A prospective randomized study to assess the clinical efficacy of gonadotrophins administered subcutaneously and intramuscularly

The purpose of this study was to compare the clinical efficacy of gonadotrophins administered s.c. or i.m., in a prospective randomized study of women undergoing in-vitro fertilization (IVF) treatment at a tertiary referral centre. In all, 71 patients undergoing a total of 162 IVF treatment cycles were randomized to receive either s.c. (n = 41) or i.m. (n = 30) administration of gonadotrophins. Up to three cycles of IVF were assessed for each patient. The main outcome measures were the number of oocytes retrieved, the total amount of gonadotrophins used, the number of follicles recruited and the cumulative pregnancy and live birth rates. The mean number of oocytes retrieved was 10.5 for each group. The number of days of stimulation was significantly shorter for the s.c. group (11.7 +/- 1.9 days, mean +/- SD) than the i.m. group (12.6 +/- 2.3 days). The cumulative conception and live birth rates after three cycles of treatment were similar between the two groups. Our results suggest that the clinical efficacy of s.c. and i.m. administration of gonadotrophins is comparable. Both routes are well tolerated by patients.     

The role of attention-placebo influences in the efficacy of systematic desensitization.

Compared systematic desensitization with 2 attention-placebo control treatments-one taken from G. L. Paul's 1966 technique and one currently devised as an elaborate, highly impressive therapeutic experience-and no treatment. It was hypothesized that (a) fear reductions following desensitization would be no greater than those associated with an equally compelling placebo treatment and (b) fear and control measure changes following the previously used attention-placebo treatment would be less than those following desensitization and the present placebo control manipulations. In an experiment with 39 female undergraduates both hypotheses were supported, although support for the 1st was more consistent than for the 2nd hypothesis. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptom relief through insight during systematic desensitization: A case study.

Presents the case of a male undergraduate suffering from severe test anxiety in which the symptom-centering and guided imagery techniques of systematic desensitization were instrumental in the S's acquisition of insight and symptom relief. In this case, the presenting symptom was an unconscious expression of intrapersonal conflicts concerning anger, dominance, and decision-making problems in the S's marriage. Psychodynamic and behavioral explanations of the relation between the S's test-taking and marital problems are discussed. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Habituation model of systematic desensitization.

Discusses the relevance of habituation as a model for response decrement in desensitization. A discussion of the relationship between habituation and extinction leads to the view that there are no sound reasons for explaining desensitization as an extinction rather than as a habituation phenomenon. The maximal habituation theory of desensitization proposed by M. H. Lader and A. M. Mathews (1968) is discussed and relevant evidence reviewed. Finally, a revised habituation theory of desensitization, based on the dual-process theory of habituation, is elaborated, and the role in desensitization of relaxation, stimulus intensity, stimulus lengths, and interstimulus interval lengths are discussed in the context of this theory. It is suggested that relaxation and an incremental stimulus hierarchy may reduce sensitization rather than facilitate habituation. (60 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Studying therapist warmth in analogue systematic desensitization research: A reply to McGlynn.

Replies to F. D. McGlynn (see PA, Vol 56:Issue 1) who stated that the conclusion reached by the present authors (see record 1974-28353-001) in their study of therapist warmth and desensitization was not justified by their research. It is argued that McGlynn misrepresented their statement of conclusion which was, in fact, couched in tentative terms. McGlynn's selection of literature to support his view is also criticized. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials.

A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs were equivalent to other active treatments and yielded moderate effects (from .25 to .57) compared with no treatment and/or placebo for problems involving alcohol, drugs, and diet and exercise. Results did not support the efficacy of AMIs for smoking or HIV-risk behaviors. AMIs showed clinical impact, with 51% improvement rates, a 56% reduction in client drinking, and moderate effect sizes on social impact measures (d=0.47). Potential moderators (comparative dose, AMI format, and problem area) were identified using both homogeneity analyses and exploratory multiple regression. Results are compared with other review results and suggestions for future research are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detrimental effects of a self-reward contracting program on subjects' involvement in self-administered desensitization.

