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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

Safe at home [electronic resource] : agoraphobia and the discourse on women's place / by Suzie Siegel.

Siegel, Suzie. January 2002 (has links)
Title from PDF of title page. / Document formatted into pages; contains 90 pages. / Thesis (M.A.)--University of South Florida, 2001. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: My thesis explores how discourse and material practices have created agoraphobia, the fear of public places. This psychological disorder predominates among women. Throughout much of Western history, women have been encouraged to stay home for their safety and for the safety of society. I argue that agoraphobic women have internalized this discourse, expressing fears of being in public or being alone without a companion to support and protect them; losing control over their minds or their bodies; and endangering or humiliating themselves. Therapeutic discourse also has created agoraphobia by naming it, categorizing the emotions and behaviors associated with it, and describing the characteristics of agoraphobics. / The material practice of therapy reinforces this discourse. Meanwhile, practices such as rape and harassment reinforce the dominant discourse on women&softsign;s safety. I survey psychological literature, beginning with the naming of agoraphobia in 1871, to explain why the disorder is now diagnosed primarily in women. I examine nineteenth-century discourse that told women they belonged at home while men controlled the public domain. In 1871, the Paris Commune revolt epitomized the fear of women publicly out of control. I return to Paris a century later for a reading of the novel Certificate of Absence, in which Sylvia Molloy explores identity through the eyes of a woman who might be labeled agoraphobic. / I ask whether homebound women are resisting or retreating from a hostile world. Instead of seeing agoraphobia only as a personal problem, people should question why so many women fear themselves and the world outside their home.My methodology includes an analysis of nineteenth-century texts as well as current media, prose, and poetry. I also support my arguments with material from professional journals and nonfiction books in different disciplines. Common to feminist research, an interdisciplinary approach was needed to situate a psychological disorder within a social context. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.
42

Störungsspezifische, visuelle emotionale Stimuli bei der Agoraphobie mit Panikstörung / Disorder specific emotional imagery for differential and quantitative assessment of agoraphobia

Neumann, Marie-Charlott 10 October 2012 (has links)
No description available.
43

Effect of Cognitive-Behavioral Therapy on Neural Correlates of Fear Conditioning in Panic Disorder

Kircher, Tilo, Arolt, Volker, Jansen, Andreas, Pyka, Martin, Reinhardt, Isabelle, Kellermann, Thilo, Konrad, Carsten, Lüken, Ulrike, Gloster, Andrew T., Gerlach, Alexander L., Ströhle, Andreas, Wittmann, André, Pfleiderer, Bettina, Wittchen, Hans-Ulrich, Straube, Benjamin 23 October 2013 (has links) (PDF)
Background: Learning by conditioning is a key ability of animals and humans for acquiring novel behavior necessary for survival in a changing environment. Aberrant conditioning has been considered a crucial factor in the etiology and maintenance of panic disorder with agoraphobia (PD/A). Cognitive-behavioral therapy (CBT) is an effective treatment for PD/A. However, the neural mechanisms underlying the effects of CBT on conditioning processes in PD/A are unknown. Methods: In a randomized, controlled, multicenter clinical trial in medication-free patients with PD/A who were treated with 12 sessions of manualized CBT, functional magnetic resonance imaging (fMRI) was used during fear conditioning before and after CBT. Quality-controlled fMRI data from 42 patients and 42 healthy subjects were obtained. Results: After CBT, patients compared to control subjects revealed reduced activation for the conditioned response (CS+ > CS–) in the left inferior frontal gyrus (IFG). This activation reduction was correlated with reduction in agoraphobic symptoms from t1 to t2. Patients compared to control subjects also demonstrated increased connectivity between the IFG and regions of the “fear network” (amygdalae, insulae, anterior cingulate cortex) across time. Conclusions: This study demonstrates the link between cerebral correlates of cognitive (IFG) and emotional (“fear network”) processing during symptom improvement across time in PD/A. Further research along this line has promising potential to support the development and further optimization of targeted treatments.
44

Arquitetura e luto na obra de Adolf Loos / Architecture and mourning in the work of Adolf Loos

