Treatment outcome studies of social phobia are equivocal relative to the superiority of two interventions, in vivo exposure and cognitive restructuring. Reasons include the condition that is studied, i.e., generalized (multiple fears) or simple (specific fear) phobia, methodological and practical constraints on treatments, the severity of the disorder, and the inherent efficacy of each intervention. In the current study, in vivo exposure and cognitive restructuring were contrasted in an applied investigation of an uncommon but debilitating social phobia, psychogenic urinary retention (PUR). The study was undertaken in a federal prison where random urinalysis is conducted under public scrutiny. Eight inmate volunteers who met criteria for PUR were treated with either in vivo exposure or cognitive restructuring. Employing a multiple baseline design across subjects, improvement was evaluated daily across behavioral indices (latency to onset of urination, duration of urination, urinating to desired volume), and subjective (SUDS) ratings of distress. Attitudinal change during the study and urges to urinate were also monitored. Follow-up probes after the project was terminated were also conducted. One subject improved during baseline prior to the implementation of his treatment. Of the remaining inmates, response to the cognitive intervention was poor. Three of six inmates demonstrated variable improvement with exposure, ranging from minor to total amelioration. Improvement was based on behavioral criteria, decreases in rated subjective distress, and changes in attitudinal measures, all with unchanged urges to urinate relative to baseline. Factors impeding greater improvement with exposure were infrequent and low attendance rates to treatment sessions due to environmental constraints, increased subject inattention to treatment guidelines, and anticipatory / distress. There were, however, suggestive data indicating that more severe manifestations of PUR may be unresponsive to either treatment. The use of a single-subject design is discussed, among other points, in terms of its value to the study of an unusual disorder. / Source: Dissertation Abstracts International, Volume: 51-12, Section: B, page: 6103. / Major Professor: Jon Bailey. / Thesis (Ph.D.)--The Florida State University, 1990.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_78396 |
| Contributors | Gay, Jose Antonio., Florida State University |
| Source Sets | Florida State University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | 230 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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