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Biomedical subjects

E B Foa

Publications and source records attributed to E B Foa.

At least 19 recordsLinked to original sources
PubMed1995

Memory for actual and imagined events in OC checkers.

Information-processing theorists have suggested that obsessive-compulsive (OC) checking may be a function of either (1) an impaired memory of emotional events, (2) an attenuated ability to distinguish between real and imagined events or (3) a dissatisfaction with one's recall without actual memory impairment. These hypotheses were tested by having OC and control Ss engage in real and imagined actions. Some of the actions were designed to produce anxiety in the OC Ss while other events were designed to be emotionally neutral. No differences in reality-monitoring ability were found between OC and control Ss. Contrary to our prediction, OC Ss recall of their last actual behavior was superior to controls, but only for those actions that elicited anxiety. OC Ss, but not controls, reported that they desired higher levels of memory vividness than they were able to produce. The potential mechanism whereby dissatisfaction with memory vividness could contribute to repetitive checking is discussed.

Adult↗
PubMed1995

Cognitive influences on electrocortical and heart rate activity in obsessive-compulsive disorder.

The present study examined patterns of electrocortical and heart rate activity in obsessive-compulsive (OC) patients, and both high and low trait anxious control groups. Physiological patterns were examined in light of an intake-rejection attentional paradigm. For each group, electrocortical and cardiac activity were recorded during conditions of mental rest and mental activity requiring the internal versus external processing of information. The pattern of heart rate activity observed in the present study validated the choice of tasks used to examine intake and rejection attentional processes. Overall, the study reported three major findings. First, at baseline, both OC patients and high trait anxious subjects showed a pattern of activity in their EEG spectrum that differed significantly from low trait anxious subjects. Second, similar heart rate differences for the intake and rejection tasks were detected in all three groups. Third, EEG patterns unique to OCs were evidenced in the frontal region during intake and rejection tasks.

Adult↗
PubMed1995

Arousal, numbing, and intrusion: symptom structure of PTSD following assault.

OBJECTIVE: This study investigated hypotheses concerning the importance of symptoms of numbing in posttraumatic stress disorder (PTSD). METHODS: Symptoms of PTSD were assessed in 72 female rape victims and 86 female victims of nonsexual assault approximately 3 months after the crimes occurred. A principal-components factor analysis of subjects' symptoms was then undertaken. RESULTS: The analysis yielded three factors: arousal/avoidance, numbing, and intrusion. These were somewhat different from the symptom clusters in DSM-III-R, since effortful avoidance and numbing symptoms did not load on the same factor. Numbing symptoms appeared to be particularly important in identifying individuals with PTSD. CONCLUSIONS: The results imply that there are two patterns of posttrauma symptoms, one characterizing PTSD and the second characterizing a phobic reaction.

Adolescent↗
PubMed1995

DSM-IV field trial: obsessive-compulsive disorder.

OBJECTIVE: Three issues relevant to revising the DSM-III-R criteria for obsessive-compulsive disorder were examined in a field trial: 1) the requirement that symptoms of obsessive-compulsive disorder be viewed by the patient as excessive or unreasonable, 2) the presence of mental compulsions in addition to behavioral compulsions, and 3) ICD-10 subcategories. METHOD: The authors studied symptom patterns of obsessive-compulsive disorder as well as strength of obsessive belief among 431 patients with obsessive-compulsive disorder at seven hospital outpatient clinics. Two methods of subject selection were used: consecutive entry of everyone who contacted the clinics for evaluation of obsessive-compulsive disorder and entry of patients with obsessive-compulsive disorder who had continuing contact with the clinics since before the field trial and who were still symptomatic. Primary measures were the Yale-Brown Obsessive Compulsive Scale and face-valid questions about fixity of obsessive-compulsive beliefs. RESULTS: The large majority of patients were uncertain about whether their obsessive-compulsive symptoms were unreasonable or excessive, and most had both mental and behavioral compulsions. Results on the ICD-10 subcategories were equivocal. CONCLUSIONS: The present results converge with previous findings to indicate a broad range of insight among patients with obsessive-compulsive disorder. The DSM-III-R requirement for insight should be de-emphasized in DSM-IV, and mental rituals should be included in the definition of compulsions.

Adult↗
PubMed1994

Obsessions, overvalued ideas, and delusions in obsessive-compulsive disorder.

The prevailing view is that individuals with obsessive-compulsive disorder (OCD) are able to think rationally about their obsessive concerns and are thus able to recognize them as senseless. However, clinical observations indicate that at least some obsessive-compulsives do not regard their symptoms as unreasonable or excessive, and their ideas have been characterized as overvalued or delusional. In the present paper the concepts of obsessions, overvalued ideas, and delusions are discussed and compared, and the available studies of insight among obsessive-compulsives are reviewed. It is concluded that obsessive-compulsive ideas can not satisfactorily be dichotomized according to patients' insight, and that the notion of a continuum of strength of obsessive-compulsive beliefs is more appropriate. The relationship between degree of obsessive-compulsive conviction and outcome of therapy remains unclear. Methodological issues that complicate our understanding of OCD are considered, and theories of delusions are examined in relation to their development in OCD.

