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G H Eifert

Publications and source records attributed to G H Eifert.

At least 19 recordsLinked to original sources

Using a single-subject design to assess the development of anxiety in humans.

Laboratory studies of conditioned anxiety using a between-subjects group design typically involve only one session of conditioning trials. Because research suggests that anxiety disorders develop and change with repeated exposure to aversive events, these studies may fail to mimic the developmental course of anxiety in the natural environment. We highlight the limitations of single-session studies for examining the development of conditioned anxiety within individual participants and discuss how many of these limitations can be avoided using single-subject designs. Furthermore, we suggest that the most comprehensive account of anxiety can be attained by using a single-subject design in conjunction with more commonly used group designs.

Anxiety

Devices and methods for administering carbon dioxide-enriched air in experimental and clinical settings.

Although researchers successfully have used carbon dioxide-enriched air in experimental and clinical preparations, its functional properties may differ across laboratories due to procedural differences. Additionally, current procedures may be too simplistic for more complex experimental designs. To address these issues, we present three devices for administering carbon dioxide-enriched air. Although these devices differ concerning variables such as mode of operation, ease and cost of implementation, and complexity of experimental designs that may be undertaken, a reasonable level of standardization may be achieved because the inhalations experienced by participants are functionally equivalent across devices. We discuss advantages and disadvantages of these devices regarding experimental panic provocation and aversive conditioning preparations.

Carbon Dioxide

Response intensity in content-specific fear conditioning comparing 20% versus 13% CO2-enriched air as unconditioned stimuli.

This study examined the relation between the intensity of CO2-induced psychophysiological responses and content-specific fear conditioning. Sex-balanced groups of undergraduates (N = 96) were assigned to 1 of 3 conditioned stimuli (CSs) differing in fear-relevance, and within each CS, to either 20% or 13% CO2-enriched air (unconditioned stimuli [UCS]). Several psychophysiological measures were assessed before, during, and following conditioning phases. Consistent with expectation, electrodermal and cardiac conditioned responses were larger and more resistant to extinction when associated with fear-relevant compared with fear-irrelevant stimuli, and this overall effect of fear-relevance was more robust to the more intense UCS. Severity and frequency of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) panic symptoms also varied reliably with UCS intensity, and women reported more distress and symptoms than men. Overall, the findings suggest that content-specific fear conditioning is mediated, in part, by the intensity of the bodily response. The authors discuss clinical and theoretical implications for understanding fear onset in the absence of obvious environmental pain or trauma.

Adolescent

Avoidance of 20% carbon dioxide-enriched air with humans.

Four college students were exposed to a Sidman avoidance procedure to determine if an avoidance contingency involving 20% carbon dioxide-enriched air (CO2) would produce and maintain responding. In Phase 1, two conditions (contingent and noncontingent) were conducted each day. These conditions were distinguished by the presence or absence of a blue or green box on a computer screen. In the contingent condition, CO2 presentation were delivered every 3 s unless a subject pulled a plunger. Each plunger pull postponed CO2 presentations for 10 s. In the noncontingent condition, CO2 presentations occurred on the average of every 5 min independent of responding. Following stable responding in Phase 1, condition-correlated stimuli were reversed. In both conditions, plunger response rate was high during the contingent condition and low or zero during the noncontingent condition. Furthermore, subjects avoided most CO2 presentations. However, CO2 presentations did not increase verbal reports of fear. Overall, the results from the present study suggest that CO2 can be used effectively in basic studies of aversive control and in laboratory analogues of response patterns commonly referred to as anxiety.

Air

Heart-focused anxiety, illness beliefs, and behavioral impairment: comparing healthy heart-anxious patients with cardiac and surgical inpatients.

Psychological features and complaints of persons presenting to medical settings with heart-focused anxiety and noncardiac chest pain are poorly understood. Comparing 20 healthy heart-anxious patients to cardiac and surgical inpatients and nonpatient controls, we found that healthy heart-anxious patients (a) were as afraid of chest pain and heart palpitations as inpatients with heart disease, (b) were as incapacitated by symptoms and using medical services as much as both inpatient groups; and (c) reported higher levels of cardiac disease conviction, heart awareness, and behaviors designed to protect their heart than surgical patients and nonpatients. Compared to all other groups, healthy heart-anxious patients reported more panic and other anxiety disorders, hypochondriacal beliefs, physical symptoms, obsessive-compulsive concerns, and negative affect. Following a hyperventilation test, heart-anxious patients also indicated more distressing symptoms and thoughts, and felt less safe and in control than surgical patients and nonpatients. Results support efforts for a timely recognition, diagnosis, and behavioral treatment of persons with heart-focused anxiety.

