Session 1

2007 ◽  
pp. 17-24
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree
Keyword(s):  
Prolonged Exposure ◽  
Imaginal Exposure ◽  
Breathing Retraining ◽  
First Session

Chapter 3 outlines the first session of treatment and provides an overview of the program and the procedures that will be used during the course of the treatment (imaginal exposure and in vivo exposure), as well as techniques for breathing retraining and relaxation, and a rationale for treatment by prolonged exposure.

Variations and How to Decide

2020 ◽  
pp. 115-122
Author(s):  
Sheila A. M. Rauch ◽  
Barbara O. Rothbaum ◽  
Erin R. Smith ◽  
Edna B. Foa
Keyword(s):  
Program Design ◽  
Prolonged Exposure ◽  
Imaginal Exposure ◽  
Outpatient Program ◽  
Intensive Outpatient Program ◽  
Intensive Outpatient

This therapist guide presents the scaffold and structure for the Prolonged Exposure-Intensive Outpatient Program (PE-IOP). The program is focused on exposure as provided through individual imaginal exposure and group in vivo exposure. The format presented is based primarily on the model used in the Emory Healthcare Veterans Program (EHVP), but this chapter provides a focus on the most common variations in program design with a discussion of how to decide between the different potential variations. Relevant inclusions and exclusions are presented along with rationales.

Introduction

2019 ◽  
pp. 1-10
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Sheila A. M. Rauch
Keyword(s):  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Perceived Threat ◽  
Imaginal Exposure ◽  
Loved One ◽  
Processing Theory ◽  
Therapy Program ◽  
Threat To Life

Posttraumatic stress disorder (PTSD) is a fear and stress disorder that may develop after an event that is experienced or witnessed and involves actual or perceived threat to life or physical integrity to oneself or a loved one. This chapter discusses the characteristics of the disorder and explains both prolonged exposure (PE) therapy and Emotional Processing Theory. Readers will learn about the benefits and risks of the treatment as well as what is involved. The main tools of this therapy program, imaginal exposure and in vivo exposure, are presented.

Foundations of Prolonged Exposure

2019 ◽  
pp. 1-22
Author(s):  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Barbara Olasov Rothbaum ◽  
Sheila A. M. Rauch
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Emotional Distress ◽  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Traumatic Events ◽  
Ptsd Symptoms ◽  
Imaginal Exposure

Foundations of prolonged exposure (PE) include (1) education about common reactions to trauma, what maintains trauma-related symptoms, and how PE reduces posttraumatic stress disorder (PTSD) symptoms; (2) repeated in vivo confrontation with situations, people, or objects that the patient is avoiding because they are trauma-related and cause emotional distress such as anxiety, shame, or guilt; and (3) repeated, prolonged imaginal exposure to the trauma memories followed by processing the details of the event, the emotions, and the thoughts that the patient experienced during the trauma. The aim of in vivo and imaginal exposure is to enhance emotional processing of traumatic events by helping the patient face the trauma memories and reminders and process the emotions and thoughts, as well as the details of the trauma that emerge during revisiting experiences.

Session 1

2019 ◽  
pp. 17-26
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Sheila A. M. Rauch
Keyword(s):  
Treatment Program ◽  
Real Life ◽  
Imaginal Exposure ◽  
Patient Will ◽  
Breathing Retraining

In Session 1, the patient learns about the overall treatment program and the procedures that will be used, including both imaginal exposure (reliving the trauma in imagination) and in vivo exposure (reexperiencing the trauma situation in real life). The patient will complete the Trauma Interview with the therapist and learn breathing retraining. Finally, the patient will be taught about how session recordings will be used and will learn about homework expectations.

