Subjective Units Of Distress Scale Research Articles

Reducing Anxiety through Music Therapy at a Community Residential Alcohol and Drug withdrawal Unit

Anxiety is a main symptom of withdrawal from substances and can be detrimental to treatment. There is little evidence which supports the use of a particular therapeutic treatment in reducing the anxiety associated with withdrawal. This study aimed to reduce anxiety associated with withdrawal through participation in group music therapy for adults admitted to a community residential alcohol and drug withdrawal unit. A quasi-experimental design was adopted, using the self-report Subjective Units of Distress Scale (SUDS) to measure anxiety pre and post a single session. A total of 35 participants attended a one hour music therapy group session and contributed to data collection over ten sessions. A paired two-tailed t-test indicated a highly statistically significant difference (p = <0.0001) between the pre and post session scores, suggesting that music therapy significantly decreased anxiety for participants. The results of this study provide support for the future funding of music therapy programs in inpatient withdrawal settings and contributes to the limited evidence base supporting the use of music therapy for people with substance use disorders.

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OBJECTIVES/SPECIFIC AIMS: Alcohol craving, particularly in response to stress and alcohol cues, can lead to relapse in alcohol-dependent individuals. Hypothalamus-pituitary-adrenal (HPA) axis markers such as the cortisol to corticotrophin (CORT:ACTH) ratio have been shown to be a significant predictor of alcohol relapse. Our objective was to evaluate the influence of HPA-axis measures on intravenous alcohol self-administration (IV-ASA) in binge and nonbinge drinkers. METHODS/STUDY POPULATION: Healthy, non-dependent binge drinkers (n=14) and nonbinge drinkers (n=11) participated in this study. They underwent 3 personalized imagery sessions, where they heard 5-minute personalized audio scripts designed to trigger stress, alcohol craving, and neutral-relaxation states. Immediately following these cues, participants were given access to alcohol using a novel IV-ASA paradigm for 120 minutes. Serial blood samples were collected for cortisol and ACTH levels. Subjective measures were collected serially using the Subjective Units of Distress Scale (SUDS), Drug Effects Questionnaire (DEQ), and Alcohol Urge Questionnaire (AUQ). Analyses were conducted using linear regression. RESULTS/ANTICIPATED RESULTS: Results showed that peak and average ACTH levels as well as the CORT:ACTH ratio during the early phase of the IV-ASA session following the stress and alcohol cues were significantly higher than the neutral script; this effect was seen primarily in binge drinkers. After script administration, a greater change from baseline for ACTH predicted time to peak BrAC during IV-ASA. Gender and binge group predicted AUQ MAX (peak alcohol craving over the entire study session) and WANT MAX (peak “want more alcohol” scores over the session). There was a significant correlation between IV-ASA and increased ACTH peak and average values in binge drinkers. The DEQ and AUQ measures were positively correlated with ACTH peak and ACTH change from baseline. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings, to our knowledge, are the first demonstration that exposure to both stress and alcohol cues lead to an increase in ACTH during cue-induced IV-ASA, particularly in binge drinkers. These results suggest that changes in HPA-axis reactivity following stress and alcohol may be important determinants of alcohol consumption in non-dependent binge drinkers.

Efficacy of eye movement desensitization and reprocessing on the phantom limb pain of patients with amputations within a 24-month follow-up

The aim of this study was to evaluate the efficacy of eye movement desensitization and reprocessing (EMDR) on the phantom limb pain (PLP) of patients with amputations within a 24-month follow-up. This study was a randomized-controlled trial. A total of 60 patients with amputations were selected by a purposive sampling and patients were divided randomly into two experimental and control groups. Samples were assigned through randomized allocation. EMDR therapy was administered individually to the experimental group participants in 12 one-hour sessions over a 1-month period In each session, the patient completed the Subjective Units of Distress Scale and a pain-rating scale before and after the intervention. Follow-up measures were obtained 24 months later for the experimental group. The participants in the control group were measured on the two scales at an initial session and again after 1- and 24-month follow-up. The mean PLP decreased in the experimental group between the first and last sessions and remained so at a 24-month follow-up. No decrease occurred for the control group over the 1- and 24-month period. The differences were statistically significant (P<0.001) according to a repeated-measures analysis of variance. EMDR therapy proved to be a successful treatment for PLP. Because of its efficacy and the fact that the positive effects were maintained at the 24-month follow-up, this therapy is recommended for the treatment of PLP.

