SEARCH · Search PubMed
Results for “Implosive Therapy”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Living-related small bowel transplantation: report of 2 cases].
OBJECTIVE: To investigate the result in treating short bowel syndrome with living-related small bowel transplantation. METHODS: Two patients with short bowel syndrome underwent living-related small bowel transplantation. One patient was an 18-year-old boy and the donor was his father. A segment of 150 cm distal small bowel was resected as the graft from the donor. Another patient was a 15-year-old boy and the donor was his mother. The graft was 160 cm long, with arteries and veins anastomosed to the recipient's infrarenal aorta and cava respectively. Intestinal continuity was restored with an end-to-end anastomosis between the recipient's jejunum and the donor's ileum, and the distal end was made as fistulization. Treatment of immunosuppression, antibiotics, anti-thrombosis and nutritional support were given posttransplantation. RESULTS: Complications such as anaemia and acute rejection occurred in the first recipient and were handled properly and brought under control after operation. The patient has been surviving 26 months since the transplantation. The graft's function is well. The patient can eat food and resume his daily work. In the second recipient, acute rejection occurred on day 26 after operation and was controlled by implosion therapy. Serious rejection occurred on day 80 again and did not respond to implosion therapy with methylprednisolone. After use of OKT3 and ATG the rejection was minimized. Because of uncontrolled infection, the patient died on 5th month after operation. CONCLUSION: Living-related small bowel transplantation is an ideal treatment for short bowel syndrome.
[Modified implosive (flooding) therapy: treatment of phobias in London].
Explore the source record for details and available documents.
Behavioral techniques in the treatment of a writing phobia.
This paper presents the theoretical bases of the counterconditioning techniques of systematic desensitization and the extinction techniques of implosion therapy and flooding. A case history is presented in which progressive muscle relaxation, diaphragmatic breathing, and flooding were used to extinguish and countercondition a writing phobia in a junior-year occupational therapy student. Two target behaviors were selected for modification: to increase the number of words written within a specified time period, and, at the same time, to decrease the number of self-doubting thoughts. Twenty treatment sessions were conducted in which the subject practiced these techniques and wrote an essay during a specified time period. The results support the effectiveness of these techniques in modifying maladaptive anxiety or fear arising from a situation that is not objectively dangerous.
Effectiveness of anxiety management training in the treatment of posttraumatic stress disorder: a preliminary report.
This preliminary study investigated the effectiveness of anxiety management training (AMT), a coping skills treatment similar to systematic desensitization, in comparison to implosive therapy (IT), an exposure-based treatment, for treating six Vietnam combat veterans with posttraumatic stress disorder (PTSD). The Clinician Administered PTSD Interview Scale (CAPS; Blake et al. (1988), The Behaviour Therapist, 18, 187-188) and a self-monitoring measure (Weathers et al., 1991) were used as dependent measures. A single-subject, multiple-baseline, crossover design (ABC/ACB) was employed. A new statistic for such designs (Mueser et al. (1991), Behaviour Modification, 15, 134-155), based on classical test theory, was used to assess treatment effects on intrusive war memories and avoidance of stimuli reminiscent of war. Within-subject results indicated that AMT and IT were similarly effective in reducing the frequency and intensity of intrusions and avoidance. This preliminary report therefore suggests that it may be productive to investigate multidimensional approaches (combining coping skills, exposure-based, and other approaches) to the treatment of combat-related PTSD as Foa et al. (1991), Journal of Consulting and Clinical Psychology, 59, 715-723 and Nishith et al. (1995), Behaviour Therapy, 26, 319-335 have for rape-related PTSD.
A learning-theory perspective of brief psychodynamic psychotherapy.
The authors discuss the role of repeated exposure, a universal aspect of learning theory, in implosive therapy and brief psychodynamic psychotherapy. After demonstrating that it is one common denominator of these distinctive treatment modalities, they offer hypotheses concerning the workings of brief psychodynamic psychotherapy based on observations of the role of repeated exposure in behaviorally oriented therapies.
[Psychological and psychotherapeutic aspects of grief].
Psychological theories on the significance and the process of mourning are discussed, and an approach to the psychotherapy of pathological grief is described. Bereavement behaviour refers to the total response pattern, psychological and physiological, displayed by an individual following the loss of a significant object, usually a loved person. Various theories on the nature and course of bereavement are reviewed. The following psychological aspects associated with bereavement are discussed in more detail: Shock, denial, searching, depression, guilt, aggression, anxiety, jealousy and reintegration. Specific conditions that might lead to pathological mourning are pointed out. At last, an implosive therapy approach to pathological mourning is described, which is based on the prolonged exposure to the painful stimuli until extinction of the severe emotional response occurs ("flooding"). The procedure is illustrated by examples from actual therapies.
