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"Fear psychology"
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The art of fear : why conquering fear won't work and what to do instead
The extreme skier argues that people react incorrectly to fear, advocating that they embrace it through a mindfulness technique called \"Shift,\" which allows for the building of a new relationship with the emotion.
Book
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study
Rationale
Standard therapeutic approaches to reduce social anxiety in autistic adults have limited effectiveness. Since 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy shows promise as a treatment for other anxiety disorders, a blinded, placebo-controlled pilot study was conducted.
Objectives
To explore feasibility and safety of MDMA-assisted psychotherapy for reduction of social fear and avoidance that are common in the autistic population.
Methods
Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg,
n
= 8) or inactive placebo (0 mg,
n
= 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 non-drug psychotherapy sessions following each. The primary outcome was change in Leibowitz Social Anxiety Scale (LSAS) Total scores from Baseline to one month after the second experimental session. Outcomes were measured again six months after the last experimental session.
Results
Improvement in LSAS scores from baseline to the primary endpoint was significantly greater for MDMA group compared to the placebo group (
P
= 0.037), and placebo-subtracted Cohen’s
d
effect size was very large (
d
= 1.4, CI − 0.074, 2.874). Change in LSAS scores from baseline to 6-month follow-up showed similar positive results (
P
= 0.036), with a Cohen’s
d
effect size of 1.1 (CI − 0.307, 2.527). Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase.
Conclusions
This pilot trial demonstrated rapid and durable improvement in social anxiety symptoms in autistic adults following MDMA-assisted psychotherapy. Initial safety and efficacy outcomes support expansion of research into larger samples to further investigate this novel treatment for social anxiety.
Trial registration
clinicaltrials.gov
identifier, NCT02008396
Journal Article
Afraid : understanding the purpose of fear and harnessing the power of anxiety
About a third of the world population suffers from an anxiety disorder, and half of Americans have had at least one traumatic experience like rape, assault, shooting, or natural disasters. 'Afraid' provides a broad and entertaining overview of fear from evolution, to modern day challenges, and how clinicians treat trauma, anxiety and PTSD today.
Book
Time and Covid-19 stress in the lockdown situation: Time free, «Dying» of boredom and sadness
A lockdown of people has been used as an efficient public health measure to fight against the exponential spread of the coronavirus disease (Covid-19) and allows the health system to manage the number of patients. The aim of this study (clinicaltrials.gov NCT00430818) was to evaluate the impact of both perceived stress aroused by Covid-19 and of emotions triggered by the lockdown situation on the individual experience of time. A large sample of the French population responded to a survey on their experience of the passage of time during the lockdown compared to before the lockdown. The perceived stress resulting from Covid-19 and stress at work and home were also assessed, as were the emotions felt. The results showed that people have experienced a slowing down of time during the lockdown. This time experience was not explained by the levels of perceived stress or anxiety, although these were considerable, but rather by the increase in boredom and sadness felt in the lockdown situation. The increased anger and fear of death only explained a small part of variance in the time judgment. The conscious experience of time therefore reflected the psychological difficulties experienced during lockdown and was not related to their perceived level of stress or anxiety.
Journal Article
Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison
Background
Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education.
Methods
This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT;
n
= 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the
Mind in Labor (MIL)
:
Working with Pain in Childbirth
, based on
Mindfulness-Based Childbirth and Parenting
(MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected.
Results
In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women’s childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls.
Conclusions
This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum depression symptoms. There is also some indication that MIL participants may use mindfulness coping in lieu of systemic opioid pain medication. A large-scale RCT that captures real-time pain perceptions during labor and length of labor is warranted to provide a more definitive test of these effects.
Trial registration
The ClinicalTrials.gov identifier for the PEARLS study is:
NCT02327559
. The study was retrospectively registered on June 23, 2014.
