DOCSLIB.ORG

1 Anxiety Disorders

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
1 Anxiety Disorders Anxiety Disorders: Assessment and Treatment 2 CE Hours Learning objectives 1. Identify the DSM-5 diagnostic criteria for each type of anxiety disorder. 2. Describe the assessment tools used to identify the subcategories of anxiety disorders. 3. List the symptoms of the subcategories of anxiety disorders. 4. Discuss strategies that parents can use to assist children with anxiety disorders. 5. Explain the different classes of medications used to treat each type of anxiety disorder. 6. Discuss therapeutic treatment models used for specific anxiety disorders. Introduction Mandy is a 52-year-old woman who has a responsible job as an accountant. To her friends and family, she appears to to “have it all together.” However, in the last three months, Mandy has been more reluctant to go to places she describes as “open”— in particular, to the mall. Two months ago when she was at the mall, Mandy felt her legs go numb and tingle. She felt different and scared for no real reason; however, it went away after a few minutes. The next week when at the mall again, Mandy felt as if she were having a heart attack: her heart began to pound uncontrollably and she began shaking and gasping for breath. Her friend called 911; Mandy was examined by the emergency medical personnel who later determined that nothing was wrong with her heart. Mandy felt foolish and embarrassed. As a result, she has become very reluctant to go out with friends and now frequently stays at home. She has made an appointment to go see her primary care doctor because she is sure that something is wrong with her heart. James, 29, has always described himself as a “neurotic.” He is a perfectionist who worries over every detail of his life, including his job as a nurse. He has recently begun to 1 wake up in the middle of the night two or three times a week, worrying that he has forgotten to do something important at work. He calls the hospital to check on his patients, as well as any tasks that he was assigned. His coworkers found this amusing at first— a sign of how conscientious he was as a nurse. In the last week, however, his coworkers started to laugh at him and to appease him: they tell him that they have checked on things when they really had not done so. James also constantly worries that something will happen to his young son. He is unable to stop worrying that his son will get cancer or have an accident. When these thoughts occur, James cannot concentrate on anything else. He also forbids his son to participate in activities – such as skateboarding or playing basketball with other kids— because he is afraid the boy will get hurt. He has also begun to worry about his wife leaving him. He asks her for daily reassurance that she will not divorce him and she is becoming increasingly annoyed by the questioning. Jordan is a 7-year-old boy who recently witnessed his father die in a car accident. Jordan was a passenger in the car, but was unharmed. He has been having nightmares and has also started sucking his thumb and wetting the bed. His mother noted that while playing, Jordan acts out a car accident with his toys. Jordan is well behaved, but his mother is worried about his other behaviors. All of the individuals in these vignettes are displaying symptoms consistent with some form of an anxiety disorder. Anxiety is a broad term that encompasses a broad spectrum of disorders, each with their own distinct features and courses of treatment. According to the Anxiety and Depression Association of America, (2016a): • Anxiety disorders are the most common mental illness in the U.S. and affect about 18.1 percent of the U.S. adult population, or about 42 million people. Numbers may be even higher due to untreated and unreported cases. 2 • Anxiety disorders are highly treatable, yet only 36.9% of those suffering receive treatment. • People with an anxiety disorder are three to five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders. • Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events. • It is not uncommon for someone with an anxiety disorder to also suffer from depression, or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. • Many of these persons have dual diagnoses; for example, some have both PTSD and GAD, or co-occurring social phobia and OCD. • There are a large number of individuals with anxiety disorders who also experience co-occurring substance abuse issues (National Institute of Mental Health, 2016a). The impact on society is enormous. In particular, those with anxiety disorders tend to have physical issues