Adult

More theory-driven and less diagnosis-based behavior therapy.

Individualized treatment based on a functional analysis of problem behavior used to be considered a hallmark of behavior therapy. Yet the relative success of recently developed treatment manuals for DSM-defined disorders has cast doubts as to whether treatment individualization is really necessary. This article evaluates some of the relative merits of assessments and manualized treatments based on DSM categories and discusses data that indicate when a protocol treatment approach is sufficient and when it is not. Finally, a theory-driven approach to conducting behavior therapy is proposed as a way to complement individualized and manualized treatments. This approach is illustrated by presenting a model-based assessment and treatment approach to overcome excessive heart-focused anxiety (cardiophobia).

Behavior Therapy

"Cleaning-up cognition" in triple-response fear assessment through individualized functional behavior analysis.

Improvements in behavioral assessment spurred by the triple-response concept have been overshadowed by a preoccupation with content of assessment and a lack of regard for the context of assessment. The aims of this article are to (a) clarify the imprecise use of the verbal-subjective-cognitive mode and to reinterpret cognitive events based on evidence and methods derived from clinical behavior analysis, (b) discuss the limitations of the triple-response assessment framework, and (c) suggest an alternative functional idiographic approach to assessment and treatment that may direct attention toward behavior relations understood functionally within the context of environmental contingencies; an approach that once was the hallmark of behavior therapy and the basis for therapeutic interventions.

Agoraphobia

How can behavior therapy treat the same disorder with different techniques and different disorders with the same technique?

Traditional psychiatric diagnostic labels fail to differentiate patients on the basis of the function of the problematic behavior because such labels do not specify the nature of the individual's behavioral deficits or excesses. In contrast, behavior therapy strives to classify clinical phenomena based upon their functional characteristics guided by theoretical considerations. Yet, the anomaly exists that for a given disorder there is frequently a long list of suggested treatments that all have some degree of demonstrated efficacy. Similarly, there are a number of apparently different disorders that have been successfully treated with the same general technique. The implications of this paradox will be discussed in the context of treatments for depression. Our recent work suggests that different types of depression respond to different interventions depending on whether interventions match or do not match those types.

Adolescent

Heart-focused and general illness fears in relation to parental medical history and separation experiences.

Disease fears, such as excessive heart-focused anxiety (HFA), are quite common, and yet their origin is only poorly understood. Explanatory models of HFA have emphasized observational learning, parental cardiac disease, and the effects of separation experiences as key ethological factors. The purpose of this study was: (a) to provide descriptive information on the prevalence of HFA in an unselect sample of younger adults; and (b) to investigate the relation of HFA and general illness fears to parental medical history and different types of separation experiences. 421 undergraduate students completed the Cardiac Anxiety Questionnaire (CAQ), Illness Attitude Scales, Parental Medical History Questionnaire, and Separation Anxiety and Experience Questionnaire. Approximately 2-3% of our sample reported excessive HFA, and both illness attitudes and parental cardiac disease predicted 23% of total CAQ variance. Subjects with high CAQ scores reported more parental cardiac and other medical problems than low HFA subjects. Although high and low HFA subjects did not differ in terms of number of personal intimate relationships that ended in separation, subjects with separated parents reported more HFA than persons with nonseparated parents. We discuss the relevance of these findings for our understanding of HFA.

Adolescent

Cognitive vs. contextual causation: different world views but perhaps not irreconcilable.

In this commentary, we address some of the divisive issues between cognitive theorists and behavior analysts concerning the aims and goals of science and differing views of causality. We suggest that evidence for the causal status of cognition has been inconclusive, largely due to the fact that most of this research can be framed in terms of environmental causes. We examine (1) what we can consider as causes of behavior and (2) how we can manipulate these causes in therapy. We conclude that a rapprochement between cognitivists and behavior analysts will require more careful description of the multiple causal pathways responsible for experimental and therapeutic effects.

