Browsing by Author "Febbraro, Gregorio A. R."

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    A critical examination of the phenomenon of claustrophobia: do subtypes exist?
    Febbraro, Gregorio A. R. (Virginia Tech, 1993-12-05)
    Claustrophobia, a fear of enclosed spaces, is thought of as being a unitary phenomenon. However, different subtypes of claustrophobia may exist. Some claustrophobics may be more similar to individuals with Panic Disorder with Agoraphobia in terms of situations feared, cognitions and symptoms whereas others might be similar to simple phobics with a specific fear of enclosed spaces. The purpose of this study was to investigate whether such subtypes exist. The Claustrophobia Situations Questionnaire (CSQ) and the Claustrophobia General Cognitions Questionnaire (CGCQ) were developed and exploratory factor analyses were performed on these scales. Two-factor solutions for both the anxiety and avoidance ratings on the CSQ were obtained accounting for 40.8% and 33.8% of the variance, respectively. Two subscales were created from each two-factor solution. A three-factor solution was obtained for the CGCQ accounting for 53.6% of the variance from which three subscales were created. Differential validity of the scales and their utility in identifying claustrophobic subtypes was assessed. Self-report measures and physiological response to a hyperventilation challenge were used to validate claustrophobic subtypes. A significant main effect for "Avoidance of Crowds" was found when using heart rate change and post heart rate as dependent measures. Specifically, subjects high on the "Avoidance of Crowds" subscale demonstrated greater heart rate change and post heart rate than subjects low on the "Avoidance of Crowds" subscale. This suggests subjects avoidant of panic-like situations had a greater physiological reaction to the hyperventilation challenge, a task considered to be problematic for panic disordered individuals. Therefore, the results generally suggest the existence of claustrophobic subtypes. The present study was the first to compare subjects differentiated on the basis of claustrophobic subtypes in terms of their physiological response to a hyperventilation challenge. This study both supported and extended past research by developing questionnaires (the CSQ and CGCQ) capable of identifying different claustrophobic situational and cognitive factors.
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    An investigation of the differential effectiveness of bibliotherapy and self-regulatory treatments in individuals with panic attacks
    Febbraro, Gregorio A. R. (Virginia Tech, 1997-04-21)
    Several studies targeting individuals with panic disorder have demonstrated that Cognitive-behavioral treatment (CST) is the psychological treatment of choice. CST interventions that include exposure to panic symptoms, along with cognitive restructuring. breathing retraining, and relaxation training are more effective than any of these components administered alone. Past studies have demonstrated the efficacy of imparting the above CBT components in the form of bibliotherapy (BT) in the treatment of panic disorder. The present study examined the differential effectiveness of BT and self-regulatory treatments in the treatment of individuals with panic attacks. The present study examined a much purer version of a self-help bibliotherapy intervention by reducing therapist contact much more than prior studies had done. In addition, the present study examined the additive effectiveness of self-regulatory components-self-monitoring (SM) and feedback (FB)--to BT. Sixty-three participants who experienced a DSM-IV full-blown or limited symptom attack in the two weeks prior to beginning the Self-help Project were assigned via stratified randomization to 1 of 4 experimental conditions: 1) BT alone (N = 17); 2) ST plus DML (daily self-monitoring plus feedback; (N = 15); 3) DML (N = 13); or 4) WL (N = 18). The present study utilized a pre - post treatment assessment design with pre-treatment assessment occurring two weeks prior to treatment and post-treatment assessment occurring approximately two weeks after the end of treatment. Treatment was 8 weeks in duration. Participants were sent pre-treatment assessment and treatment materials via mail in order to minimize therapist contact. At post-treatment assessment, participants were assessed either in-person or via mail/phone depending upon their geographic location. It was expected that participants in all treatment conditions would experience less full-blown panic attacks, limited-symptom attacks, avoidance, fear of having a panic attack, panic cognitions. panic symptoms, state anxiety and depressive symptoms and increases in coping strategies and coping self-efficacy than participants in the WL condition. Furthermore, it was expected that participants in the BT plus DML condition would experience more change on the above dependent variables than participants in the BT alone and DML alone conditions from pre- to post-treatment assessment. A 4 X 2 repeated measures MANOVA revealep no Condition by Time interaction or Condition effect. However, a main effect for time across conditions emerged. Univariate tests revealed significant reductions from pre- to post-treatment assessment for full blown panic attacks, avoidance. fear of having a panic attack. panic cognitions, panic symptoms, depressive symptoms, and state anxiety. In addition, an exploratory 4 X 2 repeated measures ANOVA revealed a Condition by Time interaction with partiCipants in the BT and BT plus DML conditions increasing in coping self-efficacy from pre- to post-treatment. Partial correlations revealed that change in coping self-efficacy was related to lower scores on the Panic Attack Symptoms Questionnaire (PASQ) at post-treatment assessment for participants in the BT and BT plus DML conditions. The results of this study are discussed in terms of motivational issues and the effectiveness of such "pure" self-help interventions with individuals experiencing panic attacks.