Long-term outcome of social phobia treated by exposure

Fava, Giovanni A.; Grandi, Silvana; Rafanelli, Chiara; Ruini, Chiara; Conti, Sandra; Belluardo, Piera

doi:10.1017/s0033291701004020

Cited by 67 publications

(55 citation statements)

References 28 publications

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“…Techniques such as exposure, social skills training, and cognitive restructuring are used. [1][2][3][4] One of the most efficient methods for treating phobias is exposure, [5][6][7] which can be in vivo or imagined (in vitro). In vivo exposure is superior to imagination, but it is costly and timeconsuming, and situational elements are difficult to control.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Gebara

Barros-Neto

Gertsenchtein

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Methods: Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Results: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. Conclusion: This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings.

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Section: Introductionmentioning

confidence: 99%

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Gebara

Barros-Neto

Gertsenchtein

et al. 2015

Rev. Bras. Psiquiatr.

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“…1 The use of acid to produce facial burns in women was witnessed in many rural communities in developing countries. 2 The first recorded acid attacks in developing countries occurred in Bangladesh in 1967, followed by India in 1982, and Cambodia in 1993. Since then, research has witnessed an increase in the amount and severity of acid attacks in the region.…”

Section: Fred Rogersmentioning

confidence: 99%

Community Oriented Prevention and Rehabilitation of Burns

Afzal¹

2016

Annals KEMU

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“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. The people around can help us know that we are not alone.” Fred Rogers In spite of the efforts of public health physicians to prevent burn injury through fire prevention, awareness campaigns and educational programs, still burn injuries continue to present a significant social and financial burden through patient mortality, morbidity, and long term disability. Life after burns is a continuous struggle to improve quality of life in society, seeking employment to remain functional, acceptance in community without any stigmatization and medical support to combat health problems. Cost of medical care and rehabilitation is enormous and can be avoided through community oriented prevention of burns and later on effective rehabilitation in particular community. The causes and types of burn injuries determine prevention and rehabilitation plans. Especially when burns are associated with violence, terrorism conflicts and fights. The conflicts include inter racial differences; inter religious assassinations, revengeful traditions, attempted murders, honor killings, domestic violence and terrorism in a community.1 The use of acid to produce facial burns in women was witnessed in many rural communities in developing countries.2 The first recorded acid attacks in developing countries occurred in Bangladesh in 1967, followed by India in 1982, and Cambodia in 1993. Since then, research has witnessed an increase in the amount and severity of acid attacks in the region. However, this can be traced to significant underreporting in the 1980s and 1990s, along with a general lack of research for this phenomenon during that period.3 Acid attacks were reported in many parts of the world. Since the 1990s, Bangladesh had been reporting the highest number of attacks and highest incidence rates for women with 3,512 Bangladeshi people acid attacked between 1999 and 2013.3 Although acid attacks occur all over the world, including in Europe and the United States, this type of gender based violence is concentrated in rural communities of India, Bangladesh and Pakistan where the implementation of regulations needs further exploration. In Pakistan, the majority of these attacks occurred in the summer. According to a report, up to 150 attacks on women occurred every year. They also reported that the attacks were often the result in rise of domestic abuse, and the majority of victims were female.4 The gender violence increased the morbidity rates in burns survivors. The efforts to produce community oriented prevention and rehabilitation of the adult burn survivors and to measure their health outcomes, preventing social isolation, providing social support and better quality of life after burn injury are almost negligible. WHO working groups states that quality of life is an individual perception of their position in life in context of culture and values system which they live in relation to their goals, expectations, standard and concerns.5 Eventual outcome depends on injury severity, individual physical characteristics of patient’s motivation, and social support by family and friends.5 It was documented that large number of people living with burn scars need social support more than healthy people for better quality of life.6 There is a dire need for better understanding of multifaceted determinants of burn injuries and quality of life in adult survivors in the context of society norms and cultural pressures in community settings, in order to plan better preventive strategies to combat this public health problem. Prevention efforts are urgently needed to reduce the rate of these unacceptably high burn injuries, and should be developed on a local level in response to risk factors identified in individual areas. Community oriented prevention and rehabilitation of burns is a cost effective strategy. Community participation, use of appropriate technology, accessibility and equitable distribution of preventive and rehabilitative services are its components. Thus efforts should be directed to decrease sufferings of the burn survivors in society and social support systems should be developed to improve quality of life of burn victims through community oriented prevention and rehabilitation of burns.

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“…Apesar das freqüentes dificuldades relacionadas à remissão completa, estudos evidenciam que os sintomas residuais são um dos principais fatores associados à recaída dos quadros de TAS em médio e longo prazo 4 . Em função da baixa procura por tratamento, pacientes com TAS freqüentemente perdem oportunidades de crescimento pessoal e profissional, desenvolvendo auto-avaliação negativa e isolando-se ainda mais na participação na sociedade.…”

Section: Introductionunclassified

Diretrizes da Associação Médica Brasileira para o tratamento do transtorno de ansiedade social

Levitan

Chagas²,

Crippa³

et al. 2011

Rev. Bras. Psiquiatr.

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ResumoIntrodução: O transtorno de ansiedade social (TAS) é o transtorno de ansiedade mais comum, freqüentemente sem remissões, sendo comumente associado com importante prejuízo funcional e psicossocial. A Associação Médica Brasileira (AMB), através do "Projeto Diretrizes", busca desenvolver consensos de diagnóstico e tratamento para as doenças mais comuns. O objetivo deste trabalho é apresentar os achados mais relevantes das diretrizes relativas ao tratamento do TAS, servindo de referência para o médico generalista e especialista. Método: O método utilizado foi o proposto pela AMB. A busca foi realizada nas bases de dados do MEDLINE (PubMed), Scopus, Web of Science e Lilacs, entre 1980 e 2010. A estratégia utilizada baseou-se em perguntas estruturadas na forma P.I.C.O (acrônimo das iniciais "paciente ou população"; "intervenção, indicador ou exposição"; "controle ou comparação" e; "outcome ou desfecho"). Resultados: Estudos evidenciam que o tratamento farmacológico de primeira linha para adultos e crianças são os inibidores seletivos de recaptação de serotonina e os inibidores de recaptação de serotonina e noradrenalina, enquanto que a terapia cognitivo-comportamental é apontada como melhor tratamento psicoterápico. Além disso, algumas comorbidades psiquiátricas foram associadas a uma pior evolução do TAS. Conclusões: Apesar da alta prevalência, o TAS acaba por não receber a devida atenção e tratamento. A melhor escolha para o tratamento de adultos é a associação psicoterapia cognitivo-comportamental com inibidores seletivos de recaptação de serotonina e os inibidores de recaptação de serotonina e noradrenalina. Outras opções como benzodiazepínicos ou inibidores da monoaminooxidase devem ser usados como segunda e terceira opção respectivamente. Abstract Introduction: Social anxiety disorder (SAD) is the most common anxiety disorder, usually with no remission, and is commonly associated with significant functional and psychosocial impairment. The Brazilian Medical Association (BMA), with the project named Diretrizes (Guidelines, in English), seeks to develop consensus for the diagnosis and treatment of common diseases. The aim of this article is to present the most important findings of the guidelines on the treatment of SAD, serving as a reference for the general

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Long-term outcome of social phobia treated by exposure

Cited by 67 publications

References 28 publications

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Community Oriented Prevention and Rehabilitation of Burns

Diretrizes da Associação Médica Brasileira para o tratamento do transtorno de ansiedade social

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