Behavior analysis, cognitive therapy, and covert conditioning.
Branch (The Behavior Therapist 10, 79-84, 1987) and others have expressed interest in extending the behavior analytic framework into the realm of behavior therapy and private events. We point out that several imagery-based behavior therapy procedures such as systematic desensitization, implosive therapy, and covert conditioning were designed to be employed according to learning principles and that covert conditioning is specifically based on principles of operant conditioning. Since the covert conditioning model already combines the advantages of behavior analysis, behavior therapy, and imagery, covert conditioning, rather than cognitive therapy, should be considered by behavior analysts seeking ways to study and modify both private and public events.
Two-phase treatment of panic disorder and posttraumatic stress disorder with associated personality features resulting from childhood abuse: case study.
The treatment of a women diagnosed with panic disorder with Agoraphobia and posttraumatic stress disorder and maladaptive personality features resulting from childhood sexual and physical abuse is described. The treatment consisted of nine sessions of cognitive behavior therapy (CBT) for Panic Disorder with Agoraphobia and nine sessions of implosive therapy (IT) for Posttraumatic Stress Disorder. CBT decreased scores on the clinical scales of the Personality Assessment Inventory (PAI), but did not reduce revised Impact of Event Scale (IES) scores, or Dimensional Assessment of Personality Problems-Basic Questionnaire (DAPP-BQ). IT decreased scores on the IES and the DAPP-BQ, and further reduced scores on the PAI. The results are discussed with regard to Levis' (1985) implosive theory of psychopathology, which suggests that psychopathology can be explained by Pavlovian conditioning of serial cues and instrumentally conditioned avoidance responses.
What's the fear of? Using implosion to explore the bodily-injury fear complex.
The present study utilized implosive therapy scenes to assess fear reactions to cues hypothesized to be instrumental in the development and maintenance of bodily-injury phobia. In addition to a bodily mutilation stimulus, the cue areas targeted were loss of control and death fears. Twenty-six high-fear subjects and 24 low-fear subjects rated their fear while imagining that they were the woman depicted in four audiotaped scenes. A repeated measures analysis of variance detected significant group differences for the fear ratings, with the high-fear group reporting more fear than the low-fear group. Also, the high-fear group's skin conductance response amplitudes averaged across the four scenes were significantly higher than those of the low-fear group. Finally, the high-fear group's more pathological questionnaire scores were significantly different from the low-fear group's for both the Self-Control Schedule and the Lester Attitude Toward Death Scale. This study is the first to assess various components of bodily injury fear through the use of imagery while measuring across two response-modes.
Extrapolation of two-factor learning theory of infrahuman avoidance behavior to psychopathology.
This paper involves a theoretical attempt to extend O. H. Mowrer's two-factor theory of infrahuman avoidance behavior to the area of human psychopathology, Central to any such theoretical extrapolation is the need to explain why human fears and avoidance behavior manifest such strong resistance to extinction while the abundance of infrahuman findings suggests that the extinction of such behaviors is rapid. The position is advanced that this noted paradox can be resolved both theoretically and empirically by modifying and extending the Solomon and Wynne conservation of anxiety hypothesis to include complex, serial ordered cues. The model presented also provides the rationale for an extinction approach to psychotherapy, referred to as implosive therapy which is briefly described. Supporting data for the model as well as alternative explanations are provided and discussed.
Residual fear of the conditioned stimulus as a function of response prevention after avoidance or classical defensive conditioning in the rat.
