Journal of Behavior Therapy and Experimental Psychiatry, 2008
Virtual reality exposure therapy (VRET) is an increasingly common treatment for anxiety and speci... more Virtual reality exposure therapy (VRET) is an increasingly common treatment for anxiety and specific phobias. Lacking is a quantitative meta-analysis that enhances understanding of the variability and clinical significance of anxiety reduction outcomes after VRET. Searches of electronic databases yielded 52 studies, and of these, 21 studies (300 subjects) met inclusion criteria. Although meta-analysis revealed large declines in anxiety symptoms following VRET, moderator analyses were limited due to inconsistent reporting in the VRET literature. This highlights the need for future research studies that report uniform and detailed information regarding presence, immersion, anxiety and/or phobia duration, and demographics. r
Background: A practice-based study was carried out to assess the comparative effectiveness and ac... more Background: A practice-based study was carried out to assess the comparative effectiveness and acceptability of standardised hypnosis, hypnosis with individualised imagery, cognitive behavioural treatment (CBT) and general anaesthesia (GA) in the treatment of dental phobia. Methods: A 4-group design was used with 4 repeated measurement occasions. Of an initial total of 137 dental phobics, 77 completed the study with sample sizes of between 14 and 29 patients in the 4 groups. Participants completed questionnaires of dental anxiety at the beginning of the trial, before and after the first dental appointment and again before the second dental appointment a week later. Results: Standardised hypnosis evidenced a significantly higher rate of premature termination of treatment than CBT. The completer analysis showed a significant reduction of dental anxiety after CBT and individualised hypnosis compared to the GA condition. The intent-to-treat analysis showed significant improvement only after CBT. Conclusions: The results suggest that CBT is the treatment of choice in dental phobia when taking both effectiveness and acceptability into account.
We performed a quantitative review of associations between the higher order personality traits in... more We performed a quantitative review of associations between the higher order personality traits in the Big Three and Big Five models (i.e., neuroticism, extraversion, disinhibition, conscientiousness, agreeableness, and openness) and specific depressive, anxiety, and substance use disorders (SUD) in adults. This approach resulted in 66 meta-analyses. The review included 175 studies published from 1980 to 2007, which yielded 851 effect sizes. For a given analysis, the number of studies ranged from three to 63 (total sample size ranged from 1,076 to 75,229). All diagnostic groups were high on neuroticism (mean Cohen's d ϭ 1.65) and low on conscientiousness (mean d ϭ Ϫ1.01). Many disorders also showed low extraversion, with the largest effect sizes for dysthymic disorder (d ϭ Ϫ1.47) and social phobia (d ϭ Ϫ1.31). Disinhibition was linked to only a few conditions, including SUD (d ϭ 0.72). Finally, agreeableness and openness were largely unrelated to the analyzed diagnoses. Two conditions showed particularly distinct profiles: SUD, which was less related to neuroticism but more elevated on disinhibition and disagreeableness, and specific phobia, which displayed weaker links to all traits. Moderator analyses indicated that epidemiologic samples produced smaller effects than patient samples and that Eysenck's inventories showed weaker associations than NEO scales. In sum, we found that common mental disorders are strongly linked to personality and have similar trait profiles. Neuroticism was the strongest correlate across the board, but several other traits showed substantial effects independent of neuroticism. Greater attention to these constructs can significantly benefit psychopathology research and clinical practice.
An emerging literature suggests that memory enhancement may augment the effects of learning-based... more An emerging literature suggests that memory enhancement may augment the effects of learning-based treatments such as cognitive behavioral therapy. Release of stress hormones, such as cortisol, has been shown to enhance memory. In this report, we evaluated whether a cold pressor stressor (CPS), which reliably generates stress hormones, may also augment treatment for specific phobias. Spider phobics were randomly assigned to CPS or warm water bath following a standardized session of exposure therapy. Inconsistent with our hypothesis, the CPS condition showed no significant enhancement in fear reduction compared to the control condition.
Abstract We hypothesize that there is a general bias, based on both innatepredispositions and exp... more Abstract We hypothesize that there is a general bias, based on both innatepredispositions and experience, in animals and humans, to give greater weight to negative entities (eg, events, objects, personal traits). This is manifested in 4 ways:(a) negative potency ( ...
