48-53 In Durham et al’s48 study psychoanalytic therapy had within-group positive effects, but these effects were significantly inferior to those of CBT immediately after the test, and at 1-year follow-up. One should also mention that the psychoanalytic method used by White49 was less than optimal. Rogerian nondirective therapy in GAD Two studies reported Inhibitors,research,lifescience,medical equal effects
of Rogerian therapy and CBT. Two reported a better effect of CBT. Further studies should be done to clarify this point. Table II also presents the outcomes of these four studies.50-53 Table II. Generalized anxiety disorder: cognitive behavior therapy (CBT) versus other therapies. ST, supportive therapy. Posttraumatic stress disorder CBT in PTSD Methods Treatment of PTSD is the center of a growing interest in the literature. Th erapeutic programs involve relaxation, which is beneficial in case of high emotional arousal, exposure to avoided situations or images related to the trauma, Inhibitors,research,lifescience,medical and CT. Five methods have been proposed. All the methods IPI-145 mouse insist on the necessity of respecting the pace of Inhibitors,research,lifescience,medical the patient to reach the peak of the horror that, is at the center of the traumatic experience. Systematic desensitization presents the feared stimuli in imagination under relaxation in a graded way prior to in vivo
exposure. Exposure in imagination and in vivo aims at habituating the patient to the aversive stimulus, Inhibitors,research,lifescience,medical by reducing abnormal reactivity and avoidance. In vivo exposure to the nondangerous situations being avoided is then suggested. Stress management emphasizes the development, of coping strategies to deal with fears (relaxation, social skills training [SST], modification of anxious verbalization, or thought
stopping). Cognitive therapy Inhibitors,research,lifescience,medical also suggests exposure in imagination and representation of coping strategies, but puts a greater emphasis on dealing with automatic thoughts and dysfunctional attitudes (personalization, guilt, illusion of a safe world, and necessity of revenge). Eye movement desensitization and reprocessing (EMDR) consists in inducing eye movements when concentrated on feared imagery, bodily sensations, and negative statements associated with the trauma, in order to reduce anxiety and hence modify cognition in a positive way.54 Sessions last. 90 minutes and are limited to 4 or 5. This method was hypothesized Megestrol Acetate to work on neuropsychological functions. In fact, there is no clear evidence that EMDR is no more than a variant of the usual CBT programs. A controlled study55 found that EMDR with or without ocular movements gave the same positive outcomes as a standard psychiatric procedure at. posttest and a 6-month follow-up. Nonspecific factors might be implied in EMDR. Outcomes: meta-analysis Most, of the studies showed positive results. TTtierc is no difference in outcomes between CT and BT56 About 60% of patients respond to the treatment. Follow-up studies seldom exceed 6 months or 1 year.