Current Search: exposure therapy (x)
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- Title
- A Randomized Control Trial of Video Modeling for enacting skill change in a group of Master's level trainee clinicians.
- Creator
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Matsumiya, Brandon, Bowers, Clint, Beidel, Deborah, Neer, Sandra, University of Central Florida
- Abstract / Description
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The (")research-to-practice(") gap is a problem that the field of medicine faces regarding disseminating findings from research into the field of practice. The traditional methods of disseminating best practices, using workshops and manuals, has been found to be ineffective. Several more active learning strategies, such as the use of behavioral models and behavioral rehearsals have been suggested as possible alternatives that may increase transfer of knowledge after a training. Additionally,...
Show moreThe (")research-to-practice(") gap is a problem that the field of medicine faces regarding disseminating findings from research into the field of practice. The traditional methods of disseminating best practices, using workshops and manuals, has been found to be ineffective. Several more active learning strategies, such as the use of behavioral models and behavioral rehearsals have been suggested as possible alternatives that may increase transfer of knowledge after a training. Additionally, web-based trainings have been suggested as another possible avenue for increasing dissemination of evidence-based practices. This is particularly important for evidence-based treatments such as Exposure Therapy for PTSD which suffers a (")public relations problem(") in the field of mental health.This study examined the utility of using a video model to disseminate the skill of fear hierarchy construction for patients with PTSD. Analyses were conducted using a moderated mediation model looking at how video modeling or script condition moderate the relationship between condition and change in self-efficacy, and if this change mediates the relationship between condition and change in fear hierarchy skill. Self-efficacy and positive attitudes toward exposure therapy were increased, however, there was no connection between treatment condition and change in skill. The study's findings suggest that short online trainings may be effective at reducing negative attitudes toward EBTs, and at increasing self-efficacy for a related skill of fear hierarchy construction.
Show less - Date Issued
- 2019
- Identifier
- CFE0007679, ucf:52490
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007679
- Title
- Post-traumatic stress disorder: The effect of age and military status on the military population's awareness of community mental health resources.
- Creator
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Stapp, Susan, Kaplan, Jeffrey, Cornell, Richard, Moskal, Patsy, Brophy-Ellison, James, University of Central Florida
- Abstract / Description
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This study sought to explore the existence of a relationship between age and/or military affiliation (active, veteran, or family member) and awareness of local community mental health programs available for the treatment of post-traumatic stress disorder. The study separated age from military affiliation to better distinguish between influences on awareness level. Considerations that remain critical regarding post-traumatic stress disorder were described and used to guide a comprehensive...
Show moreThis study sought to explore the existence of a relationship between age and/or military affiliation (active, veteran, or family member) and awareness of local community mental health programs available for the treatment of post-traumatic stress disorder. The study separated age from military affiliation to better distinguish between influences on awareness level. Considerations that remain critical regarding post-traumatic stress disorder were described and used to guide a comprehensive review of the literature to find directions to fulfill the goal of this study. A survey was conducted and 586 active military, veterans, and their family members responded to an instrument that contained 40 items. This study was constrained to three items from the survey; age, military affiliation, self-rated awareness of treatment for PTSD. Multiple analysis techniques found no significant (p (<) .05) correlation between either age and awareness or military affiliation and awareness. Further analysis found a significant (p = .003) correlation between veterans and awareness, as well as between family members of veterans (p = .017) and awareness. Veterans and their family members indicated a greater awareness of local community mental health programs available for the treatment of post-traumatic stress disorder than did active troops and/or their family members. The significance of this finding presents new opportunities to study and improve both the marketing and the delivery of mental health treatment for PTSD to the active military population. Multiple opportunities for future research are discussed.
Show less - Date Issued
- 2014
- Identifier
- CFE0005266, ucf:50586
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005266
- Title
- Odorants, memory, and presence in warfighters: Do the scents of war matter?.
- Creator
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Munyan, Benson, Neer, Sandra, Beidel, Deborah, Jentsch, Florian, Joseph, Dana, University of Central Florida
- Abstract / Description
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Background: Exposure therapy (EXP) is a first-line intervention for combat-related PTSD. EXP works by repeatedly exposing the patient to the feared stimuli, situation, or physical sensations in the absence of actual danger until the stimuli no longer evoke maladaptive responses. Over the past decade, multiple technologies have been introduced to augment the EXP process by presenting multi-sensory cues (e.g., sights, smells, sounds) to increase patients' sense of presence. Exploratory research...
