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Psychosocial Aspects of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
With frequent panic attacks and avoidance behaviors, drug therapy plus intensive psychotherapy is needed. Antidepressants, benzodiazepines, and combinations of these can be helpful. When antidepressants are used with benzodiazepines, it is usually as an initial treatment. The benzodiazepines are slowly decreased in dosage and often eventually discontinued or used more sporadically. Some patients respond well only to combination therapy. Psychotherapies include exposure therapy and cognitive-behavioral therapy are also used together. Exposure therapy helps patients to directly experience and confront feared situations in a controlled environment, and reduce avoidance until the fear is extinguished. Cognitive-behavioral therapy teaches how to recognize and change distorted thoughts and false beliefs, and modify behaviors to become more adaptive to situations. With diabetes, treatment may also involve relaxation training incorporating slow breathing techniques while monitoring CO2 levels in order to prevent hyperventilation. Biofeedback is an additional therapeutic technique that can improve symptoms of anxiety or panic while reducing the respiratory rate. This method gives patients visible evidence of how they are improving, thus providing them with a sense of control over their symptoms. Breathing training is helpful in panic disorder whether there is or is not any concurrent respiratory problems.
Eliminating Avoidance
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
The point of exposure therapy should be to reduce your anxiety in specific situations or environments in which you often or usually feel somewhat anxious. It’s far more important to be able to go to a restaurant with friends, than it is to try to force yourself to eat greasy French fries or drink coffee. But if you are afraid of food, that very fear may be exacerbating your gut distress. Avoiding food is such an important topic for people with IBS that I’ve devoted an entire chapter to it. If you’re one of those people who restricts your diet a great deal and consistently avoids a wide array of foods because you believe they’re “dangerous triggers,” read Chapter 9, “Diet and IBS,” and then think about some exposure exercises you might try to address these issues.
Posttraumatic Stress Disorder (PTSD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
What treatments have been employed with patients who select not to engage in exposure therapy? For patients with PTSD who do not wish exposure methods, psychodynamic therapy is warranted, and interpersonal therapy (IPT) has been used to treat PTSD as well (Sharpless & Barber, 2011). Hypnosis has been utilized alone and along with other treatments, and has been found to decrease the symptoms of PTSD (Abramowitz, Barak, Ben-Avi, Knobler, 2008; Sharpless & Barber, 2011).
Virtual Reality Exposure Therapy as a Treatment Method Against Anxiety Disorders and Depression-A Structured Literature Review
Published in Issues in Mental Health Nursing, 2023
Omar Hawajri, Jennifer Lindberg, Sakari Suominen
According to the TAM theory, several factors or barriers can effect the care recipient’s attitude to care interventions, and subsequently, their intention and use of the care intervention. The first factor to mention comprises the patient’s fears and misconceptions of prolonged exposure therapy and its consequences like cybersickness, which can increase the refusal or drop out (Boeldt et al., 2019). Secondly, general practical issues can influence the arrangement of exposure therapy in different clinical settings, such as limited time and the logistics for planning the therapy, therapists’ own anxiety and distress related to using exposure-based interventions and lack of dissemination of exposure therapy (Pittig et al., 2019). Thirdly, the concerns about exposure-based therapy found among therapists can be distressing for both the therapist and patient, increasing the risk of worsening the patient’s anxiety. A fourth factor is that only a limited number of mental healthcare professionals are clinically and formally trained in this kind of therapy and may have individual barriers to the use of it. Also, mental health providers may be reluctant to the use the latest evidence-based interventions due to individual negative attitudes (Botella et al., 2015). Furthermore, confidentiality risks for patients, accessibility and controllability of the stimuli, privacy, and ethical concerns may also exist (Ma et al., 2021; Maples-Keller et al., 2017).
Acceptability and Effectiveness of Humor- and Play-Infused Exposure Therapy for Fears in Williams Syndrome
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2022
Bonita P. Klein-Tasman, Brianna N. Young, Karen Levine, Kenia Rivera, Elizabeth J. Miecielica, Brianna D. Yund, Sydni E. French
The majority of research about the effectiveness of cognitive-behavioral interventions for anxiety in children with developmental disabilities has been among individuals with autism spectrum disorders (ASD). While not focused specifically on treatment of fears and phobias, several meta-analyses have concluded that Cognitive-Behavioral Therapy (CBT) is indeed useful for the treatment of anxiety in people with ASD (Sukhodolsky et al., 2013) with recent studies including comparison to both treatment-as-usual and to a control group (Kreslins et al., 2015; Ung et al., 2015). The promise of CBT approaches for anxiety includes support from randomized control trials with adolescents with ASD (Storch et al., 2015; Wood et al., 2009). Few include younger children (i.e., under age 7). There are also few studies specifically examining the role and utility of exposure therapy (graduated exposure, systematic desensitization) specifically related to treatment for fears and phobias. A notable exception is Maskey and colleagues who have conducted both case series (Maskey et al., 2014, 2019a) and a randomized control feasibility trial (Maskey et al., 2019b) of the utility of three to four 30-minute sessions of CBT and virtual reality with children ages 7 through 14 with ASD, with promising results.
Genes in treatment: Polygenic risk scores for different psychopathologies, neuroticism, educational attainment and IQ and the outcome of two different exposure-based fear treatments
Published in The World Journal of Biological Psychiatry, 2021
André Wannemüller, Robert Kumsta, Hans-Peter Jöhren, Thalia C. Eley, Tobias Teismann, Dirk Moser, Christopher Rayner, Gerome Breen, Jonathan Coleman, Svenja Schaumburg, Simon E. Blackwell, Jürgen Margraf
Among cognitive behavioural treatments (CBT), exposure-based strategies are considered the gold standard for treating fear and avoidance behaviour. Exposure therapy has been shown to be highly effective, whether applied alone or in combination with cognitive restructuring or somatic coping strategies (Norton and Price 2007; Hofmann and Smits 2008). However, there is a substantial inter-individual variation in treatment response and long-term treatment efficacy. While many patients show a complete recovery, others continue to experience significant levels of symptoms after treatment (Loerinc et al. 2015) or display a (partial) return of their fear symptoms over time (Craske and Mystkowski 2006). Therefore, in order to further improve the effectiveness of psychotherapeutic interventions, it is necessary to identify psychological and biological factors that influence their outcomes.