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Anxiety is a universal human emotion, described as a state of changed mood with obvious negative affect and expectation of future adversity and danger (American Psychiatric Association, 1994). Although anxiety can be an important motivational drive, it can become debilitating when experienced to an extreme degree (Smith et al., (1996). Nervousness or apprehension in students due to an upcoming examination is an extremely widespread occurrence. However, some students experience test related anxiety to such an extent that it interferes with their studying and may lead to other negative effects of anxiety such as inability to concentrate or focus, depression, poor academic results and loss of self-esteem and self-confidence (American Counseling Association, 2004). Homoeopathy is an effective form of treatment for many acute disorders and the remedy Argentum nitricum is considered a specific treatment for anxiety, especially when related to an upcoming event (Morrison, 1993; Swayne, 1998). The aim of this study was to determine the effect of Argentum nitricum 200CH on blood pressure, pulse rate and perceived levels of anxiety in students undergoing a test. The research study was conducted according to the randomized, double-blind method. Forty participants older than eighteen years of age and studying the same course were recruited from the University of Johannesburg. The fact that the participants were currently in the same year and studying the same course, ensured that that similar stress levels were experienced. Participants were randomly divided into an experimental and control group consisting of twenty participants respectively. During the course of the study, neither the researcher nor the participants were aware of the nature of the groups. Perceived anxiety levels as well as cardiovascular responses to anxiety were assessed by way of a State-Trait-Anxiety-Inventory (Appendix F) and measurement of blood pressure and pulse rate. Each participant was required to undergo these investigations fifteen days prior to the test, as this provided a baseline level to compare with measurements taken on the day that participants wrote a test. Argentum nitricum 200CH or placebo was taken daily at eight o’clock in the morning for five days prior to the test, including the day of the test. Results from measurement of blood pressure and pulse rate were entered on the participant’s Data Collection Table (Appendix B) and compared and analysed according to the paired t-test. Furthermore the results from the State-Trait-Anxiety-Inventory for each participant was determined, compared and analysed using the paired t-test. The results of this study showed that Argentum nitricum 200CH does not reduce test related anxiety in a general population of tertiary students, although it did have a definite effect on the pulse rate of the experimental group which remained more stable and increased to a lesser degree than that of the control group. / Dr. S.C. van Es Dr. A. Fourie Dr. R.K. Razlog

Anxiety disorders are among the most prevalent forms of mental illness. There is a great need to acquire techniques which effectively and rapidly treat anxiety. The purpose of this study was to determine if the use of affirmations aids in the reduction of anxiety. In addition, this study examined if the use of affirmations combined with relaxation music aids in the reduction of anxiety and examined if the use of relaxation music alone aids in the reduction of anxiety. An experimental research design was used in this study. Three treatment groups were investigated and one control group. Each treatment group received a ten minute audio tape of either affirmations statements played alone (without relaxation music), affirmations statements played with relaxation music, or a ten minute audio tape of relaxation music alone. The control group was instructed to sit and wait for ten minutes. The Beck Anxiety Inventory was utilized to obtain anxiety scores. Pre and post-tests were administered to determine the extent to which the treatment reduced the anxiety scores. A two-way analysis of variance (ANOVA) with repeated measures was deemed suitable for these data. There were modest reductions in anxiety scores among the affirmations groups (alone and with music) and the control group. The music only group dropped the most in anxiety and appears to be the treatment of choice when considering a non-invasive, easily accessible and effective treatment for anxiety. Recommendations were made for future research and implications for educators and counselors were discussed.

