The current study examined the effects of specific phobia on an individual's quality of life (QOL) and life satisfaction. To that end, 29 individuals with DSM-IV diagnoses of specific phobia and 30 control participants with no current diagnosable psychopathology completed several widely utilized self-report questionnaires and an interview on QOL. Trained and reliable clinicians also completed ratings of participants QOL. Results were divided into participant-rated QOL findings and clinician-rated QOL findings. Participant-rated findings suggested phobic individuals experienced significantly more dissatisfaction with their ability to learn and acquire new skills than did controls. Phobic participants, however, also rated themselves as having less impairment than controls from pain—presumably related to their phobic avoidance. Clinician-rated findings suggested significant distress and impairment in phobic individuals' QOL relative to controls across a variety of domains (e.g., school, family, etc.). Discrepant findings between participant ratings and clinician ratings were explained using a cognitive dissonance model. Implications for future QOL research in those individuals with specific phobia as well as implications for their treatment were discussed. / Ph. D. / [Appendix D: Quality of Life Inventory, p. 68-74, was removed Nov. 8, 2011 GMc]

Because extreme weather events are relatively common in the Southeastern U.S., and the current treatments for phobias can be time-consuming and costly, it is important to find an effective early intervention program for those individuals who are at risk of developing severe weather phobia (SWP). Participants (N = 12) were randomly assigned to the experimental or modified control condition. Participants from both conditions participated in the therapist-aided self-help early intervention program. However, the modified control condition completed posttest measures approximately 3 weeks after baseline, before beginning the intervention. The intervention was most effective at reducing subjective fear and avoidance behavior related to severe weather events. Additionally, participants’ subjective views of their fears were no longer categorized as excessive, or unreasonable, nor did they avoid or endure severe weather with intense anxiety or distress after the three-week early intervention.

The present study attempted to answer two general questions: (1) what is the relation between expected and actual reactions to a spider in individuals afraid of spiders? and (2) are inaccurate expectancies updated on the basis of experience? Behavioral and cognitive-behavioral learning models of fear, treatment protocols developed in relation to these, and recent findings from our laboratory necessitated answers to two additional questions: (3) does the expectation accuracy of individuals who meet DSM-IV criteria for diagnosis with a specific phobia differ from that of individuals who are fearful but do not meet criteria? and (4) does expectation accuracy vary as a function of context? Two final questions were obvious: (5) do the actual reactions of individuals who meet criteria for diagnosis differ predictably from those of fearful individuals? and (6) do reactions vary contextually? Student participants reported and tested a series of trial-specific expectancies about their reactions to a live, mechanical, or virtual tarantula over seven trials. Participants then completed three final trials in the presence of a live tarantula. Participants poorly anticipated the quality and intensity of their initial reactions, but expectation accuracy increased quickly. No clear tendencies for over- or under-prediction emerged. Participants updated expectancies in relation to prior trial expectation accuracy, either increasing or decreasing their predicted reactions relative to the original expectancy. Participants who met criteria for diagnosis with a specific phobia consistently anticipated and reported more intense reactions than did those who were fearful, but diagnostic status was not predictive of expectation accuracy. Participants in the live and virtual spider groups reported similar levels of fear that were greater than those in the mechanical spider group. Participants in the virtual spider group more readily reduced the distance maintained between themselves and the spider stimulus than did those in the live or mechanical spider groups. Expectation accuracy did not vary contextually. Results are discussed in light of the theoretical models presented, with findings lending greater support to behavioral models of fear learning relative to cognitive models that postulate a substantial role for conscious processing and appraisal in specific fear. Practical recommendations are made to researchers and clinicians based on present findings.

A growing body of literature suggests that Virtual Reality is a successful tool for exposure therapy for anxiety disorders. Virtual Reality (VR) researchers posit the construct of presence, interpreting an artificial stimulus as if it were real, as the mechanism that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses 1) Presence is related to in session anxiety and treatment outcome; 2) Presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; 3) Presence is positively related to the amount of phobic elements included within the virtual environment. Results supported presence as the mechanism by which anxiety is experienced in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome

A growing body of literature suggests that Virtual Reality is a successful tool for exposure therapy for anxiety disorders. Virtual Reality (VR) researchers posit the construct of presence, interpreting an artificial stimulus as if it were real, as the mechanism that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses 1) Presence is related to in session anxiety and treatment outcome; 2) Presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; 3) Presence is positively related to the amount of phobic elements included within the virtual environment. Results supported presence as the mechanism by which anxiety is experienced in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome

Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed. / Ph. D.

