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Exposure and communications training in the treatment of agoraphobia
Authors:Dianne L. Chambless  Edna B. Foa  Gerald A. Groves  Alan J. Goldstein
Affiliation:1. Department of Psychology, University of Georgia, Athens, GA 30602, USA;2. Department of Psychiatry, Temple University Medical School, Philadelphia, PA 19129, USA;3. Department of Psychiatry, Boston University Medical School, Boston, MA 02215, U.S.A.
Abstract:
Twenty-one agoraphobics participated in a 6-month study designed to (a) compare imaginal flooding under high- (no sedation) and low- (sedation used) anxiety conditions: (b) examine the long-term effects of imaginal flooding in the absence of further exposure treatment; and (c) explore the impact of communications training on chronic anxiety and panic attacks. A reevaluation of the effects of sedation is presented in this report.Imaginal flooding without sedation was, on the whole, superior to the attention control placebo and imaginal flooding with sedation on therapists' and clients' ratings of fear and avoidance. However, the superiority of the non-drug flooding group cannot be attributed (as was concluded in an earlier report) to higher levels of anxiety across flooding sessions. Rather the drug (methohexitone sodium) appears to have impeded across-session habituation, perhaps by interfering with long-term memorial processes.The effects of imaginal flooding without sedation were stable over 4 months without further exposure treatment. These clients did receive training in solving important interpersonal problems through self monitoring and increased expressiveness. Contrary to hypotheses, not only was no further improvement obtained on fear and avoidance with this treatment, but also anxious mood and panic attacks remained unaffected. It is surprising to note that in-vivo treatment was no more effective than imaginal flooding on fear and avoidance. These and other findings suggest imaginal flooding well warrants further study.
Keywords:To whom all reprint requests should be addressed.
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