Effectiveness of a smartphone-based,augmented reality exposure app to reduce fear of spiders in real-life: A randomized controlled trial

Although in vivo exposure therapy is highly effective in the treatment of specific phobias, only a minority of patients seeks therapy. Exposure to virtual objects has been shown to be better tolerated, equally efficacious, but the technology has not been made widely accessible yet.We developed an augmented reality (AR) application (app) to reduce fear of spiders and performed a randomized controlled trial comparing the effects of our app (six 30-min sessions at home over a two-week period) with no intervention. Primary outcome was subjective fear, measured by a Subjective Units of Distress Scale (SUDS) in a Behavioural Approach Test (BAT) in a real-life spider situation at six weeks follow-up.Between Oct 7, 2019, and Dec 6, 2019, 66 individuals were enrolled and randomized. The intervention led to significantly lower subjective fear in the BAT compared to the control group (intervention group, baseline: 7.12 [SD 2.03] follow-up: 5.03 [SD 2.19] vs. control group, baseline: 7.06 [SD 2.34], follow-up 6.24 [SD 2.21]; adjusted group difference -1.24, 95 % CI -2.17 to -0.31; Cohen’s d = 0.57, p = 0.010).The repeated use of the AR app reduces subjective fear in a real-life spider situation, providing a low-threshold and low-cost treatment for fear of spiders.     

The neural correlates of attentional bias in blood phobia as revealed by the N2pc

In the literature, a lack of attentional bias in blood phobia has been reported, using both behavioral and ERP measures. However, in the tasks employed so far, attentional resources to single stimuli, rather than attentional selection, were evaluated. The present study investigated whether in blood phobics disorder-relevant pictures can capture visuo–spatial attention when paired with neutral or non-specific unpleasant pictures (attack), and participants have to focus on a visual detection task. The N2pc component of the ERPs was measured as an index of spatial attentional selection. Results showed that in blood phobics, but not in controls, injuries elicited a larger early N2pc than attack pictures when paired with neutral material. Moreover, only in blood phobics a reliable N2pc to injury-attack pairs was found. The late N2pc reversal to injury pictures suggests that early orienting to phobic cues was followed by cognitive avoidance.     

Attentional Bias Toward Facial Stimuli Under Conditions of Social Threat in Socially Phobic and Nonclinical Participants

The present studies examined attentional bias for photographed faces and household objects among individuals diagnosed with generalised social phobia using a letter-probe computer task. Study 1 was conducted to replicate previous findings showing evidence of avoidance for faces among individuals diagnosed with generalised social phobia using a similar methodology as Mansell, W., Clark, D., Ehlers, A., and Chen, Y. P. (1999, Cognition and Emotion, 13(6), 673–690) on a clinical sample. Thirty-one clinical participants and 32 matched controls received identical threat instructions regarding an upcoming speech-task following the computer task. Contrary to previous findings, clinical participants demonstrated a preference for attending toward faces than household objects, regardless of facial expression and more so than controls. Study 2 was conducted on a different clinical sample in an attempt to replicate the findings of Study 1 with clearer instructions regarding the upcoming speech task. Thirty-one clinical participants and 32 matched controls were administered the same speech threat and task instructions as those used by Mansell, W., Clark, D., Ehlers, A., and Chen, Y. P. (1999, Cognition and Emotion, 13(6), 673–690). Findings revealed the same pattern found in Study 1. Hence, in contrast to previous findings, both studies demonstrated that under conditions of social threat individuals diagnosed with generalised social phobia are more vigilant of pictorial faces generally than non-anxious individuals. The current findings lend support to cognitive models predicting that anxious individuals prefer to attend more to social cues of threat, in this case, faces. Explanations for these contradictory findings on attentional processing in social phobia are discussed with reference to the possible impact of perceived social threat and altered levels of state anxiety. Suggestion is also made for clearer research to reconcile these seemingly opposing results.

4959人次艾滋热线电话资料分析

目的 了解目前东方艾滋病热线求询者的常住地、年龄、性别组成、咨询问题等,在此基础上做针对性的工作安排,提高热线服务质量.方法 将2007年5月1日至2008年4月30日,共4 959人次热线电话来电者的性别、年龄、常住地、求询内容等资料,运用社会科学统计软件(SPSS 13.0)进行分析.结果 男性来电者3 957人次,女性为1 002人次,比例为3.9:1.恐惧艾滋病咨询电话979人次,咨询3 980人次.涉及到HIV感染的电话1 327人次,在来电中有过高危行为者896人次.21～40岁人群来电达4 477人次,占总体来电量的90.28%;而41岁及以上者来电404人次,占8.15%.结论 来电者主要为21～40岁年龄段的人群,咨询内容主要是HIV感染和检测的问题.在恐艾者中间,女性多于男性,40岁以上者多于40岁以下者,这种差异具有统计学意义.     