Behavior Therapy

The effects of running and meditation on beta-endorphin, corticotropin-releasing hormone and cortisol in plasma, and on mood.

The relations between three hormones of the hypothalamic-pituitary-adrenocortical (HPA) axis, beta-endorphin (beta-EP), corticotropin-releasing hormone (CRH) and cortisol, and mood change were examined in 11 elite runners and 12 highly trained mediators matched in age, sex, and personality. Despite metabolic differences between running and meditation, we predicted that mood change after these activities would be similar when associated with similar hormonal change. Compared to pre-test and control values, mood was elevated after both activities but not significantly different between the two groups at post-test. There were significant elevations of beta-EP and CRH after running and of CRH after meditation, but no significant differences in CRH increases between groups. CRH was correlated with positive mood changes after running and mediation. Cortisol levels were generally high but erratic in both groups. We conclude that positive affect is associated with plasma CRH immunoreactivity which itself is significantly associated with circulating beta-EP supporting a role for CRH in the release of beta-EP. Increased CRH immunoreactivity following meditation indicates, however, that physical exercise is not an essential requirement for CRH release.

Adult

The effects of running, environment, and attentional focus on athletes' catecholamine and cortisol levels and mood.

This study was designed to examine some of the psychoneuroendocrine effects of exercise-induced emotional experiences and the mediating effects of environmental setting and subjects' attentional focus. Trained runners were tested during an outdoor run and two indoor treadmill running conditions. Excretions of catecholamines and cortisol significantly increased after all running conditions but not after a control condition. Results indicate that patterns of endocrine and concomitant emotional change through exercise differ when environmental setting and attentional focus are altered in such a way that a normally pleasant task such as running becomes tedious and negatively evaluated. These findings support the notion that setting, attention, and cognitive appraisal may alter the emotional experience associated with physical exercise.

Adolescent

From behavior theory to behavior therapy: the contributions of behavioral theories and research to the advancement of behavior therapy.

As we approach the latter years of the twentieth century, a century that witnessed the birth of the behavior therapy movement, it becomes increasingly important to understand the forces that shaped the development, advancement, and success of behavior therapy. This paper is an introduction to a series of articles analyzing how major behavioral theories and research have contributed to the advancement of behavior therapy. In view of the fact that many behavior therapists have lost touch with the relation between behavior theory and behavior therapy and the challenges of the "cognitive revolution", we argue that the field would benefit conceptually and practically from integrating and utilizing the resources provided by recent advances in basic behavioral theory and research. The articles in this symposium attempt to build conceptual, methodological, and practical bridges to help behavior therapists recognize and utilize basic behavioral research and concepts.

Behavior Therapy

Unifying the field: developing an integrative paradigm for behavior therapy.

The limitations of early conditioning models and treatments have led many behavior therapists to abandon conditioning principles and replace them with loosely defined cognitive theories and treatments. Systematic theory extensions to human behavior, using new concepts and processes derived from and built upon the basic principles, could have prevented the divisive debates over whether psychological dysfunctions are the results of conditioning or cognition and whether they should be treated with conditioning or cognitive techniques. Behavior therapy could also benefit from recent advances in experimental cognitive psychology that provide objective behavioral methods of studying dysfunctional processes. We suggest a unifying paradigm for explaining abnormal behavior that links and integrates different fields of study and processes that are frequently believed to be incompatible or antithetical such as biological vulnerability variables, learned behavioral repertoires, and that also links historical and current antecedents of the problem. An integrative paradigmatic behavioral approach may serve a unifying function in behavior therapy (a) by promoting an understanding of the dysfunctional processes involved in different disorders and (b) by helping clinicians conduct functional analyses that lead to theory-based, individualized, and effective treatments.

Behavior Therapy

Cardiophobia: a paradigmatic behavioural model of heart-focused anxiety and non-anginal chest pain.

