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Objectives The purpose of this study was to systematically review the literature to describe the knowledge, attitude and practice of CAM by nurses. Methods Three databases were searched for relevant studies from launch through September of 2017 and included MEDLINE, Scopus and Web of science. Results The average knowledge of CAM therapies by nurses was 62.2% with attitude about use averaging 65.7%. Close to two-thirds (65.9%) reported use of CAM therapies with patients. The primary reasons nurses suggested use of CAM were for stress and anxiety reduction and health improvement. Conclusion Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data.

The advantages of using traditional closed-book examinations are closely compared to the advantages of using open-book examinations for the development of critical thinking skills in nursing students. The use of critical thinking skills is vital among nurses to assess patient needs and modify standard approaches to individualize care for better patient outcomes. The following areas are compared and contrasted for both closed-book and open-book examinations: examination preparation, rote memorization versus active learning, intellectual engagement, simulation of working environment, higher order thinking skills, anxiety reduction and student satisfaction. During investigation of closed-book examinations and open-book examinations, the use of collaborative testing was unveiled. Collaborative testing combines areas from both closed-book and open-book examinations. Based on the systematic review of literature, the recommendation is to use a mixed method of examination types throughout the course of the nursing program. Each type of examination helps develop different skill sets in the nursing student.

Researchers note the use of recorded music for anxiety reduction, but have rarely studied the effects of instrumentation. The investigator asked two questions: (a) Do string music, piano music, and marimba music each promote a reduction in anxiety, and (b) Is there a difference among these instrument types regarding their ability to facilitate anxiety reduction? Prior to giving a classroom presentation, university student participants ( N = 54) listened to a version of Bach Air from Orchestra Suite No. 3 in D. Major , BWV 1068, using strings, piano, or marimba. Results indicated a significant difference for anxiety reduction from pretest to posttest when all participants were included as one group, or when in their separate respective groups. Analysis indicated no significant difference among the three groups for anxiety reduction. This feasibility study therefore offers preliminary indications that particular types of percussion instrumentation may be as effective as other instrumentation for anxiety reduction.

Despite a wealth of knowledge on the importance of resource availability and reward processing for emotional regulation, surprisingly little is known about the extent to which these two mechanisms interact. Indeed, while research largely supports a positive association between reward processing and recovering from a negative emotional experience, the research does not make a clear prediction regarding the effect of resource availability on this relationship. In two experiments, we explored the extent to which resource availability impacts the efficacy of reward processing to reduce the aversive emotional experience of anxiety. We manipulated participants' mental resource availability, induced anxiety, and varied exposure to either a rewarding or non-rewarding stimulus. The findings consistently demonstrate an interaction between resource availability and reward processing; specifically, the combination of high resource availability and reward processing facilitated the greatest levels of anxiety reduction. Moreover, this interaction was shown to amplify with the intensity of participants' exposure to the reward stimulus. We discuss the practical contributions of these findings and their generative nature for further clarifying the processes underlying emotional regulation.

Although millions of cats live among humans worldwide the scientific community knows relatively little about cat behavior and cognition. Olfaction is an important perceptual sense for many members of Carnivora, however the role of chemical signals in cat social relationships is not fully understood. Research indicates chemical signals play an important role in many areas of cat behavior including mother-offspring and conspecific interactions and exploration of their environment. Chemical cues appear to play a role in stress and anxiety reduction, allowing cats to feel secure in their environment. A better understanding of cat chemical signals, especially as it relates to within and between species communication, may lead to an increase in cat wellbeing as humans can utilize this knowledge in applied settings. Therefore, the purpose of this review is to investigate how cats process and use chemical signals in social contexts and identify ways this information can be applied to address cat behavioral issues, such as inappropriate litter box and scratching behavior, and improve cat welfare, including species-appropriate ways of reinforcing the human-cat bond.