‘It will get even better’: preliminary findings from a trauma-focused psychotherapy effectiveness study reveal false positive patients’ long-term outcome expectations after the treatment

Background: There is considerable evidence that outcome expectations may predict psychotherapy outcomes. However, little is known about the long-term outcome expectations following the end of the treatment.Aims: The aim of this study was to evaluate patients’ long-term outcome expectations after trauma-focused post-traumatic stress disorder (PTSD) psychotherapy in a single group effectiveness study.Methods: Twenty participants with various traumatic experiences who completed the Brief Eclectic Psychotherapy for Post-Traumatic Stress Disorder (BEPP) and all the assessments were included into the study. Self-report measures were used to evaluate the therapeutic outcomes: Impact of Event Scale–Revised (IES-R), Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) at pre-treatment, post-treatment, and 6-month follow-up. Subjective Units of Distress Scale was used to measure long-term outcome expectations at post-treatment, asking participants to measure the expected distress in 6 months following the treatment. Assessments at 6-month follow-up were used to estimate the accuracy of patients’ expectations of their distress at previous post-treatment assessment.Results: Significant decline of PTSD symptoms at post-treatment with large effect sizes was observed. At post-treatment assessment participants expected significant improvement of their condition in 6 months after the treatment. However, therapeutic effects remained stable at the 6-month follow-up.Conclusion: It is concluded that the PTSD patients, even after successful trauma-focused treatment, tend to expect further significant positive changes. However, therapeutic effects were stable half a year after the psychotherapy, and patients tend to have false expectations about further improvement of their condition.

Effect of Induced Anxiety on Respiratory Resistance Using Virtual Reality Simulation

Background: The purpose of this research was to identify significant changes to respiratory resistance resulting from anxiety inducing simulations presented through the medium of virtual reality (VR) goggles. The tested hypothesis was that a virtual reality simulation would produce anxiety in the wearer, and, with it, a statistically significant change in subject respiratory resistance. It was also suggested that there may be a significant difference in the levels of respiratory resistance responses of males and females. The Oculus Rift DK2 VR goggles with video software designed for the Rift were used to induce anxiety in the wearers. Methods: Respiratory resistances in both inhalation and exhalation directions were measured with the Airflow Perturbation Device (APD), a medical instrument used noninvasively. Two groups of subjects were tested: the test group watched a simulation deemed to be anxiety inducing, and the Control group watched a simulation determined to be non-anxiety inducing. Anxiety levels and respiratory resistance were measured before and during the simulation with two anxiety measures, the State Trait Anxiety Inventory (STAI) and the Subjective Units of Distress Scale (SUDS). Results: Statistically significant increases in anxiety level and respiratory resistance were found in the Test group, but no significant differences in anxiety and respiratory resistance levels were found in the control group. Anxiety affected both breathing phases similarly. For the gender hypothesis, we found that one of the tests used to measure anxiety, (the SUDS difference) was statistically significant, while the other test and the difference in respiratory resistance were not statistically significant. Conclusion: Results from this experiment show that anxiety level can be a significant contributor to the physiological measurement of respiratory resistance, and this can have implications for pulmonary function test environments and the psychological conditions of the patients being tested.