resulting from their anxiety which mimic a variety of physical ailments. Therefore, persons with anxiety disorders spend $42 billion dollars a year due to anxiety disorder; $22.84 billion of that is spent seeking treatment for physical problems that have mimicked anxiety symptoms, instead of seeking treatment for the real cause – underlying anxiety (Folk and Folk, 2017). It is important, however, to differentiate between ordinary life stressors and true anxiety. For example, stress experienced as “butterflies in the stomach” before giving a speech or a presentation is normal; however, being so afraid to speak before a group that one resigns from a job rather than give a speech is a more serious form of anxiety. Furthermore, worrying about doing a good job on a paper for school and stressing over the outcome is normal; however, being so concerned about failing that a student is unable 3 to start the project and then fails the class is more in line with one who is experiencing a generalized anxiety disorder. Most people are hesitant to go into a new social setting and may occasionally turn down an invitation because they “won’t know anyone there.” Someone who avoids social contact altogether, however, has more serious social phobia issues. Statistics on prevalence The following statistics are from the National Institute of Mental Health, (2016a): • Generalized anxiety disorder (GAD) GAD affects 6.8 million adults, or 3.1% of the U.S. population, yet only 43.2% are receiving treatment. Women are twice as likely to be affected as men. GAD often co-occurs with major depression. • Panic disorder (PD) PD affects six million adults, or 2.7% of the U.S. population. Women are twice as likely to be affected as men. Social anxiety disorder affects 15 million adults, or 6.8% of the U.S. population. It is equally common among men and women and typically begins around age 13. According to an ADAA (2016a) survey, 36% of people with social anxiety disorder report experiencing symptoms for 10 years or more before seeking help. • Specific phobias Specific phobias affect 19 million adults, or 8.7% of the U.S. population. Women are twice as likely to be affected as men. Symptoms typically begin in childhood; the average age-of-onset is seven years old. • Obsessive-compulsive disorder (OCD) OCD affects 2.2 million adults, or 1.0% of the U.S. population. OCD is equally common among men and women. The average age of onset is 19; 25 percent of cases occur by age 14. One-third of affected adults first experienced symptoms in childhood. 4 • Post-traumatic stress disorder (PTSD) PTSD affects 7.7 million adults, or 3.5% of the U.S. population. Women are more likely to be affected than men. Rape is the most likely trigger of PTSD: 65% of men and 45.9% of women who are raped will develop the disorder. Childhood sexual abuse is also a strong predictor of lifetime likelihood for developing PTSD. Children Anxiety disorders affect 25.1% of children between 13 and 18 years old. Research shows that untreated children with anxiety disorders are at a higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. Anxiety disorders also often co-occur with other disorders such as depression, eating disorders, and attention-deficit/hyperactivity disorder (ADHD). Note: All children experience a certain amount of anxiety. However, worry that interferes with daily functioning may become problem. Not all children may meet the criteria for an anxiety disorder. There are many helpful tips for parents when managing an anxious child, regardless of the child’s diagnosis. The Anxiety and Depression Association of America (2016c) provides the following tips to help parents dealing with an anxious child: • Pay attention to the child’s feelings. • Stay calm when the child becomes anxious about a situation or an event. • Recognize and praise small accomplishments. Build on the child’s strengths. • Do not punish mistakes or lack of progress. • Be flexible and try to maintain a normal routine. • Support the child but help him/her learn to do things on his/her own. • Help children handle feelings; they need to know it is OK to feel anxious, express how they feel, and that they can cope with these feelings. 5 • Do not pass fears to children. Model positive responses and strategies to handle anxiety. • Modify expectations during stressful periods. • Plan for transitions. (For example, allow extra time in the morning if getting to school is difficult.) Parents must keep in mind that a child’s anxiety disorder diagnosis is not a sign of poor parenting. It may add stress to family life so it is helpful to build a support network of relatives and friends.