Show moreBackground: Exposure therapy (EXP) is a first-line intervention for combat-related PTSD. EXP works by repeatedly exposing the patient to the feared stimuli, situation, or physical sensations in the absence of actual danger until the stimuli no longer evoke maladaptive responses. Over the past decade, multiple technologies have been introduced to augment the EXP process by presenting multi-sensory cues (e.g., sights, smells, sounds) to increase patients' sense of presence. Exploratory research has only broadly examined the effect of odorants on the patient's sense of presence during simulated exposure tasks. This study hypothesized that those with autobiographical memories similar to the virtual environment (VE) and those who received odorants would report experiencing more presence than experimental controls. Methods: 61 veterans and civilian subjects were randomized and asked to participate in a virtual environment simulating a routine OIF/OEF/OND convoy. The effects of odorants and autobiographical memory on presence were assessed via electrodermal activity, respiration, heart rate variability, and self-report measures. Results: Odorants did not significantly influence presence. A relationship between military experience and presence, HRV, and realism was observed. Conclusion: Odorants did not have a statistically significant effect on presence while engaged in a simulated exposure task, which was inconsistent with previous research. The rationale for these findings and recommendations for future research are made.
Show less - Date Issued
- 2018
- Identifier
- CFE0007060, ucf:51999
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007060
- Title
- Habituation Trajectory During Exposure Therapy: Comparing Trauma Frequency and Trauma Type.
- Creator
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Marks, Madeline, Bowers, Clint, Beidel, Deborah, Newins, Amie, Jasinski, Jana, University of Central Florida
- Abstract / Description
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The current DSM-5 criteria for Posttraumatic Stress Disorder (PTSD) affords heterogeneous symptom presentations; however, current treatment fails to consider differences in trauma frequency and trauma type. These different symptom profiles that exist within the PTSD framework lead to questions about the generalizability of treatment outcomes from one group to another group. One group of interest is those that experience multiple traumatic events and report multiple index traumas (trauma...
Show moreThe current DSM-5 criteria for Posttraumatic Stress Disorder (PTSD) affords heterogeneous symptom presentations; however, current treatment fails to consider differences in trauma frequency and trauma type. These different symptom profiles that exist within the PTSD framework lead to questions about the generalizability of treatment outcomes from one group to another group. One group of interest is those that experience multiple traumatic events and report multiple index traumas (trauma frequency). The second group of interest is those with a PTSD diagnosis from occupational exposure to traumatic events (trauma type). Appreciation of the reinforcement schedule may be particularly crucial for understanding treatment response. The current study aims to investigate habituation responses during exposure therapy to inform treatment modifications and decisions. Exposure therapy process variables, session variables, and PTSD severity were examined for a sample of 128 participants that sought treatment for combat-related PTSD or occupation-related PTSD, some of whom endorsed multiple index traumas, and some of whom endorsed a single index trauma. Results revealed no significant differences based on trauma frequency or trauma type for within-session and between-session habituation. This suggests that the effectiveness of a flooding approach to extinguish avoidance behavior may overcome the impact of reinforcement schedule on fear habituation. The results of the present study contribute to the growing body of literature that suggests the exclusion of patients based on the pre-treatment characteristics of trauma frequency and trauma type is unfounded.
Show less - Date Issued
- 2019
- Identifier
- CFE0007676, ucf:52458
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007676
- Title
- How Much is Enough? Trauma Recall and the Exposure Therapy Process.
- Creator
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Morrison, Krystal, Beidel, Deborah, Bowers, Clint, Bohil, Corey, University of Central Florida
- Abstract / Description
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Prevailing theoretical models of posttraumatic stress disorder (PTSD) as well as exposure therapy (EXP) methodology suggest that recall of a trauma is crucial to altering the conditioned fear response associated with PTSD (Benito (&) Walther, 2015; Craske et al., 2008; Foa (&) Kozak, 1986). However, it is unclear whether limited recall of the event impacts the EXP process and treatment outcomes. This study examined whether incomplete trauma recall affected pre-treatment PTSD severity, Initial...
