Prolonged Exposure: a Rapid Treatment for Phobias

Abstract

13to anticholinergic drugs, is treatable with equal or greater efficiency by L-dopa alone.In our series the patient's age, the severity and duration of the disease, and the time since the last operation did not influence the therapeutic response. One limiting factor in both the "surgical" and "non-surgical" groups of patients was hypertension. Pre-existing hypertension (diastolic B.P.> 100 mm Hg but <110 mm Hg) was found in 100% of patients showing little or no response and in only 2504 and 33 % respectively of those showing a marked or moderate response to treatment. No other obvious cause of a poor response was found; the average daily dose of L-dopa attained by this poorly-responding group was 3-3 g which is similar to the average final dose in the whole series (3-1 g).Controllable side effects were seen in almost all patients; a note of caution is sounded by the occurrence of femoral neck fractures in two women, one during the trial and one shortly afterwards when the drug was reintroduced. Both were postmenopausal and both had been severely restricted in their activities by akinesia and rigidity. Both showed considerably increased mobility, and perhaps this sudden bound in activity against a background of disuse and of postmenopausal osteoporosis was sufficient to overstress the femur; in one case there was no apparent trauma and in the other it was minimal. under their care, and we are grateful to Mrs. Brenda Welsh and Miss Gillian Lough for carrying out the occupational therapy assessments. Some of the early mood assessments with use of the Hildreth self-rating scale were performed by Dr. Andrew Rabavilas.

Alternatives to Debriefing and Modifications to Cognitive Behavior Therapy for Posttraumatic Stress Disorder

“…Further mechanisms were hinted at by Watson et al [55]. They had an impression from another study which exposed phobics to live phobic cues that anxiety might simply have been an unfortunate and unnecessary by-product of exposure rather than the prime agent of improvement.…”

Some Etiological Factors in Phobic Neurosis

“…The findings reported here suggest that this in itself is often ineffective. The phobias of many patients were not eliminated, but on the contrary were intensified by exposure to the phobic situation, although perhaps a longer or indefinitely long-time exposure may facilitate extinction (23). Indeed it seems that in animal experiments (3,21) persist ence of an avoidance response and the length of time required to extinguish it is dependent upon its strength during conditioning.…”

Is EMDR an exposure therapy? A review of trauma protocols

“…Continuous stimulation in neurons and immune and endocrine cells tends to dampen responses, and intermittent stimulation tends to increase them. (Marks et al, 1998, p. 324) The idea that decreases in physiological arousal precede cognitive changes during exposure has also been empirically supported (Gauthier & Marshall, 1977;Lande, 1982;Shahar & Marks, 1980;Watson, Gaind, & Marks, 1971). Foa and Kozak (1986) have identified several factors that can reduce the effectiveness of exposure, including procedural variables and client characteristics.…”