Examine biomedical, individual and group approaches to treatment.
As a treatment for phobias rarely used on its own – Benzodiazepines (Valium, Sobril, Xanax, Xanor, Mogadon, Rohypnol) enhance the effectiveness of GABA. When a single dose is compared to a single psychotherapy session for dental anxiety, the dose was worse.
Serotonin hypothesis: inadequate amount between synaptic gap for effective transmission to occur. Drugs aim to increase the amount of serotonin in the brain. Fluoextine ie. Prozac is a selective serotonin reuptake inhibitor SSRI (does similar sort of job as physostigmine with acetylcholine ie it prevents ‘mopping up.’)
* Kirsch 2008 – metanalysis suggests that there is only a small difference between the drug and a placebo. * Cuijpers 2009 – metanalysis: i/ Control (spontaneous remission) ii/ psychotherapy better, iii/ medication best. Besterist = combination of ii and iii. * ECT electroconvulsive therapy: used where other forms of therapy have failed, use is declining, over half who receive at are over 65, the majority are female. * Somatic/biomedical treatments, PG 218-9 Grahame Hill
* Behavioral therapy
* i/ Systematic desensitization: hierarchical set of fear situations related to phobic stimulus, and training in muscle relaxation. Choy 2007 can reduce anxiety but not necessarily the avoiding behavior. When effective, the benefits are long lasting. Benefit over drugs is that it corrects the problem, doesn’t just alleviate the symptoms. * Flooding. The opposite of SD.
* Aversion therapy: uses emetics or electrical shocks.
* Cognitive therapy: a phobia sufferer believes that the feared situation is inherently dangerous. This belief leads to negative automatic thoughts that occur as soon as the feared situation is encountered. The automatic thoughts lead to a phobic reaction. Cognitive techniques...
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