Virtual Reality Exposure Therapy for PTSD

2016 ◽  
Author(s):  
Michael J. Roy ◽  
Albert Rizzo ◽  
JoAnn Difede ◽  
Barbara O. Rothbaum
Keyword(s):  
Virtual Reality ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Treatment Guidelines ◽  
Traumatic Experience ◽  
Sufficient Evidence ◽  
Institute Of Medicine ◽  
Imaginal Exposure ◽  
Consensus Statements

Expert treatment guidelines and consensus statements identified imaginal exposure therapy as a first-line treatment for posttraumatic stress disorder (PTSD) more than a decade ago. Subsequently, an Institute of Medicine report concluded that cognitive–behavioral therapy with exposure therapy is the only therapy with sufficient evidence to recommend it for PTSD. Imaginal exposure has been the most widely used exposure approach. It requires patients to recall and narrate their traumatic experience repeatedly, in progressively greater detail, both to facilitate the therapeutic processing of related emotions and to decondition the learning cycle of the disorder via a habituation–extinction process. Prolonged exposure, one of the best-evidenced forms of exposure therapy, incorporates psychoeducation, controlled breathing techniques, in vivo exposure, prolonged imaginal exposure to traumatic memories, and processing of traumatic material, typically for 9 to 12 therapy sessions of about 90 minutes each. However, avoidance of reminders of the trauma is a defining feature of PTSD, so it is not surprising that many patients are unwilling or unable to visualize effectively and recount traumatic events repeatedly. Some studies of imaginal exposure have reported 30% to 50% dropout rates before completion of treatment. Adding to the challenge, some patients have an aversion to “traditional” psychotherapy as well as to pharmacotherapy, and may find alternative approaches more appealing. Younger individuals in particular may be attracted to virtual reality-based therapies.

Exposure in PE-IOP

2020 ◽  
pp. 47-88
Author(s):  
Sheila A. M. Rauch ◽  
Barbara O. Rothbaum ◽  
Erin R. Smith ◽  
Edna B. Foa
Keyword(s):  
Emotional Processing ◽  
Prolonged Exposure ◽  
Imaginal Exposure ◽  
Exposure Session ◽  
Outpatient Program ◽  
Intensive Outpatient Program ◽  
Intensive Outpatient ◽  
The Individual

This chapter presents in-depth details of how to implement the exposure component of the Prolonged Exposure-Intensive Outpatient Program (PE-IOP), including places where variation is acceptable and why. The authors present the logistics and rationale for individual sessions that include imaginal exposure and individualized trauma emotional processing. In addition, the authors present in vivo group exposure session logistics and rationale. The in vivo group includes the general psychoeducation components of PE, the in vivo exposure hierarchy creation, and the practice of in vivo exposure. The exposures may occur in a group or individually, escorted or non-escorted, as clinically indicated for the individual patient.

scholarly journals Effects of Hyperglycemia on Vascular Smooth Muscle Ca2+Signaling

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Nahed El-Najjar ◽  
Rashmi P. Kulkarni ◽  
Nancy Nader ◽  
Rawad Hodeify ◽  
Khaled Machaca
Keyword(s):  
Insulin Resistance ◽  
Smooth Muscle ◽  
Sarcoplasmic Reticulum ◽  
Vascular Smooth Muscle ◽  
Complex Disease ◽  
Prolonged Exposure ◽  
In Vitro System ◽  
A7r5 Cells

Diabetes is a complex disease that is characterized with hyperglycemia, dyslipidemia, and insulin resistance. These pathologies are associated with significant cardiovascular implications that affect both the macro- and microvasculature. It is therefore important to understand the effects of various pathologies associated with diabetes on the vasculature. Here we directly test the effects of hyperglycemia on vascular smooth muscle (VSM) Ca2+signaling in an isolated in vitro system using the A7r5 rat aortic cell line as a model. We find that prolonged exposure of A7r5 cells to hyperglycemia (weeks) is associated with changes to Ca2+signaling, including most prominently an inhibition of the passive ER Ca2+leak and the sarcoplasmic reticulum Ca2+-ATPase (SERCA). To translate these findings to the in vivo condition, we used primary VSM cells from normal and diabetic subjects and find that only the inhibition of the ER Ca2+leaks replicates in cells from diabetic donors. These results show that prolonged hyperglycemia in isolation alters the Ca2+signaling machinery in VSM cells. However, these alterations are not readily translatable to the whole organism situation where alterations to the Ca2+signaling machinery are different.