Load more

Recommended publications
  • List of Phobias: Beaten by a Rod Or Instrument of Punishment, Or of # Being Severely Criticized — Rhabdophobia
    Beards — Pogonophobia. List of Phobias: Beaten by a rod or instrument of punishment, or of # being severely criticized — Rhabdophobia. Beautiful women — Caligynephobia. 13, number — Triskadekaphobia. Beds or going to bed — Clinophobia. 8, number — Octophobia. Bees — Apiphobia or Melissophobia. Bicycles — Cyclophobia. A Birds — Ornithophobia. Abuse, sexual — Contreltophobia. Black — Melanophobia. Accidents — Dystychiphobia. Blindness in a visual field — Scotomaphobia. Air — Anemophobia. Blood — Hemophobia, Hemaphobia or Air swallowing — Aerophobia. Hematophobia. Airborne noxious substances — Aerophobia. Blushing or the color red — Erythrophobia, Airsickness — Aeronausiphobia. Erytophobia or Ereuthophobia. Alcohol — Methyphobia or Potophobia. Body odors — Osmophobia or Osphresiophobia. Alone, being — Autophobia or Monophobia. Body, things to the left side of the body — Alone, being or solitude — Isolophobia. Levophobia. Amnesia — Amnesiphobia. Body, things to the right side of the body — Anger — Angrophobia or Cholerophobia. Dextrophobia. Angina — Anginophobia. Bogeyman or bogies — Bogyphobia. Animals — Zoophobia. Bolsheviks — Bolshephobia. Animals, skins of or fur — Doraphobia. Books — Bibliophobia. Animals, wild — Agrizoophobia. Bound or tied up — Merinthophobia. Ants — Myrmecophobia. Bowel movements, painful — Defecaloesiophobia. Anything new — Neophobia. Brain disease — Meningitophobia. Asymmetrical things — Asymmetriphobia Bridges or of crossing them — Gephyrophobia. Atomic Explosions — Atomosophobia. Buildings, being close to high
    [Show full text]
  • List of Phobias and Simple Cures.Pdf
    Phobia This article is about the clinical psychology. For other uses, see Phobia (disambiguation). A phobia (from the Greek: φόβος, Phóbos, meaning "fear" or "morbid fear") is, when used in the context of clinical psychology, a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational. In the event the phobia cannot be avoided entirely the sufferer will endure the situation or object with marked distress and significant interference in social or occupational activities.[1] The terms distress and impairment as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) should also take into account the context of the sufferer's environment if attempting a diagnosis. The DSM-IV-TR states that if a phobic stimulus, whether it be an object or a social situation, is absent entirely in an environment - a diagnosis cannot be made. An example of this situation would be an individual who has a fear of mice (Suriphobia) but lives in an area devoid of mice. Even though the concept of mice causes marked distress and impairment within the individual, because the individual does not encounter mice in the environment no actual distress or impairment is ever experienced. Proximity and the degree to which escape from the phobic stimulus should also be considered. As the sufferer approaches a phobic stimulus, anxiety levels increase (e.g. as one gets closer to a snake, fear increases in ophidiophobia), and the degree to which escape of the phobic stimulus is limited and has the effect of varying the intensity of fear in instances such as riding an elevator (e.g.
    [Show full text]
  • Overcoming Fear of Heights by Antony
    In the aftermath of the World Trade Center attacks, treatment for fear of flying has become more difficult, owing to increased secu- rity and restricted access to airplanes for persons in need of expo- sure therapy. Overcoming Fear of Heights thus fills a tremen- dous gap for people who suffer from this disabling fear. Antony and Rowa have done a masterful job with this book. In a clear and gentle fashion, these authors walk the reader through the step-by-step process of conducting exposure, including a remark- ably useful section on how to troubleshoot the typical problems that arise during this process. The book is peppered with case examples, which help to illustrate how to overcome your fear of heights. A job well-done! —J. Gayle Beck, Ph.D., is professor of psychology and associate chair of the Department of Psychology at the State University of New York, Buffalo. She is past president of the Association for Behavioral and Cognitive Therapies. Antony and Rowa have written an excellent book for people who are afraid of heights, people who care about people who are afraid of heights, and people who would like to learn how to help people who are afraid of heights. The book provides clear and helpful instructions, based in the science of behaviour change, that are an excellent guide for those who wish to overcome their fears. Research tells us that there is a very effective treatment for the fear of heights, and this book contains the details. —Adam Radomsky, Ph.D., is associate professor of psychology at Concordia University in Montreal, QC.