Assessed a self-reward contracting procedure intended to facilitate the completion of self-administered desensitization. 24 self-referred snake phobics received either (a) self-administered desensitization, (b) self-administered desensitization with self-reward contracting, or (c) a self-administered placebo with self-reward contracting. Results show that the self-reward procedure significantly impaired the amount of time and number of sessions that Ss devoted to their self-instructional manuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of expectancy manipulation in systematic desensitization.

Manipulated expectancy, relaxation, and hierarchy content in a 2 * 2 design with 2 additional control groups. Ss were 76 spider-phobic undergraduates. It was hypothesized that a major portion of therapeutic change following desensitization could be accounted for by the Ss' responses to positive feedback inherent in the paradigm. Ss saw either photographs of spiders or blank slides that they believed to be tachistoscopically-presented pictures of spiders. One-half of the Ss believed their progress through the hierarchy to be contingent on autonomic responses; the others believed rate of progress to be random. Findings did not support the hypothesis that expectancy is the only factor in desensitization, but they did clarify the role of expectancy vis-a-vis the counterconditioning elements typically discussed in the literature. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The importance of the therapeutic relationship in systematic desensitization.

To determine the importance of therapist warmth in effecting positive behavior change using systematic desensitization, 23 female snake-phobic undergraduates were assigned to 1 of 3 groups: warm therapist, cold therapist, or no-treatment controls. Ss in each group were matched on initial Snake Avoidance Test scores. Posttreatment evaluation on the Snake Avoidance Test occurred after 6 20-min desensitization sessions and follow-up scores were obtained 21/2 mo later. Results show that the warm therapist group improved significantly more than either the cold therapist or control group, with no significant differences between these latter 2 groups. Results suggest that therapist warmth is an important variable in systematic desensitization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of nightmares via relaxation and desensitization: A controlled evaluation.

32 self-referred nightmare sufferers (mean age 36 yrs) were randomly assigned to relaxation training, systematic desensitization, or a waiting-list control. Ss on the average had been having 9 nightmares/mo and reported mean problem duration of 12 yrs prior to treatment. After the intervention phase, both treated groups showed significant decreases in nightmare frequency relative to controls. After subsequent treatment, the waiting-list group showed similarly decreased frequency but remained unimproved on nightmare intensity relative to prior treated groups. Hierarchical desensitization did not increase efficacy at 15 wks beyond benefits associated with relaxation alone. At 25 wks, however, desensitized Ss showed significantly greater reduction in nightmare intensity. Overall, at least 80% reduction in nightmares was reported by 20 Ss, of whom 12 reported total elimination of symptoms at 25-wk follow-up. Some Ss experienced fewer but more intense nightmares, others maintained frequency of previously disturbing dreams but were no longer awakened or distressed by them, and 2 reported substantial worsening of symptoms. Unfavorable outcome was associated with personality disorder profiles on the MMPI. Findings are discussed in relation to a conceptualization of nightmares as a symptom of a more generalized arousal disorder. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A two-year follow-up on systematic desensitization with data pertaining to the external validity of laboratory fear assessment.

A 2-yr follow-up questionnaire was sent to Ss originally tested by the present authors (1976). Initial treatment gains for self- and therapist-directed desensitization Ss were maintained. Posttest behavior approach scores were not predictive of real-life behavioral change as reported at follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pilot study on the effectiveness of systematic desensitization with neurologically impaired children with phobic disorders.

A modified version of J. Wolpe's systematic desensitization therapy involving direct confrontation with the fear-inducing stimulus was attempted with 30 neurologically impaired children with phobic symptoms. 2 hypotheses were tested: (a) a nonverbal therapeutic technique not requiring motivation will produce successful symptom reduction for these Ss, and (b) awareness of therapeutic procedure is not necessary for successful results. Both hypotheses were confirmed. (23 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The process of fear reduction through systematic desensitization.

Investigated the process of fear change during a course of systematic desensitization therapy with 15 female snake-phobic undergraduates. Behavioral, subjective (e.g., Subjective Anxiety Scale and the S-R Inventory of Anxiousness), and physiological measures of fear were taken following each of 8 therapy sessions. Generally, linear reductions were found on behavior and subjective measures, whereas a cubic trend was detected for baseline heart rate. Changes in 1 fear system did not appear to be primary in initiating changes in the other systems. Real-life nonavoidance exposure to the feared stimulus appears to provide an important steering function during the fear change process. High baseline heart rate was a good predictor of behavioral change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential ordering of stimulus presentation in systematic desensitization.

