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Psychiatrike = Psychiatriki 2016During the last decade a number of studies have been conducted in order to examine if virtual reality exposure therapy can be an alternative form of therapy for the... (Review)
Review
During the last decade a number of studies have been conducted in order to examine if virtual reality exposure therapy can be an alternative form of therapy for the treatment of mental disorders and particularly for the treatment of anxiety disorders. Imaginal exposure therapy, which is one of the components of Cognitive Behavioral Therapy, cannot be easily applied to all patients and in cases like those virtual reality can be used as an alternative or a supportive psychotherapeutic technique. Most studies using virtual reality have focused on anxiety disorders, mainly in specific phobias, but some extend to other disorders such as eating disorders, drug dependence, pain control and palliative care and rehabilitation. Main characteristics of virtual reality therapy are: "interaction", "immersion", and "presence". High levels of "immersion" and "presence" are associated with increased response to exposure therapy in virtual environments, as well as better therapeutic outcomes and sustained therapeutic gains. Typical devices that are used in order patient's immersion to be achieved are the Head-Mounted Displays (HMD), which are only for individual use, and the computer automatic virtual environment (CAVE), which is a multiuser. Virtual reality therapy's disadvantages lie in the difficulties that arise due to the demanded specialized technology skills, devices' cost and side effects. Therapists' training is necessary in order for them to be able to manipulate the software and the hardware and to adjust it to each case's needs. Devices' cost is high but as technology continuously improves it constantly decreases. Immersion during virtual reality therapy can induce mild and temporary side effects such as nausea, dizziness or headache. Until today, however, experience shows that virtual reality offers several advantages. Patient's avoidance to be exposed in phobic stimuli is reduced via the use of virtual reality since the patient is exposed to them as many times as he wishes and under the supervision of the therapist. The technique takes place in the therapist's office which ensures confidentiality and privacy. The therapist is able to control unpredicted events that can occur during patient's exposure in real environments. Mainly the therapist can control the intensity of exposure and adapt it to the patient's needs. Virtual reality can be proven particularly useful in some specific psychological states. For instance, patients with post-traumatic stress disorder (PTSD) who prone to avoid the reminders of the traumatic events. Exposure in virtual reality can solve this problem providing to the patient a large number of stimuli that activate the senses causing the necessary physiological and psychological anxiety reactions, regardless of his willingness or ability to recall in his imagination the traumatic event.
Topics: Anxiety Disorders; Humans; Implosive Therapy; Phobic Disorders; Software; Stress Disorders, Post-Traumatic; Treatment Outcome; Virtual Reality Exposure Therapy
PubMed: 28114091
DOI: 10.22365/jpsych.2016.274.276 -
Revista Brasileira de Psiquiatria (Sao... Mar 2012This article aims to review the clinical features and therapeutic characteristics that may predict treatment response in patients with social anxiety disorder (SAD). (Review)
Review
OBJECTIVE
This article aims to review the clinical features and therapeutic characteristics that may predict treatment response in patients with social anxiety disorder (SAD).
METHODS
A systematic review of trials identified through databases of ISI, Medline, PsycInfo, Cochrane, LILACS, Current Controlled Trials, and in references of previously selected articles published in English up to December 2010. In our literature search, we used the words prediction/predictors and social anxiety disorder or social phobia.
RESULTS
Early onset, greater disease severity, comorbidity with other anxiety disorders (including generalized anxiety disorder and simple phobia), and high expectations about the role of the therapist emerged as potential predictors of less effective treatment in SAD.
CONCLUSIONS
Knowledge of various clinical and treatment features may help professionals to predict possible responses to therapeutic interventions in patients with SAD. However, given the diversity of measures used to assess response, further studies should be performed with standardized methods to investigate the aspects related to treatment resistance in SAD.
Topics: Clinical Trials as Topic; Combined Modality Therapy; Humans; Phobic Disorders; Predictive Value of Tests; Prognosis; Risk Factors; Severity of Illness Index; Treatment Failure
PubMed: 22392395
DOI: 10.1590/s1516-44462012000100016 -
International Journal of Environmental... Apr 2021Technological progress not only brings with it resources that improve and facilitate the day-to-day life of the people who make up society but also entails health risks,...
Technological progress not only brings with it resources that improve and facilitate the day-to-day life of the people who make up society but also entails health risks, with the emergence of terms, such as nomophobia, which is considered an anxiety disorder produced by the fear that not having a mobile phone generates in a person. This research aims to identify the relationship and influence between levels of nomophobia and the age or educational stage of students. The research method is based on a correlational and predictive design of quantitative methodology. The instrument used is the NMP-Q questionnaire. The study population is students from different educational stages (obligatory secondary education, baccalaureate, vocational training and university). The results show that students over 12 years old present an average level of "nomophobia" (no-mobile-phone phobia), namely, not being able to communicate with the family where the highest levels are presented. We conclude that students over 12 years of age and of any educational stage present an average level of nomophobia, and it cannot be determined that either the educational stage or the age are determining factors in the presentation of this problem. This can occur at any age and at any level of the different educational stages, although there are risk indicators that we should bear in mind to avoid the appearance of nomophobia.
