Background: Pre-session administration of D-cycloserine (DCS) has been found to augment exposure ... more Background: Pre-session administration of D-cycloserine (DCS) has been found to augment exposure therapy outcomes in a variety of anxiety disorders. To be able to enhance learning only for successful exposure sessions, it would be beneficial to have the option of administering DCS after rather than before the session, a strategy encouraged by pre-clinical work. We believe the present study is the first published report on the efficacy of post-session administration of DCS in humans. Method: Adults (N ¼ 29) with a DSM-IV diagnosis of acrophobia were randomized to receive two sessions of virtual reality exposure therapy (VRE) in combination with placebo or 50 mg of DCS. Instead of administering the pill prior to each of the sessions, as has been done in extant work, we administered the pill immediately following each session. Measures of acrophobia severity were collected at baseline, at each treatment session, 1-week post-treatment, and at 1-month follow-up. Results: Mixed-effects repeated-measures ANOVAs and GLMMs revealed significant improvement in all outcome measures over time, but no between-group differences were observed. At post-treatment, 63.5% of patients in the placebo condition vs. 60.0% of those in the DCS condition were in remission. At 1-month follow up, 63.4% of those in the placebo condition vs. 66.6% of those in the DCS condition were in remission. Conclusions: These findings do not support the application of post-session DCS administration for augmenting the efficacy of exposure-based treatments. Possible reasons for these findings are discussed. Trial Registry: The Trial is registered at ClinicalTrials.gov (NCT01102803).
Obsessive-compulsive disorder (OCD) is a leading cause of disability, which is gaining increased ... more Obsessive-compulsive disorder (OCD) is a leading cause of disability, which is gaining increased recognition as evidenced by the disorder’s own category of related disorders in the DSM-5. Nonetheless, OCD remains undertreated despite the availability of well-researched and effective treatment options. Selective serotonin reuptake inhibitors (SSRIs) are a typical first-line approach, but require 4-8 weeks to become fully effective and often result in only a partial response. Underdosing is a common problem, since higher doses are usually required for OCD than for antidepressant effects. Sexual side effects are a common problem and may result in discontinuation. For partial responders, SRIs (including SSRIs and the tricyclic clomipramine) are often augmented with neuroleptics, but new research calls into question the benefits of this approach. Exposure and response/ritual prevention (Ex/RP) is a more effective method for augmenting antidepressant medications. New research indicates th...
This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adh... more This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adherence to a yoga intervention. Participants were 27 women who participated in a yoga intervention as part of a randomized controlled trial. Attendance and distress tolerance were assessed weekly, and body image and BMI were measured at baseline. Multilevel modeling revealed a three-way interaction of distress tolerance, BMI, and body image (p < .001). For participants with few body image concerns, distress tolerance was positively associated with adherence regardless of BMI (p = .009). However, for those with poor body image, increases in distress tolerance were associated with increases in adherence among overweight participants (p < .001) but lower adherence among obese participants (p = .007). Distress tolerance may be implicated in adherence to a yoga intervention, although its effects may be dependent on body image concerns, BMI, and their interaction. Research and clinical im...
Individuals with low distress tolerance (DT) experience negative emotion as particularly threaten... more Individuals with low distress tolerance (DT) experience negative emotion as particularly threatening and are highly motivated to reduce or avoid such affective experiences. Consequently, these individuals have difficulty regulating emotions and tend to engage in maladaptive strategies, such as overeating, as a means to reduce or avoid distress. Hatha yoga encourages one to implement present-centered awareness and non-reaction in the face of physical and psychological discomfort and, thus, emerges as a potential strategy for increasing DT. To test whether a hatha yoga intervention can enhance DT, a transdiagnostic risk and maintenance factor, this study randomly assigned females high in emotional eating in response to stress (N = 52) either to an 8-week, twice-weekly hatha (Bikram) yoga intervention or to a waitlist control condition. Self-reported DT and emotional eating were measured at baseline, weekly during treatment, and 1-week post-treatment. Consistent with prediction, partic...
... Jasper AJ Smits, Angela C. Berry, Mark B. Powers, Tracy L. Greer, and Michael W. Otto ... Mor... more ... Jasper AJ Smits, Angela C. Berry, Mark B. Powers, Tracy L. Greer, and Michael W. Otto ... Moreover, several studies have now shown that exercise training programs are associated with significant improvements in self-reported sleep quality (King, Oman, Brassington, Bliwise, &amp;amp; ...