Effect of as-needed use of intranasal PH94B on social and performance anxiety in individuals with social anxiety disorder

There are no medications approved for as-needed use for feared situations for individuals with social anxiety disorder (SAD). In the present study, intranasal PH94B was provided for use as needed during stressful events. Twenty-two subjects were randomized (double-blind) to 2 weeks of treatment with intranasal PH94B or placebo. Following self-administration of medication prior to a feared event, peak levels of anxiety were recorded using the Subjective Units of Distress Scale (SUDS). After 2 weeks, subjects were crossed over to the opposite treatment for 2 weeks. Average peak SUDS during treatment with PH94B and placebo were compared using a paired t-test. Significant differences in favor of PH94B were found on the primary outcome measure: mean peak SUDS change from baseline for all subjects receiving PH94B was 15.6 points versus 8.3 points for placebo (paired t = 3.09, P = .006, effect size of .658). PH94B showed less superiority over placebo when placebo was given second rather than first, likely due to a carryover effect. Looking between groups at just the first 2 weeks of treatment, PH94B also showed trend superiority to placebo on the Liebowitz Social Anxiety Scale (LSAS) (P = .07) and a significant difference on the Patient Global Impression of Change (P = .024) and the LSAS Avoidance subtotal (P = .02). While further study is needed, these results, combined with earlier findings, suggest that PH94B could represent a useful as-needed treatment for SAD, and continue to validate the nasal chemosensory system as a novel mechanism for medication delivery.

Feasibility of Virtual Reality Environments for Adolescent Social Anxiety Disorder

Purpose: This study assessed the feasibility of virtual reality (VR) exposure as an assessment and treatment modality for youth with social anxiety disorder (SAD). Methods: Forty-one adolescents, 20 of which were identified as having SAD, were recruited from a community sample. Youth with and without SAD were exposed to two social virtual environments—party and public speaking—and two neutral virtual environments. Results: All youth reported significantly higher ratings on the Subjective Units of Distress Scale (SUDS) during the party and public speaking scenarios compared to the two neutral environments, while youth with SAD reported significantly higher SUDS in the public speaking and party environments than those without SAD. Youth also demonstrated acceptable levels of presence and immersion in the VR environments. Discussion: VR exposure treatment appears to be feasible for youth with SAD, highlighting the need for further research on its development.

Multimodal neurorehabilitation for treatment of mild traumatic brain injury

Multimodal neurorehabilitation for treatment of mild traumatic brain injury

Aerobic exercise reduces anxiety symptoms and improves fitness in patients with panic disorder

OBJECTIVE: To investigate the effects of a regularly repeated aerobic exercise series on anxiety and maximum oxygen consumption (VO2max) in Panic Disorder patients. METHODS: Ten previously sedentary female subjects diagnosed with Panic Disorder performed 36 sessions of aerobic exercise (at 70 to 75% of VO2max), 3 times per week during 12 weeks. A cardiopulmonary evaluation (ergospirometry test) was used to set the intensity of training as well as to establish baseline and post-training VO2max parameters. The assessment of anxiety symptoms was performed at baseline, at the end of the 6th and 12th weeks, using the Trait Anxiety Inventory (STAI-T) and State Anxiety Inventory (STAI-S), and the Subjective Units of Distress Scale (SUDS) questionnaires. One-way ANOVA for repeated measurements (at 3 moments: Baseline, 6th week (mid-training) and 12th week (post-training) was used to compare the evolution of the questionnaires; the Bonferroni post hoc test was applied to identify differences between moments. A dependent t-test was performed for measures of VO2max. RESULTS: Compared to baseline, (a) STAI-T showed significant anxiety reductions at mid- and post-training moments; (b) STAI-S and SUDS recorded anxiety reductions only at Post-training; (c) VO2max showed a significant improvement at Post-training. CONCLUSION: This protocol promoted beneficial effects on cardiorespiratory fitness and anxiety levels of Panic Disorder patients.

Response to Smith.