Cardiophobia is defined as an anxiety disorder of persons characterized by repeated complaints of chest pain, heart palpitations, and other somatic sensations accompanied by fears of having a heart attack and of dying. Persons with cardiophobia focus attention on their heart when experiencing stress and arousal, perceive its function in a phobic manner, and continue to believe that they suffer from an organic heart problem despite repeated negative medical tests. In order to reduce anxiety, they seek continuous reassurance, make excessive use of medical facilities, and avoid activities believed to elicit symptoms. The relationship of cardiophobia to illness phobia, health anxiety, and panic disorder is discussed. An integrative psychobiological model of cardiophobia is presented which includes previous learning conditions relating to experiences of separation and cardiac disease; deficient and inappropriate behavioural repertoires which constitute a psychological vulnerability for cardiophobic problems; negative life events, stressors, and conflicts in the person's present situation that trigger and contribute to the symptoms; current affective, cognitive, and behavioural symptoms and their stimulus properties; and genetic and acquired biological vulnerability factors. Finally, recommendations for the treatment of cardiophobia are derived from the model and areas of future research are outlined.

Arousal

The triple response approach to assessment: a conceptual and methodological reappraisal.

Despite its positive effects on the increased use of multiple assessments and improved assessment validity, the triple-response concept has led to some conceptual and practical confusion. This is mainly due to two problems: (1) a confounding of the content and method of assessment; and (2) an imprecise and vague use of the 'verbal-subjective mode' which has been expanded to include cognitive elements since the introduction of cognitive-behavioural theories and treatments. A new matrix is proposed that clearly distinguishes content and method of assessment. It also defines a separate cognitive/information-processing content area and introduces affect as an additional content area. Thus, four content areas are suggested: behavioural, physiological, cognitive, and affective, which can be measured in three different ways: by means of self-report, observation, and instruments or technical equipment. We point out the implications of these changes for (1) a more appropriate selection of assessment procedures and outcome measures in clinical research; (2) a more adequate individualization of treatment through matching individual response profiles to specific treatments; and (3) an improved understanding of the interrelationship between behavioural, physiological, cognitive, and affective processes in anxiety and depression. Finally, we suggest that the lack of agreement between measures of physiological, cognitive, behavioural and affective changes in some studies may be as much a reflection of the lack of agreement arising from spurious sources of variance within content areas as it is a reflection of the operation of different processes and systems.

Affective Symptoms

Matching treatments to client problems not diagnostic labels: a case for paradigmatic behavior therapy.

The present article critically analyzes the current approach to treatment outcome research and the uncritical use of treatment packages. Comparing various combinations of treatments with groups of clients randomly assigned to these conditions has led to the neglect of individual differences between persons falling into broad diagnostic categories. The inconclusive results of such studies say little about the efficacy of a particular treatment for an individual client and are also not very useful in helping clinicians to decide which specific treatment to use for a given client. Although treatment packages may be attractive and at times helpful to clinicians, their simplistic use is antithetical to the original and unique approach of behavior therapy and no substitute for treatment individualization. Using the example of agoraphobic problems we show how a conceptual understanding of the processes involved in a given clinical problem and the development of an integrative paradigmatic behavioral model may guide the researcher/clinician toward more effective treatment planning. Conceptually derived treatments can be individualized more easily and therefore take better account of individual differences between clients suffering from a seemingly similar problem. Treatment outcome studies should specifically compare the efficacy of matching particular types and constellations of dysfunctional processes with different procedures which specifically target those dysfunctions.

Agoraphobia

Components of generalized anxiety: the role of intrusive thoughts vs worry.

This study explored possible mechanisms involved with the maintenance of generalized anxiety. While several general anxiety-related variables were investigated, the relationship between worry and intrusive thoughts was of primary interest. We postulated that anxious persons continue to worry in order to avoid recollections of distressing life events. Accordingly, we hypothesized that worry can be distinguished from intrusive thoughts and that the experience of worry would be preferred to intrusive thoughts. Results of a factor analysis indicated that worry and intrusive thought items loaded on separate factors, which supports the hypothesis that worry can be distinguished from intrusive thoughts. The study also examined whether different patterns of worry and intrusive thoughts distinguish between high-anxious, panic, and low-anxious persons and how anxiety sensitivity and self-consciousness are related to generalized anxiety and panic. Finally, we discussed the implications of our results for understanding the psychopathology base of Generalized Anxiety Disorder.

Adult