Attention↗
PubMed1994

Relapse prevention program for treatment of obsessive-compulsive disorder.

Eighteen participants with obsessive-compulsive disorder received 3 weeks of intensive treatment by exposure and response prevention, which were followed by either a relapse prevention (RP) program or associative therapy (AT; an attention-control program). Independent evaluators conducted assessments of obsessive-compulsive symptoms, anxiety, and depression, before and after intensive behavior therapy, after the week of intensive RP or AT and at a 6-month follow-up. Results indicated that the RP program was effective in preventing relapse: Both treatment groups improved immediately after the intensive treatment, but the RP group remained improved at follow-up, whereas the AT group showed some return of symptoms.

Adult↗
PubMed1993

Perceived controllability and the development of posttraumatic stress disorder (PTSD) in crime victims.

This study evaluated the association between perception of controllability and the development of posttraumatic stress disorder (PTSD) following criminal assault. Factor analysis of a perceived controllability scale revealed three factors; perceived controllability felt during the assault, expected controllability over future assaults, and perceived controllability over aversive events more generally. Only the latter factor was associated with PTSD symptom severity. The hypothesis that perceived controllability would be negatively associated with assault severity was partially supported. Further analyses showed that the association between controllability and PTSD was not mediated or moderated by assault severity measures. The role of perceived controllability in the development of PTSD is discussed.

Adaptation, Psychological↗
PubMed1992

Uncontrollability and unpredictability in post-traumatic stress disorder: an animal model.

The disturbances observed in animals subjected to unpredictable and uncontrollable aversive events resemble post-traumatic stress disorder (PTSD) symptoms and thus may constitute an animal model of this disorder. It is argued that the similarity between animals' symptoms and those of trauma victims may reflect common etiological factors. Relevant experiments in which animals exhibit generalized fear and arousal, discrete fear of a conditioned stimulus (CS), analgesia, and avoidance are reviewed with the view that these manifestations may be analogous to the PTSD symptom clusters of persistent arousal, reexperiencing, numbing, and avoidance, respectively. Finally, animal paradigms are suggested to test the validity of the model and specific hypotheses are derived from the animal literature regarding trauma variables that are predictive of particular PTSD symptom clusters.

Analgesia↗
PubMed1992

Treatment of depressive and obsessive-compulsive symptoms in OCD by imipramine and behaviour therapy.

The efficacy of behavioural treatment of obsessive-compulsive disorder (OCD) has been well documented. However, severely depressed OCD patients showed fewer short- and long-term benefits than less depressed patients. The present study tested the hypothesis that reduction of depression by imipramine prior to behaviour therapy would enhance the effects of behavioural therapy on depressed OC patients. Thirty-eight patients were divided into highly and mildly depressed groups according to their scores on the Beck Depression Inventory; half of each group received imipramine and half received placebo for six weeks. All patients then received three weeks of daily behavioural treatment (exposure and response prevention) followed by 12 weekly sessions of supportive psychotherapy. Results indicated that although imipramine improved depressive symptoms in depressed patients, it did not affect OC symptoms. Behaviour therapy markedly reduced OC symptoms but, contrary to our hypothesis, imipramine did not potentiate the effects of behaviour therapy. No differences between highly depressed and mildly depressed patients on OC symptoms were found in their responses to behavioural or supportive therapy.

Adult↗
PubMed1991

Processing of threat-related information in rape victims.

We investigated selective processing of threat information in persons with posttraumatic stress disorder (PTSD) by using a modified Stroop procedure. Subjects were 15 rape victims with PTSD, 13 rape victims without the disorder, and 16 nontraumatized control subjects. They were asked to name the color of four types of words: specific threat (rape-related) words, general threat (related to physical harm and death) words, neutral words, and nonwords. Rape victims with PTSD evidenced a longer response latency for color naming of rape-related words than for other target-word types. Response latencies of non-PTSD victims and nonvictim control subjects did not differ across word types. Possible mechanisms underlying the selective processing of threat material are considered, and clinical implications are discussed.

Cognition↗
PubMed1991

Diagnostic issues in posttraumatic stress disorder: considerations for the DSM-IV.

Four issues of key interest with regard to posttraumatic stress disorder in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are discussed. These include: (a) how to define the stressor criterion, especially, whether or not the victim's response ought to be included and whether low-magnitude traumas qualify etiologically; (b) the cohesiveness of the syndrome and the validity of items across stressor groups; (c) the position of posttraumatic stress disorder within DSM-IV; and (d) comorbidity with other illnesses.