    [Show full text]
  • Psychological Approaches in the Treatment of Specific Phobias: a Meta-Analysis ☆ ⁎ Kate B
    Available online at www.sciencedirect.com Clinical Psychology Review 28 (2008) 1021–1037 Psychological approaches in the treatment of specific phobias: A meta-analysis ☆ ⁎ Kate B. Wolitzky-Taylor, Jonathan D. Horowitz, Mark B. Powers 1, Michael J. Telch Laboratory for the Study of Anxiety Disorders, Department of Psychology, The University of Texas at Austin, United States Received 21 August 2007; received in revised form 11 February 2008; accepted 27 February 2008 Abstract Data from 33 randomized treatment studies were subjected to a meta-analysis to address questions surrounding the efficacy of psychological approaches in the treatment of specific phobia. As expected, exposure-based treatment produced large effects sizes relative to no treatment. They also outperformed placebo conditions and alternative active psychotherapeutic approaches. Treatments involving in vivo contact with the phobic target also outperformed alternative modes of exposure (e.g., imaginal exposure, virtual reality, etc.) at post-treatment but not at follow-up. Placebo treatments were significantly more effective than no treatment suggesting that specific phobia sufferers are moderately responsive to placebo interventions. Multi-session treatments marginally outperformed single-session treatments on domain-specific questionnaire measures of phobic dysfunction, and moderator analyses revealed that more sessions predicted more favorable outcomes. Contrary to expectation, effect sizes for the major comparisons of interest were not moderated by type of specific phobia. These findings provide the first quantitative summary evidence supporting the superiority of exposure-based treatments over alternative treatment approaches for those presenting with specific phobia. Recommendations for future research are also discussed. © 2008 Elsevier Ltd. All rights reserved. Keywords: Specific phobia; Meta-analysis; Exposure treatment Contents 1.
    [Show full text]
  • List of Phobias
    Important Phobias - List Of Phobias List Of Phobias Achluophobia - Fear of darkness Acrophobia - Fear of heights Aerophobia - Fear of flying Algophobia - Fear of pain Agoraphobia - Fear of open spaces or crowds Aichmophobia - Fear of needles or pointed objects Amaxophobia - Fear of riding in a car Androphobia - Fear of men Anginophobia - Fear of angina or choking Anthrophobia - Fear of flowers Anthropophobia - Fear of people or society Aphenphosmphobia - Fear of being touched Arachibutyrophobia - Fear of peanut butter Arachnophobia - Fear of spiders Arithmophobia - Fear of numbers Astraphobia - Fear of thunder and lightning Ataxophobia - Fear of disorder or untidiness Atelophobia - Fear of imperfection Atychiphobia - Fear of failure Automatonophobia - Fear of Human-Like Figures Autophobia - Fear of being alone Bacteriophobia - Fear of bacteria Barophobia - Fear of gravity Bathmophobia - Fear of stairs or steep slopes Batrachophobia - Fear of amphibians Belonephobia - Fear of pins and needles Bibliophobia - Fear of books Botanophobia - Fear of plants Cacophobia - Fear of ugliness Catagelophobia - Fear of being ridiculed Catoptrophobia - Fear of mirrors Chionophobia - Fear of snow Chromophobia - Fear of colors Chronomentrophobia - Fear of clocks Chronophobia - Fear of Time Claustrophobia - Fear of confined spaces Coulrophobia - Fear of clowns Cyberphobia - Fear of computers Cynophobia - Fear of dogs Dendrophobia - Fear of trees Dentophobia - Fear of dentists Domatophobia - Fear of houses Dystychiphobia - Fear of accidents Ecophobia - Fear
    [Show full text]
  • The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders Jessica L
    REVIEW The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders Jessica L. Maples-Keller, PhD, Brian E. Bunnell, PhD, Sae-Jin Kim, BA, and Barbara O. Rothbaum, PhD Learning objectives: After participating in this activity, learners should be better able to: • Evaluate the literature regarding the effectiveness of incorporating virtual reality (VR) in the treatment of psychiatric disorders • Assess the use of exposure-based intervention for anxiety disorders Abstract: Virtual reality (VR) allows users to experience a sense of presence in a computer-generated, three-dimensional environment. Sensory information is delivered through a head-mounted display and specialized interface devices. These devices track head movements so that the movements and images change in a natural way with head motion, allowing for a sense of immersion. VR, which allows for controlled delivery of sensory stimulation via the therapist, is a convenient and cost-effective treatment. This review focuses on the available literature regarding the effectiveness of incorporating VR within the treatment of various psychiatric disorders, with particular attention to exposure-based intervention for anx- iety disorders. A systematic literature search was conducted in order to identify studies implementing VR-based treatment for anxiety or other psychiatric disorders. This article reviews the history of the development of VR-based technology and its use within psychiatric treatment, the empirical evidence for VR-based treatment, and the benefits for using VR for psy- chiatric research and treatment. It also presents recommendations for how to incorporate VR into psychiatric care and discusses future directions for VR-based treatment and clinical research.