Journal of Behavior Therapy and Experimental Psychiatry, 2003
Some data suggest that panic patients with extensive agoraphobia (PDA) display more intense respi... more Some data suggest that panic patients with extensive agoraphobia (PDA) display more intense respiratory distress during their panic attacks than Panic disorder (PD) patients. However, no studies have determined if PDA patients also show heightened sensitivity to a respiratory challenge compared to PD patients. The current study examined the differential emotional responding to hyperventilation among PDA patients, PD patients, and
Background: Pre-session administration of D-cycloserine (DCS) has been found to augment exposure ... more Background: Pre-session administration of D-cycloserine (DCS) has been found to augment exposure therapy outcomes in a variety of anxiety disorders. To be able to enhance learning only for successful exposure sessions, it would be beneficial to have the option of administering DCS after rather than before the session, a strategy encouraged by pre-clinical work. We believe the present study is the first published report on the efficacy of post-session administration of DCS in humans. Method: Adults (N ¼ 29) with a DSM-IV diagnosis of acrophobia were randomized to receive two sessions of virtual reality exposure therapy (VRE) in combination with placebo or 50 mg of DCS. Instead of administering the pill prior to each of the sessions, as has been done in extant work, we administered the pill immediately following each session. Measures of acrophobia severity were collected at baseline, at each treatment session, 1-week post-treatment, and at 1-month follow-up. Results: Mixed-effects repeated-measures ANOVAs and GLMMs revealed significant improvement in all outcome measures over time, but no between-group differences were observed. At post-treatment, 63.5% of patients in the placebo condition vs. 60.0% of those in the DCS condition were in remission. At 1-month follow up, 63.4% of those in the placebo condition vs. 66.6% of those in the DCS condition were in remission. Conclusions: These findings do not support the application of post-session DCS administration for augmenting the efficacy of exposure-based treatments. Possible reasons for these findings are discussed. Trial Registry: The Trial is registered at ClinicalTrials.gov (NCT01102803).
Obsessive-compulsive disorder (OCD) is a leading cause of disability, which is gaining increased ... more Obsessive-compulsive disorder (OCD) is a leading cause of disability, which is gaining increased recognition as evidenced by the disorder’s own category of related disorders in the DSM-5. Nonetheless, OCD remains undertreated despite the availability of well-researched and effective treatment options. Selective serotonin reuptake inhibitors (SSRIs) are a typical first-line approach, but require 4-8 weeks to become fully effective and often result in only a partial response. Underdosing is a common problem, since higher doses are usually required for OCD than for antidepressant effects. Sexual side effects are a common problem and may result in discontinuation. For partial responders, SRIs (including SSRIs and the tricyclic clomipramine) are often augmented with neuroleptics, but new research calls into question the benefits of this approach. Exposure and response/ritual prevention (Ex/RP) is a more effective method for augmenting antidepressant medications. New research indicates th...
This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adh... more This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adherence to a yoga intervention. Participants were 27 women who participated in a yoga intervention as part of a randomized controlled trial. Attendance and distress tolerance were assessed weekly, and body image and BMI were measured at baseline. Multilevel modeling revealed a three-way interaction of distress tolerance, BMI, and body image (p < .001). For participants with few body image concerns, distress tolerance was positively associated with adherence regardless of BMI (p = .009). However, for those with poor body image, increases in distress tolerance were associated with increases in adherence among overweight participants (p < .001) but lower adherence among obese participants (p = .007). Distress tolerance may be implicated in adherence to a yoga intervention, although its effects may be dependent on body image concerns, BMI, and their interaction. Research and clinical im...
Individuals with low distress tolerance (DT) experience negative emotion as particularly threaten... more Individuals with low distress tolerance (DT) experience negative emotion as particularly threatening and are highly motivated to reduce or avoid such affective experiences. Consequently, these individuals have difficulty regulating emotions and tend to engage in maladaptive strategies, such as overeating, as a means to reduce or avoid distress. Hatha yoga encourages one to implement present-centered awareness and non-reaction in the face of physical and psychological discomfort and, thus, emerges as a potential strategy for increasing DT. To test whether a hatha yoga intervention can enhance DT, a transdiagnostic risk and maintenance factor, this study randomly assigned females high in emotional eating in response to stress (N = 52) either to an 8-week, twice-weekly hatha (Bikram) yoga intervention or to a waitlist control condition. Self-reported DT and emotional eating were measured at baseline, weekly during treatment, and 1-week post-treatment. Consistent with prediction, partic...
... Jasper AJ Smits, Angela C. Berry, Mark B. Powers, Tracy L. Greer, and Michael W. Otto ... Mor... more ... Jasper AJ Smits, Angela C. Berry, Mark B. Powers, Tracy L. Greer, and Michael W. Otto ... Moreover, several studies have now shown that exercise training programs are associated with significant improvements in self-reported sleep quality (King, Oman, Brassington, Bliwise, &amp;amp; ...
Journal of Behavior Therapy and Experimental Psychiatry, 2003
Some data suggest that panic patients with extensive agoraphobia (PDA) display more intense respi... more Some data suggest that panic patients with extensive agoraphobia (PDA) display more intense respiratory distress during their panic attacks than Panic disorder (PD) patients. However, no studies have determined if PDA patients also show heightened sensitivity to a respiratory challenge compared to PD patients. The current study examined the differential emotional responding to hyperventilation among PDA patients, PD patients, and
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