Studies employing response prevention (RP) are reviewed. Considering assessment difficulties and conflicting findings, it is questionable whether RP actually reduces fear to a conditioned stimulus (CS). This study measured fear after RP via a conditioned emotional response (CER) paradigm. Hypotheses were that fear of an auditory CS (conditioned in an avoidance paradigm) is reduced during RP, and that fear conditioning would occur to aspects of the conditioning environment per se. Also evaluated was the effectiveness of RP when fear had been learned under two different conditions: (a) avoidance or (b) classical defensive conditioning. Seven groups of 10 experimentally naive female rats were run. Animals were initially trained to bar press for food pellets on a variable interval (VI) 2 schedule. Three groups were then avoidance trained in a two-way shuttle box to a criterion of 10 successive avoidances. Immediately following acquisition, one group received RP (blocking) in the shuttle box (Condition A-B). This consisted of placing a door between the two sides of the box and presenting the 85 dB (A) white noise CS for 15 20-sec periods with a variable 1-min interstimulus interval. One group did not receive RP (nonblocked) and was instead immediately returned to its home cage (Condition A-NBHC). The third group was treated as was A-B except the CS was not presented (Condition A-NBSB). Two other groups were trained in a classical defensive paradigm. These animals were matched to A-B animals in terms of number, order, and duration of CSs and USs. Following conditioning, one group received the same treatment as A-B (Condition CD-B), and the other received the same treatment as A-NBHC (Condition CD-NBHC). Two groups served as controls. A backward control (Condition BC-NBHC) was matched to A-NBHC in terms of number, order, and duration of CSs and USs. A sensitization control (Condition SC-NBHC) was matched to A-NBHC in terms of number, order, and duration of CS presentations. Immediately following conditioning trials, control animals received the same treatment as A-NBHC animals. After differential treatments all animals were immediately returned to the lever box in which they had learned to bar press, a VI 2 schedule was reinstated, and the CER was measured. A-B showed significant suppression initially but significantly less than A-NBHC, suggesting that although RP was effective in reducing fear to the CS, some fear remained. Controls showed essentially no suppression and did not differ. A-B did not differ from A-NBSB, suggesting that conditioning of fear did occur to the environment and that this fear was subsequently reduced in A-NBSB. A-B suppressed significantly more than CD-B, suggesting that RP was more effective when fear was learned in a classical as compared to an avoidance paradigm. Theoretical implications and generalizations to implosive therapy are discussed.
Effectiveness and moderators of PE and CPT in adult PTSD treatment: a systematic review and meta-analysis.
Background: Posttraumatic Stress Disorder (PTSD) is a prevalent and debilitating condition that challenges mental health services worldwide. Effective psychological interventions are crucial for treatment, among which Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are prominent. Comparative analyses of these treatments, considering moderators such as patient demographics and treatment specifics, are necessary to tailor interventions effectively.Objective: This meta-analysis synthesised findings from 175 treatment arms across 163 studies to evaluate the comparative effectiveness of PE and CPT for PTSD. Effect sizes were calculated as Hedges' g for between-group (treatment vs. control) and within-group (pre-post) comparisons.Results: Using a random-effects model, the overall pooled effect size was large (Hedges' g = 1.67, 95% CI [1.56, 1.79]), suggesting substantial treatment-related symptom improvement. Multivariate meta-regression revealed, across the full sample, none of the main effects or interactions was significant. A sensitivity analysis excluding 10 influential outliers reduced the overall effect size (g = 1.55), indicating that PE was associated with larger effects than CPT among non-military samples, and larger effects were observed in studies with a higher proportion of female participants, military samples, and samples with lower proportions of sexual trauma. Treatment-by-sample-characteristic interactions were not significant in the trimmed model.Conclusions: Findings suggest that PE and CPT produce large effects in reducing PTSD symptoms, with some variation across treatment type and sample characteristics. Results underscore the importance of examining contextual moderators such as treatment setting and population type and highlight the need for transparent reporting of key sample features to improve future meta-analytic precision.
Explosion of renal replacement therapy after the implosion of the Soviet Empire.
After the implosion of the Soviet Empire, renal replacement therapy in Central and Eastern Europe has undergone dramatic transformation and improvement with respect to quantity and quality. While the prevalence (ie, the number of patients on renal replacement therapy) is still lower than in Western Europe, the incidence (ie, the number of patients accepted for renal replacement therapy) has by now reached on average the level seen in Western Europe, albeit with wide differences between the individual countries. The rate of renal transplantation is still highly variable. Substantial differences of organizational structures for renal replacement therapy exist, with private organizations gradually taking over from public services.
Distraction during flooding (exposure): concordance between results in animals and man.
Explore the source record for details and available documents.
Behavioral, cognitive, and pharmacological treatments of panic disorder with agoraphobia: critique and synthesis.
Theoretical, methodologic, and clinical research issues pertaining to these treatments are examined as are their strengths, limitations, and possible interactions. Attrition, outcome, and maintenance effects are compared. Composite indices of clinically significant improvement, endstate functioning, and longitudinal adjustment are presented. The article also highlights emerging models, theoretical advances, and promising interventions. Advantages and limitations of current treatments are discussed, with recommendations for future research. It is concluded that significant advances have been made in the conceptualization and treatment of panic disorder with agoraphobia.
Exposure therapy and antidepressant medication for treatment of chronic PTSD.
Explore the source record for details and available documents.
Posttraumatic stress disorder among military returnees from Afghanistan and Iraq.
Explore the source record for details and available documents.