Topics: Cell Phone; Child; Fear; Humans; Phobic Disorders; Students; Surveys and Questionnaires
PubMed: 33922221
DOI: 10.3390/ijerph18094450 -
Psychiatria Danubina Dec 2009This paper gives an overview on the epidemiology of social phobia. About 4.5% of the adult general populations suffer from social phobia, i.e. it is the most frequent of... (Review)
Review
This paper gives an overview on the epidemiology of social phobia. About 4.5% of the adult general populations suffer from social phobia, i.e. it is the most frequent of all anxiety disorders. Social phobia is clearly more frequent among women than among men. About the half of all individuals with social phobia suffer from any comorbid mental disorders. Reviews show a large variability between single studies, probably due to methodological differences. Several population surveys indicate that a marked proportion of those with social phobia do not receive adequate treatment.
Topics: Adult; Comorbidity; Cross-Sectional Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Health Surveys; Humans; Incidence; Male; Mental Disorders; Phobic Disorders; Psychotherapy; Psychotropic Drugs; Sex Factors
PubMed: 19935488
DOI: No ID Found -
Biological Psychiatry Dec 1998Specific phobia is a common, heterogeneous disorder whose central feature is persistent, unreasonable fear of a circumscribed object or situation. This article reviews... (Review)
Review
Specific phobia is a common, heterogeneous disorder whose central feature is persistent, unreasonable fear of a circumscribed object or situation. This article reviews current etiological theories and empirical data that seem likely to be important in investigating the pathophysiology of this disorder. These include conditioning, modified conditioning, and nonassociative models of phobia development, physiological response to the phobic stimulus, neuroimaging, primate, and biological challenge studies. Pathophysiological hypotheses suggested by recent research on the neurocircuitry of conditioned fear are also discussed. Though specific phobias have been of less public health and clinical interest than other anxiety disorders, their circumscribed nature and possible relationship to conditioned fear may make them a productive subject for research into basic pathophysiology.
Topics: Animals; Conditioning, Psychological; Extinction, Psychological; Fear; Humans; Phobic Disorders
PubMed: 9861472
DOI: 10.1016/s0006-3223(98)00274-1 -
Revista Brasileira de Psiquiatria (Sao... 2017Trypophobia refers to the fear of, or aversion to, clusters of holes. We assessed clinical features of trypophobia and investigated whether it most resembled a specific...
OBJECTIVE
Trypophobia refers to the fear of, or aversion to, clusters of holes. We assessed clinical features of trypophobia and investigated whether it most resembled a specific phobia or obsessive-compulsive disorder.
METHODS
An online survey was conducted to gather information on sociodemographic variables, course and duration, severity, associated features, comorbid psychiatric diagnoses, and levels of psychological distress and impairment in individuals with trypophobia. The survey also explored whether such individuals experienced more fear or disgust, and whether symptoms showed more resemblance to a specific phobia or to obsessive-compulsive disorder. Associations of symptom severity and duration with degree of impairment were investigated.
RESULTS
One hundred and ninety-five individuals completed the questionnaire. Symptoms were chronic and persistent. The most common associated comorbidities were major depressive disorder and generalized anxiety disorder. Trypophobia was associated with significant psychological distress and impairment. The majority of individuals experienced disgust rather than fear when confronted with clusters of holes, but were more likely to meet DSM-5 criteria for specific phobia than for obsessive-compulsive disorder. Symptom severity and duration were associated with functional impairment.
CONCLUSIONS
Given that individuals with trypophobia suffer clinically significant morbidity and comorbidity, this condition deserves further attention from clinicians and researchers.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Internet; Male; Middle Aged; Obsessive-Compulsive Disorder; Phobic Disorders; Severity of Illness Index; Surveys and Questionnaires; Young Adult
PubMed: 28423069
DOI: 10.1590/1516-4446-2016-2079 -
Nature Neuroscience Feb 2013Post-traumatic stress disorder, panic disorder and phobia manifest in ways that are consistent with an uncontrollable state of fear. Their development involves heredity,... (Review)
Review
Post-traumatic stress disorder, panic disorder and phobia manifest in ways that are consistent with an uncontrollable state of fear. Their development involves heredity, previous sensitizing experiences, association of aversive events with previous neutral stimuli, and inability to inhibit or extinguish fear after it is chronic and disabling. We highlight recent progress in fear learning and memory, differential susceptibility to disorders of fear, and how these findings are being applied to the understanding, treatment and possible prevention of fear disorders. Promising advances are being translated from basic science to the clinic, including approaches to distinguish risk versus resilience before trauma exposure, methods to interfere with fear development during memory consolidation after a trauma, and techniques to inhibit fear reconsolidation and to enhance extinction of chronic fear. It is hoped that this new knowledge will translate to more successful, neuroscientifically informed and rationally designed approaches to disorders of fear regulation.
