Treatment of specific phobia in adults

Choy, Yujuan; Fyer, Abby J.; Lipsitz, Josh D.

doi:10.1016/j.cpr.2006.10.002

Cited by 461 publications

(299 citation statements)

References 90 publications

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“…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%

“…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]. Despite success of established exposure protocols, major limitations include the need for skilled clinicians, a clinical environment, and significant expenditure of cost and time.…”

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: Introductionmentioning

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

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“…Exposure therapy is a prime exemplar of a learning situation during which new memory traces are formed that need to be consolidated and integrated with pre-existing memories and experiences. It has consistently been shown to be effective in the treatment of phobia, which represents one of the most frequent types of mental disorders (Magee et al 1996;Ruhmland & Margraf, 2001;Choy, 2007;Norton & Price, 2007). However, some patients do not respond to this form of treatment, achieve only partial symptom remission, or fear often returns following initially successful therapy (Mystkowski et al 2002.…”

Section: Introductionmentioning

confidence: 99%

Sleep enhances exposure therapy

et al. 2013

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Background: Sleep benefits memory consolidation. Here, we tested the beneficial effect of sleep on memory consolidation following exposure psychotherapy of phobic anxiety. Method: A total of 40 individuals afflicted with spider phobia according to DSM-IV underwent a one-session virtual reality exposure treatment and either slept for 90 min or stayed awake afterwards. Results: Sleep following exposure therapy compared with wakefulness led to better reductions in self-reported fear (p = 0.045, d = 0.47) and catastrophic spider-related cognitions (p = 0.026, d = 0.53) during approaching a live spider, both tested after 1 week. Both reductions were associated with greater percentages of stage 2 sleep. Conclusions: Our results indicate that sleep following successful psychotherapy, such as exposure therapy, improves therapeutic effectiveness, possibly by strengthening new non-fearful memory traces established during therapy. These findings offer an important non-invasive alternative to recent attempts to facilitate therapeutic memory extinction and consolidation processes with pharmacological or behavioral interventions.

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“…However, the limitations of exposure therapy include a high dropout rate and a failure by many to maintain treatment gains in the long term (Choy et al, 2007). This has prompted the comment that a 'therapeutic impasse' has been reached, and an understanding of the neural mechanisms underlying fear inhibition is necessary for further clinical progress to be made (McNally, 2007).…”

Section: Introductionmentioning

confidence: 99%

Acute Systemic Fibroblast Growth Factor-2 Enhances Long-Term Extinction of Fear and Reduces Reinstatement in Rats

Graham

Richardson

2009

Neuropsychopharmacol

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Despite having made substantial advances in the treatment of anxiety disorders over the past few decades it appears that we have now reached a 'therapeutic impasse'. Further clinical progress requires a greater understanding of the neural mechanisms underlying fear inhibition. In this study, we examined, for the first time, the effects of fibroblast growth factor-2 (FGF2), a mitogen involved in the molecular cascade of memory, on extinction and relapse in rats. In all experiments, rats were first trained to fear a white noiseconditioned stimulus, and then had this learned fear extinguished the following day. Extinction is the process underlying exposure-based therapy in humans. Experiments 1 and 2 demonstrated that FGF2 facilitated the loss of learned fear (ie, extinction) when given either prior to or immediately after extinction but not when given 4 h after extinction. This suggests that FGF2 must be present during the consolidation of the extinction memory to have an effect. Experiment 3 further supported this interpretation by showing that short-term extinction must occur for FGF2 to facilitate long-term extinction, suggesting that FGF2 is facilitating the translation of memory from short-term to long-term storage. In experiment 4 rats given FGF2 immediately after extinction exhibited less shock-induced reinstatement, which is a model preparation of relapse, than did vehicle-treated rats. Together, these experiments demonstrate that FGF2 facilitates extinction and attenuates relapse. Thus, FGF2 may be a novel pharmacological adjunct to exposure therapy.

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Treatment of specific phobia in adults

Cited by 461 publications

References 90 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

Sleep enhances exposure therapy

Acute Systemic Fibroblast Growth Factor-2 Enhances Long-Term Extinction of Fear and Reduces Reinstatement in Rats

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