Show morePrevailing theoretical models of posttraumatic stress disorder (PTSD) as well as exposure therapy (EXP) methodology suggest that recall of a trauma is crucial to altering the conditioned fear response associated with PTSD (Benito (&) Walther, 2015; Craske et al., 2008; Foa (&) Kozak, 1986). However, it is unclear whether limited recall of the event impacts the EXP process and treatment outcomes. This study examined whether incomplete trauma recall affected pre-treatment PTSD severity, Initial Fear Activation (IFA), Overall Fear Activation (OFA), Within-Session Habituation (WSH), Between-Session Habituation (BSH; overall extinction), average length of EXP sessions, number of EXP sessions, and post-treatment PTSD severity, in 166 veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, who completed EXP treatment. Contrary to predicted outcomes, the extent of recall did not attenuate veterans' participation in EXP as measured by IFA, OFA, WSH and BSH. Furthermore, less recall did not result in more severe pre-treatment PTSD, longer EXP sessions, more EXP sessions, or attenuated treatment response, as measured by the Clinician-Administered PTSD Scale for DSM-IV (CAPS; Weathers, Ruscio, (&) Keane, 1999) and PTSD Checklist Military Version (PCL-M; Weathers, Huska, (&) Keane, 1991) at pre- and post-treatment. This suggests that veterans who are unable to recall aspects of their traumatic experience can engage successfully and benefit equally from EXP akin to veterans who experience less difficulty recalling trauma details. This research is the first to examine trauma recall in the context of the EXP process and contributes to the current body of literature that aims to address the question: For whom do treatments work?
Show less - Date Issued
- 2018
- Identifier
- CFE0007347, ucf:52116
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007347
- Title
- The Effect of Traumatic Brain Injury on Exposure Therapy in Veterans with Combat-related Posttraumatic Stress Disorder.
- Creator
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Ragsdale, Kathleen, Beidel, Deborah, Neer, Sandra, Bowers, Clint, Ni, Liqiang, University of Central Florida
- Abstract / Description
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Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are presenting for treatment with high rates of combat-related posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), spurring a need for clinical research on optimal treatment strategies. While exposure therapy has long been supported as an efficacious treatment for combat-related PTSD, some clinicians are hesitant to utilize this treatment for veterans with TBI history due to presumed...
Show moreVeterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are presenting for treatment with high rates of combat-related posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), spurring a need for clinical research on optimal treatment strategies. While exposure therapy has long been supported as an efficacious treatment for combat-related PTSD, some clinicians are hesitant to utilize this treatment for veterans with TBI history due to presumed cognitive deficits that may preclude successful engagement. The purpose of this study was to compare exposure therapy process variables in veterans with PTSD only and veterans with PTSD+TBI. Results suggest that individuals with PTSD+TBI engage successfully in exposure therapy, and do so no differently than individuals with PTSD only. Additional analyses indicated that regardless of TBI status, more severe PTSD was related to longer sessions, more sessions, and slower extinction rate during imaginal exposure. Finally, in a subset of participants, self-report of executive dysfunction did not impact exposure therapy process variables. Overall, findings indicate that exposure therapy should be the first-line treatment for combat-related PTSD regardless of presence of TBI history.
Show less - Date Issued
- 2015
- Identifier
- CFE0005868, ucf:50894
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005868
- Title
- Role of Sleep in Exposure Therapy for Posttraumatic Stress Disorder in OIF/OEF Combat Veterans.
- Creator
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Mesa, Franklin, Beidel, Deborah, Neer, Sandra, Bowers, Clint, Ni, Liqiang, University of Central Florida
- Abstract / Description
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Exposure therapy is theorized to reduce posttraumatic stress disorder (PTSD) symptomatology by promoting habituation/extinction of fear responses to trauma-related cues. Empirical evidence indicates that emotional memory, including habituation/extinction learning, is enhanced by sleep. However, service members with combat-related PTSD often report disturbed sleep. In this study, quality of sleep and indicators of extinction learning were examined in veterans of recent wars who had completed...
Show moreExposure therapy is theorized to reduce posttraumatic stress disorder (PTSD) symptomatology by promoting habituation/extinction of fear responses to trauma-related cues. Empirical evidence indicates that emotional memory, including habituation/extinction learning, is enhanced by sleep. However, service members with combat-related PTSD often report disturbed sleep. In this study, quality of sleep and indicators of extinction learning were examined in veterans of recent wars who had completed an exposure-based PTSD intervention. Fifty-five participants were categorized into two groups based on self-reported quality of sleep: low sleep disruption severity (LSDS; N = 29) and high sleep disruption severity (HSDS; N = 26). Participants in the LSDS group exhibited faster habituation to their traumatic memories and reported less PTSD symptomatology during and following treatment relative to participants in the HSDS group. These findings indicate that individuals with combat-related PTSD reporting less disturbed sleep experience greater extinction learning during exposure therapy. Thus, incorporating interventions that target PTSD-related sleep disturbances may be one way to maximize exposure therapy outcomes in service members with PTSD.