Objective: To evaluate the mental health of Iranian medical students with regard to sex differenc... more Objective: To evaluate the mental health of Iranian medical students with regard to sex differences. Methods: Participants: 200 junior (50 women, 50 men) and senior (50 women, 50 men) medical students selected randomly. Measurements: The Middlesex Hospital Questionnaire (The MHQ) was used to measure free floating anxiety. Phobia, obsession, somatization, depression and hysteria. Results: The mean age of 200 medical students was 23.7 year (SD=3.6), range 17 to 36. There was significant difference between mean age of women (22.3, SD=2.7) and men (25, SD=3.8), P<.001. The mean scores for psychiatric disorders for 200 students were: anxiety (women=7.5, men=5.2, P<.001), phobia (women=7.2, men=5.3, P=.008), obsession (women=9.9, men=8.9, P=.03), somatization (women=4.7, men=4.2, P=. 2), depression (women=7.9, men=6.7, P=.009) and hysteria (women=8.2, men=6.6, P=.03). Junior students reported significantly more psychiatric disorders (except hysteria) than senior students. Conclusions: Iranian female medical students reported significantly more anxiety, phobia, depression, obsession and hysteria than male medical students, and single medical students had more anxiety than married student (German J Psychiatry 2004; 7: 51-55).
To compare specific phobias with an assumed phylogenetic or ontogenetic origin in responses to fe... more To compare specific phobias with an assumed phylogenetic or ontogenetic origin in responses to fear-relevant (FR) stimuli, 17 spider-and 17 flight-phobic participants were exposed to pictures of spiders, flight accidents, or mushrooms randomly followed by either a startling noise or nothing else. While both groups showed a disorder-specific expectancy bias, only spider-phobic participants exhibited a disorder-specific covariation bias. Spider-phobic participants also showed enhanced skin conductance responses (SCRs), event-related brain potentials (ERPs), and startle responses triggered by disorderspecific FR pictures while flight-phobic participants showed only disorder-specific enhanced SCRs. In sum, our direct comparison between ontogenetic and phylogenetic phobias revealed that the former is characterized by biased and enhanced responses triggered by disorder-specific FR stimuli presumably based on a biological preparedness.
The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turk... more The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turkish substance dependents and to investigate the relationship between CAN with axis I disorders, personality disorders and severity of depression and anxiety symptoms.
Journal of Behavior Therapy and Experimental Psychiatry, 2008
Virtual reality exposure therapy (VRET) is an increasingly common treatment for anxiety and speci... more Virtual reality exposure therapy (VRET) is an increasingly common treatment for anxiety and specific phobias. Lacking is a quantitative meta-analysis that enhances understanding of the variability and clinical significance of anxiety reduction outcomes after VRET. Searches of electronic databases yielded 52 studies, and of these, 21 studies (300 subjects) met inclusion criteria. Although meta-analysis revealed large declines in anxiety symptoms following VRET, moderator analyses were limited due to inconsistent reporting in the VRET literature. This highlights the need for future research studies that report uniform and detailed information regarding presence, immersion, anxiety and/or phobia duration, and demographics. r
Background: A practice-based study was carried out to assess the comparative effectiveness and ac... more Background: A practice-based study was carried out to assess the comparative effectiveness and acceptability of standardised hypnosis, hypnosis with individualised imagery, cognitive behavioural treatment (CBT) and general anaesthesia (GA) in the treatment of dental phobia. Methods: A 4-group design was used with 4 repeated measurement occasions. Of an initial total of 137 dental phobics, 77 completed the study with sample sizes of between 14 and 29 patients in the 4 groups. Participants completed questionnaires of dental anxiety at the beginning of the trial, before and after the first dental appointment and again before the second dental appointment a week later. Results: Standardised hypnosis evidenced a significantly higher rate of premature termination of treatment than CBT. The completer analysis showed a significant reduction of dental anxiety after CBT and individualised hypnosis compared to the GA condition. The intent-to-treat analysis showed significant improvement only after CBT. Conclusions: The results suggest that CBT is the treatment of choice in dental phobia when taking both effectiveness and acceptability into account.
