Psychological approaches in the treatment of specific phobias: A meta-analysis

Wolitzky-Taylor, Kate; Horowitz, Jonathan D.; Powers, Mark B.; Telch, Michael J.

doi:10.1016/j.cpr.2008.02.007

Cited by 433 publications

(289 citation statements)

References 75 publications

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“…The virtual platform can be adapted to provide a portable, safe, and flexible analog to practice systematic exposure, desensitization to feared stimuli, or coping skills relevant for blood/needle procedures [37]. Given its ability to induce presyncopal symptoms among fearful participants, the paradigm can provide a context to target such symptoms directly using interventions such as applied muscle tension [23].…”

Section: Discussionmentioning

confidence: 99%

“…Considerable evidence suggests that in-vivo exposure is among the most effective interventions for blood-injection-injury phobia, as well as variety of other feared experiences or stimuli [4,23,24,37]. During in-vivo exposure an individual is asked to come into contact with the feared stimulus, usually progressing from the least to most anxiety-provoking aspect of the stimulus [4].…”

Section: Introductionmentioning

confidence: 99%

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Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Trost

Jones

Guck

et al. 2017

Journal of Anxiety Disorders

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Fear of blood, injections, and needles commonly prevents or delays individuals' receipt of health care, such as vaccines or blood draws. Innovative methods are needed to overcome these fears and reduce anxiety related to activities of this nature. The present study describes initial testing of an arm illusion paradigm that may prove useful during early phases of graded exposure for people with blood and needle fear. Seventy-four undergraduate students aged 18-29 years were tested. In line with study aims, results indicated that the virtual blood draw paradigm promoted strong perceptions of arm ownership and elicited significant changes in physiological indices (blood pressure, heart rate, electrodermal activity, respiratory rate) in response to key procedure elements (e.g., needle insertion). Further, bivariate correlations indicated that individual differences in self-reported blood and needle fear collected prior to the illusion paradigm were significantly associated with presyncopal symptoms reported following the procedure. In regression analyses, self-reported measures of blood and needle fear explained unique variance in presyncopal symptoms even after controlling for general state anxiety. These findings provide initial support for the virtual blood draw paradigm as a promising tool to help provide graded exposure to medical procedures involving needles and blood draw.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Trost

Jones

Guck

et al. 2017

Journal of Anxiety Disorders

View full text Add to dashboard Cite

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“…This latter finding was attributed to further improvements for 'other' exposure-based treatment rather than return of fear for in vivo treatment (Wolitzky-Taylor et al, 2008).…”

Section: Introductionmentioning

confidence: 87%

“…These treatment approaches include guided relaxation, instructionalbased self-exposure (Marks, Kenwright, McDonough, Whittaker, & Mataix-Cols, 2004), vicarious exposure (Gilroy, Kirkby, Daniels, Menzies, & Montgomery, 2003), virtual reality (Krijn, Emmelkamp, Olafsson, & Biemond, 2004) and symbolic exposure via images and videos (Bornas et al, 2002;Matthews, Scanlan, & Kirkby, 2012;Vansteenwegen et al, 2007). A recent metaanalysis concluded that exposure-based interventions were more effective than placebo, or alternative psychotherapeutic interventions, and that in vivo exposure (involving direct contact with the phobic stimulus) was more effective than 'other' exposure-based interventions (e.g., imaginal, virtual reality) at post-treatment but not at follow-up (Wolitzky-Taylor et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Specific phobia can be successfully treated with exposure-based interventions (Öst, 1997;WolitzkyTaylor, Horowitz, Powers, & Telch, 2008), but many people do not seek treatment (Bebbington et al, 2000;Stinson et al, 2007). Barriers to treatment include unawareness of treatment options, fear of interaction with the phobic stimulus, and factors such as treatment availability, accessibility, labour intensiveness, stigma, and cost (Ritterband, Thorndike, Cox, Kovatchev, & Gonder-Frederick, 2009;Wolitzky-Taylor et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Symbolic online exposure for spider fear: Habituation of fear, disgust and physiological arousal and predictors of symptom improvement

Matthews

Naran

Kirkby

2015

Journal of Behavior Therapy and Experimental Psychiatry

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Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders

et al. 2014

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IMPORTANCEThere is debate about the effectiveness of psychiatric treatments and whether pharmacotherapy or psychotherapy should be primarily used.OBJECTIVES To perform a systematic overview on the efficacy of pharmacotherapies and psychotherapies for major psychiatric disorders and to compare the quality of pharmacotherapy and psychotherapy trials. EVIDENCE REVIEWWe searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library (April 2012, with no time or language limit) for systematic reviews on pharmacotherapy or psychotherapy vs placebo, pharmacotherapy vs psychotherapy, and their combination vs either modality alone. Two reviewers independently selected the meta-analyses and extracted efficacy effect sizes. We assessed the quality of the individual trials included in the pharmacotherapy and psychotherapy meta-analyses with the Cochrane risk of bias tool.FINDINGS The search yielded 45 233 results. We included 61 meta-analyses on 21 psychiatric disorders, which contained 852 individual trials and 137 126 participants. The mean effect size of the meta-analyses was medium (mean, 0.50; 95% CI, 0.41-0.59). Effect sizes of psychotherapies vs placebo tended to be higher than those of medication, but direct comparisons, albeit usually based on few trials, did not reveal consistent differences. Individual pharmacotherapy trials were more likely to have large sample sizes, blinding, control groups, and intention-to-treat analyses. In contrast, psychotherapy trials had lower dropout rates and provided follow-up data. In psychotherapy studies, wait-list designs showed larger effects than did comparisons with placebo.CONCLUSIONS AND RELEVANCE Many pharmacotherapies and psychotherapies are effective, but there is a lot of room for improvement. Because of the multiple differences in the methods used in pharmacotherapy and psychotherapy trials, indirect comparisons of their effect sizes compared with placebo or no treatment are problematic. Well-designed direct comparisons, which are scarce, need public funding. Because patients often benefit from both forms of therapy, research should also focus on how both modalities can be best combined to maximize synergy rather than debate the use of one treatment over the other.

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Psychological approaches in the treatment of specific phobias: A meta-analysis

Cited by 433 publications

References 75 publications

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Symbolic online exposure for spider fear: Habituation of fear, disgust and physiological arousal and predictors of symptom improvement

Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders

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