Show less - Date Issued
- 2016
- Identifier
- CFE0006355, ucf:51520
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006355
- Title
- Using Exposure Therapy to Treat People Who Stutter: A Multiple Baseline Design.
- Creator
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Scheurich, Jennifer, Beidel, Deborah, Neer, Sandra, Vanryckeghem, Martine, University of Central Florida
- Abstract / Description
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Social anxiety disorder (SAD) is a debilitating condition, and it is estimated that approximately half of adults who stutter have SAD. Thus, there is a need for the assessment and treatment of SAD in this population. Cognitive-behavioral therapy (CBT) has shown promise in decreasing anxiety symptoms among adults who stutter and have SAD, but exposure, the key ingredient for successful CBT for SAD, has been understudied and underemphasized. The aims of this study were to develop an exposure...
Show moreSocial anxiety disorder (SAD) is a debilitating condition, and it is estimated that approximately half of adults who stutter have SAD. Thus, there is a need for the assessment and treatment of SAD in this population. Cognitive-behavioral therapy (CBT) has shown promise in decreasing anxiety symptoms among adults who stutter and have SAD, but exposure, the key ingredient for successful CBT for SAD, has been understudied and underemphasized. The aims of this study were to develop an exposure therapy protocol specifically for people who stutter and have SAD and to evaluate its efficacy for reducing anxiety and stuttering severity. Utilizing a multiple baseline design, six participants were randomized to receive zero, two, or four sessions of progressive muscle relaxation therapy. This served to establish the staggered start and to account for the common factors of therapy. All participants received ten sessions of exposure therapy. Participants recorded daily social anxiety levels, and anxiety and stuttering severity were assessed at major assessment points. All participants demonstrated substantial reductions in social anxiety and substantial improvements in the affective, behavioral, and cognitive experiences of stuttering following exposure therapy. No reliable change was observed for stuttering frequency. Results suggest that exposure therapy may be useful for people who stutter and have SAD, but will not necessarily influence their speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between psychologists and speech-language pathologists may prove beneficial for this population.
Show less - Date Issued
- 2017
- Identifier
- CFE0006914, ucf:51702
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006914
- Title
- Optimizing Strategies for In Vivo Exposure in the Traditional Clinical Setting.
- Creator
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Owens, Maryann, Beidel, Deborah, Cassisi, Jeffrey, Bowers, Clint, Neer, Sandra, University of Central Florida
- Abstract / Description
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This study examined the ability of a pre-recorded videoconferencing (VC) audience to elicit the physiological and subjective arousal associated with Social Anxiety Disorder (SAD) when giving a formal presentation. This study had three objectives: (a) to determine whether speaking to the VC audience elicited significant increases in physiological response (e.g., heart rate and electrodermal activity) and subjective distress over baseline resting conditions (b) to determine whether the VC task...
Show moreThis study examined the ability of a pre-recorded videoconferencing (VC) audience to elicit the physiological and subjective arousal associated with Social Anxiety Disorder (SAD) when giving a formal presentation. This study had three objectives: (a) to determine whether speaking to the VC audience elicited significant increases in physiological response (e.g., heart rate and electrodermal activity) and subjective distress over baseline resting conditions (b) to determine whether the VC task more closely replicates the physiological and subjective experience of giving a speech to a comparable real-life audience than levels elicited by a Virtual Reality (VR) environment and (c) to determine whether the VC task elicited higher levels of presence and fear of negative evaluation than the VR task, more closely replicating levels elicited by an in vivo speech. All participants gave an impromptu speech under three conditions: in vivo, VC, and VR audience while measures of physiological arousal, self-reported distress, and presence were obtained. Results demonstrated that the VC task elicited significantly greater increases in heart rate, electrodermal activity, and self-reported distress than the VR task and VC responses were not significantly different from in vivo. In addition, participants reported levels of immersion and fear of negative evaluation during the VC task that were significantly greater than during the VR task, and did not differ significantly from in vivo. Clinical implications of these findings including cost effectiveness and the role of VC in the treatment of SAD are discussed.
Show less - Date Issued
- 2016
- Identifier
- CFE0006367, ucf:51513
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006367
- Title
- Health Behaviors in Military Veterans with and without Posttraumatic Stress Disorder.