We performed a quantitative review of associations between the higher order personality traits in... more We performed a quantitative review of associations between the higher order personality traits in the Big Three and Big Five models (i.e., neuroticism, extraversion, disinhibition, conscientiousness, agreeableness, and openness) and specific depressive, anxiety, and substance use disorders (SUD) in adults. This approach resulted in 66 meta-analyses. The review included 175 studies published from 1980 to 2007, which yielded 851 effect sizes. For a given analysis, the number of studies ranged from three to 63 (total sample size ranged from 1,076 to 75,229). All diagnostic groups were high on neuroticism (mean Cohen's d ϭ 1.65) and low on conscientiousness (mean d ϭ Ϫ1.01). Many disorders also showed low extraversion, with the largest effect sizes for dysthymic disorder (d ϭ Ϫ1.47) and social phobia (d ϭ Ϫ1.31). Disinhibition was linked to only a few conditions, including SUD (d ϭ 0.72). Finally, agreeableness and openness were largely unrelated to the analyzed diagnoses. Two conditions showed particularly distinct profiles: SUD, which was less related to neuroticism but more elevated on disinhibition and disagreeableness, and specific phobia, which displayed weaker links to all traits. Moderator analyses indicated that epidemiologic samples produced smaller effects than patient samples and that Eysenck's inventories showed weaker associations than NEO scales. In sum, we found that common mental disorders are strongly linked to personality and have similar trait profiles. Neuroticism was the strongest correlate across the board, but several other traits showed substantial effects independent of neuroticism. Greater attention to these constructs can significantly benefit psychopathology research and clinical practice.
An emerging literature suggests that memory enhancement may augment the effects of learning-based... more An emerging literature suggests that memory enhancement may augment the effects of learning-based treatments such as cognitive behavioral therapy. Release of stress hormones, such as cortisol, has been shown to enhance memory. In this report, we evaluated whether a cold pressor stressor (CPS), which reliably generates stress hormones, may also augment treatment for specific phobias. Spider phobics were randomly assigned to CPS or warm water bath following a standardized session of exposure therapy. Inconsistent with our hypothesis, the CPS condition showed no significant enhancement in fear reduction compared to the control condition.
Abstract We hypothesize that there is a general bias, based on both innatepredispositions and exp... more Abstract We hypothesize that there is a general bias, based on both innatepredispositions and experience, in animals and humans, to give greater weight to negative entities (eg, events, objects, personal traits). This is manifested in 4 ways:(a) negative potency ( ...
Objective: To evaluate the mental health of Iranian medical students with regard to sex differenc... more Objective: To evaluate the mental health of Iranian medical students with regard to sex differences. Methods: Participants: 200 junior (50 women, 50 men) and senior (50 women, 50 men) medical students selected randomly. Measurements: The Middlesex Hospital Questionnaire (The MHQ) was used to measure free floating anxiety. Phobia, obsession, somatization, depression and hysteria. Results: The mean age of 200 medical students was 23.7 year (SD=3.6), range 17 to 36. There was significant difference between mean age of women (22.3, SD=2.7) and men (25, SD=3.8), P<.001. The mean scores for psychiatric disorders for 200 students were: anxiety (women=7.5, men=5.2, P<.001), phobia (women=7.2, men=5.3, P=.008), obsession (women=9.9, men=8.9, P=.03), somatization (women=4.7, men=4.2, P=. 2), depression (women=7.9, men=6.7, P=.009) and hysteria (women=8.2, men=6.6, P=.03). Junior students reported significantly more psychiatric disorders (except hysteria) than senior students. Conclusions: Iranian female medical students reported significantly more anxiety, phobia, depression, obsession and hysteria than male medical students, and single medical students had more anxiety than married student (German J Psychiatry 2004; 7: 51-55).
To compare specific phobias with an assumed phylogenetic or ontogenetic origin in responses to fe... more To compare specific phobias with an assumed phylogenetic or ontogenetic origin in responses to fear-relevant (FR) stimuli, 17 spider-and 17 flight-phobic participants were exposed to pictures of spiders, flight accidents, or mushrooms randomly followed by either a startling noise or nothing else. While both groups showed a disorder-specific expectancy bias, only spider-phobic participants exhibited a disorder-specific covariation bias. Spider-phobic participants also showed enhanced skin conductance responses (SCRs), event-related brain potentials (ERPs), and startle responses triggered by disorderspecific FR pictures while flight-phobic participants showed only disorder-specific enhanced SCRs. In sum, our direct comparison between ontogenetic and phylogenetic phobias revealed that the former is characterized by biased and enhanced responses triggered by disorder-specific FR stimuli presumably based on a biological preparedness.
The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turk... more The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turkish substance dependents and to investigate the relationship between CAN with axis I disorders, personality disorders and severity of depression and anxiety symptoms.
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