Introduction Music Care is a smartphone-based music intervention for pain and anxiety management that has previously been evaluated in large variety of patients with primary chronic painful conditions. The objective of this study was to evaluate the use of the app to reduce pain and anxiety in women attending an obstetrics before or during labor. Methods This observational study describes the first evaluation of the app in 62 women before or during labor in a department of obstetrics. Results Participants reported a significant reduction of pain intensity and anxiety after the use of the intervention, with small to moderate effect-size for pain reduction (ES 0.32) and large effect size for anxiety reduction (ES 0.76). Responder rates (> = 33% pre-post reduction of pain/anxiety) for ratings of pain intensity were at 31.6% (n = 19) and 50% for anxiety (n = 31). In general, participants rated high satisfaction with the intervention. Conclusion Overall, these data support the use of the Music Care app as adjuvant tool – in particular for the reduction of pain and anxiety in women in labor. More large-scaled and well-controlled studies are needed to further evaluate the effectiveness of this intervention.

Background Performance anxiety related to nursing simulation can potentially impede student learning. Method This study employed a randomized control group pretest–posttest design to examine the effect of music listening on anxiety, self-efficacy, and performance among baccalaureate nursing students undergoing simulation testing (N = 38; Mage = 23.05, standard deviation = 3.41). Results Heart rate, mean arterial pressure, and state-trait anxiety scores were significantly lower in the experimental group, F(3, 35) = 6.55, p = .02, η2 = 0.27, whereas instructor performance ratings were significantly higher than the control condition (p = .009). No differences were seen on self-efficacy scores (p = .37). Conclusions The intervention has the potential to reduce anxiety, improve performance, and facilitate learning in simulation testing experiences.

The study on drama and anxiety reduction was conducted with 24, 12 th grade students at a high school in Kozan, Turkey. The triangulation of the data was established with pre and post-tests, semi-structured pre and post-interviews, and student diaries. The teacher's reflections strengthened the qualitative aspect of the study. After six weeks of language and drama training, the drama techniques significantly lowered the speaking anxiety of EFL learners.

We hypothesized that initial cross-group friendships lead to a reduction of intergroup anxiety and increase self-confidence in communication which in turn increases positive attitudes towards contact and facilitates further contact. Our hypotheses were derived from the Anxiety and Uncertainty Management theory of communication (AUM; Gudykunst, 2005a ). This theory postulates that individuals are more likely to approach interpersonal communication with strangers when they are able to manage anxiety and uncertainty. In the present research, we considered intergroup anxiety and self-confidence in communication as mediators in this process. We tested the predicted model in a study with Spanish-speaking immigrants in Germany ( N = 216). Initial cross-group friendships were measured retrospectively. Furthermore, we assessed current intergroup anxiety, current self-confidence in communication, current attitudes toward cross-group contact, as well as current contact and current time spent with friends from the receiving society. The predicted model showed a good fit.

This study aimed to evaluate the effectiveness of massage with or without guided imagery in reducing anxiety prior to cardiac catheterization.A total of 55 inpatients and outpatients received massage, guided imagery, or massage with guided imagery prior to cardiac catheterization. Self-reported anxiety levels and blood pressure (BP) and heart rate (HR) were evaluated in participants and a matched comparison group.Massage with and without guided imagery resulted in significant reductions in self-reported anxiety (p 0.0001). Patients receiving intervention had lower diastolic BP and HR vs. the comparison group (p 0.0001 and p 0.05).Massage with or without guided imagery immediately reduced self-reported anxiety. This pilot study has certain limitations: a non-randomized, convenience sample and a matched control group that was created retrospectively. However, the study indicates a benefit to providing massage or massage with guided imagery prior to anxiety-inducing medical procedures such as cardiac catheterization.