Back to table of contents Previous article Next article Communications and UpdatesFull AccessResponse to SmithBarbara Olasov Rothbaum, Ph.D., A.B.P.P. Matthew Price, Ph.D. Kerry Ressler, M.D., Ph.D.Barbara Olasov RothbaumSearch for more papers by this author, Ph.D., A.B.P.P. Matthew PriceSearch for more papers by this author, Ph.D. Kerry ResslerSearch for more papers by this author, M.D., Ph.D.Published Online:1 Nov 2014https://doi.org/10.1176/appi.ajp.2014.14070827rAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Dr. Smith asks an important question, namely if “d-cycloserine augmentation of virtual reality exposure therapy appeared to be associated with worse outcomes for the subset of patients experiencing little response or worsening of subjective distress during the treatment.” The figure and analysis to which Dr. Smith refers are implied from a mixed-effect model that included all participants (N=156). Different outcomes were discovered based on different measures in this study. The most robust beneficial effects of d-cycloserine were seen in the more objective measures of psychophysiological startle and salivary cortisol, consistent with the animal literature on the facilitation of extinction by d-cycloserine. Less consistent were the posttraumatic stress disorder (PTSD) clinical measures that were all based on patient self-report. Even though the Clinician Administered PTSD Scale is a clinical interview, it is based on patient self-report of PTSD symptoms. Even more subjective is the Subjective Units of Distress Scale, which the analysis of emotional learning within and between sessions (to which Dr. Smith refers) is based. Using raw change in Clinician Administered PTSD Scale scores as an indicator of treatment response, we identified two participants in the d-cycloserine condition who had worse symptoms at posttreatment relative to pretreatment. This was less than the six participants in the alprazolam condition and eight in the placebo condition who had worse symptoms at posttreatment relative to pretreatment. The two participants in the d-cycloserine condition with negative scores did not demonstrate negative emotional learning. The graphs in the figure correspond to model-implied trajectories, suggesting that it is theoretically possible that a participant with sufficient negative emotional learning could have poorer outcomes with d-cycloserine relative to a lack of d-cycloserine. This phenomena, however, was not observed in our current sample. Furthermore, the graphs we presented correspond to response in the d-cycloserine condition relative to change in the placebo or alprazolam conditions. That is, these graphs suggest that the negative outcomes obtained are relative to other conditions as opposed to overall functioning. Dr. Smith then suggests “adding the d-cycloserine or a similar agent after the first couple of sessions and only for that subset of patients that have already started to experience a positive response to the treatment.” We think this is a very interesting and important idea, and it is similar to what has been attempted in several recent trials of d-cycloserine combined with exposure therapy (1–3). Most of these have found benefit only for those patients who demonstrated emotional learning within that session, as was found in our study administering d-cycloserine 30 minutes prior to exposure therapy. We absolutely agree with Dr. Smith’s suggestions to determine who is most likely to respond well to exposure therapy and to exposure therapy combined with cognitive enhancers. In this study, those patients who displayed larger startle responses prior to treatment and had lower salivary cortisol in response to the virtual scenes embedded with acoustic startle probes fared better when the virtual reality exposure therapy was combined with d-cycloserine compared with alprazolam or placebo.From the Trauma and Anxiety Recovery Program, Emory University School of Medicine, Atlanta; the University of Vermont, Burlington, Vt.; and the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine.The authors’ disclosures accompany the original article.References1 Smits JA, Rosenfield D, Otto MW, Powers MB, Hofmann SG, Telch MJ, Pollack MH, Tart CD: d-cycloserine enhancement of fear extinction is specific to successful exposure sessions: evidence from the treatment of height phobia. Biol Psychiatry 2013; 73:1054–1058Crossref, Medline, Google Scholar2 Tart CD, Handelsman PR, Deboer LB, Rosenfield D, Pollack MH, Hofmann SG, Powers MB, Otto MW, Smits JA: Augmentation of exposure therapy with post-session administration of d-cycloserine. J Psychiatr Res 2013; 47:168–174Crossref, Medline, Google Scholar3 Guastella AJ, Richardson R, Lovibond PF, Rapee RM, Gaston JE, Mitchell P, Dadds MR: A randomized controlled trial of d-cycloserine enhancement of exposure therapy for social anxiety disorder. Biol Psychiatry 2008; 63:544–549Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 171Issue 11 November 01, 2014Pages 1223-1224 Metrics PDF download History Accepted 1 August 2014 Published online 1 November 2014 Published in print 1 November 2014

The Living Room, a Community Crisis Respite Program: Offering People in Crisis an Alternative to Emergency Departments

