Browsing by Subject "Exposure therapy"
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Item The effects of emotional acceptance and suppression upon emotional processing in exposure treatment of claustrophobia(2009-08) Horowitz, Jonathan David; Telch, Michael JosephRecent investigations have suggested that the use of emotion-avoidance or emotion- suppression strategies to cope with anxiety contributes to the development and maintenance of anxiety disorders, and that substituting these strategies with emotional acceptance can lead to effective symptom reduction. We wished to consider whether attempts to suppress the negative emotions associated with exposure therapy would serve to impede emotional processing and symptom reduction, and conversely, whether acceptance of these emotions would augment treatment efficacy. Fifty-nine participants displaying marked claustrophobic fear were assigned to receive 30 minutes of exposure (enclosure in a small chamber) while receiving, A) instructions to accept and allow the experience of unpleasant emotions (ACC), B) instructions to control and suppress the experience of unpleasant emotions (SUP), or C) no instructions regarding emotion regulation (exposure only; EO). Outcome assessments were conducted prior to treatment, immediately following treatment, and at one-month follow-up, and included fear and heart rate reactivity in response to a behavioral approach test. We predicted that ACC participants would display greater reductions in claustrophobic fear than EO participants, and that EO participants would in turn display greater reductions in claustrophobic fear than SUP participants. These hypotheses were not supported. In addition, a detailed analysis of treatment process data was conducted. Peak fear ratings, claustrophobic threat expectancies, self-efficacy, and acceptance of anxiety were collected over the course of the treatment session, and hierarchical linear modeling (HLM) was used to produce individual growth curves for these variables. Three hypotheses were formulated: 1) ACC participants would display a more rapid improvement in these measures than SUP and EO participants, 2) threat expectancies, self-efficacy and anxiety would mediate reductions in fear over the course of treatment, and 3) mediational pathways would be moderated by treatment condition. Though no support was found for our first process hypothesis, treatment specific mediation was found. Among ACC participants, self-efficacy and suffocation expectancies mediated the session-fear relationship, and among EO participants, entrapment expectancies mediated this relationship. Among SUP participants, no significant mediators were identified.Item Enhancing exposure therapy with acute exercise : an initial test(2016-08) Jacquart, Jolene Ann; Smits, Jasper A. J.; Monfils, MarieExposure-based therapies are one of the most effective strategies for treating a large range of anxiety disorders; yet there remains a substantial (20-50%) non-response rate. Since exposure therapies are based on fear extinction principles, strategies that can enhance the acquisition and retention of fear extinction memories should, theoretically, facilitate the outcome of exposure therapy. Pharmacological agents acting as cognitive enhancers have shown some effectiveness in augmenting exposure therapy. Aerobic exercise may similarly act as a cognitive enhancer as it has been shown to affect learning and memory processes broadly. The current study builds upon the extant literature by conducting an initial test of the efficacy of acute aerobic exercise for enhancing exposure therapy outcomes. Adults with a marked fear of heights were randomized to either 30-minutes of vigorous aerobic exercise or rest immediately prior to 30-minutes of virtual reality exposure therapy (VRET). Participants’ fear of heights was assessed 1- and 2-weeks later by clinician ratings and self-report questionnaires. On average, participants showed significant decreases in fear of heights from baseline to 1- and 2-weeks post-VRET, but these changes did not significantly differ by treatment condition. This remained true even after including potential moderators of treatment condition. These findings do not support acute exercise as an augmentation strategy for exposure therapy. Clinical and research implications are discussed.Item The war at home : a veteran's use of critical design methods for post-deployment reintegration(2015-05) Perez, Jose Manuel; Catterall, Kate; Sonnenberg, StephenMany combat veterans underestimate the on-going traumatic effects of war, effects that eventually surface in civilian life, causing health, relationship and career problems. During a deployment, emotions such as vigilance, anger, and fear are beneficial for the soldier and aide in coping with multiple combat-related adversities. Suppression of emotions that do not assist the soldier or mission during deployment is necessary and becomes habitual as it helps the soldier stay motivated and focused for the duration of the deployment. Post-deployment, the coping mechanisms previously necessary for survival, contribute to the difficulties of reintegration. The problems encountered by veterans can include, but are not limited to: social withdrawal, economic decline, self-medication, and most problematic, suicidal tendencies. As a veteran myself, I began to ask, is there another way to prepare veterans for re-entry to civilian life, to prevent unnecessary hardships and tragedies, educate them in unfamiliar ways, and perhaps contribute to an effective healing process? As a designer I approached these questions, searching for a way to communicate the adversities veterans face from an unexpected angle. Presented here are prototypes, diagrams, and warning systems designed to help veterans 1) be more self-aware and alert to the symptoms of posttraumatic stress and depression, 2) engage the armed forces and the VA in a discussion about innovative and more effective ways to talk about and treat the psychologically damaged soldier, and 3) foster communities to support veterans in their re-entry to civilian life. The objects I designed for my thesis exhibition are not intended to correct a complex problem such as Posttraumatic Stress Disorder (PTSD) or moral injury. Instead, they are created as a collection of tools to facilitate difficult conversations, provoke thought, and as an alternative approach to reach combat veterans who are in their own process of reintegration. My work is one method to process the effects of war through a non-destructive practice for those veterans who may not pay attention to the wall of pamphlets or other forms of disseminating information.