Sixty-four primary school going boys of the Indian sub-continent in the age range of 9-12 years having high trait anxiety and attention-deficits, volunteered as the participants in this experiment. Half of them were recruited from residential academic institution in Bangladesh, while their counterparts were selected from identical residential academic institution in India. For the experiment proper, in both of the set-ups participants were categorised into two groups, viz. Gr. A (Control group, not exposed to any intervention program) and Gr. B (Experimental group, received Abbreviated version of Progressive Muscle Relaxation – (APMR training). Both groups were subjected to the pre-intervention assessment of attentive capacity, electrical muscle potentiality and different variables of skin conductance measure (as indices of heightened emotionality). Thereafter Gr. B boys were introduced to the training of APMR (monitored training of APMR for 15 min.s/day; three days/week) for a period of two months during the afternoon sessions under the guidance of a qualified and trained instructor. Post-intervention assessment and follow up assessment (after two months), on all the aforesaid variables however revealed that in both of the set-ups (in Bangladesh as well as in India) training and subsequent monitored long-term practice of APMR was found effective in reducing anxiety level and in developing better attentive capacity in the children of the both of the countries, who were exposed to the respective intervention. Improvement in frontalis muscle tension and in the basal skin conductance level along with higher autonomic habituation as an impact of long-term and regulated APMR training was suggested as facilitator of sustainable improvement in attentive capacity in the children.

Patients with Body Dysmorphic Disorder (BDD) may spend many hours in front of a mirror but little is known about the psychopathology or the factors that maintain the behaviour. A self-report mirror gazing questionnaire was used to elicit beliefs and behaviours in front of a mirror. Two groups were compared, which consisted of 55 controls and 52 BDD patients. Results: Prior to gazing, BDD patients are driven by the hope that they will look different; the desire to know exactly how they look; a belief that they will feel worse if they resist gazing and the desire to camouflage themselves. They were more likely to focus their attention on an internal impression or feeling (rather than their external reflection in the mirror) and on specific parts of their appearance. They were also more likely to practise showing the best face to pull in public or to use “mental cosmetic surgery” to change their body image than controls. BDD patients invariably felt worse after mirror gazing and were more likely to use ambiguous surfaces such as the backs of CDs or cutlery for a reflection. Conclusion: Mirror gazing in BDD consists of a series of complex safety behaviours. It does not follow a simple model of anxiety reduction that occurs in the compulsive checking of obsessive–compulsive disorder. The implications for treatment are discussed.  2001 Elsevier Science Ltd. All rights reserved.

Summary The aim of this paper is to discuss the mechanisms and magnitude of the placebo effect of treatment and to consider the ethical and moral implications of using placebo physiotherapy. Placebo or non-specific treatment effects were long considered to contribute a fixed fraction (one-third) to any treatment effect. Recent evidence has revealed this commonly held clinical belief to be erroneous. The placebo effect of any treatment is a highly variable and complex phenomenon that is influenced by a myriad factors. The outcome may be positive (eg analgesia) or negative (eg increased dependency on healthcare practitioners). Although the mechanisms of effect are not fully understood, evidence supports the influence of classical conditioning, anxiety reduction, and the expectations of both patients and practitioners. The relationship between patients and practitioners influences the magnitude of placebo effects as does the method of treatment presentation. A charismatic or caring practitioner can evoke analgesia with or without further treatment. And treatment presented with an air of ‘mystery‘, apparent sophistication, or positive expectation can evoke analgesia simply through the method of its presentation. Questions regarding the ethical use of treatments that are primarily placebo need to be addressed. When and under what conditions are placebo treatments acceptable in the short or long term? Is it a benevolent lie, or a regular lie, to use treatments that have only placebo effects? And, perhaps more importantly, do we know what those treatments are?

Some aromatherapists suggest that geranium oil is useful for reducing anxiety but do not recommend the use of rosemary oil. To examine these assertions, using a standard psychological instrument for measuring anxiety, three groups of twelve undergraduates filled out the Spielberger State-Anxiety Inventory (STAI) and then inhaled either just steam, steam plus geranium oil, or steam with rosemary oil added. After inhalation volunteers filled out the STAI again immediately and a third time one hour later. Analysis revealed no difference between the groups in either state or trait anxiety scores before inhalation. In the steam only condition STAI scores did not change across the session. However a significant and this reduction was maintained across the session. It is likely that volunteers' expectations coloured the way they responded in the study but it is argued that anxiolyic effects are demonstrated in addition to those effects associated with conforming to the experimental situation. With geranium oil inhalation both state and trait scores were significantly lowered across the session. The reduction in reported anxiety is probably only of sufficient magnitude (18%) to be clinically important for state anxiety following geranium oil inhalation.

