Comparison of three methods of reducing test anxiety: Systematic desensitization, implosive therapy, and study counseling.

Administered the Alpert-Haber Achievement Anxiety Test to 39 undergraduates. Finger sweat prints were also included as anxiety measures. Ss were assigned to 4 groups: systematic desensitization, implosive therapy, study counseling, and a no-treatment control group. Groups met for 4 1-hr sessions for 2 wks. Results suggest that systematic desensitization is more effective in reducing debilitating anxiety than either implosive therapy or study counseling and that implosive therapy is more effective than study counseling, which was not significantly different than no treatment. No significant differences between treatments were found on the physiological measure of anxiety, GPAs (compared before and after treatment), or facilitating anxiety. Findings support previous studies comparing desensitization and study counseling. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy treatment of emotionally disturbed retardates.

Investigated the effectiveness of implosive therapy with institutionalized emotionally disturbed retardates (mean CA, 21 yrs; mean IQ, 70.3). 24 Ss, matched according to age, sex, race, and IQ, were randomly assigned to 1 treatment and 2 control groups. The treatment group received 10 sessions of implosive therapy. The control groups consisted of a no-treatment control and a group that received 10 sessions of pseudotreatment-oriented discussions. All Ss were maintained on psychiatric medication and participated in the regular hospital activities. The Ss were assessed behaviorally, subjectively, and clinically prior to, at the midpoint, at completion of the experimental conditions, and at a 6-wk follow-up. Following treatment, Ss in the implosive therapy group showed significantly more improvement across all indices than those who received the pseudotherapy-oriented and no-treatment control conditions. Although the implosive therapy group continued to show the most pronounced gains at follow-up, their superiority over the control groups was considerably less than when observed immediately after treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classroom-related behavior problems: Counsel parents, teachers, or children?

Compared the effectiveness of group counseling with significant adults (parents or teachers) and of group counseling with elementary school children in reducing classroom behavior problems. Ss were 372 children of average socioeconomic backgrounds. Results of an analysis of variance following a 10-wk treatment period indicate that the indirect approach (Adlerian group counseling with significant adults) was more effective than the direct approach (eclectic group counseling with the children), regardless of grade level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy and desensitization theory using free association in the treatment of inpatients.

Treated 36 male psychiatric inpatients with implosive therapy, a desensitization procedure using free association, or standard hospital milieu treatment. Ratings of achievement of individualized behavioral goals, the MMPI, and the Mooney Problem Check List were administered before and after treatment and at 6 mo. following treatment. Employment and hospitalization status were recorded during the year following treatment. Both individually treated groups showed immediate outcomes superior to controls; the implosive group was superior on more measures and maintained improvement better at 6 mo. As predicted, the implosive group reported more anxiety-related physiological stress (e.g., heart pounding, butterflies in stomach) during therapy sessions than Ss in the desensitization group. Support was not obtained, however, for the hypothesis that the degree of self-reported stress during therapy sessions is related to behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy: A critical analysis of Morganstern's review.

Presents a critique of K. P. Morganstern's (see record 1973-31818-001) review of implosive therapy and "flooding" literature. It is concluded that (a) the majority of negative results published by investigators using implosive therapy with analog Ss occurred with taped therapy presentations which violate the implosive therapy procedure in 2 important ways, (b) at the analog level only 1 study provided negative results with an actual therapist, (c) all patient therapy studies cited reported that an implosive therapy or flooding procedure was effective, (d) only 1 study using a live therapist reported that a systematic desensitization procedure was more effective than implosive therapy, and (e) whether it was the implosive therapy technique per se that produced the positive findings is still unclear. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy and flooding procedures: A critical review.

Presents a brief explanation of implosive theory and technique and critically reviews the case reports and experimental investigations of implosive therapy and flooding procedures with human Ss. Much of the research has produced confusing and contradictory results, and these findings are discussed in terms of the type of response rehearsed in therapy, exposure time, and cognitive factors. It is concluded that there is, at present, no convincing evidence of the effectiveness of implosion or flooding with human Ss, nor is there any evidence that the techniques are superior to systematic desensitization. In addition, the theoretical basis of implosive therapy appears to be unsupported. Finally, serious realistic and ethical questions are raised in regard to the desirability of the clinical use of implosive procedures. (78 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implosive therapy and desensitization therapy with inpatients: A five-year follow-up.