50 snake-phobic female Ss were matched on degree of behavioral avoidance and subjective fear and then randomly assigned to 1 of 3 desensitization or 2 control groups: (a) imagined stimuli presented in order of increasing aversiveness, (b) stimuli presented in a decreasingly aversive order, (c) random order presentation, (d) pseudodesensitization, and (e) no-treatment control. Ss in the 3 desensitization groups showed significantly greater improvement than did Ss in either control group. While no differences were found between Ss exposed to an increasingly aversive hierarchy and Ss who received a decreasing order, the random order tended to be less effective than the other 2. An ascending aversive order of stimulus presentations is not an essential and integral part of successful desensitization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group therapy of phobic disorders by systematic desensitization.

Phobic patients were placed in groups receiving either insight or desensitization (Wolpe, 1958) therapy. In approximately 20 sessions, 13 of 18 Ss treated by Wolpe's method were able to tolerate the fantasy of their phobic situation as well as to live through the experience outside of therapy without experiencing anxiety. Only 2 patients were symptom free in a comparable number of hours of insight-oriented group therapy. The 15 non-symtom-free Ss in the latter group were then placed in densensitization groups: 10 improved in 10 sessions. The implication of the results were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnosis versus systematic desensitization in the treatment of test anxiety.

Assessed the comparative effectiveness of systematic desensitization (SD) and the directed experience hypnotic technique (HT) in reducing self-reported test anxiety and increasing the academic performance of 36 test-anxious undergraduates. Ss were assigned randomly to either the HT or SD conditions or to 1 of 2 control groups. All Ss had previously scored above the 50th percentile on Sarason's Test Anxiety Questionnaire (TAQ) and below the 85th percentile on a midterm exam. Results indicate that only the SD treatment significantly reduced TAQ scores. No significant improvement in academic performance was observed for either treatment. An additional analysis of high- vs moderate-anxious subgroups failed to show differential treatment effects on either dependent measure. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of implosive therapy and systematic desensitization in the treatment of test anxiety.

Administered I. G. Sarason's 21-item Test Anxiety Scale as a pre- and posttest measure of the comparative efficacy of 2 techniques for reducing test anxiety in 34 undergraduates. Both desensitization and implosive therapy resulted in significant decreases in scores. However, the desensitization group also demonstrated a significant reduction in state anxiety assessed during simulated testing sessions and a significant increase in GPA, while the implosive therapy group showed no comparable improvement. Results are discussed in relation to a number of conceptual and methodological issues that have received relatively little empirical attention in behavior therapy research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contribution of selective positive reinforcement and therapeutic instructions to systematic desensitization therapy.

Ss were 30 female undergraduates with severe fear of snakes. Following treatment, the increase in approach behavior was significantly greater for Group 1 (graded hierarchy, relaxation, reinforcement, and therapeutic instructions) than for Group 2 (graded hierarchy and relaxation only). Group 2 did not differ significantly from a no-treatment control group. Results pose certain problems for reciprocal inhibition conceptions, and suggest that the effects of systematic desensitization cannot be attributed solely to the variables of a graded hierarchy plus relaxation. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rational-emotive therapy versus systematic desensitization: A comment on Moleski and Tosi.

States that the results of R. Moleski and D. J. Tosi's (see record 1977-01710-001) study, purporting the superiority of rational-emotive therapy over systematic desensitization in the treatment of stuttering, can largely be explained by chance sample fluctuation alone. It is argued that their expected error rate is unacceptably high because of their questionable ANOVA design and use of an alpha level of .10. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of isoxsuprine in essential dysmenorrhea. A controlled clinical study

The "uterus-specific" beta-adrenoceptor stimulator isoxsuprine was used for the treatment of primary dysmenorrhea in a double-blind controlled clinical study. No significant beneficial effect of the drug was evident.