Die Spezifischen Phobien stellen die häufigste Gruppe der Angststörungen dar. Die Angst vor dem Verschlucken bzw. dem Ersticken wurde jedoch nur sehr selten beschrieben. Bei der Behandlung der Spezifischen Phobien wird fast immer eine Konfrontation in vivo eingesetzt. Die Angst vor dem Verschlucken scheint aber eine der Spezifischen Phobien zu sein, bei der eine Konfrontation schwierig ist. Die hier vorgestellte Fallgeschichte schildert eine mögliche Vorgehensweise, die Ängste vor dem Verschlucken mit einer Reizkonfrontation in vivo zu behandeln. Dabei werden die verschiedenen Schwierigkeiten, die aufgetreten sind, und ihre Lösungen geschildert. Die Therapie wurde erfolgreich abgeschlossen, und auch die Ergebnisse der Nachuntersuchungen zeigten eine stabile Verbesserung. / Specific phobias are the most common anxiety disorders. However, the fear of swallowing the wrong way and choking has rarely been described. Specific phobias are usually treated using exposure therapy. The excessive fear of swallowing the wrong way does not seem to be very well suited for an exposure in vivo. In this case study, a patient afflicted with the fear of swallowing and choking was treated with flooding. The various difficulties encountered during treatment and their remedies will be described. The therapy was successful. The patient showed stable and lasting improvements at posttreatment and at one-year follow-up. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The present dissertation consists of three empirical studies on children and adolescents presenting with various specific phobias in Stockholm, Sweden and in Virginia, USA. The overall aim was to contribute to our understanding of childhood fears, anxiety and phobias and to evaluate the efficacy and portability of a one-session treatment of specific phobias in youth. Study I tested the dimensionality of the Parental Bonding Instrument, across three generations and for two countries, and examined if parenting behaviors of indifference and overprotection were associated with more anxiety problems in children. The results showed that the four-factor representation of parental behavior provided an adequate fit for the instrument across informants. Perceived overprotection was associated with significantly more anxiety symptoms and comorbid diagnosis in children. Study II explored parent-child agreement on a diagnostic screening instrument for youths. The results indicated that children scoring high on motivation at treatment entry had generally stronger parent-child agreement on co-occurring diagnoses and severity ratings. Parents reported overall more diagnoses for their children, and parents who themselves qualified for a diagnosis seemed more tuned in to their children’s problematic behavior. Study III compared a one-session treatment with an education-supportive treatment condition, and a wait-list control condition for children presenting with various types of specific phobias. The results showed that both treatment conditions were superior to the wait-list control condition and that one-session exposure treatment was superior to education-supportive treatment on several measures. Treatment effects were maintained at a 6-month follow-up. Overall, the above findings suggest that the one-session treatment is portable and effective in treating a variety of specific phobias in children and adolescents.

Die Spezifischen Phobien stellen die häufigste Gruppe der Angststörungen dar. Die Angst vor dem Verschlucken bzw. dem Ersticken wurde jedoch nur sehr selten beschrieben. Bei der Behandlung der Spezifischen Phobien wird fast immer eine Konfrontation in vivo eingesetzt. Die Angst vor dem Verschlucken scheint aber eine der Spezifischen Phobien zu sein, bei der eine Konfrontation schwierig ist. Die hier vorgestellte Fallgeschichte schildert eine mögliche Vorgehensweise, die Ängste vor dem Verschlucken mit einer Reizkonfrontation in vivo zu behandeln. Dabei werden die verschiedenen Schwierigkeiten, die aufgetreten sind, und ihre Lösungen geschildert. Die Therapie wurde erfolgreich abgeschlossen, und auch die Ergebnisse der Nachuntersuchungen zeigten eine stabile Verbesserung. / Specific phobias are the most common anxiety disorders. However, the fear of swallowing the wrong way and choking has rarely been described. Specific phobias are usually treated using exposure therapy. The excessive fear of swallowing the wrong way does not seem to be very well suited for an exposure in vivo. In this case study, a patient afflicted with the fear of swallowing and choking was treated with flooding. The various difficulties encountered during treatment and their remedies will be described. The therapy was successful. The patient showed stable and lasting improvements at posttreatment and at one-year follow-up. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The diploma thesis deals with an emotional state called fear and it's pathological form - phobia. The thesis is focused on frequency and form of fears of pupils in older school age and on influence of these fears on teaching of Natural Sciences. The analysis of educational field of Natural Sciences, the interview and the questionnaire investigation of pupils were used in the diploma thesis. On the basis of research results I suggested basic recommendations for teachers who meet pupils with fear or specific phobia during classes. The diploma thesis uses methods of qualitative and quantitative research.