The empirical research in this thesis focused on individual differences in subjective- and physiological reactivity to flight-related stimuli. The results of these studies are mixed, making them... Show moreThe empirical research in this thesis focused on individual differences in subjective- and physiological reactivity to flight-related stimuli. The results of these studies are mixed, making them difficult to fit into existing theoretical models. The relationship between emotional response systems is likely affected by many intervening variables, including higher order cognitive processes. Pre-treatment individual differences in subjective distress reactivity and physiological reactivity to flight related stimuli, and pre-treatment use of cognitive coping strategies were not prognostic of short- and long-term post-treatment clinical course. In the course of therapy, individual reactivity became more strongly related to treatment outcome. The magnitude of change in the use of maladaptive coping strategies during therapy was indicative of long-term persistence of flight anxiety and long-term flying behaviour. Subjective distress reactivity, pre-exposure and during actual flight, was prognostic for short- and long-term treatment outcomes. Adding measurements of physiological reactivity improved the prediction of treatment outcome. The magnitude of synchronous change in subjective and physiological reactivity did not increase with higher intensity of phobic stimuli, and was not related to outcome. Subjective and physiological measurements of fear activation provided partly independent information. Prognosis for clinical course of aviophobia therefore could benefit from including physiological reactivity measurements. Show less
We investigated the effects of two novel treatments for posttraumatic stress disorder (PTSD). The first treatment is Attentional Bias Modification (ABM). This treatment for anxiety disorders has... Show moreWe investigated the effects of two novel treatments for posttraumatic stress disorder (PTSD). The first treatment is Attentional Bias Modification (ABM). This treatment for anxiety disorders has become quite popular in a relatively short time and was featured in recent articles in the New York Times and The Economist. ABM is a brief, computerized treatment in which patients are trained to keep their attention away from the threatening stimuli from which they automatically attend. Since attentional bias (AB) is considered an important feature of PTSD, we tested ABM in a randomized controlled trial. ABM did not effect PTSD, nor did it change AB. We also investigated an individualized version of ABM in a case series and saw no therapeutic effects. Since the current popularity of ABM is based on smaller studies than our RCT, dissemination efforts may have to be reconsidered. Next, we explored the usefulness of a 8-week course of mindfulness-based cognitive therapy (MBCT) in a pilot study with patients with chronic PTSD. No adverse effects were observed and patients evaluated the course positively. About half of the patients who finished MBCT demonstrated positive clinical effects. However, considering the early dropout rate, different formats may have to be developed to increase its acceptability in this group. Show less