Treating Spider Phobics with Eye Movement Desensitization and Reprocessing: A Controlled Study

1997 ◽  
Vol 25 (1) ◽  
pp. 39-50 ◽  
Author(s):  
Peter Muris ◽  
Harald Merckelbach
Keyword(s):  
Treatment Outcome ◽  
Eye Movement ◽  
Specific Phobia ◽  
Controlled Study ◽  
Control Group ◽  
Exposure Group ◽  
Imaginal Exposure ◽  
Avoidance Test ◽  
Behavioural Avoidance

The present study examined the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of a specific phobia. Twenty-four spider phobic subjects were randomly assigned to either (1) an EMDR group (n=8), (2) an imaginal exposure group (n=8), or (3) a control group (n=8). Both the EMDR and the imaginal exposure group underwent a one-hour treatment. The control group initially received no treatment, and waited for one hour. Next, all groups received exposure in vivo. Treatment outcome was evaluated with a standardized Behavioural Avoidance Test (BAT). No evidence was found for EMDR being more effective than imaginal exposure or waiting list control. In fact, only exposure in vivo therapy resulted in significant improvement on the BAT.

Anti-Diabetic Retinopathy Potential of Noni: The beneficial effect and possible mechanism

2020 ◽  
Vol 3 (1) ◽  
pp. 01-21
Author(s):  
Faisal Ali
Keyword(s):  
Diabetic Retinopathy ◽  
Prolonged Exposure ◽  
Morinda Citrifolia ◽  
In Vivo Studies ◽  
Laboratory Research ◽  
Tropical Region ◽  
Bioactive Substances ◽  
High Blood Glucose

Noni (Morinda citrifolia L.) is being evaluated in laboratory research for its benefits as an antioxidant and immunity booster, as well as for its properties to prevent tumors and cure diabetes. The vast spread of Noni in tropical region of the globe, from America reaching to Africa and Southeast Asia, contributed in enhancing its usage and potency due to the diversity in harvest zone. Noni parts comprise fruits, seeds, leaves, and flowers are being used for individual nutritional and therapeutical values. Nevertheless, the fruit is widely characterized to contain the most valuable bioactive substances. On the other hand, diabetic retinopathy (DR) is a microvascular disorder impacting the small blood vessels in the retina, which includes microaneurysms, retinal hemorrhages, and hard exudates results from prolonged exposure to high blood glucose levels. The anti-diabetes effect of Noni extract and juice has been examined but the beneficial role of Noni and its potential mechanisms against the development of diabetic retinopathy phenotype is still ambiguous. This review, therefore, will discusses in details the pharmacological actions of M. citrifolia fruit, along with their isolated phytochemical compounds on diabetic retinopathy markers, through describing the conducted in vitro and in vivo studies as well as clinical data.

scholarly journals Design and in vivo evaluation of a microparticulate depot formulation of buprenorphine for veterinary use

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Viktoria Schreiner ◽  
Mattea Durst ◽  
Margarete Arras ◽  
Pascal Detampel ◽  
Paulin Jirkof ◽  
...  
Keyword(s):  
Drug Release ◽  
Prolonged Exposure ◽  
Drug Formulation ◽  
Spherical Particles ◽  
Laboratory Animals ◽  
Attractive Alternative ◽  
Burst Release ◽  
In Vivo Evaluation ◽  
Duration Of Action

Abstract Buprenorphine is a frequently used analgetic agent in veterinary medicine. A major drawback, however, is the short duration of action requiring several daily administrations. We therefore designed a poly-lactic-co-glycolic acid (PLGA) based microparticulate drug formulation for sustained parenteral drug release. Particles were designed to allow for a fast onset of action and a duration of the analgesic effect of at least two days in laboratory mice. Microparticles were produced using a solvent evaporation technique. Release rate was dependent on polymer type and particle size. Spherical particles used for subsequent animal studies had a mean size of 50 µm and contained 4.5% of buprenorphine. Drug release was characterized by an initial burst release of 30% followed by complete release over seven days. In vivo pharmacokinetic experiments in female C57BL/6 J mice confirmed prolonged exposure in plasma and brain tissue and correlated with the pharmacological effect in the hot plate assay or after minor abdominal surgery. No adverse side effects with respect to food and water intake, body weight, local tolerability, or nesting behavior were observed. Our formulation is an attractive alternative to established immediate release formulations. A use for prolonged pain management in laboratory animals is proposed.

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