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Sixty-eight patients suffering from generalized anxiety disorder were allocated to one of four groups to study how hypnotizability (high versus low) and type of suggestion (direct versus indirect) were related to treatment outcome. Patients were assessed on three occasions (Pre-treatment; Post-treatment; and three month Follow-up) using seven anxiety measures and one depression inventory. The Creative Imagination Scale (CIS) was used to assess susceptibility to hypnotic responding. Twenty Ss dropped out prematurely due to both practical and treatment related issues. Interestingly, dropouts were also found to have been significantly more depressed than completers. Patients were given six treatment sessions of hypnotherapy at weekly intervals while the author remained blind to CIS scores. Therapy focused on accessing S's unconscious abilities and resources for symptom resolution, using either direct or indirect suggestion. Patients were provided with self-hypnosis tapes for anxiety reduction in between appointments. Results indicated that completers significantly improved on all dependent measures, but few differences emerged between the four groups. Interestingly, highly hypnotizable patients who received indirect suggestion relapsed slightly on all measures by the Follow-up period, having improved from Pre- to Post-treatment. Discussion is offered on the possible implications these results have for the integrity of the independent variables, concluding that both hypnotizability and type of suggestion have a clinically significant interactive effect. Direct suggestion is recommended for highly hypnotizable generalized anxiety disorder clients, while both direct and indirect suggestion can be used with low hypnotizables, as long as all are couched within permissive language. Limitations of the present research are discussed, along with recommendations for clinical practice and future research

The aim of the thesis is three fold: a-To develop a new questionnaire that measures anxiety in terms of four components (feeling, cognitive, behavior and somatic). b-To investigate the relationship between feeling and cognition with regard to anxiety. c-To identify, with the application of Three Systems Theory, the most salient component of anxiety in each of the DSM-III anxiety disorder sub-classifications and to evaluate the validity of DSM-III anxiety disorder sub-classifications. a-In order to assess the level of anxiety, I have developed a new Four Systems Anxiety Questionnaire (FSAQ). FSAQ incorporates a feeling component along with the behavioral, somatic and cognitive components. A psychometric evaluation (reliability and validity levels) of the questionnaire was found to be satisfactory. b-Another aim is to reconsider one of the tenets of cognitive therapy that cognitive appraisals are the necessary preconditions for the emergence of feeling. Such a view assumes that feeling is merely an epiphenomenon of cognitive processes. This research establishes, however, that feeling and cognition appear to be relatively independent systems and that their modes of interaction are influenced by the personality structure of the individual. This conclusion was obtained by using the FSAQ on university students and various categories of anxiety patients. In particular, the research compared the scores on the feeling and cognitive components of both males and females, obsessive-compulsives and rest of the DSM-III anxiety patients. c- A further aim of the reseach was to examine the DSM-III anxiety disorders classification from the Three Systems Theory's point of view. The Three Systems Theory proposes that anxiety has three relatively independent components: cognitive, behavioral and somatic. In the various anxiety sub-classifications of DSM-III one or other of these three components dominates. The other purpose of my research was to consider each of the DSM-III anxiety disorders separately and to determine which of the three components plays the major role in the manifestation of the particular syndrome. In general, the results indicate that each anxiety disorder is indeed characterised by a different profile. An anticipated outcome of this research is that a clinician will be able to identify the main component of anxiety in a particular syndrome and hence select most appropriate treatment. The results of this study support DSM-III classification of anxiety disorders into two main categories of phobic and non-phobic (i.e. phobic and anxiety states).

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This study examined the differential effects of an audiotaped progressive relaxation message and an audiotaped positive reinterpretation message, repeatedly presented over three sessions to socially anxious subjects. Self report measures of social anxiety, attitude towards anxiety, coping effectiveness, and acceptance of anxious self, and the frequency of action taken in target situations were examined. The subjects were 14 males and females aged 19-38 (M=26.14) who were randomly assigned to either positive reinterpretation or progressive relaxation treatment condition. Repeated measures analysis of variance indicated no clear statistically significant support for the superiority of one treatment approach over the other, or for the uniform differential effectiveness of the two treatments over time. There was a significant difference between the two groups on the measure of social anxiety but this difference was time dependent, that is, time interacted positively with one group relative to the other group at follow-up, and the reverse was true at post-test. Effect size indicated clinically meaningful differences between treatment groups on attitude towards anxiety and on acceptance of anxious self. / Education, Faculty of / Graduate