P. A. Boudewyns and A. E. Wilson (see record 1973-02805-001) treated 32 male psychiatric inpatients with either implosive therapy or a desensitization therapy using free association. Immediately following therapy and again at 6- and 12-mo follow-ups, the implosive group had improved more than controls treated with the regular hospital milieu. The present investigation with 28 of the Ss found the implosive group had maintained this improvement even after 5 yrs when compared with controls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing the relationship between maternal opiate use and neonatal mortality

We undertook a number of meta-analyses to estimate more precisely the relationship between neonatal mortality and use of opiates in three groups of women. First, women who continued to use illicit heroin throughout pregnancy; secondly, women stabilized on methadone at the time of conception or shortly after and thirdly, women who use heroin well into pregnancy with late entry into methadone treatment, or who continued to use illicit heroin during pregnancy while receiving methadone. FINDINGS: The pooled estimates of the relative risks of neonatal mortality for separate heroin and methadone use were both near unity: 1.47 (95% CI 0.88-2.33) and 1.75 (95% CI 0.60-4.59), respectively. The result for heroin may be due to the inclusion in the meta-analysis of a particularly large study, which, unlike the two other smaller studies included found a relative risk near unity. When this study was excluded from the meta-analysis the pooled estimate of the relative risk of neonatal mortality for heroin use was 3.27 (95% CI 0.95-9.60). In contrast to the results for use of methadone only, the pooled relative risk associated with heroin and methadone use was 6.37 (95% CI 2.57-14.68). CONCLUSIONS: The increased relative risk for neonatal mortality associated with women using heroin and methadone during pregnancy, compared to those stabilized on methadone, is probably due to the chaotic and high-risk life-style associated with illicit heroin use and not solely to the use of heroin and methadone per se. It is recommended tht women who use heroin well into pregnancy with late entry into methadone treatment, or who continue to use illicit heroin during pregnancy while receiving methadone, receive special attention over and above that provided to women stabilized on methadone.     

Family ties of drug abusers.

Examined the family ties of heroin addicts applying for drug treatment. Information was abstracted from the intake applications of 98 consecutive admissions to methadone maintenance program to determine the extent to which applicants were connected with family members. Results indicate that approximately 67% of Ss lived with a family member, including 26% who lived with a parent; 52% of Ss were born in the local area; 75% claimed to have close relationships with their mothers. Results imply that drug treatment programs might increase their effectiveness by using a family systems approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heroin addicts in substitution programs

40 heroin addicts of whom 20 were undergoing maintenance therapy with hydrocodone (Dicodid) and another 20 with methadone have been questioned by standardized interview regarding their previous history and present situation. With data on the history we examined how well heroin addicts succeed in getting away from criminality and prostitution and look for employment while undergoing drug maintenance therapy. We were also interested to learn whether reaching the aim depended on the maintenance medication, i.e. if hydrocodone is as appropriate as methadone for maintenance therapy. The inquiry showed a significant reduction of criminality and prostitution. The rate of employment was quite stable. The therapeutic successes, measured by employment, prostitution and criminality did not differ with medication by hydrocodone or methadone. Although the more reliable patients received hydrocodone and the less reliable methadone, they did not differ either in past history or in therapeutic success. We conclude that hydrocodone can be recommended for maintenance therapy of relatively reliable heroin addicts.     

MMPI evaluation of 5-year methadone treatment status.

Evaluated treatment outcome over a 5-yr period for 148 1st admissions (mean age, 27.14 yrs) to a methadone treatment program. Eleven Ss (7%) were successful treatment completions, 16 Ss (11%) transferred to other methadone programs, 38 Ss (26%) remained in continuous treatment, and 83 Ss (56%) were unsuccessful treatment terminations. Discriminant analysis using the MMPI suggested that the more stable Ss at admission had the best treatment outcome. For the patients in continuous treatment, MMPIs administered at 6-wk, 6-mo, and 5-yr intervals indicated that this group of Ss did not change on the personality dimension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of methadone maintenance for heroin addiction

Methadone maintenance programs have effectively reduced heroin dependency and are available in most countries affected by heroin addiction. Methadone, developed in Germany during World War II as a pain killer, does not have the euphoric effects of heroin and the goal of treatment is to substitute methadone for heroin use. Recidivism is probably a life-long risk. Methadone maintenance programs began in the 1960s in the United States in New York City. Once tolerance is developed, it may be used continually without harmful side effects. Dosage is important for effectiveness as are counseling, rehabilitation services, and employment support. Reduction in criminality and AIDS has been associated with methadone maintenance programs.     

The relationship between maternal use of heroin and methadone and infant birth weight