Objective: To describe The Living Room, a community crisis respite center that offers individuals in crisis an alternative to obtaining services in an emergency department (ED). Methods: This article describes the problems individuals in a mental health crisis may encounter in traditional EDs and explains how The Living Room addresses these problems. The Living Room’s development, setting, staffing and procedures are described in order to promote increased use of this type of program. Results: In its first year of operation, The Living Room hosted 228 visits by 87 distinct individuals (termed “guests”). Guests were deflected from EDs on 213 of those visits – a 93% deflection rate. These deflections represent a savings of approximately $550,000 to the State of Illinois since guests of The Living Room are overwhelmingly individuals with Medicaid or no insurance of any kind. On 84% (n=192) of the occurrences in which guests were deflected from EDs, they alleviated their crises sufficiently to decide to leave The Living Room and return to the community. These guests reported an average decrease of 2.13 points on the Subjective Units of Distress Scale. Conclusions: Community crisis respite centers such as The Living Room represent an important alternative to EDs by remedying many criticisms of traditional EDs made by individuals in crisis. Outcomes from The Living Room’s first year of operation suggest that community crisis respite centers are cost-effective, effective in helping many individuals alleviate crises, and have the potential to decrease the use of EDs for mental health crisis.

Comprehensive Behavioral Intervention to Improve Occupational Performance in Children With Tourette Disorder

OBJECTIVE. We evaluated the efficacy of a comprehensive behavioral intervention for tics (CBIT) program to reduce tic severity and improve occupational performance in children with tic disorder using a one-group pretest-posttest design. METHOD. Thirty children with tic disorder completed an eight-session CBIT program. The program focused on habit reversal, relaxation training, and function-based approaches to address how the environment and social situations (antecedents and consequences) sustain or influence tic severity. RESULTS. We observed significant reduction in the number of tics and improvement in scores on the Parent Tic Questionnaire, Subjective Units of Distress Scale, and Child Occupational Self Assessment after CBIT compared with scores at baseline. CONCLUSION. Findings provided support that CBIT reduced the number of tic expressions, tic severity, and level of distress associated with tic and improved these children's self-perception of their competence in and importance of performing everyday activities (i.e., occupational performance).

Online Exposure Treatment for Spider Fear: The Effects of Moving Versus Static Images on Treatment Adherence, Fear Elicitation and Habituation

This research aimed to examine the effects of moving (videos) versus static (pictures) images on habituation and progression in a hierarchy during online symbolic exposure (OSE) for spider fear. Participants were 351 people with high spider fear who logged on to an OSE website (www.feardrop.com) for self-help purposes. The inclusion of moving images in the exposure hierarchy increased adherence rates relative to static images, particularly among those with lower relative to higher spider fear. Those who viewed moving images at Stage 2 showed higher Subjective Units of Distress Scale (SUDS) ratings overall, but a similar pattern of habituation relative to those who viewed static images. In addition, 71% of participants completed at least one stage of the OSE program, representing an improvement from 30% adherence in previous research that used an earlier version of the program. These findings support the development of tailored exposure hierarchies to maximise adherence and treatment benefit for individual participants.

Online Exposure for Spider Phobia: Continuous Versus Intermittent Exposure

AbstractBackground: The aim of this research was to evaluate an online exposure treatment for spider phobia (www.feardrop.com) and to investigate the effects of intermittent versus continuous exposure.Methods: Spider phobic participants (N = 23) completed two 14-minute stages of laboratory-based online exposure. In the first of these stages exposure was either continuous or intermittent (alternating fearrelevant and -irrelevant images). One week later, participants commenced a sixstage home-based graded online exposure task, which was undertaken over 30 days. Subjective Units of Distress Scale (SUDS) ratings were taken throughout all exposure stages. Spider fear was assessed prior to treatment, and at 1-week and 1-month post treatment.Results: Habituation was observed across each stage for both the laboratory and home-based tasks and generalisation of habituation was found between stages. Habituation was not impaired in the alternating fear-relevant and -irrelevant image condition, though subjects experienced less summed anxiety. Adherence rates were low in home-based online exposure. However, participants who completed 30-days post-treatment assessment (n = 14) showed a significant reduction in spider fear as measured by the Fear of Spiders Questionnaire (FSQ).Conclusions: Online exposure produces habituation and generalisation of habituation to spider images as well as longer-term reductions in spider fear. Alternating fear-relevant and -irrelevant exposure is feasible in online exposure and may lead to habituation with less summed anxiety that has implications for tolerability and acceptability. Measures to increase adherence rates and hence dosage delivered are a key consideration for further online exposure research.