Pilot Study: a) 21 Generalised Anxiety Disorder (GAD) patients were treated double-blind with either diazepam or placebo for 6 weeks. This active treatment period was preceded by one-week single-blind placebo 'wash-in', and followed by two-week single-blind 'washout'. Results showed that diazepam used in moderate doses for 6 weeks produced anxiety recurrence and withdrawal symptoms. b) 10 GAD patients were randomly allocated to Cognitive-Behaviour Therapy (CBT) and compared with the above diazepam and placebo groups. All treatments were balanced for degree of Psychologist/patient contact. At cessation of active treatment CBT superiority was indicated. Post-Study psychotropic prescription and psychological treatment were assessed at 12 months follow-up. The CBT group had the lowest incidence of subsequent treatment interventions. Main Study : 101 GAD patients were randomly allocated to diazepam, placebo, CBT, CBT + diazepam, and CBT + placebo, and treated over 10 weeks. Outcome measures at end of treatment and at 6 months follow-up revealed the superiority of all CBT treatments; especially CBT alone, and CBT + diazepam. Diazepam was more effective than placebo. CBT + diazepam, and diazepam groups showed no anxiety recurrence during graded withdrawal. Secondary Study : 205 long-term benzodiazepine users were matched for age and sex with controls. Inspection of medical case notes showed that benzodiazepine users had higher rates of previous physical illness, GP attendance, and non-psychotropic drug prescription. Differences emerged between anxiolytic, hypnotic, and anxiolytic + hypnotic benzodiazepine users in age, history of physical illness, and previously prescribed medication. Tertiary Study : 44 long-term benzodiazepine users were interviewed. The incidence of psychological ill-health and social problems was lower than expected. Patients were dependent on medication, and reported concern if their medication were to be stopped. Nevertheless 40% considered stopping benzodiazepines. Results from the above studies are discussed in relation to clinical management of GAD, and current concerns about benzodiazepine dependence and withdrawal.

Social (public speaking) anxiety disorder is the most prevalent of all anxiety disorders, and it often impairs social and occupational functioning. Intervention studies indicate that cognitive-behavioral therapy (CBT) is an efficacious treatment for social anxiety. However, access to therapists skilled in CBT for social anxiety is often difficult. In order to respond to the problem of access, the use of videoconferencing for mental health care has developed. No published study has investigated the efficacy of CBT for social anxiety when provided via videoconferencing. The purpose of this study, therefore, was to determine the efficacy of CBT for social anxiety when provided via videoconferencing. A single-case replication design was employed that included a baseline period of 3 weeks, followed by 12 weeks of . treatment, 1-week post-intervention period, and 3-month follow-up. Five participants completed treatment. It was hypothesized that participants would reduce their social anxiety symptoms (i.e., decrease anxiety during speech task, increase duration of speech task, and decrease public speaking anxiety) assessed on standardized measures of social anxiety. Exploratory analyses of changes in self-monitored social anxiety, negative cognitions (public self-consciousness, fear of negative evaluation, internal attributions), working alliance, client satisfaction with treatment, and client comfort with videoconferencing were also performed. Analyses included visual and statistical significance, as well as clinical significance (i.e., endstate functioning, social phobia diagnostic status). The results indicated that two of three hypotheses were supported (i.e., anxiety during speech task reduced and duration of speech task increased over time). At 3-month follow-up, treatment gains were maintained or improved further; 3 participants no longer met the DSM-IV-TR criteria for social anxiety disorder, and 4 participants met criteria for moderate or high level of endstate functioning (i.e., clinical significance). Exploratory analyses revealed that self-monitored social anxiety decreased for 3 of 5 participants, and that a decrease in negative cognitions was associated with a decrease in social anxiety. Working alliance ratings remained high throughout treatment. Satisfaction with videoconferencing decreased over treatment for the participant who did not improve. Generally, comfort with videoconferencing increased over time. The results offer preliminary support for further research about the efficacy of the intervention.