Effects of diazepam on phobic avoidance behavior and phobic anxiety.

The efficacy of diazepam for controlling phobic avoidance behavior and phobic anxiety and the potential usefulness of the behavioral approach measure for screening new antianxiety drugs was investigated in a double-blind study. The distance from the phobic object beyond which the subject would not approach and a rating of subjective anxiety at closest approach were made in 14 phobic patients immediately before and again 2 hr after 10-mg oral diazepam or placebo. Behavioral approach to the object was increased and subjective anxiety was decreased by diazepam as compared to placebo. The method appeared useful for early clinical screening of new drugs because it discriminated drug from placebo in a single short session using small groups and because it employed a more objective dependent measure than self-report of subjective feeling states.     

Dependent personality disorder associated with phobic avoidance in patients with panic disorder

Eighty-eight panic disorder patients were divided into three groups according to the extent of their phobic avoidance (none, limited, or extensive). These groups were compared on three personality disorder instruments: the Structured Interview for DSM-III Personality Disorders, the Personality Diagnostic Questionnaire, and the Millon Clinical Multiaxial Inventory. Phobic patients were found to have significantly more dependent personality disorder and DSM-III third-cluster personality disorders than nonphobic patients. A subgroup of patients with social phobic symptoms was found to resemble the rest of the phobic group in terms of personality.     

Treatment of phobic postural vertigo

In balance clinic practice, phobic postural vertigo is a term used to define a population with dizziness and avoidance behavior often as a consequence of a vestibular disorder. It has been described as the most common form of dizziness in middle aged patients in dizziness units. Anxiety disorders are common among patients with vestibular disorders. Cognitive–behavioral therapy is an effective treatment for anxiety disorders, and vestibular rehabilitation exercises are effective for vestibular disorders. This study compared the effect of additional cognitive–behavioral therapy for a population with phobic postural vertigo with the effect of self–administered vestibular rehabilitation exercises. 39 patients were recruited from a population referred for otoneurological investigation. Treatment effects were evaluated with the Dizziness Handicap Inventory, Vertigo Symptom Scale, Vertigo Handicap Questionnaire, and Hospital Anxiety and Depression Scale. All patients had a self treatment intervention based on education about the condition and recommendation of self exposure by vestibular rehabilitation exercises. Every second patient included was offered additional cognitive behavioral therapy. Fifteen patients with self treatment and 16 patients with cognitive– behavioral treatment completed the study. There was significantly larger effect in the group who received cognitive behavioral therapy than in the self treatment group in Vertigo Handicap Questionnaire and the Hospital Anxiety and Depression scale and its subscales. Cognitive–behavioral therapy has an additional effect as treatment for a population with phobic postural vertigo.A multidisciplinary approach including medical treatment, cognitive–behavioral therapy and physiotherapy is suggested.     

Spasmodic torticollis and phobic neurosis

Psychopathology is reported to be common in patients with spasmodic torticollis (ST). We describe two ST patients with a coexisting phobic neurosis. In the first patient the phobic neurosis appeared independent of ST. In the second patient the phobia could be directly attributed to the development of essential tremor which may be an antecedent to the onset of ST. The two phobias were successfully eliminated with paradoxical intention. The elimination of the phobia had no effect on ST. Care should be taken in assuming that the presence of psychopathology is causally relevant to the development of ST.     

The development of the jamming avoidance response in the weakly electric fish, Eigenmannia

The jamming avoidance response (JAR) in young weakly electric fish, Eigenmannia, develops at the onset of a functional electrosensory phase-coding system, a neural pathway that is critical for the performance of the JAR. Size (measured in head to tail length) seems to be the best predictor of the onset of the JAR. A distinguishable JAR value (0.15 Hz or greater) develops in fish at a length of 12-15 mm, and its strength continues to increase with maturity until it approaches an adult value (8-20 Hz) at a length of about 45 mm. The JAR is not dependent upon social interactions, as it can be performed correctly upon first stimulation by animals raised in individual aquaria from the egg stage. Preliminary studies suggest that there are anatomical correlates to the development of the JAR behavior. As the JAR strengthens with age, there is a concomitant increase in the number of giant cells and a development of the commissural plexus in lamina 6 of the torus semicircularis. Giant cells play a pivotal role in the phase comparison circuit. Both phase and amplitude information play a role in the proper performance of the JAR, but the discrete nature of the phase comparison circuit allows the correlation between the development of the JAR and an essential part of the phase comparison circuit (lamina 6 of the torus) to be observed in Eigenmannia.