study of relative efficacy of three … of relative efficacy of three behavioral therapeutic...

STUDY OF RELATIVE EFFICACY OF THREE BEHAVIORAL THERAPEUTIC TECHNIQUES IN ANXIETY,

PHOBIA & DISSOCIATIVE DISORDER* Vandana Patel

Babu Banarasi Das National Institute of Technology & Management, Luclnow, Uttar Pradesh, India

The wo d " y y was referred to the study of r Ps cholog " the mind. Currently, it is defined as a science that studie the beha iour of man s v and other living beings T e word eha iour refer t the acti ities . h b v s o vo the at can either be o served bf borganism th y anoth r e b a tud of such activities by e p rson or y s y usin certain instrument r to lg s o o s. Man is essentially s s syc o ogy a living organi m P h l i. prim il once ned with the pon e of these ar y c r s s resorganism t the r ut id wo lds o o s e ri .

The Field of PsychologyPsychology is interested in understanding the behaviour of people in different situations and contexts l and also in applying the genera. psychology principle in differ ne t fields of human life. The different fields of psychology are: Clinical Psychology , Counseling Psychology ,Community Psychology, Developmental Psychology, Experi-mental Psychology, Educational Psychology ,Industrial Psychology, Psychometric Psychology

,Health Psychology, Social Psychology, Environ-mental Psychology, Organizational Psychology

The Problem of Classification Classification has been carried out i different n ways o a e av o rf abnorm l b h i u In 1952 the APA . (American Psychiatric Association) adopted a classification of mental disorders that wa ba d s selargel n sch m ky o a e e wor ed out by the United States Army during World War II. In 1968 the APA adopted a modified classification worked out in the World Health Organization. This international classification permits mental health workers o tcompare incidence, types of disorders, treatment procedures and other elevant data concerning rmental disorders throughout the world.

Current Classification of Mental Disorders Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition) DSM IV is devised by the American Psychiatric Association. There also

*Address for correspondence : Dr. Vandana Patel, Associate Professor, Babu Banarasi Das National Institute of Technology & Management, Luclnow, Uttar Pradesh, India,

Email ID : [email protected]

ABSTRACT

On t e b sis of t e esu t of pplication of p chological t eatm nt tech iq e t ay c c e th t h a h r l the a n u s i m on lud d asy r e , P R n n thM in combination with stematic dese sitizatio is e most effective techniqu for th tr atm nt of sy e e e ephobia. PMR in combination with CBT is the most effective technique of dissociative reactions. Anxiety can effectively be treated by PMR in combination with CBT or systematic desensitization. During the present study, the phobic patients were treated by PMR and systematic desensit zat recovered i ion werein 15 days. The pat ents of dissociative disorders were treated with PMR and BT t 0 the apeutic i C ook 2 rda s to recover completel It took 30 sess on fo the reco er of an iet and di at act on y y. i s r v y x y ssoci ive re ipatients treated with PMR Phobic pat ent h s o co e ed the a The phobic . i a n t re v r by tre tment of only PMR. patien s were treated P R d reco er e pat en o d soc att with M an CBT took 30 sessi n to v Th i ts f is i ive o s . reactions were treated b PMR nd s te t i w re i v i 30 sessions T e xi y y a ys ma ic desensitizat on ere l e ed n h an et. p d d eatients were treate with the combinati n f PMR d systematic es nsitization or PMR and CBT o o antook 15 session t recover of their dis r rs ut ook 25 sessions when e ted with nl PMRs o r a o y . o de b t tKeywords: Disorder; Phobia; Anxiety

INTRODUCTION

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International Journal of Scientific and Innovative Research 2017; 5(1) : 103‐106P‐ISSN 2347‐2189, E‐ ISSN 2347‐4971

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Organization) lCD-10 which covers all diseases , and both physical and mental AP A and disorders, . exists a worldwide classification system, called the

thinternational classification of Diseases 9 Edition , (World Health WHO ha e worked closely over the vyears to ensure compatibility between their two-classification systems. The mental disorders were classified in 10 categories or Axes: Mental Retardation, Organic Brain Syndromes, Psychoses ,Neuroses, Personality Disorders and Certain Other Nonpsychotic Mental Disorders , Psychophy-siological Disorders ,Special Symptoms ,Transient Sit ational Disturbances, Behaviour Disorders of uChildhood a d n Conditions without Manifest Psychiatric Disorder and Nonspecific Conditions

Personality Personality has been regarded as a practical force in determin n succe r ure in life. i g ss o ailf The importance of personality increases as social life becomes more omplex A 'pleasing' personality in c . a complex society simple cultures here the scale , , wof social relations is low and beha iou is regulated v r b old- age customs, personality is of less concern.y Personality Disorders The behavior which is maladaptive and which causes significant ha to the ndividual is called rm ipersonality disorders Personality disorders are . described as Antisocial Personality, Paranoid Personality, Dependent Personality, Hystrionic Personality, Schizoid Personality, Obsessional Personality

Classification of Anxiety is e s D ord r

Anxiety Disorders Classify In ICD10 Anxiety Disorders Classify In DSM IV

(A) Phobic Anxiety Disorders (i) Agoraphobia

Without panic disorder With panic disorder

(ii) Social phobia (iii) Specific phobia (B) Other Anxiety Disorders Panic disorders (i) Generalized anxiety disorders (ii) Mixed anxiety and depressive disorders

(i) Agoraphobia Without a history of panic Disorder (ii) Social phobia (iii) Specific phobia (i) Panic disorders without agoraphobia (ii) Generalized anxiety disorders

Research Design The presen applies the psychological t studyintervention techniques for the treatment of cases of anxiety, phobia and dissociative reactions. It is a qualitative and utility research. Since the research is concerned with the treatment of psychological problems and thus improving their ability to adjust in the society and family make it a qualitative research.