    [Show full text]
  • Phobia, Panic, and the Anxiety Disorders
    Phobia, Panic, and the Anxiety Disorders Chapter 5 1 2 The Nature Of Anxiety Disorders • False alarms in response to harmless stimuli • Inordinately apprehensive, tense, uneasy • Interferes with functioning • May be disabling • Physical and psychological reactions • Cognitive and affective components • Twelve percent of Americans affected 3 The Nature of Anxiety Disorders • Fear is an innate alarm response to a dangerous or life-threatening situation. • Anxiety is the state in which an individual is inordinately apprehensive, tense, and uneasy about the prospect of something terrible happening. • People with anxiety disorders are incapacitated with chronic and intense feelings of anxiety. 4 Discriminate between the Disorders • Phobia is a fear of a specific object • PTSD numbing fear after experiencing a specific trauma • Panic anxiety that occurs suddenly • Agoraphobia fear of a panic attack in a public place • GAD pervasive anxiety that is nonspecific, experiential an chronic 5 Fear Specific vs. General Anxiety Object vs. Experience Sudden vs. Chronic Generalized Panic Phobia PTSD Anxiety Disorder Disorder Agora phobia 6 Four Elements of Fear • Cognitive - thoughts of impending harm, exaggerating the actual amount of danger; • Somatic - paleness of skin, goose bumps, muscle tension, face of fear, heart rate increase, accelerated respiration; • Emotional/subjective - feelings of dread, fear, or panic, queasiness or "butterflies"; and • Behavioral - decreasing appetite, escape, avoidance, freezing, aggression. 7 1. In which of the four areas do you most intensely feel anxiety? 8 Fear vs. Anxiety • Anxiety has the same four components as fear, • The cognitive component differs – fear is the expectation of a clear and specific danger, – anxiety is the expectation of something of a much more diffuse danger; Ex.
    [Show full text]
  • 0Phobia – Towards a Virtual Cure for Acrophobia: Study Protocol for a Randomized Controlled Trial T
    Donker et al. Trials (2018) 19:433 https://doi.org/10.1186/s13063-018-2704-6 STUDYPROTOCOL Open Access 0Phobia – towards a virtual cure for acrophobia: study protocol for a randomized controlled trial T. Donker1,2*, S. Van Esveld3, N. Fischer1,2 and A. Van Straten1,2 Abstract Background: Virtual reality exposure therapy (VRET) has been shown to be as effective as traditional forms of in vivo exposure therapy for the treatment of specific phobias. However, as with in vivo exposure, VRET still involves relatively high costs and limited accessibility which makes it prohibitive for a large part of the population. Innovative methods using smartphone applications (apps) may improve accessibility and scalability of VRET. The aim of this study is to evaluate 0Phobia, a gamified self-guided VRET for acrophobia that is delivered through a smartphone app in combination with rudimentary cardboard virtual reality (VR) goggles. Methods/design: Participants (N =180,aged18–65 years) with acrophobia symptoms will be recruited from the Dutch general population and randomized to either 0Phobia (n = 90) or a waitlist control condition (n =90).0Phobia will be delivered over a period of 3 weeks and includes psychoeducation, VR exposure, cognitive techniques, monitoring of symptoms, and relapse prevention. The primary outcome measure will be the Acrophobia Questionnaire. Secondary outcome measures will include user-friendliness, symptoms of anxiety, depression, and mastery. Assessments will take place online at baseline, directly after the intervention (post test) and at follow-up (3 months). Discussion: This study capitalizes on novel technology and recent scientific advances to develop an affordable and scalable treatment modality.
