Cognitive Therapy and Performance-Based Exposure Both Reduce Panic Attacks

1996 ◽  
Author(s):  
S. L. Williams ◽  
J. Falbo
1995 ◽  
Vol 167 (3) ◽  
pp. 374-379 ◽  
Author(s):  
S. Oehrberg ◽  
P. E. Christiansen ◽  
K. Behnke ◽  
A. L. Borup ◽  
B. Severin ◽  
...  

BackgroundThis study compared the efficacy and tolerability of paroxetine with placebo in the treatment of panic disorder.MethodAfter three weeks of placebo, patients received 12 weeks of treatment with paroxetine (20, 40, or 60 mg) or placebo, and finally two weeks of placebo. Dosages were adjusted according to efficacy and tolerability. Standardised cognitive therapy was given to all patients. The primary measure of outcome was reduction in the number of panic attacks.ResultsAnalysis of the results showed statistically significant differences in favour of paroxetine between the two treatment groups in two out of the three primary measures of outcome, i.e. 50% reduction in total number of panic attacks and number of panic attacks reduced to one or zero over the study period. For the third measure of outcome, the mean change in the total number of attacks from baseline, there was a positive trend in favour of paroxetine. The results of the primary measures of outcome were strongly supported by the results of the secondary efficacy measures of outcome. In addition, paroxetine, at all doses, was very well tolerated.ConclusionParoxetine plus cognitive therapy was significantly more effective than placebo plus cognitive therapy in the treatment of panic disorder.


1991 ◽  
Vol 5 (3) ◽  
pp. 215-226 ◽  
Author(s):  
Paul M. Salkovskis ◽  
David M. Clark

Although cognitive therapy for panic attacks is a relatively recent development, it has attracted considerable interest; partly because of early reports of good long-term outcome. Cognitive treatment of panic focuses on the identification and modification of misinterpretations of bodily sensations. Outcome studies suggest that the treatment is highly effective and the theory upon which treatment is based is supported by a growing body of experimental evidence. The present article provides a brief outline of the details of treatment. As the treatment contains several elements, the extent to which re-appraisal of bodily symptoms is an active element is discussed and possible alternative explanations of treatment effectiveness are considered. The available evidence is consistent with the view that cognitive factors are at least partly responsible for the effectiveness of treatment. Ways in which clinicians might maximize treatment effectiveness are also discussed.


1996 ◽  
Vol 10 (4) ◽  
pp. 281-289 ◽  
Author(s):  
Asle Hoffart

An in vivo cognitive treatment of panic attacks that combine active behavioral instructions and standard cognitive procedures is described. A case example is presented that both illustrates the method and indicates the potential significance of this treatment component in a complete cognitive therapy package. It is argued that a reason for residual problems among panic/ agoraphobic patients after traditional cognitive therapy may be that the patients are still afraid of severe panic attacks and that in vivo treatment of such attacks may remediate this fear.


1991 ◽  
Vol 29 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Paul M. Salkovskis ◽  
David M. Clark ◽  
Ann Hackmann

Author(s):  
H. M. Thieringer

It has repeatedly been show that with conventional electron microscopes very fine electron probes can be produced, therefore allowing various micro-techniques such as micro recording, X-ray microanalysis and convergent beam diffraction. In this paper the function and performance of an SIEMENS ELMISKOP 101 used as a scanning transmission microscope (STEM) is described. This mode of operation has some advantages over the conventional transmission microscopy (CTEM) especially for the observation of thick specimen, in spite of somewhat longer image recording times.Fig.1 shows schematically the ray path and the additional electronics of an ELMISKOP 101 working as a STEM. With a point-cathode, and using condensor I and the objective lens as a demagnifying system, an electron probe with a half-width ob about 25 Å and a typical current of 5.10-11 amp at 100 kV can be obtained in the back focal plane of the objective lens.


Author(s):  
Huang Min ◽  
P.S. Flora ◽  
C.J. Harland ◽  
J.A. Venables

A cylindrical mirror analyser (CMA) has been built with a parallel recording detection system. It is being used for angular resolved electron spectroscopy (ARES) within a SEM. The CMA has been optimised for imaging applications; the inner cylinder contains a magnetically focused and scanned, 30kV, SEM electron-optical column. The CMA has a large inner radius (50.8mm) and a large collection solid angle (Ω > 1sterad). An energy resolution (ΔE/E) of 1-2% has been achieved. The design and performance of the combination SEM/CMA instrument has been described previously and the CMA and detector system has been used for low voltage electron spectroscopy. Here we discuss the use of the CMA for ARES and present some preliminary results.The CMA has been designed for an axis-to-ring focus and uses an annular type detector. This detector consists of a channel-plate/YAG/mirror assembly which is optically coupled to either a photomultiplier for spectroscopy or a TV camera for parallel detection.


Author(s):  
Joe A. Mascorro ◽  
Gerald S. Kirby

Embedding media based upon an epoxy resin of choice and the acid anhydrides dodecenyl succinic anhydride (DDSA), nadic methyl anhydride (NMA), and catalyzed by the tertiary amine 2,4,6-Tri(dimethylaminomethyl) phenol (DMP-30) are widely used in biological electron microscopy. These media possess a viscosity character that can impair tissue infiltration, particularly if original Epon 812 is utilized as the base resin. Other resins that are considerably less viscous than Epon 812 now are available as replacements. Likewise, nonenyl succinic anhydride (NSA) and dimethylaminoethanol (DMAE) are more fluid than their counterparts DDSA and DMP- 30 commonly used in earlier formulations. This work utilizes novel epoxy and anhydride combinations in order to produce embedding media with desirable flow rate and viscosity parameters that, in turn, would allow the medium to optimally infiltrate tissues. Specifically, embeding media based on EmBed 812 or LX 112 with NSA (in place of DDSA) and DMAE (replacing DMP-30), with NMA remaining constant, are formulated and offered as alternatives for routine biological work.Individual epoxy resins (Table I) or complete embedding media (Tables II-III) were tested for flow rate and viscosity. The novel media were further examined for their ability to infilftrate tissues, polymerize, sectioning and staining character, as well as strength and stability to the electron beam and column vacuum. For physical comparisons, a volume (9 ml) of either resin or media was aspirated into a capillary viscocimeter oriented vertically. The material was then allowed to flow out freely under the influence of gravity and the flow time necessary for the volume to exit was recored (Col B,C; Tables). In addition, the volume flow rate (ml flowing/second; Col D, Tables) was measured. Viscosity (n) could then be determined by using the Hagen-Poiseville relation for laminar flow, n = c.p/Q, where c = a geometric constant from an instrument calibration with water, p = mass density, and Q = volume flow rate. Mass weight and density of the materials were determined as well (Col F,G; Tables). Infiltration schedules utilized were short (1/2 hr 1:1, 3 hrs full resin), intermediate (1/2 hr 1:1, 6 hrs full resin) , or long (1/2 hr 1:1, 6 hrs full resin) in total time. Polymerization schedules ranging from 15 hrs (overnight) through 24, 36, or 48 hrs were tested. Sections demonstrating gold interference colors were collected on unsupported 200- 300 mesh grids and stained sequentially with uranyl acetate and lead citrate.


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