Denis Joelsons 05 June 2017 (has links)
O presente trabalho propõe a leitura da obra de Adolf Loos (1870-1933) através das transformações históricas que marcaram a Europa na passagem da segunda metade do século XIX à primeira do século XX. A complexidade de sua obra é uma expressão privilegiada para o entendimento das contradições instauradas no período. Por um lado, o fôlego de suas ideias é dado pela persistência de problemáticas que surgiram no século XIX; por outro, parte de sua obsolescência também se explica pela resistência que Loos apresentou a tais mudanças. Transformações que ele identificou como perdas. O tema da perda permeia toda sua produção: nos edifícios, por vezes ele figura na justaposição de elementos contraditórios (tradição ou modernidade), por outras na cisão irreparável entre interior e exterior (público ou privado) e, em alguns casos, o uso de espelhos e aberturas simetricamente dispostas cria uma tensão de ambiguidade entre espaço e imagem (realidade e representação). O eixo de leitura proposto nesta dissertação se estabelece a partir das reações do arquiteto às perdas impostas por sua época. A obra estudada é interpretada como um trabalho de luto. Textos e edifícios representativos do pensamento de Adolf Loos são investigados à luz de algumas reflexões de importantes pensadores da cultura europeia do período, como Walter Benjamin, Camilo Sitte, Georg Simmel e Sigmund Freud. A abordagem se dá através de três temas centrais: a morte da tradição, a perda de vitalidade no espaço público das metrópoles e a decadência da experiência subjetiva. / It has been over a century since Adolf Loos\'s (1870-1933) most famous works, such as Ornament and Crime (1908) and Goldman & Salatsch building (1911), came to fruition. And, in spite of that, the contradictory nature of his legacy as an architect and writer still fuels and replenishes the debates and investigations of scholars to this day. This dissertation proposes a look at Adolf Loos\'s works through the historical transformations that characterized the transition of the second half of the nineteenth century to the twentieth century. The complexity of his production is a powerful expression of the contradictions that established this period. On one hand, the perseverance of his ideas comes from the persistence of issues that were originated on the nineteenth century, on the other; his obsolescence can also be explained by his opposition to the changes that came along with the new century. Loos identifies these changes as losses. Loss is a theme that impregnates all his production. In his architecture it often surfaces as contradictory elements (tradition and modernity) overlapping one another, or, at times, as an irreparable rupture between interior and exterior (public and private), and in some cases he creates a tension of ambiguity between space and image (reality and representation) by the use of mirrors and symmetrically opposed openings. It is this demeanor, and his reactions to the losses imposed by his time, that will be the axis that guides this dissertation. We can interpret many signs in his work as symbols of mourning. We investigate writings and buildings that represent his thought through the light of important contemporary thinkers of occidental culture, such as Walter Benjamin, Georg Simmel, Camilo Sitte e Sigmund Freud. We will approach his production by three lines: the death of tradition, the loss of vitality of public spaces in the metropolis and the decadence of subjective experience.
45

Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia

Lueken, U., Straube, B., Reinhardt, I., Maslowski, N. I., Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Konrad, C., Ewert, A., Uhlmann, C., Arolt, V., Jansen, A., Kircher, T. 11 June 2020 (has links)
Background: Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients. Method: The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls. Results: Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation. Conclusions: The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
46

Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial

Gloster, Andrew T., Sonntag, Rainer, Hoyer, Jürgen, Meyer, Andrea H., Heinze, Simone, Ströhle, Andreas, Eifert, Georg, Wittchen, Hans-Ulrich 05 August 2020 (has links)
Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-ofprinciple data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed.
47

Effects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobia

Wittmann, André, Schlagenhauf, Florian, Guhn, Anne, Lueken, Ulrike, Elle, Manja, Stoy, Meline, Liebscher, Carolin, Bermpohl, Felix, Fydrich, Thomas, Pfleiderer, Bettina, Bruhn, Harald, Gerlach, Alexander L., Straube, Benjamin, Wittchen, Hans-Ulrich, Arolt, Volker, Heinz, Andreas, Ströhle, Andreas, Kircher, Tilo 19 May 2020 (has links)
Background: Patients suffering from panic disorder and agoraphobia are significantly impaired in daily life due to anxiety about getting into a situation due to apprehension about experiencing a panic attack, especially if escape may be difficult. Dysfunctional beliefs and behavior can be changed with cognitive behavioral therapy; however, the neurobiological effects of such an intervention on the anticipation and observation of agoraphobia-specific stimuli are unknown. Methods: We compared changes in neural activation by measuring the blood oxygen level-dependent signal of 51 patients and 51 healthy controls between scans before and those after treatment (group by time interaction) during anticipation and observation of agoraphobia-specific compared to neutral pictures using 3-T fMRI. Results: A significant group by time interaction was observed in the ventral striatum during anticipation and in the right amygdala during observation of agoraphobia-specific pictures; the patients displayed a decrease in ventral striatal activation during anticipation from pre- to posttreatment scans, which correlated with clinical improvement measured with the Mobility Inventory. During observation, the patients displayed decreased activation in the amygdala. These activational changes were not observed in the matched healthy controls. Conclusions: For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorderspecific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.
48