Journal Article
Preventing the return of fear in humans using reconsolidation update mechanisms
Recent research on changing fears has examined targeting reconsolidation. During reconsolidation, stored information is rendered labile after being retrieved. Pharmacological manipulations at this stage result in an inability to retrieve the memories at later times, suggesting that they are erased or persistently inhibited. Unfortunately, the use of these pharmacological manipulations in humans can be problematic. Here we introduce a non-invasive technique to target the reconsolidation of fear memories in humans. We provide evidence that old fear memories can be updated with non-fearful information provided during the reconsolidation window. As a consequence, fear responses are no longer expressed, an effect that lasted at least a year and was selective only to reactivated memories without affecting others. These findings demonstrate the adaptive role of reconsolidation as a window of opportunity to rewrite emotional memories, and suggest a non-invasive technique that can be used safely in humans to prevent the return of fear.
An appointment with fear
Reconsolidation is a natural mechanism in human memory: the reconsolidation phase allows new information available at the time of retrieval to be incorporated into an old memory. Although pharmacological blockade of reconsolidation has been used to prevent the return of fear in animal models, many of these manipulations involve compounds that are toxic to humans. Elizabeth Phelps and co-workers now report a non-invasive technique of rewriting fear memories that avoids the use of drugs. The procedure is based on an established technique in which memories of traumatic events are 'extinguished' by repeated exposure to traumatic reminders in a safe environment. This works up to a point, but memories are masked rather than eliminated and can return, for example with the passage of time or due to stress. The new advance lies in timing: if the 'safe' information is introduced during the reconsolidation window of old fear memories, the fear does not return. This work suggests that post-traumatic stress disorder and other anxiety conditions might be responsive to new types of non-invasive therapy.
During reconsolidation of memories, stored information is rendered labile after being retrieved and can be manipulated. Previous studies have used pharmacological intervention to disrupt retrieved memories; here, however, a non-invasive, behavioural technique is used to target the reconsolidation of fear memories in humans. Non-fearful information provided during the reconsolidation window appears to update old fear memories, causing a lack of expression of fear responses.
Journal Article
I hope I screw this up : how falling in love with your fears can change the world
\"After twenty-five years of achieving what he thought were his dreams of being a headlining touring comedian and actor, Kyle Cease suddenly discovered that the belief that 'When something happens, I will be happy' is a complete lie. With nothing more than an intuition, he decided to quit his stand-up career at its peak and ... [in this book] disarms readers as he leads them to their own personal breakthroughs, helping them to recognize that actual happiness and fulfillment is available to them not in some distant future, but right now\"--Dust jacket.
Book
Family participatory clown therapy in venipuncture in hospitalized children: A non-randomized controlled trial
To explore the effectiveness of family participatory clown therapy in venipuncture in hospitalized children.
We recruited 104 children aged 3 to 6 years for a non-randomized controlled trial from March to December 2022. All participants required peripheral venepuncture infusions for treatment. The children were assigned to either the control group (n = 52) or the experimental group (n = 52).Standard care was utilized in the control group. In the experimental group, two clown nurses and a parent provided family participatory clown therapy for 35-45 minutes per child before, during, and after venipuncture. We assessed children's pain (FLACC and W-B FPS), anxiety (VAS-A), medical fear (CFS), crying incidence, compliance, parental anxiety (S-AI), and parental satisfaction.
At venipuncture, the FLACC score was lower in the experimental group (4.46±2.053) compared to the control group (5.96±2.441), the W-B FPS score was also lower in the experimental group (4.96±2.392) than in the control group (6.35±2.266), with a statistically significant difference (P<0.05).The children in the experimental group had lower levels of anxiety, medical fear, crying, and parental anxiety than the control group. In addition, child compliance and parent satisfaction were higher in the experimental group than in the control group, with statistically significant differences (P<0.05).
Family participatory clown therapy can reduce pain, anxiety, medical fear, and crying during venipuncture in children. It can also improve venipuncture compliance, reduce parental anxiety, and increase parental satisfaction.
Journal Article