The Treatment of Anxiety in the Physically Disabled by Three Different Variations of Systematic Desensitization

Systematic desensitization has become a major technique for the direct removal of maladaptive anxiety. The basic method consists of pairing progressive muscle relaxation with the imagination of anxiety producing scenes. The scenes are arranged in a hierarchy with those scenes at the top eliciting little or no anxiety and those scenes at the bottom eliciting a great deal of anxiety. It has been hypothesized that the process of progressive muscle relaxation inhibits the development of anxiety in the presence of anxiety evoking stimuli and weakens the bond between those stimuli and the anxiety. Recently, several investigators have, suggested that any procedure which lowers physiological arousal level can be as effective as progressive muscle relaxation when used in systematic desensitization. One purpose of this experiment was to test the hypothesis that suggestions to relax and imagine tranquil scenes (mental relaxation) will be as effective as progressive muscle relaxation when used in the systematic desensitization. A second purpose of this study was to determine if systematic desensitization can be used to ameliorate the anxieties of the physically disabled. A physically disabled person has to face many stressful and anxiety arousing situations. If proven effective, desensitization could be a useful tool in helping the disabled overcome their fears and anxieties. The subjects in this experiment were thirty-six disabled inpatients at the University of North Dakota Rehabilitation Hospital. Each subject was randomly assigned to one of four treatment conditions: (1) desensitization with progressive muscle relaxation, (2) desensitization \?ith mental relaxation, (3) desensitization with no relaxation, and (4) a no-treatment control group. The therapists were five advanced students at the University of North Dakota. Each subject had a different fear or worry. The target fear was selected through the subject’s responses to a seventeen item questionnaire which consisted of situations which commonly arouse anxiety in the disabled. A pre and posttest physiological measure of change in situational anxiety was employed as was a pre and posttest self-report measure of change in general and situational anxiety, hostility, and depression. The total number of scenes successfully desensitized was also used as a measure of treatment effectiveness. Finally, the self- report measure of general and situational anxiety, hostility, and depression was again given to each subject six weeks after the termination of treatment in order to determine if the treatment effect was a lasting one. At posttest time, only treatment by desensitization with progressive muscle relaxation had significantly reduced situational anxiety and hostility. None of the treatments had effectively reduced situational hostility or general anxiety, hostility, and depression at posttest time. The positive results of desensitization with muscle relaxation were not sustained at the six week follow-up time, indicating that the treatment effect was not lasting. Thus, the results of this experiment did not conclusively substantiate the hypothesis that systematic desensitization could be used to effectively treat the anxieties of the disabled. The results did not support the utility of desensitization with mental relaxation as an effective treatment for maladaptive anxiety