Mechanism of action in CBT (MAC): methods of a multi-center randomized controlled trial in 369 patients with panic disorder and agoraphobia

Gloster, Andrew T., Wittchen, Hans-Ulrich, Einsle, Franziska, Höfler, Michael, Lang, Thomas, Helbig-Lang, Sylvia, Fydrich, Thomas, Fehm, Lydia, Hamm, Alfons O., Richter, Jan, Alpers, Georg W., Gerlach, Alexander L., Ströhle, Andreas, Kircher, Tilo, Deckert, Jürgen, Zwanzger, Peter, Arolt, Volker January 2009 (has links)
Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.
49

Effekte therapeutenbegleiteter versus patientengeleiteter Exposition bei Panikstörung mit Agoraphobie

Lang, Thomas, Helbig-Lang, Sylvia, Gloster, Andrew T., Richter, Jan, Hamm, Alfons O., Fehm, Lydia, Fydrich, Thomas, Gerlach, Alexander L., Ströhle, Andreas, Alpers, Georg W., Gauggel, Siegried, Kircher, Tilo, Deckert, Jürgen, Höfler, Michael, Arolt, Volker, Wittchen, Hans-Ulrich January 2012 (has links)
Theoretischer Hintergrund: Die Rolle der Therapeutenbegleitung während Expositionsübungen bei Panikstörung mit Agoraphobie (P/A) ist bislang ungeklärt. Eine kürzlich durchgeführte klinische Studie (MAC-Studie) lieferte Hinweise auf ein günstigeres Behandlungsergebnis bei Therapeutenbegleitung. Fragestellung: Wie lassen sich Effekte therapeutenbegleiteter Exposition (T+) im Vergleich zu Exposition ohne Therapeutenbegleitung (T–) erklären? Methode: Daten von 301 Patienten, die eine expositionsbasierte KVT mit bzw. ohne Therapeutenbegleitung erhalten hatten, wurden analysiert. Untersucht wurden der Einfluss der initialen Störungsschwere, des Sicherheitsverhaltens sowie differenzielle Effekte der Bedingungen auf die Angst vor der Angst. Zusätzlich wurde überprüft, inwieweit die Übungshäufigkeit in den Behandlungsbedingungen variiert und einen Mediator des Behandlungserfolgs darstellt. Ergebnisse: Störungsschwere und Sicherheitsverhalten zeigten keine differenziellen Effekte zwischen den Bedingungen; die T+ Bedingung führte jedoch zu stärkeren Reduktionen der Angst vor der Angst im Angstsensitivitätsindex. Patienten der T+ Bedingung führten häufiger selbständig Expositionsübungen durch, während Patienten in T– im Durchschnitt länger übten. Die Übungshäufigkeit stellte dabei einen Mediator des Behandlungserfolgs dar. Schlussfolgerungen: Günstigere Effekte einer therapeutenbegleiteten Exposition gehen auf stärkere Reduktionen der Angst vor der Angst sowie auf eine höhere Übungshäufigkeit im Selbstmanagement zurück. / Theoretical background: There is a paucity of studies examining the role of therapist guidance during in-vivo exposure for panic disorder with agoraphobia (PD/AG). A recent study (MAC-study) suggested superior effects of therapist-guided exposure compared to programmed practice. Objectives: Examining potential mechanisms of therapist-guided exposure. Methods: Data from 301 patients with PD/AG who received either CBT with therapist guidance during in-vivo exposure (T+), or CBT with programmed exposure practice (T–) were analysed in regard to effects of initial symptom severity, subtle avoidance behaviours, reductions in fear of fear, and frequency of exposure homework. Results: There were no interaction effects between symptom severity or subtle avoidance and outcome. T+ was associated with higher reductions in fear of fear as well as with higher frequency of exposure homework. Frequency of exposure homework mediated the effect of group on outcome. Conclusion: Advantages of therapist-guided exposure as well as frequency of self-exposure might be attributed to higher reductions in fear of fear.
50

(Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session

Lüken, Ulrike, Mühlhan, Markus, Wittchen, Hans-Ulrich, Kellermann, Thilo, Reinhardt, Isabelle, Konrad, Carsten, Lang, Thomas, Wittmann, André, Ströhle, Andreas, Gerlach, Alexander L., Ewert, Adrianna, Kircher, Tilo January 2011 (has links)
Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.

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