Illness and associated hospitalisation are stressful events for any individual. The stress associated with an admission to a coronary care unit may be related to the severity and acuteness of the illness, the effects of hospitalisation on the individual, their family, their job and financial position, and often manifests itself as anxiety, fear or depression. This paper highlights the use of anxiety reduction strategies such as muscle relaxation, music, education and counselling. The literature reviewed does not provide any clear messages regarding the effectiveness of these strategies in the coronary care unit setting. As a consequence, there is a need to continue researching this important area of nursing practice.

This study investigated the effects of a peer-modeling film on anxiety reduction and skill acquisition in children learning to self-inject insulin. Twenty-eight insulin-dependent children, aged 6–9 years and attending a summer camp for youngsters with diabetes, were randomly assigned to view a peer-modeling film of children learning self-injection or another film addressing nutrition. Immediately after viewing the film, the children were taught to self-inject insulin. Physiological, self-report, and observational measures were obtained at several points during the experiment and at a follow-up, 4 days later. There was little evidence indicating that the children were anxious, preventing assessment of the film's utility in anxiety reduction. On the other hand, the oldest girls viewing the peer-modeling film showed greater skill in self-injection than their counterparts viewing the nutrition film. The importance of age, sex, and previous experience as variables potentially affecting a modeling film's utility was discussed.

Twenty-eight agoraphobic women were randomly allocated to one of two treatments: programmed practice in entering feared situations or a treatment aimed at anxiety reduction by resolving life problems. Each treatment was conducted by one of two therapists and both were carried out at the patient's home, involved the spouse, and used the same structured format of delivery. Behavioral changes were assessed by the patient, spouse, and an independent psychiatrist. Assessments were made before and after treatment and 3 and 6 months later. Results replicated the findings of a previous study and showed the superiority of programmed practice over the problem solving treatment. However, changes in the latter were unexpectedly large, and one therapist obtained results comparable to these which both therapists obtained with programmed practice. This finding does not support the hypothesis that systematic practice in entering the feared situations is essential for the treatment of agoraphobia.

Thirty-four endodontic patients completed dental anxiety questionnaires and had saliva samples taken prior to and at the conclusion of their initial endodontic treatment. Pain and anxiety were managed with local anesthesia, nitrous oxide--oxygen psychosedation, hypnosis, and meditation, either alone or in combination. For most patients, by the conclusion of the treatment, anxiety had decreased, salivary volume had increased, and salivary protein was reduced. Meditation and hypnosis, either alone or in combination with local anesthesia, were most effective in anxiety reduction as measured by questionnaire and/or salivary changes.

Meditation is increasingly being practiced as a therapeutic technique. The effects of practice on psychometrically assessed anxiety levels have been extensively researched. Prospective meditators tend to report above average levels of anxiety. In general, high anxiety levels predict a subsequent low frequency of practice. However, the evidence suggests that those who practice regularly tend to show significant decreases in anxiety. Meditation does not appear to be more effective than comparative interventions in reducing anxiety. There is evidence to suggest that hypnotizability and expectancy may both play a role in reported anxiety decrements. Certain individuals, with a capacity to engage in autonomous self-absorbed relaxation, may benefit most from meditation.

Pigeons were intermittently given grain reinforcement for key pecks. Occasional 30-sec keylight changes (warning stimulus) were followed by a brief electric shock, which suppressed responding during the warning stimuli. This suppression was reduced by diazepam and ethanol, yet combinations of the two drugs did not reduce suppression (antagonistic effect). Each drug reduced responding in the absence of the warning stimulus, and combinations of the drug produced still greater reductions in this safe-period responding (synergistic effect).

College students were shown anxiety provoking slides before and after systematic desensitization or placebo treatment (high-expectation-for-improvement) or no treatment. Both self-report and physiological dependent measures were taken. The self-report measure showed the desensitization and placebo treatments to have produced significant and similar decreases in anxiety. The physiological measures showed that where group differences were found, desensitization was superior to placebo treatment and no treatment. The discussion highlights one of the major problems in interpreting the expectancy literature; namely, the inadequacy of relative dependent measures for assessing the impact of expectancy manipulations.

