Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T21:35:31.619Z Has data issue: false hasContentIssue false
  • English
  • Français

Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation

Published online by Cambridge University Press:  09 July 2009

Julian Hafner  and
Isaac Marks
Julian Hafner
Affiliation:
Institute of Psychiatry, Maudsley Hospital, London
Isaac Marks
Affiliation:
Institute of Psychiatry, Maudsley Hospital, London
Get access Rights & Permissions [Opens in a new window]

Synopsis

Fifty-seven chronic agoraphobic outpatients were treated by 12 hours of exposure in vivo on four days over two weeks to check the effects of oral diazepam versus placebo during group exposure, group versus individual exposure, and high versus medium anxiety arousal during individual exposure. The controlled parallel design allowed comparative evaluation of each treatment condition to six months follow-up. Assessment was blind with respect to drug and psychological treatment. Patients in all treatment conditions improved significantly in phobias and in related life areas.

Outcome to group exposure on phobias and other measures was similar in all three drug conditions (placebo, waning diazepam, peak diazepam) with no significant differences between them. Diazepam patients had significantly less discomfort than placebo patients during group exposure treatment. Group exposure patients improved slightly but significantly more than individual exposure patients on non-phobic measures, though group exposure was accompanied by more panics during treatment yet was easier to run by the therapist. Individual exposure under high anxiety arousal was no more therapeutic than with lower anxiety. Diazepam is a mild palliative during group exposure but does not facilitate outcome to treatment. Group exposure in vivo is mildly facilitatory for outcome compared with individual exposure. Anxiety evocation during treatment was not therapeutically helpful.

Type
Research Article
Information
Psychological Medicine , Volume 6 , Issue 1 , February 1976 , pp. 71 - 88
Copyright
Copyright © Cambridge University Press 1976

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Besser, G. M. (1967). Time course of action of diazepam. Nature, 214, 428.CrossRefGoogle ScholarPubMed
Caine, T. D., Foulds, G., and Hope, K. (1967). The Manual of the Hostility and Direction of Hostility Questionnaire. University of London Press: London.Google Scholar
Crown, S., and Crisp, A. H. (1966). A short clinical diagnostic self-rating scale for psychoneurotic patients. British Journal of Psychiatry, 112, 917–923.Google Scholar
Eysenck, S. B. G., and Eysenck, H. J. (1972). The question-naire measurement of psychoticism. Psychological Medicine, 2, 50–55.CrossRefGoogle Scholar
Gelder, M. G., and Marks, I. M. (1966). Severe agoraphobia: a controlled prospective trial of behaviour therapy. British Journal of Psychiatry, 112, 309–319.CrossRefGoogle ScholarPubMed
Gelder, M. G., Marks, I. M., and Wolff, H. H. (1967). Desensitization and psychotherapy in phobic states: a controlled inquiry. British Journal of Psychiatry, 113, 53–73.Google Scholar
Hand, I., Lamontagne, Y., and Marks, I. M. (1974). Group exposure (flooding) in vivo for agoraphobics. British Journal of Psychiatry, 124, 588–602.CrossRefGoogle ScholarPubMed
Lader, M. H., and Wing, L. (1966). Physiological Measures, Sedative Drugs and Morbid Anxiety. Maudsley Monograph No. 14. Oxford University Press: London.Google Scholar
Marks, I. M., and Herst, E. R. (1970). A survey of 1200 agoraphobics in Britain. Social Psychiatry, 5, 16–24.Google Scholar
Marks, I. M., Boulougouris, J., and Marset, P. (1971a). Flooding versus desensitization in the treatment of phobic patients: a crossover study. British Journal of Psychiatry, 119, 353–375.Google Scholar
Marks, I. M., Marset, P., Boulougouris, J., and Huson, J. (1971b). Physiological accompaniments of neutral and phobic imagery. Psychological Medicine, 1, 299–307.Google Scholar
Marks, I. M., Viswanathan, R., Lipsedge, M. S., and Gardner, K. (1972). Enhanced relief of phobias by flooding during waning diazepam effect. British Journal of Psychiatry, 121, 493–505.Google Scholar
Marks, I. M., and Huson, J. (1973). Physiological aspects of neutral and phobic imagery: further observations. British Journal of Psychiatry, 122, 567–572.Google Scholar
Marks, I. M. (1975). Behavioural treatments of phobic and obsessive-compulsive disorders: A critical appraisal. In Progress in Behavior Modification. Edited by Hersen, R. et al. Academic Press; New York.Google Scholar
Stampfl, T. G. (1967). Implosive therapy: the theory, the subhuman analogue, the strategy and the technique: Part 1. The Theory. In Behavior Modification Techniques in the Treatment of Emotional Disorders, pp. 22–37. Edited by Armitage, S. G.. V. A. Publication: Battle Creek.Google Scholar
Stern, R. S., and Marks, I. M. (1973). Contract therapy in obsessive-compulsive neurosis with marital discord. British Journal of Psychiatry, 123, 681–684.Google Scholar
Stewart, R. A., Groff, C., and Kiker, V. L. Jr. (1971). Stress and Flicker perception: 1. The effects of shock induced anxiety. Perceptual Motor Skills, 33, 1211–1214.Google Scholar
Watson, J. P. and Marks, I. M. (1971). Relevant and irrelevant fear in flooding: a crossover study of phobic patients. Behaviour Therapy, 2, 275–293.Google Scholar
Mawson, A. B. (1970). Methohexitone-assisted desensitisation in the treatment of phobias. Lancet, 1, 1084–1086.Google Scholar