    [Show full text]
  • Glucocorticoids Enhance Extinction-Based Psychotherapy
    Glucocorticoids enhance extinction-based SEE COMMENTARY psychotherapy Dominique J.-F. de Quervaina,b,1, Dorothée Bentza, Tanja Michaelc, Olivia C. Boltd, Brenda K. Wiederholde,f, Jürgen Margrafg, and Frank H. Wilhelmh aDivision of Cognitive Neuroscience, Department of Psychology, and bPsychiatric University Clinics, University of Basel, 4055 Basel, Switzerland; cDepartment of Clinical Psychology and Psychotherapy, University of Saarbrücken, 66123 Saarbrücken, Germany; dDepartment of Psychology, King’s College London Institute of Psychiatry, Denmark Hill, London SE5 8AF, United Kingdom; eVirtual Reality Medical Institute, 1150 Woluwe-Saint-Pierre, Belgium; fVirtual Reality Medical Center, San Diego, CA 92121; gDepartment of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, 44301 Bochum, Germany; and hDepartment of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, 5020 Salzburg, Austria Edited* by James L. McGaugh, University of California, Irvine, CA, and approved December 20, 2010 (received for review December 6, 2010) Behavioral exposure therapy of anxiety disorders is believed to rely Mental Disorders, Fourth Edition (DSM-IV) were treated with on fear extinction. Because preclinical studies have shown that glu- three sessions of exposure therapy using virtual exposure to heights. cocorticoids can promote extinction processes, we aimed at inves- Virtual reality (VR) exposure therapy has proven effective in the tigating whether the administration of these hormones might be treatment of patients with acrophobia (30–34) and is ideal for useful in enhancing exposure therapy. In a randomized, double- clinical research, as it allows identical exposure of all patients and blind, placebo-controlled study, 40 patients with specific phobia avoids unpredicted events that may occur in real environments for heights were treated with three sessions of exposure therapy (35).
    [Show full text]
  • The Effects of Virtual Reality Therapy on Acrophobia: a Literature Review
    University of Arkansas, Fayetteville ScholarWorks@UARK The Eleanor Mann School of Nursing Undergraduate Honors Theses The Eleanor Mann School of Nursing 5-2021 The Effects of Virtual Reality Therapy on Acrophobia: A Literature Review Emma Zobal Follow this and additional works at: https://scholarworks.uark.edu/nursuht Part of the Psychiatric and Mental Health Commons, Psychiatric and Mental Health Nursing Commons, and the Psychiatry and Psychology Commons Citation Zobal, E. (2021). The Effects of Virtual Reality Therapy on Acrophobia: A Literature Review. The Eleanor Mann School of Nursing Undergraduate Honors Theses Retrieved from https://scholarworks.uark.edu/ nursuht/151 This Thesis is brought to you for free and open access by the The Eleanor Mann School of Nursing at ScholarWorks@UARK. It has been accepted for inclusion in The Eleanor Mann School of Nursing Undergraduate Honors Theses by an authorized administrator of ScholarWorks@UARK. For more information, please contact [email protected]. THE EFFECTS OF VIRTUAL REALTY THERAPY ON ACROPHOBIA 1 The Effects of Virtual Reality Therapy on Acrophobia: A Literature Review Emma Zobal University of Arkansas THE EFFECTS OF VIRTUAL REALTY THERAPY ON ACROPHOBIA 2 Introduction Specific phobias affect approximately 5%-10% of the U.S. population (Samra & Abdijadid, 2020). Examples of common specific phobias include animals, heights, flying, closed spaces, water, storms, and blood. Acrophobia is described as an extreme fear of heights and is one of the most common specific phobias (Eaton et al., 2018). Acrophobia can interfere with individuals’ ability to perform everyday tasks and can induce avoidance behaviors. Phobias are characteriZed as anxiety disorders, and common signs and symptoms seen in phobias are difficulty breathing, nausea, chest tightness, diZZiness, and fast heartbeat (Samra & Abdijadid, 2020).
