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Titov: Can psychotherapy work without the therapist?
Autor: Jordi
Slope of change throughout exposure treatment for flight phobia: the role of autonomic flexibility
This study tested the hypothesis that flight-phobic patients experience change at different rates even when they are receiving identical treatment. Faster within-session rates of change (WSRC) were expected for patients who required fewer exposure sessions. The study also tested the theoretical role of autonomic flexibility on WSRC. High flexibility should be associated with faster rates of change. Thirty-seven flight-phobic patients were successfully treated with a computer-assisted fear of flying treatment. A significant negative correlation was found between total number of sessions and WSRC: The fewer sessions patients attended, the faster their rate of change was. The role of autonomic flexibility was partially supported: A significant correlation between heart rate variability and WSRC revealed that flexible patients improved faster than less-flexible patients. (c) 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1-11, 2011.
Virtual reality versus computer-aided exposure treatments for fear of flying
Evidence is growing that two modalities of computer-based exposure therapies–virtual reality and computer-aided psychotherapy–are effective in treating anxiety disorders, including fear of flying. However, they have not yet been directly compared. The aim of this study was to analyze the efficacy of three computer-based exposure treatments for fear of flying: virtual reality exposure therapy (VRET), computer-aided exposure with a therapist’s (CAE-T) assistance throughout exposure sessions, and self-administered computer-aided exposure (CAE-SA). A total of 60 participants with flying phobia were randomly assigned to VRET, CAE-T, or CAE-SA. Results indicate that the three interventions were effective in reducing fear of flying at posttreatment and at 1-year follow-up; furthermore, there were no significant differences between them in any of the outcome measure. Large within-group effect sizes were found for all three treatment conditions at both posttreatment and at follow-up. The results suggest that therapist involvement might be minimized during computer-based treatments and that CAE can be as effective as VRET in reducing fear of flying.
Tecnología para el análisis de la regulación emocional
Linear and nonlinear analyses of EEG dynamics during non-painful somatosensory processing in chronic pain patients
The aim of our study was to characterize brain dynamics of affective modulation of somatosensory processing in chronic pain. We hypothesized that chronic pain patients will show abnormal EEG activity under negative mood conditions compared to healthy controls. Nineteen patients with chronic pain and 21 healthy subjects participated in the experiment. Multiscale entropy, fractal dimension, event-related potentials, and fast Fourier transform were used to analyze EEG data. A significant enhancement of entropy was found in pain patients at P4 compared to P3. Analysis of fractal dimension also revealed significantly higher values at P4 than P3 when pain patients were viewing unpleasant pictures. By contrast, no significant differences due to hemisphere or affective condition were found on nonlinear measures for healthy controls. Analyses of somatosensory ERPs showed that P50 amplitudes elicited by pleasant pictures were more reduced in chronic pain patients than in healthy controls. Finally, we observed that EEG band power was lower in pain patients than in healthy controls, in particular for theta and beta bands over sensorimotor cortices and temporal regions when viewing pleasant images. These findings suggest that sustained pain seems to be accompanied by an abnormal activation and dynamic of brain networks related to emotional processing of somatosensory information in chronic pain. Furthermore, our findings suggest that both linear and nonlinear measures of EEG time series may contribute to the understanding of brain dysfunction in chronic pain.
Masterclass SCRiTC 2010
Masterclass SCRiTC 2010
View more presentations from Jordi Llabrés
Exposure induced changes in EEG phase synchrony and entropy: A snake phobia case report
In this case study the electroencephalographic (EEG) activity of a 23 years old snake phobic patient was recorded one week before treatment, one week after successful one-session exposure therapy, and one year later. EEG recordings were obtained at rest and during exposure to pictures of snakes, pictures of equivalent arousing power, and emotionally neutral images, all of them taken from the International Affective Pictures System. Measures of brain dynamics were sample entropy (SampEn) for each EEG signal/channel and phase synchronization between pairs of EEG channels. Results showed dramatic changes in both measures one week after treatment: SampEn increased and phase synchrony decreased at all sites and pairs of channels respectively. At follow-up, however, we found patterns of entropy and synchrony change across conditions that were similar to the pre-treatment ones, while the patient did not report any fear at all. Despite the limitations of single case studies, these results suggest that the exposure-induced changes in EEG entropy and synchronization are large but transient. The transient increase of the brain’s flexibility could be one of the working neurophysiological mechanisms of exposure therapy.
Looking for traces of phylogenetic fears: Differences in EEG slow oscillations and complexity between spider- and flight phobic subjects
Phylogenetic fears involve stimuli representing a real or potential threat to the species¿ evolutionary ancestors. We tested whether individuals with a phylogenetic fear (spider phobics, n = 17) differed in EEG general activity (delta band power) of the oldest brain system and in complexity from individuals with a non-phylogenetic fear (flight phobics, n = 15) during eyes open and eyes closed resting states. Delta band power was higher during the eyes-closed condition at central sites FZ, CZ and PZ as well as at frontal sites FP1, FP2, and F4. No differences existed in the upper bands theta, alpha, and beta. The EEG complexity was significantly lower among individuals with spider phobia. Differences were found under both eyes closed and eyes open conditions at FZ, F4, CZ, and C4. Lower complexity was also found at PZ and O2 during eyes open. In general, the results of this ex post facto study lend support to the hypothesized prevalence of slow oscillations in phylogenetic fears. Furthermorethese results show that the EEG output of spider phobic participants is less complex than the output from flight phobic participants. The prevalence of slow brain oscillations and the lowered EEG complexity could be interpreted as traces of phylogenetic fears.
Vagally mediated heart rate variability and heart rate entropy as predictors of treatment outcome in flight phobia
In the present study a computer-assisted exposure-based treatment was applied to 54 flight phobics and the predictive role of vagally mediated heart rate (HR) variability (high frequency, 0.15-0.4 Hz band power) and heart rate entropy (HR time series sample entropy) on treatment outcome was investigated. Both physiological measures were taken under controlled breathing at 0.2 Hz and during exposure to a fearful sequence of audiovisual stimuli. Hierarchical regression analyses were conducted to assess the predictive power of these variables in these conditions on treatment self-report measures at the end of treatment and at 6 months follow-up, as well as on the behavioral treatment outcome (i.e. flying at the end of treatment). Regression models predicting significant amounts of outcome variance could be built only when HR entropy was added to the HR variability measure in a second step of the regression analyses. HR variability alone was not found to be a good predictor of neither self-reported nor behavioral treatment outcomes.
Análisis de dos estrategias de enseñanza-aprendizaje en la docencia de Terapia de Conducta
Este estudio cuasi-experimental analiza la eficacia de una metodología docente basada en seminarios y evaluación continua (grupo S) respecto a la basada en clases magistrales y una única prueba de evaluación final (grupo M), y la disposición del alumnado a seguir estas metodologías y su grado de implicación en la asignatura Terapia de Conducta de los estudios de Psicología. Los alumnos del grupo S obtuvieron un mayor rendimiento académico que los estudiantes que no optaron por esa metodología docente, tanto en lo que respecta a la calificación media obtenida como al porcentaje de aprobados. La distribución del alumnado en la selección de grupo fue bastante homogénea aunque un porcentaje importante de alumnos no completó el curso con la metodología elegida inicialmente. Los alumnos del grupo S dedicaron más tiempo a la preparación de la asignatura. No se encontró relación significativa entre el tiempo de estudio y el rendimiento académico. Los resultados se discuten en el marco de la adaptación al Espacio Europeo de Educación Superior.