Topics: Animals; Brain; Extinction, Psychological; Fear; Humans; Learning; Memory; Nerve Net; Neural Pathways; Panic Disorder; Phobic Disorders; Stress Disorders, Post-Traumatic
PubMed: 23354388
DOI: 10.1038/nn.3296 -
Psychiatry and Clinical Neurosciences Jul 2013Although specific phobia is a prevalent anxiety disorder, evidence regarding its underlying functional neuroanatomy is inconsistent. A meta-analysis was undertaken to... (Meta-Analysis)
Meta-Analysis Review
Although specific phobia is a prevalent anxiety disorder, evidence regarding its underlying functional neuroanatomy is inconsistent. A meta-analysis was undertaken to identify brain regions that were consistently responsive to phobic stimuli, and to characterize changes in brain activation following cognitive behavioral therapy (CBT). We searched the PubMed, SCOPUS and PsycINFO databases to identify positron emission tomography and functional magnetic resonance imaging studies comparing brain activation in specific phobia patients and healthy controls. Two raters independently extracted study data from all the eligible studies, and pooled coordinates from these studies using activation likelihood estimation, a quantitative meta-analytic technique. Resulting statistical parametric maps were compared between patients and healthy controls, in response to phobic versus fear-evoking stimuli, and before and after therapy. Thirteen studies were included, comprising 327 participants. Regions that were consistently activated in response to phobic stimuli included the left insula, amygdala, and globus pallidus. Compared to healthy controls, phobic subjects had increased activation in response to phobic stimuli in the left amygdala/globus pallidus, left insula, right thalamus (pulvinar), and cerebellum. Following exposure-based therapy widespread deactivation was observed in the right frontal cortex, limbic cortex, basal ganglia and cerebellum, with increased activation detected in the thalamus. Exposure to phobia-specific stimuli elicits brain activation that is consistent with current understandings of the neuroanatomy of fear conditioning and extinction. There is evidence that the effects of CBT in specific phobia may be mediated through the same underlying neurocircuitry.
Topics: Adult; Amygdala; Brain; Cerebral Cortex; Diagnostic and Statistical Manual of Mental Disorders; Female; Functional Laterality; Humans; Image Processing, Computer-Assisted; Limbic System; Magnetic Resonance Imaging; Male; Neostriatum; Phobic Disorders; Stereotaxic Techniques; Young Adult
PubMed: 23711114
DOI: 10.1111/pcn.12055 -
The Israel Journal of Psychiatry and... 2009Since the emergence of social phobia in DSM nomenclature, the mental health community has witnessed an expansion in standardized methods for the screening, diagnosis and... (Review)
Review
Since the emergence of social phobia in DSM nomenclature, the mental health community has witnessed an expansion in standardized methods for the screening, diagnosis and measurement of the disorder. This article reviews formal assessment methods for social phobia, including diagnostic interview, clinician-administered instruments, and self report questionnaires. Frequently used tools for assessing constructs related to social phobia, such as disability and quality of life, are also briefly presented. This review evaluates each method by highlighting the assessment features recommended in social phobia literature, including method of administration, item content, coverage, length of scale, type of scores generated, and time frame.
Topics: Arousal; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Humans; Interview, Psychological; Personality Assessment; Personality Inventory; Phobic Disorders; Psychometrics; Reproducibility of Results
PubMed: 19728569
DOI: No ID Found -
Depression and Anxiety Dec 2012Investigators have proposed the diagnostic value of a generalized subtype of specific phobia, with classification based upon the number of phobic fears. However, current...
BACKGROUND
Investigators have proposed the diagnostic value of a generalized subtype of specific phobia, with classification based upon the number of phobic fears. However, current and future typologies of specific phobia classify the condition by the nature of phobic fears. This study investigated the clinical relevance of these alternative typologies by: (1) presenting the prevalence and correlates of specific phobia separately by the number and nature of phobia types; and (2) examining the clinical and psychiatric correlates of specific phobia according to these alternative typologies.
METHODS
The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13-18 years in the continental United States.
RESULTS
Most adolescents with specific phobia met criteria for more than one type of phobia in their lifetime, however rates were fairly similar across DSM-IV/5 subtypes. Sex differences were consistent across DSM-IV/5 subtypes, but varied by the number of phobic types, with a female predominance observed among those with multiple types of phobias. Adolescents with multiple types of phobias exhibited an early age of onset, elevated severity and impairment, and among the highest rates of other psychiatric disorders. However, certain DSM-IV/5 subtypes (i.e. blood-injection-injury and situational) were also uniquely associated with severity and psychiatric comorbidity.
CONCLUSIONS
Results indicate that both quantitative and DSM-IV/5 typologies of specific phobia demonstrate diagnostic value. Moreover, in addition to certain DSM-IV/5 subtypes, a generalized subtype based on the number of phobias may also characterize youth who are at greatest risk for future difficulties.
Topics: Adolescent; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Female; Health Surveys; Humans; Kaplan-Meier Estimate; Logistic Models; Male; Mental Disorders; Phobic Disorders; Prevalence; United States
PubMed: 23108894
DOI: 10.1002/da.22008