The Immediate Effect of a Brief Energy Psychology Intervention (Emotional Freedom Techniques) on Specific Phobias: A Pilot Study

Specific phobia is one of the most prevalent anxiety disorders. Emotional Freedom Techniques (EFT) has been shown to improve anxiety symptoms; however, their application to specific phobias has received limited attention. This pilot study examined whether EFT, a brief exposure therapy that combines cognitive and somatic elements, had an immediate effect on the reduction of anxiety and behavior associated with specific phobias. The study utilized a crossover design with participants randomly assigned to either diaphragmatic breathing or EFT as the first treatment. The study was conducted at a regional university in the Southwestern United States. Twenty-two students meeting criteria for a phobic response to a specific stimulus (≥8 on an 11-point subjective units of distress scale). Participants completed a total of five two-minute rounds in each treatment intervention. Study measures included a behavioral approach test (BAT), Subjective Units of Distress Scale (SUDS), and Beck Anxiety Inventory (BAI). Emotional Freedom Techniques significantly reduced phobia-related anxiety (BAI P = .042; SUDS P = .002) and ability to approach the feared stimulus (BAT P = .046) whether presented as an initial treatment or following diaphragmatic breathing. When presented as the initial treatment, the effects of EFT remained through the presentation of the comparison intervention. The efficacy of EFT in treating specific phobias demonstrated in several earlier studies is corroborated by the current investigation. Comparison studies between EFT and the most effective established therapies for treating specific phobias are recommended.

Online Exposure for Spider Fear: Treatment Completion and Habituation Outcomes

AbstractThis research aimed to investigate habituation to spider images during an online exposure treatment (www.feardrop.com) among participants with a high fear of spiders. Participants (N= 392) undertook a 10-stage online exposure treatment with a stage length of either 180 or 360 seconds. Four Subjective Units of Distress Scale (SUDS) ratings were taken throughout each stage. Treatment completion was found to be a significant challenge, with less than one-third (30%) completing at least one stage of the program. Those in the shorter stage length condition were significantly more likely to complete the first stage relative to those in the longer stage length condition (43% vs. 16%). SUDS ratings decreased significantly across time at Stage 1, suggesting habituation of self-reported anxiety and there was an overall reduction in SUDS ratings at the second relative to the first stage, suggesting generalisation of habituation. The greatest habituation was observed among those with high anticipatory anxiety (pre-exposure SUDS rating), high total exposure time, and younger age. There was preliminary evidence for improvement in symptoms of spider fear at post-treatment. Directions for future research include strategies to facilitate treatment completion, evaluation of treatment outcomes, and expansion to include a range of specific fears.

Patterns and Predictors of Subjective Units of Distress in Anxious Youth

Subjective Units of Distress Scale (SUDS) ratings are commonly used during exposure tasks in cognitive behavioral treatment (CBT) for anxiety. The present study examined patterns and predictors of SUDS in a sample of anxiety-disordered youth. Youth (N = 99) aged 7 to 14 (M = 10.4, SD = 1.8) were treated with CBT for social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Analyses were conducted using hierarchical linear modeling. Child's peak SUDS and magnitude of change in SUDS significantly increased between sessions. Higher child self-reported pretreatment total Multidimensional Anxiety Scale for Children (MASC) score predicted greater change in SUDS within the first exposure session. Primary GAD diagnosis predicted less increase in change in SUDS between sessions. Results suggest that higher pretreatment total MASC scores are associated with increased first exposure within-session habituation. Additionally, youth with a principal diagnosis of GAD experienced less between-session habituation, perhaps because they may have required more imaginal than in-vivo exposures.