The present study compared the value of various criteria for determining exposure duration to phobic stimuli in flooding therapy. Results indicated that basing exposure termination on a return to resting ranges of HR was not effective in increasing approach behavior, whereas basing termination on observer's judgements was quite effective. Employing self-reported anxiety reduction as the termination criterion was no more effective than using either the HR criterion or a procedure that combined all three criteria (HR, self-report, and observer's judgements). Self-reported fear data showed similar trends with the HR criterion again failing to produce any greater benefits than control procedures. Nine-weeks follow-up indicated a persistence of the behavioral changes with some loss of the gains in subjective anxiety, and a reduction in the differences between groups.

This study examined the efficacy of cue-controlled relaxation, taught in three 2-hour workshops, in reducing the anxiety of two elementary school teachers. Anxiety was measured using direct observation of external behavior and self-report of internal states; and the effects of anxiety reduction on selected teaching behaviors were also examined. Following training, both teachers exhibited significant reductions in motoric manifestations of anxiety and in some self-reported internal states. Both teachers showed significant increases in rewarding behavior, and they reduced disapproving behavior to zero on most days. Even though results were not maintained following the treatment program, this study demonstrated that training in the self-management of stress and tension can significantly affect the anxiety and teaching behaviors of teachers.

This experiment was designed to study generalization of systematic desensitization across stimulus dimensions of a complex stimulus. Subjects were conditioned by electric shock to a “two-dimensional” stimulus. Subjects in one group were desensitized on one dimensional hierarchy, while subjects in another group were desensitized on the other dimensional hierarchy. Densitized to one dimension, groups generalized verbal reports of anxiety reduction (cognitive system) to the other dimension. Physiologically, subjects desensitized only to the dimension on which they were treated; they did not generalize to the untreated dimension. Reaction time (motor system) data were not influenced by treatment. It was concluded that verbal reports and physiological responses in systematic desensitization may not reflect the same process. In systematic desensitization, separate response systems may need to be altered before treatment can be considered successful.

An issue of major concern in the behavioral treatment of posttraumatic stress disorders (PTSD) is the extent to which the extinction of anxiety to the memory of one event generalizes to other traumatic events that the individual may have experienced. In the present study each of two Vietnam veterans presented multiple traumatic events from combat which reoccurred in the form of intrusive thoughts, nightmares, and flashbacks. Using imaginal flooding as the treatment, it was possible to document the effect of treating the memory of one traumatic event upon the anxiety-provoking nature of the remaining traumas. For the first patient, subjective units of distress measures (SUDS) verified treatment efficacy and provided some evidence for generalization of extinction along thematic (stimulus) cues. With the second patient, physiological data in conjunction with SUDS ratings documented the relative independence of the anxiety associated with different traumatic events.

The major purposes of this quasi-experimental study were to describe the differences between pre-myelogram anxiety levels in patients who received pre-test information and those who received no preparatory information, to examine differences in post-teaching anxiety level between patients who received “sensory information” and those who received “procedural information,” to measure the degree to which patients' expectations were congruent with their actual myelogram experience, and to determine the relationship between the teaching protocols and the incidence of post-myelogram side effects. Thirty patients were randomly assigned to one of three information conditions; sensory, procedural or no information. The intervention consisted of a 5-min tape recorded message of either procedural or sensory information. Patients who received procedural information reported less anxiety than patients who received no information or sensory information. Congruence between expected and actual sensations experienced was not found. Subjects exposed to sensory information reported significantly greater number of side effects than subjects in the control or procedural groups.