- Creator
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Kitsmiller, Emily, Neer, Sandra, Beidel, Deborah, Bowers, Clint, University of Central Florida
- Abstract / Description
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A link between posttraumatic stress disorder and health behaviors, such as exercise, alcohol, smoking, and caffeine has been suggested. However, it is unknown whether veterans with combat-related PTSD differ from combat veterans without PTSD and whether health behaviors change over the course of exposure therapy for PTSD or differ based on PTSD severity. This study examined the relationship between health behaviors and PTSD. More specifically, combat veterans with and without PTSD were...
Show moreA link between posttraumatic stress disorder and health behaviors, such as exercise, alcohol, smoking, and caffeine has been suggested. However, it is unknown whether veterans with combat-related PTSD differ from combat veterans without PTSD and whether health behaviors change over the course of exposure therapy for PTSD or differ based on PTSD severity. This study examined the relationship between health behaviors and PTSD. More specifically, combat veterans with and without PTSD were compared across self-reported levels of alcohol use, smoking, exercise, and caffeine. Health behaviors of combat veterans with PTSD were compared before and after a 17-week treatment for PTSD. Results showed a significant number of participants decreased alcohol use at post-treatment by an average of eight drinks over 30 days, regardless of their PTSD severity level or amount of improvement in PTSD symptoms. No significant differences were found for other health behaviors.
Show less - Date Issued
- 2017
- Identifier
- CFE0006891, ucf:51711
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006891
- Title
- Treatment Matching in PTSD: A Confirmatory Factor Analysis Based On Therapeutic Mechanisms of Action.
- Creator
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Trachik, Benjamin, Bowers, Clint, Beidel, Deborah, Jentsch, Florian, University of Central Florida
- Abstract / Description
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The current study takes an initial step toward deriving a method for empirically based, theory-driven treatment matching in a military population suffering from PTSD. Along with the more overt symptoms of PTSD (e.g., persistent hyperarousal), secondary cognitive symptoms have also been shown to be significantly associated with avoidance and intrusive symptoms, as well as contribute to functional impairment. Based on the factor analytic and treatment literature for PTSD, it appears that there...
Show moreThe current study takes an initial step toward deriving a method for empirically based, theory-driven treatment matching in a military population suffering from PTSD. Along with the more overt symptoms of PTSD (e.g., persistent hyperarousal), secondary cognitive symptoms have also been shown to be significantly associated with avoidance and intrusive symptoms, as well as contribute to functional impairment. Based on the factor analytic and treatment literature for PTSD, it appears that there are two central mechanisms associated with beneficial therapeutic change that underlies both CPT and PE treatments (i.e., habituation, changes in cognitions). Additionally, different traumatic events and peritraumatic responses may be associated with unique symptom profiles and may necessitate targeted treatment. The present study proposes a novel approach to treatment matching based on the factor structure of PTSD and underlying mechanisms of treatment response. More broadly, this paper provides evidence for a broader understanding of peritraumatic responses and the potential implications of these responses for symptom profiles and illness trajectories.
Show less - Date Issued
- 2014
- Identifier
- CFE0005727, ucf:50126
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005727
- Title
- Does Virtual Reality Elicit Physiological Arousal in Social Anxiety Disorder.
- Creator
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Owens, Maryann, Beidel, Deborah, Cassisi, Jeffrey, Bowers, Clint, Neer, Sandra, University of Central Florida
- Abstract / Description
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The present study examined the ability of a Virtual Reality (VR) public speaking task to elicit physiological arousal in adults with SAD (n=25) and Controls (n=25). A behavioral assessment paradigm was employed to address three study objectives: (a) to determine whether the VR task can elicit significant increases in physiological response over baseline resting conditions (b) to determine if individuals with SAD have a greater increase from baseline levels of physiological and self-reported...
Show moreThe present study examined the ability of a Virtual Reality (VR) public speaking task to elicit physiological arousal in adults with SAD (n=25) and Controls (n=25). A behavioral assessment paradigm was employed to address three study objectives: (a) to determine whether the VR task can elicit significant increases in physiological response over baseline resting conditions (b) to determine if individuals with SAD have a greater increase from baseline levels of physiological and self-reported arousal during the in vivo speech task as opposed to the VR speech task and (c) to determine whether individuals with SAD experience greater changes in physiological and self-reported arousal during each speech task compared to controls. Results demonstrated that the VR task was able to elicit significant increases in heart rate, skin conductance, and respiratory sinus arrhythmia, but did not elicit as much physiological or self-reported arousal as the in vivo speech task. In addition, no differences were found between groups. Clinical implications of these findings are discussed.
Show less - Date Issued
- 2013
- Identifier
- CFE0004906, ucf:49624
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004906