Anxiogenic properties of a computer simulation for panic disorder with agoraphobia

BackgroundThere are several useful methods to induce anxiety in patients with panic disorder with agoraphobia (PDA). Our aim was to ascertain if a computer simulation (CS) could induce anxiety and physiologic alterations in PDA patients. Methods10 healthy controls (HC) and 10 patients who fulfilled DSM-IV criteria for PDA were recruited for this study. The anxiety level was measured with the Subjective Units of Distress Scale (SUDS) and the Diagnostic Symptom Questionnaire (DSQ) was used to ascertain panic attack (PA) symptoms. The heart rate, skin conductance and respiration were monitored during exposure to the CS. The CS was a 3D computer animation of a short bus trip, from a first person perspective. ResultsIn PDA patients CS exposure increased anxiety levels, they also had higher scores in the DSQ and two of them had PA. Compared to the HC, the PDA patients had higher skin conductance level, electrodermal response magnitude, respiratory rate, tidal volume, and respiratory rate irregularities. The heart rate means were higher for PDA patients who had PA, followed by HC and PDA patients who did not have PA. There were no significant differences between the two groups regarding the sense of presence. LimitationsThe main limitations were the small sample size, and some PDA patients under medications. ConclusionsThis study indicated that CS exposure may induce anxiety, electrodermal and respiratory alterations in patients with PDA. CS exposure may be a useful tool in the research and treatment of PD patients.

P01-135 - Anxiogenic properties of a virtual reality simulation for panic disorder with agoraphobia

ObjectivesThere are several useful methods to induce anxiety in patients with panic disorder with agoraphobia (PDA). Our aim was to ascertain if a virtual reality simulation could induce anxiety and physiologic alterations in PDA patients.Methods10 healthy controls (HC) and 10 patients who fulfilled DSM-IV criteria for PDA were recruited for this study. Before and after the experiment the anxiety level was measured with the Subjective Units of Distress Scale (SUDS), the Diagnostic Symptom Questionnaire (DSQ) was used to ascertain panic attack symptoms. The heart rate, skin conductance and respiration parameters were monitored during the exposure to the VR. The virtual reality simulation was a 3D computer animation of a short bus trip, from a first person perspective. The Igroup Presence Questionnaire (IPQ) was used to measure the sense of presence.ResultsPDA patients had higher familial history of panic disorder. From the 10 PDA patients only 3 were not taking medications. In PDA patients the VR exposure increased anxiety levels, they also had higher scores in the DSQ and two of them had panic attacks. Compared to the HC, the PDA patients had higher skin conductance levels, electrodermal response magnitude, respiratory rate, tidal volume, and respiratory rate irregularities. The heart rates were higher for patients who had panic attacks, followed by the HC and the non-panicking patients. Regarding the sense of presence the two groups were similar.ConclusionThis study indicated that VR exposure may induce anxiety, electrodermal and respiratory alterations in patients with PDA.

Treating Spider Phobia Using Neuro Emotional Technique™: Findings from a Pilot Study

Specific phobia, the most common anxiety disorder, can disrupt lives, limit work efficiency, reduce self-esteem, and strain relationships. Current interventions show some degree of success, yet relapse is common. Consequently, the need for a more effective and durable intervention is evident. The purpose of this pilot study is to investigate the efficacy of a new intervention, Neuro Emotional Technique (NET), on individuals with spider phobia, and to determine whether further investigation is warranted. Participants who met the inclusion criterion that spider phobia impacted their daily lives were randomized to either a control group that received no intervention (N = 7), or to an experimental group that received two 30-minute sessions of NET approximately 2 weeks apart (N = 8). The primary measure was the Subjective Units of Distress Scale, and secondary measures were the Spider Questionnaire, Behavioral Assessment Test, Beck Anxiety Inventory, and change in heart rate (HR). Compared with the no-intervention control group, statistical analysis indicates a significant advantage for the NET group in regard to state anxiety/subjective distress, reported fear, and avoidant behavior. The difference between the two groups for general anxious symptomatology (trait anxiety) and change in HR was not statistically significant. No adverse reactions were reported. The findings of this pilot study suggest that NET is a promising intervention for spider phobia in adults. A larger, full-scale study is required to confirm these results.