AIMS/DESIGN: Reduction in mean birth weight and increased incidence of low birth weight are both associated with exposure to illicit heroin in pregnancy. Many studies examining neonatal outcomes in pregnant heroin users treated with methadone report improvements in birth weight. As a consequence, methadone treatment has become the 'gold standard' for the management of the pregnant heroin user. However, not all studies report significant birth weight increases associated with methadone. We undertook a number of meta-analyses on reduction in mean birth weight and incidence of low birth weight to estimate more precisely the effect of illicit heroin and methadone. FINDINGS: Results showed mean reduction in birth weight associated with heroin use: 489 g (95% CI 284-693 g), compared with methadone: 279 g (229-328 g). Similarly, the pooled relative risk estimate for low birth weight for maternal heroin use was 4.61 (95% CI 2.78-7.65), compared with 1.36 (0.83-2.22) for methadone. Analysis of data on combined heroin and methadone use produced a pooled mean reduction in birth weight of 557 g (403-710 g), with a pooled relative risk estimate for low birth weight of 3.28 (2.47-4.39). Pooling 'any' methadone data, regardless of heroin use, produced an estimated reduction in birth weight of 395 g (311-478 g) and a relative risk estimate for low birth weight of 1.90 (1.29-2.81). Combining all data in an 'any' opiate use analysis also produced a mean reduction in birth weight of 483 g (386-583 g) and a relative risk estimate for low birth weight of 3.81 (2.57-5.65). CONCLUSIONS: The current findings suggest that heroin use while receiving methadone may counteract the birth weight advantage gained from methadone alone. Whether this is due to fetal exposure to heroin plus methadone, to reduced antenatal care, other behavioural and environmental factors associated with concurrent use of heroin and methadone or a combination of these is unclear. Nevertheless, these results challenge the current belief that the pregnant user is always better off receiving methadone than not, and suggests that methadone may not be the appropriate treatment for the pregnant women who continue to use illicit heroin.     

Systematic versus semantic desensitization and implosive therapy: A comparative study.

Selected 28 female and 12 male rat-phobic undergraduates matched on the degree of behavior avoidance, subjective fear, and semantic rating of the fear object. Ss were randomly assigned to 1 of 4 treatment groups: systematic desensitization, semantic desensitization, implosive therapy, and pseudodesensitization on a neutral buffer task. Results indicate that both the systematic and the semantic desensitization treatment resulted in a significant fear decrement as compared to the controls (p     

Hemodynamic performance of four mechanical bileaflet prosthetic valves in the mitral position: an echocardiographic study

Plasma methadone concentrations and its main metabolite D,L-2-ethylidiene-1,5-dimethyl-3,5-diphenylpyrrolidine (EDDP) were determined in 93 patients under methadone maintenance treatment to assess their relationship with heroin use and opioid withdrawal symptoms. Neither plasma concentrations of methadone nor EDDP were significantly different when patients that used heroin in last 3 months were compared with those testing negative for this drug (methadone, 355 +/- 217 versus 369 +/- 216 ng/ml, t = 0.29, P = NS; EDDP, 49 +/- 28 versus 54 +/- 40 ng/ml, t = 0.51, P = NS). No correlation between opioid withdrawal scale scores and plasma concentrations of methadone (r = 0.02, P = NS) and EDDP (r = -0.14, P = NS) was found. Therapeutic drug monitoring during methadone maintenance seems to be useful for assessing compliance with treatment but not for predicting heroin use and subjective withdrawal symptoms.     

Changes in mortality, arrests, and hospitalizations in nonvoluntarily treated heroin addicts in relation to methadone treatment

This study analyzes the mortality, hospitalizations, and arrests in a cohort of severe intravenous heroin users divided into three groups: those in methadone treatment, those discharged from treatment, and those who never received treatment. The study population consists of 101 heroin users, of whom 56 were HIV-seropositive. Because of intensive drug misuse, they underwent coercive residential treatment in Stockholm during the 3-year period 1986-1988. The mortality was lower in the methadone group, and all seven deaths were related to HIV-infection. Outside the program, 24 of 29 persons died from external violence and poisoning.     

Treatment components in implosive therapy.

In an effort to evaluate reality-testing and supportive aspects of implosive therapy (IT) independent of the anxiety-eliciting scenes, 73 and 93 female undergraduates with a fear of a specific insect were administered 3 sessions of 1 of 3 tape-recorded treatments. In 2 double-blind experiments, Ss treated with IT were not found to improve significantly as measured by repeated overt behavioral tests. In both studies, the reality-supportive discussions were associated with significantly greater reductions in phobic behaviors than IT. Findings are related to the theoretical formulations of IT and to treatment applications. (34 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What effects does methadone maintenance treatment have on the rehabilitation of heroin addicts?]

The purpose of the study was to determine the effect of methadone maintenance treatment on heroin addicts. By searching in Medline and Cochrane Library two randomized controlled trials were found where methadone was the main intervention in the rehabilitation of heroin addicts. The trials were found among more than 2,350 articles on various aspects of methadone and were the only ones that met our criteria for inclusion in the study. The two studies comprised 347 participants. Both trials showed that methadone maintenance treatment had a positive effect on continuing participation in the treatment programme. One of the trials also showed that the treatment lowered the rates of opioid and cocaine use. It is alarming that only two randomized controlled trials could be found evaluating the effect of methadone maintenance treatment on the rehabilitation of heroin addicts. No trials demonstrating the effect of the treatment on mortality, crime, prostitution or risk behaviour related to communicable diseases were found.