    [Show full text]
  • Visual-Vestibular and Postural Interactions Can Act As Cues That Trigger Motion Sickness and Can Also Have a Role in Some Anxiety Disorders
    Vol. 15, No. 1, 2017, 21-33 RESEARCH ARTICLE ACTA NEUROPSYCHOLOGICA Received: 11.09.2016 Accepted: 15.03.2017 VISUAL -VESTIBULAR AND POSTURAL A – Study Design ANALYSIS OF MOTION SICKNESS PANIC B – Data Collection , , C – Statistical Analysis D – Data Interpretation AND ACROPHOBIA E – Manuscript Preparation F – Literature Search 1(A,B,D,E,F) 2(A,B,D,E,F) G – Funds Collection Carlos M. Coelho , Janete Silva , Alfredo F. Pereira 2(C,E,F) , Emanuel Sousa 2(A,E) , Nattasuda Taephant 1(A,B,E) , Kullaya Pisitsungkagarn 1(A,B,E) , Jorge A. Santos 3(A,D,E) 1 Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand 2 CIPsi, School of Psychology, University of Minho, Braga, Portugal 3 Centro Algoritmi, School of Engineering, University of Minho, Guimarães, Portugal SUMMARY Background: Visual-vestibular and postural interactions can act as cues that trigger motion sickness and can also have a role in some anxiety disorders. We explore a method to detect individual sensitivity to visual-vestibular unusual patterns, which can signal a vulnerability to develop motion sickness and possibly anxiety disorders such as a fear of heights and panic. Material/ 65 undergraduate students were recruited for the purposes of this Methods: study as voluntary participants (44 females); average age 21.65 years (SD=2.84) with normal or corrected to normal vision, without vestibular or postural deficiencies. Panic was assessed with the Albany Panic and Phobia Questionnaire, Motion Sickness with the Motion Sickness Susceptibility Questionnaire and Acrophobia was assessed by means of the Acrophobia Questionnaire. The Sharpened Romberg Test was used to test participant’s postural balance.
    [Show full text]
  • Effectiveness of a Stand-Alone, Smartphone-Based Virtual Reality Exposure App to Reduce Fear of Heights in Real-Life: a Randomized Trial
    www.nature.com/npjdigitalmed ARTICLE OPEN Effectiveness of a stand-alone, smartphone-based virtual reality exposure app to reduce fear of heights in real-life: a randomized trial Dorothée Bentz 1,2, Nan Wang1,2, Merle K. Ibach1,2, Nathalie S. Schicktanz 1,2, Anja Zimmer 1,2, Andreas Papassotiropoulos2,3,4,5 and ✉ Dominique J. F. de Quervain 1,2,5 Smartphone-based virtual reality (VR) applications (apps) might help to counter low utilization rates of available treatments for fear of heights. Demonstration of effectiveness in real-life situations of such apps is crucial, but lacking so far. Objective of this study was to develop a stand-alone, smartphone-based VR exposure app—Easy Heights—and to test its effectiveness in a real-life situation. We performed a single-blind, parallel group, randomized controlled trial. We recruited 70 participants with fear of heights, aged 18–60 years. Primary outcome was performance in a real-life Behavioral Avoidance Test (BAT) on a lookout tower after a single 1-h app use (phase 1) and after additional repeated (6 × 30 min) app use at home (phase 2). After phase 2, but not phase 1, participants in the Easy Heights condition showed significantly higher BAT scores compared to participants in the control condition (Cohen’s d = 1.3, p = 0.0001). Repeated use of our stand-alone, smartphone-based VR exposure app reduces avoidance behavior and fear, providing a low-threshold treatment for fear of heights. npj Digital Medicine (2021) 4:16 ; https://doi.org/10.1038/s41746-021-00387-7 1234567890():,; INTRODUCTION Therefore, new modes of delivery for exposure that circumvent Fear of heights is a common problem with a lifetime prevalence of the raised issues are warranted.
    [Show full text]