This study relates perceived dentist behaviors to anxiety reduction in patients during treatment, and to satisfaction with the dental visit. The sample consisted of 250 adult patients, 110 men and 140 women, at two outpatient hospital dental clinics. Immediately after treatment, patients were asked to respond to a list of 25 dentist behaviors thought to be associated with positive dentist-patient interaction. Criterion measures obtained by patients were self-ratings of anxiety during treatment and satisfaction measures from the DVSS. Ten behaviors were significantly associated with anxiety reduction. A stepwise multiple regression analysis with anxiety reduction as the dependent variable indicated that to the patient, the dentist's explicit dedication to prevent pain was the most important dentist behavior, with friendliness, working quickly, being calm, and giving moral support, being important auxiliary behaviors. Most of the 25 dentist behaviors studied were associated with patient satisfaction. A stepwise multiple regression analysis indicated that the dentist's empathy and communicativeness were among important correlates of patient satisfaction. An experimental approach to causal analysis of anxiety reducing behaviors needs to be studied.

Fear of weight gain, binging, and self-induced vomiting are the salient features of bulimia nervosa in normal weight individuals. An exposure plus vomiting response prevention procedure was evaluated in a multiple baseline design across three classes of food stimuli for a patient suffering from chronic bulimia nervosa. Amount of food consumed without vomiting increased and subjective discomfort after eating decreased when exposure plus response prevention treatment was sequentially applied to each class of food. Complete cessation of vomiting and binging and minimal discomfort were subsequently achieved during a postexperimental response prevention phase. Treatment effects were maintained at 10-month follow-up. The results suggest that binging in bulimia nervosa is more a consequence of vomiting than vomiting is a consequence of binging. They also support the hypothesis that vomiting in bulimia nervosa is an escape-avoidance response reinforced by anxiety reduction, similar in function to compulsive hand washing and checking rituals in obsessive-compulsive neuroses.

A controlled study of systematic desensitisation and social skills training was carried out on a sample of socially inadequate psychiatric patients. The results showed that both treatments led to significant improvements in the patients' social lives, which, in the case of social skills training were maintained at 6 months follow-up. Neither treatment, however, led to significantly greater anxiety reduction, improvements in social skills or clinical adjustment than the untreated control. Systematic desensitisation ran into a number of procedural difficulties and there was a substantial drop-out rate during treatment. Both treatments are discussed in the light of these mixed results and suggestions made for further research in this area.

Staats' three-function learning theory provides the basis for investigating the effects of emotionally-relevant self-verbalizations (SV) on the physiological, subjective-affective and behavioural aspects of anxiety. Using aversive electric UCSs and slides of snakes (CS), anxiety was classically conditioned in 88 volunteer S s. In 20 subsequent language-conditioning trials (without aversive electric UCSs), the same snakes slides were paired with UCS verbalizations having either positive or negative connotative meanings. Half of the Ss were exposed to a living snake prior to language conditioning. The results show a complete extinction of the conditioned anxiety response in groups with positive SV whereas negative SV impeded extinction; the latter effect could only be found in groups without exposure to snakes prior to language conditioning. In general, the affective evaluation of snakes improved in groups with positive SV and deteriorated in groups with negative SV. However, these effects were more pronounced in groups without exposure to snakes. Although the results indicate that S s in all groups with positive SV exhibited more approach behaviours than S s with negative SV, this trend was not statistically significant. The possible relevance of the results for a language-conditioning approach to anxiety reduction is briefly discussed.

The length of a social isolation experience was varied in order to determine its effect on the need for social reinforcement. The results indicate that increases in the length of time deprived (left alone in an unfamiliar room) do not result in monotonic increases in the need for social reinforcement. A 2-choice probability problem was used to determine the effectiveness of E's social approval. The results indicate a parabolic relationship with relatively short and long periods of deprivation producing the greatest need. Sex and intelligence differences were also obtained. The significance of these results in terms of a theory of anxiety reduction, reinforcement effectiveness, and binary choice behavior is discussed.

An experiment was carried out on 12 patients complaining of obsessional checking rituals in order to determine whether: (a) the execution of potentially ‘harmful’ acts produces discomfort and (b) whether the act of checking produces relief. With some exceptions and reservations, it was concluded that execution of the act does produce discomfort and completing a check does bring relief. The results are seen as providing some support for theories which depend on the concept of anxiety reduction/avoidance.