Exposure therapy triggers lasting reorganization of neural fear processing

A single session of exposure therapy can eliminate recalcitrant and disabling fear of phobogenic objects or situations. We studied neural mechanisms of this remarkable outcome by monitoring changes in brain activity as a result of successful 2-h treatment. Before treatment, phobogenic images excited activity in a network of regions, including amygdala, insula, and cingulate cortex, relative to neutral images. Successful therapy dampened responsiveness in this fear-sensitive network while concomitantly heightening prefrontal involvement. Six months later, dampened fear-network activity persisted but without prefrontal engagement. Additionally, individual differences in the magnitude of visual cortex activations recorded shortly after therapy predicted therapeutic outcomes 6 mo later, which involved persistently diminished visual responsiveness to phobogenic images. Successful therapy thus entailed stable reorganization of neural responses to initially feared stimuli. These effects were linked to fear-extinction mechanisms identified in animal models, thus opening new opportunities for the treatment and prevention of debilitating anxiety disorders.     

核磁共振成像检查致幽闭恐怖症患者的心理干预

目的探讨核磁共振检查中患者出现幽闭恐怖症后的心理干预效果。方法对43例第1次行MRI检查出现幽闭恐惧症状、无法完成核磁共振检查的患者采取综合心理干预。观察干预前后患者的生命体征和检查中不适症状的变化。结果干预后37例患者均能成功完成检查,有效率为86％,6例经多次心理干预后无法完成检查,无效率为14％。干预前后患者的生命体征和检查中不适症状差异有统计学意义（P〈0．05）。结论心理干预能够有效改善MRI检查所致幽闭恐怖症患者的恐惧心理,使其顺利配合并取得检查成功。     

Dental anxiety--an epidemiological study on its clinical correlation and effects on oral health

Pronounced dental anxiety could lead to avoidance strategies to evade dental visits. The aim of the present epidemiological study was to investigate the prevalence and related oral disease patterns of dental anxiety in young adult male soldiers. Therefore, the intensity and frequency of dental anxiety are presented and the correlation with oral clinical findings are evaluated. Three hundred seventy-four soldiers who underwent a compulsory dental check-up were randomly assigned to this study. Psychological parameters were collected based on a protocol integrating the Dental Anxiety Scale (DAS) and the Gatchell Fear Scale (GaFS). Patient-based measures included D3,4MF-scores for dental status and the Community Periodontal Index of Treatment Need (CPITN) for periodontal status. Thirty-two individuals (8.6%) showed DAS-scores of 13 or 14 (anxious), while 4.6% had a DAS-score > or = 15 (highly anxious/phobic). Highest DAS-values were measured among patients' aged 19-29 (n = 262). DMFS-values of anxious and less anxious patients showed only minor differences. However, anxious patients had significantly more carious lesions (P < 0.001). CPITN periodontal values showed no significant differences between both groups. 89.2% of less anxious individuals and 79.6% of anxious patients went for regular dental check-ups. Thus, every tenth patient was considered to have high dental anxiety. Anxiety results in avoidance behaviour, which can only be discovered upon compulsory examinations and which is associated with higher caries morbidity and need for oral rehabilitation. As anxiety has a direct influence on oral health, it should be detected and accounted for in a treatment concept integrating dental and cognitive-behavioural therapeutic approaches.     

Baseline Differences in Social Support Among Treatment-Seeking Alcoholics With and Without Social Phobia

Differences on demographics and seven measures of social support between matched, treatment-seeking alcoholics with and without social phobia (SP and NSP groups, respectively) were examined. The groups did not differ on most demographic variables, although the SP group (n = 397) had a lower occupational status and had fewer years of education (both p's < .01) than the NSP group (n = 397). On social support measures, the SP group had less perceived social support from friends and had a lower performance on the social behavior role scale than the NSP group (both p's < .001). The two groups were unexpectedly more similar than different on the measures of interest in this study; however, the differences identified are meaningful for treatment planning. It is important to ascertain the quantity and sources of social support which are available to these clients in order to maximize positive treatment outcomes.     

The mental health of elderly women in the community

This community study of the mental health of women demonstrates twice as much psychiatric ill-health among those over the age of 65 compared to younger women. The findings are best explained in terms of the loss of the work role for the elderly women rather than the loss of the domestic role. An apparently high frequency of phobia in the urban women is seen as an understandable reaction to their increased vulnerability and decreased mobility consequent on their chronic physical ill-health.