Sample The study is related to three neurotic disorders viz., Anxiety, Phobia and Dissociative disorders In . each disorder, there were 10 patients The sample . of the study has been selected from the Department of Ps chiatry King George's Medical University, y , Lucknow, Uttar Pradesh, India and various psychological Uttar Pradesh, cl ni ics in ucknow , LIndia.

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Characteristics of Patients Anxiety Phobia

Dissociative

Disorder

No. of Male 8 7 4

Patients Female 2 3 6

Age range (Yrs.) 30-40 30-40 30-40

Educational standard Graduation Graduation Graduation

Income 10,000 10,000 10,000

Duration of illness (Y rs.) 1-2 1-2 1-2

A s f 30 patient o which 10 were in each ample o s f categor f disorder anxiety, i nd y o phob a ad ssociative reactions were selected for the present istudy. Their age range was 30 40 years their - , educational standard was graduation and their monthly income was Rs.10 000 (INR).,

Therapeutic Techniques Applied The study is related to three neurotic disorders Anxiety, Phobia and Dissociative Disorder There . are 10 patients in each disorder The patients were . characterized by the c1inicians in different categories of psychological problems. Thereafter the following treatment techniques were applied in different combinations (1) Cognitive Behavior : Therapy (2) Systematic Desensitization (3) Jacobson's Progressive Muscular Relaxation Technique

Procedure Patients in each group were put in three sub groups.

First subgroup was treated by only progressive relaxation for two weeks. The second subgroup of patients was treated by progressive muscular r e l a x a t i o n c o m b i n e d w i t h s y s t e m a t i c desensitization The third subgroup was . treated by the combination o progressive muscular f relaxation and cogn t ve behavior therapy. In first i iand second subgroup, there were three patients in each while in third subgroup there were four patients The therapeut c procedures were applied . ieveryday in the morning for an hour individually to each patient for a period of 30 days The . effectiveness of the treatment was assessed by the clinical interview.

Applications of Techniques and Results The therapeutic procedures described in proceeding chapter were used for the treatment of patients of different disorders anxiety, phobia and , dissociative disorder The number of patients . treated by the techniques were as follows:

Table 2 : No. of patients treated by different treatment techniques

Number of Patients

Treatment Techniques Anxiety Phobia Dissociative Disorders

PMR 3 3 3

PMR + Systematic Desensitization 3 3 3

PMR + CBT 4 4 4

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P e treatment fe t res of nxietyr a u A-1. Whole body burn2. Dry mouth3. Frequent loose motions4. Prickling sensation5. Difficulty in inhaling6. Feeling of discomfort over the heart7. Awareness of missed beats8. Poor concentration9. Menstrual discomfort10. Urine frequency

Pre-treatment features of Phobia1. Tension2. Headache3. Back pains4. Stomac up etsh s5. Dizz spelly s6. Fear of cracking7. Feelings of unreality8. Difficult in makin deciy g sions

Pre-treatment features of Dissociative disorders:

1 . Repetitive thought 2. Loss of vision, hearing or smel1 3. Inability to recall 4. Unable to remember important aspects 5. Patient feel two or more dist inct

personalities 6. Repetition of speech 7. Partial or complete loss of any or all of the

normal utaneous sensations over part or call of the body (Specify touch pinprink, , vibration, heat and cold)

8. Amnesia (Forget fullness) 9. Loss of the usual sense of personal identity

Eva ua n of ea e t l tio Tr tm nAfter 30 days of treatment or at a point where the patient reported that he/she has no prob em and they lhave fully reco ered and e aluati e session was v v vdevoted to assess the effect of treatment in which the patient under o clinical inter iew in order to know s g vwhether the ha e an problem or noty v y .

F ll w p o o -UF w up after six month for each patie t was ollo - ncarr ed out in which the were interviewed to know i y if they had any problem in this period of is x months

but it was found that there were no specific problem related to their disorder.

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treatment of a case of hysterical aphonia in a thirteen-year-old girl . .J. Speech Hearing Dis., 1949, 14,312-317.

2. Barber, T. X. & Calverley, D.S. Experimental studies of "hypnotic" behavior: suggested deafness eva1uated b., de1ayed auditory feedback. Brit. J. Psychol ., 1964, 55, 439- 446

3. Harber, T.X.& Deeley, D.C. Experimental evidence for a theory of "Hypnotic color blindness" without Hypnosis”. Internet J.Clin.Exp. Hypnosis, 1961,9,79-86

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