The treatment of a case of impotence related to homosexual orientation is described. In addition to the usual anxiety reduction procedures an arousal reconditioning procedure was employed. The latter consisted of introducing heterosexual stimuli at chosen times in the arousal induced by homosexual fantasies during masturbation and also during heterosexual activity. The homosexual arousal was later phased out of the treatment.

The authors were unable to discover reports in the literature that established a clear and ambiguous relationship between anxiety reduction and improvement in stuttering. Furthermore, they were unsatisfied that therapies in which the intended treatment agent is anxiety reduction may actually produce their effect by this means. They report a programme of treatment using feedback modification techniques in which, despite a substantial decline in stuttering, there was no decline in measures of general and state anxiety.

This study dealt with: (A) the effectiveness of automated desensitization with minimal therapist-patient interaction, (B) the effects of therapist-patient sex differences on treatment outcome, and (C) the generalization of anxiety reduction to objects and/or situations not directly treated by the automated desensitization procedure. Sixteen male and female snake-anxious college students were selected for treatment on the basis of a modified Fear Survey Schedule and behavioral avoidance tests to a snake and spider. Four treatment groups were used in order to balance for therapist-client sex differences. Four additional groups, balanced for sex differences, who received the same number of self-rating and behavioral avoidance tests but no desensitization served as controls. Desensitization was conducted using a modified Stenorette dictating machine, timers, and a series of standardized tapes which dealt with various aspects of the desensitization procedure. Each treatment S received two sessions of relaxation training, two sessions of visualization training, and five sessions of automated desensitization in order to complete and partially review a standardized, 16 item snake hierarchy. After each hierarchy item was presented for visualization, the S pressed one of four buttons corresponding to different levels of anxiety. The equipment was programmed to move forward to the next item or return to relaxation instructions depending on the S 's button response. There was no personal interaction between the E and S once therapy began. Dependent measures were obtained prior to treatment, after treatment, and four weeks following treatment. Results indicated that automated desensitization was effective in significantly reducing anxiety toward the target behavior, snakes. Sex differences between therapist and client were not a critical factor in treatment outcome. Evidence for generalized anxiety reduction following automated desensitization was less conclusive due to changes that occurred in both experimental and control groups. It was concluded that automated desensitization can be a useful and time-saving psychotherapeutic approach; however, there are certain considerations (e.g. initial instructions, S s control of visualization and relaxation, amount of relaxation practice, etc.) which should be taken into account.

Persons threatened by electric shock want to be with similarly threatened people. Schachter concluded that this was due to the subjects' desire for anxiety-reduction and for evaluation of their emotions by comparison with others. Seventy-eight female subjects were run in an experiment that sought to determine the relative strengths of the anxiety-reduction needs and emotional evaluation needs of a threatened subject. Each subject was given information about the initial emotional reactions of two other subjects (actually confederates of the experimenter) and then allowed to choose which of these other persons she wished to be with. The subject reported her initial fear reaction, then one of the confederates reported being slightly more afraid than the subject, while the other confederate reported being considerably calmer. High-Fear subjects chose to wait with the slightly more nervous confederate significantly more than did the Low-Fear control group (p < .01), indicating that emotional comparison was the relatively more important determinant of affiliation choice. An additional group of subjects heard the high-fear instructions and then received some information that could be interpreted as uncertainty producing. These subjects chose to wait alone or with the calmer confederate more than even the Low-Fear group (p < .05). This may indicate that, when subjects have the possibility of minimizing a fear provoking threat, they will make affiliation choices which will enable them to do so rather than choices dictated by needs for social comparison.

Changes in test anxiety in college students were compared among three groups: (1) those who received group-administered systematic desensitization, (2) those who received group insight therapy, and (3) a no-treatment control group. The measures of test anxiety included a questionnaire, course test grades, and performance on a laboratory reading test. There was no difference in anxiety reduction among the groups, despite the fact that all the systematic desensitization subjects completed their stimulus hierarchiest at least twice. Also, there was no significant change of any group on any of the measures.