginal exposure. In line with previous research (Wald, 2008;Wald & Taylor, 2007, 2008, many exercises precipitated trauma-related memories, possibly because the sensations elicited by IE (e.g. palpitations, muscle tension, pain) occurred during the MVA.…”

Section: Discussionsupporting

confidence: 89%

“…Thus, repeated exposure to sensations during IE may also involve exposure to trauma-related memories and thus contribute to a reduction of PTSD symptoms through this mechanism. Also in line with prior research (Wald, 2008;Wald & Taylor, 2007, 2008, IE had a positive impact on other symptoms that are amplified by AS, such as pain and depression. It is possible that the reduction of AS during IE also lessened their physiological arousal (e.g.…”

Section: Discussionsupporting

confidence: 88%

“…Four sessions were devoted to IE because this duration has been found to be effective in reducing AS in treatment studies of panic disorder (Taylor, 2000). A fixed sequence was used because IE is theoretically expected to facilitate TRE (Wald & Taylor, 2007). That is, by reducing their fear of arousal-related sensations through IE, patients may become more willing to complete TRE exercises, better able to tolerate the distress or arousal evoked by TRE, and less likely to drop out of TRE.…”

Section: Methodsmentioning

confidence: 99%

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Posttraumatic Stress Disorder and Chronic Pain Arising from Motor Vehicle Accidents: Efficacy of Interoceptive Exposure Plus Trauma-Related Exposure Therapy

Wald

Taylor

Chiri

et al. 2009

Cognitive Behaviour Therapy

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Preliminary data are presented on the pattern of treatment response of combining interoceptive exposure (IE) with trauma-related exposure therapy (TRE) in five female patients with posttraumatic stress disorder (PTSD) and comorbid chronic musculoskeletal pain originating from motor vehicle accidents. Treatment consisted of four sessions of IE followed by eight sessions of TRE. Four participants reported a reduction in PTSD symptoms after completing treatment, and three no longer met diagnostic criteria for PTSD. Although both interventions were associated with reductions in PTSD symptoms, TRE was associated with greater reductions in PTSD symptoms than IE and was particularly effective at reducing avoidance. IE was associated with larger reductions in anxiety sensitivity than TRE. Pain symptoms lessened slightly during IE and then worsened following TRE. Anxiety decreased after completing treatment, whereas panic and depressive symptoms responded less so. Three individuals completed a 3-month follow-up assessment. There was no change in their PTSD diagnostic status, and all experienced a slight loss of pre-post gains, particularly involving the return of pain. Clinical and research implications are discussed.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

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Posttraumatic Stress Disorder and Chronic Pain Arising from Motor Vehicle Accidents: Efficacy of Interoceptive Exposure Plus Trauma-Related Exposure Therapy

Wald

Taylor

Chiri

et al. 2009

Cognitive Behaviour Therapy

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“…For prevention, trauma exposed individuals could be screened and individuals high in related vulnerabilities could be identified and psychoeducation and/or prevention techniques designed to correct the cognitive distortions could be provided. Regarding treatment interventions, initial examinations suggest that interoceptive exposure may be effective in reducing PTSD severity (Wald & Taylor, 2007). As cognitive techniques are identified and supported for treating PTSD it may be beneficial to use them either alone or as supplements to traditional PTSD treatment.…”

Section: Re-experiencingmentioning

confidence: 99%

Attributional style and anxiety sensitivity as maintenance factors of posttraumatic stress symptoms: A prospective examination of a diathesis–stress model

Elwood

Mott

Williams

et al. 2009

Journal of Behavior Therapy and Experimental Psychiatry

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“…Interoceptive exposure is regarded as one of the crucial treatment interventions in panic disorder (Sanchez-Meca et al 2010), and it is also a method to reduce anxiety sensitivity (Taylor 1995). Notably, it is also used in the treatment of posttraumatic stress disorder as an addition to trauma-related exposure therapy (Wald and Taylor 2007). At a theoretical level, it is the difficult to determine whether the present results originate from an attentional bias.…”

Section: Discussionmentioning

confidence: 84%

The Nature of Threat: Enhanced Recall of Internal Threat Words in Fear of Flying

2010

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Conditioning theories propose that fear of flying becomes a conditioned response through the association of flight situations with a threatening aversive event. This implicates that targeting the source of the conditioned fear is essential for exposure treatment. Therefore, the present study aims to investigate the nature of threat in fear of flying, which can be external or internal. The sample consisted of 25 undergraduate students: 12 with fear of flying and 13 controls. We measured free recall of external versus internal threat words and neutral words embedded in a dichotic listening task. The results indicated that all subjects reported more external threat words as compared to the other word categories. However, the only group difference was found for the internal threat words: subjects with fear of flying recalled significantly more internal threat words than controls. This enhanced recall for internal threat-related stimuli in individuals with fear of flying indicates that internal sensations may also be essential threat stimuli to use in exposure, next to external stimuli.Keywords Fear of flying Á Dichotic listening Á Memory bias Á Anxiety People suffering from fear of flying experience an intense fear to take a flight, not only during the different stages of the flight but commonly also in anticipation of a flight.Because flying becomes more popular as a means of transportation, ever more people struggle with their fear to fly, with estimates of prevalence ranging from 10 to 40% of the general population (Van Gerwen et al. 1997).Limited research has been done on underlying mechanisms in fear of flying, with most of the research efforts relating to the treatment of the disorder. This is unfortunate because in order to effectively treat the disorder, knowledge on its causal and maintaining factors is essential. In line with conditioning theories of the etiology of fear, flying becomes a conditioned stimulus (CS) when it is paired or associated with a threatening aversive event (the unconditioned stimulus or UCS) such as an accident, which inherently produces fear [unconditioned reaction (UCR)]. Simply taking a flight will subsequently also elicit fear as a conditioned reaction (or CR). However, this account has some limitations, which also relate to more general criticisms formulated to conditioning theory (Davey 1999). First, not everyone with fear of flying has experienced threatening, aversive or traumatic events while flying. In fact, there a not enough aircraft-related incidents to explain the high prevalence of fear of flying in the general population. Second, not everyone who has experienced aversive events while flying develops fear of flying. For instance, a study by Wilhelm and Roth (1997) has shown that controls cite more flight-related aversive events than flight phobic subjects do. These limitations of conditioning theory to explain the origin fear of flying show that there might be other sources of conditioned fear than the abovementioned external aversive unconditioned stimuli. Alternativel...

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Efficacy of interoceptive exposure therapy combined with trauma-related exposure therapy for posttraumatic stress disorder: A pilot study

Cited by 75 publications

References 20 publications

Posttraumatic Stress Disorder and Chronic Pain Arising from Motor Vehicle Accidents: Efficacy of Interoceptive Exposure Plus Trauma-Related Exposure Therapy

Posttraumatic Stress Disorder and Chronic Pain Arising from Motor Vehicle Accidents: Efficacy of Interoceptive Exposure Plus Trauma-Related Exposure Therapy

Attributional style and anxiety sensitivity as maintenance factors of posttraumatic stress symptoms: A prospective examination of a diathesis–stress model

The Nature of Threat: Enhanced Recall of Internal Threat Words in Fear of Flying

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