Dissociative Disorders↗
PubMed1991

Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling.

Rape victims with posttraumatic stress disorder (PTSD; N = 45) were randomly assigned to one of four conditions: stress inoculation training (SIT), prolonged exposure (PE), supportive counseling (SC), or wait-list control (WL). Treatments consisted of nine biweekly 90-min individual sessions conducted by a female therapist. Measures of PTSD symptoms, rape-related distress, general anxiety, and depression were administered at pretreatment, posttreatment, and follow-up (M = 3.5 months posttreatment). All conditions produced improvement on all measures immediately post-treatment and at follow-up. However, SIT produced significantly more improvement on PTSD symptoms than did SC and WL immediately following treatment. At follow-up, PE produced superior outcome on PTSD symptoms. The implications of these findings and direction for treatment and future research are discussed.

Adaptation, Psychological↗
PubMed1989

Anxiety and cerebral blood flow during behavioral challenge. Dissociation of central from peripheral and subjective measures.

To investigate the relationship between anxiety and regional cerebral blood flow, we administered behavioral challenges to 10 patients with obsessive-compulsive disorder while measuring regional cerebral blood flow with the xenon 133 inhalation technique. Each patient was studied under three conditions: relaxation, imaginal flooding, and in vivo (actual) exposure to the phobic stimulus. Subjective anxiety, obsessive-compulsive ratings, and autonomic measures (heart rate, blood pressure) increased significantly, but respiratory rate and PCO2 did not change across the three conditions. Regional cerebral blood flow increased slightly (in the temporal region) during imaginal flooding, but decreased markedly in several cortical regions during in vivo exposure, when anxiety was highest by subjective and peripheral autonomic measures. These results demonstrate that intense anxiety can be associated with decreased rather than increased cortical perfusion and that ostensibly related states of anxiety (eg, anticipatory and obsessional anxiety) may be associated with opposite effects on regional cerebral blood flow.

Adult↗
PubMed1989

Anxious mood and memory.

Influenced by Bower (Am. Psychol. 36, 129-148, 1981) and Lang (Anxiety and the Anxiety Disorders, Erlbaum, Hillsdale, N.J., 1985), we tested three hypotheses concerning anxious mood and memory: (1) the mood state dependent hypothesis which states that memory retrieval will be greater when mood at encoding and at recall are the same than when they are different: (2) the encoding mood congruent hypothesis which states that information semantically related to mood at encoding is retrieved more readily than information unrelated to mood at encoding; and (3) the recall mood congruent hypothesis which states that information semantically related to mood at recall is retrieved more readily than information unrelated to mood at recall. We induced anxiety in speech anxious students by informing them that they would be delivering a speech during the experiment. Mood could be either anxious or nonanxious at encoding, recall, both, or neither. Hence, there were four groups: Anxiety-Anxiety, Anxiety-Nonanxiety, Nonanxiety-Anxiety, and Nonanxiety-Nonanxiety. Subjects were asked to rate the self-descriptiveness of anxiety (e.g. NERVOUS) and nonanxiety adjective (e.g. POLITE) during the encoding phase, and to recall them later. Anxious mood was measured by self-report scales and by heart rate. No support was obtained for any of the three hypotheses. However, post-hoc analyses indicated that anxiety words were recalled least often in subjects whose heart rate increased from encoding to recall. This suggests that attention to threat information may diminish in aroused nonclinical subjects.

Adult↗
PubMed1989

Effects of imipramine on the autonomic responses of obsessive-compulsives to auditory tones.

It has been argued that a mechanism of clomipramine's efficacy for obsessive-compulsive disorder is its reduction of excessive autonomic reactivity. The present study evaluated this proposed mechanism of action by assessing the effect on autonomic responding of imipramine, which is structurally similar to clomipramine, but lacks therapeutic efficacy for obsessive-compulsives. Twenty-three obsessive-compulsive patients received three sessions of 20 unsignalled 1000-Hz, 100-dB tones of 1-sec duration and 100-msec rise-time. Skin conductance level, response frequency and magnitude, and heart rate were scored for an adaptation period and for each tone onset. Six weeks after the first tone session, during which half of the subjects received imipramine while the remainder received placebo, the second tone assessment was performed. A third tone assessment was performed after an additional 4 weeks of medication. Percentage of nonresponders was also evaluated for each group. Imipramine reduced electrodermal activity and increased heart rate. Skin conductance level and both number and amplitude of responses decreased significantly after 6 weeks of imipramine, compared with placebo, with further attenuation of electrodermal activity after 10 weeks of the drug. Electrodermal nonresponding increased dramatically for the imipramine group as compared to the nondrug group. These results reveal effects of imipramine on autonomic responding, and cast doubt on the hypothesis that a mechanism for successful drug treatment of obsessive-compulsive disorder is decreased autonomic reactivity.

Acoustic Stimulation↗