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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Fear of mice may be treated by any standard treatment for specific phobias. The standard treatment of animal phobia is systematic desensitization, and this can be done in the consulting room (in vivo), or in hypnosis (in vitro). Some clinicians use a combination of both in vivo and in vitro desensitization during treatment. It is also helpful to encourage patients to experience some positive associations with mice: thus, the feared stimulus is paired with the positive rather than being continuously reinforced by the negative.
The fear of spiders can be treated by any of the general techniques suggested for specific phobias. The first line of treatment is systematic desensitization – also known as exposure therapy – which was first described by South African psychiatrist Joseph Wolpe. Before engaging in systematic desensitization it is common to train the individual with arachnophobia in relaxation techniques, which will help keep the patient calm. Systematic desensitization can be done in vivo (with live spiders) or by getting the individual to imagine situations involving spiders, then modelling interaction with spiders for the person affected and eventually interacting with real spiders. This technique can be effective in just one session.
Recent advances in technology have enabled the use of virtual or augmented reality spiders for use in therapy. These techniques have proven to be effective.
Radiation, most commonly in the form of X-rays, is used frequently in society in order to produce positive outcomes. The primary use of radiation in healthcare is in the use of radiography for radiographic examination or procedure, and in the use of radiotherapy in the treatment of cancerous conditions. Radiophobia can be a fear which patients experience before and after either of these procedures, it is therefore the responsibility of the healthcare professional at the time, often a Radiographer or Radiation Therapist, to reassure the patients about the stochastic and deterministic effects of radiation on human physiology. Advising patients and other irradiated persons of the various radiation protection measures that are enforced, including the use of lead-rubber aprons, dosimetry and Automatic Exposure Control (AEC) is a common method of informing and reassuring radiophobia sufferers.
Similarly, in industrial radiography there is the possibility of persons to experience radiophobia when radiophobia sufferers are near industrial radiographic equipment.
This method was developed in 1979 by interpreting the files of patients diagnosed with claustrophobia and by reading various scientific articles about the diagnosis of the disorder. Once an initial scale was developed, it was tested and sharpened by several experts in the field. Today, it consists of 20 questions that determine anxiety levels and desire to avoid certain situations. Several studies have proved this scale to be effective in claustrophobia diagnosis.
This method was developed by Rachman and Taylor, two experts in the field, in 1993. This method is effective in distinguishing symptoms stemming from fear of suffocation and fear of restriction. In 2001, it was modified from 36 to 24 items by another group of field experts. This study has also been proven very effective by various studies.
As with most phobias this fear could be cured with therapy. Relaxation techniques or support groups could also be effective.
The most common methods for the treatment of specific phobias are systematic desensitization and in vivo or exposure therapy.
Like many other phobias, lilapsophobia can often be treated using cognitive-behavioral therapy, but if it stems from post-traumatic stress disorder, then alternative therapy may be more recommended.
Fear of bats, sometimes called chiroptophobia (from the Greek χείρ - "cheir", "hand" and πτερόν - "pteron", "wing" referring to the order of the bats, and φόβος - "phobos", meaning "fear"), is a specific phobia associated with bats and to common negative stereotypes and fear of bats.
Like astraphobia, lilapsophobia is a common fear for children, although less common. Because children are just learning to distinguish between fantasy and reality, major storm broadcasts on television or discussion by parents can cause fear that the storm is coming with a tornadic potential or a hurricane.
Because fear is a part of normal child development, this phobia is not diagnosed unless if persisted for more than six months. Parents should conquer the child's fear by telling them how rare the major storms that hit hometown area are.
Anxiety around mirrors and at all costs staying away from mirrors
The fear of flying may be created by various other phobias and fears:
- Fear of crashing, which in rare cases will cause death, is the most common reason for the fear of flying.
- Fear of closed in spaces (claustrophobia), such as that of an aircraft cabin
- Fear of heights (hypsophobia)
- Feeling of not being in control
- Fear of vomiting, where a person will be afraid that they'll have motion sickness on board, or encounter someone having motion sickness and have no control over it (such as escaping it)
- Fear of having panic attacks in certain places, where escape would be difficult and/or embarrassing (agoraphobia)
- Fear of hijacking or terrorism
As is common with specific phobias, an occasional fright may give rise to abnormal anxiety that requires treatment. An abnormal fear of bats may be treated by any standard treatment for specific phobias. Due to the fact that the fear is not life altering, it can usually just be left untreated.
Fear of needles, especially in its more severe forms, is often comorbid with other phobias and psychological ailments; for example, iatrophobia, or an irrational fear of doctors, is often seen in needle phobic patients.
A needle phobic patient does not need to physically be in a doctor's office to experience panic attacks or anxiety brought on by needle phobia. There are many triggers in the outside world that can bring on an attack through association. Some of these are blood, injuries, the sight of the needle physically or on a screen, paper pins, examination rooms, hospitals, white lab coats, hospital gowns, doctors, dentists, nurses, the antiseptic smell associated with offices and hospitals, the sight of a person who physically resembles the patient's regular health care provider, or even reading about the fear.
Fear of being buried alive is the fear of being placed in a grave while still alive as a result of being incorrectly pronounced dead. The abnormal, psychopathological version of this fear is referred to as taphophobia (from Greek τάφος - "taphos", "grave, tomb" and φόβος - "phobos", "fear"), which is translated as "fear of graves".
Before the advent of modern medicine, the fear was not entirely irrational. Throughout history, there have been numerous cases of people being buried alive by accident. In 1905, the English reformer William Tebb collected accounts of premature burial. He found 219 cases of near live burial, 149 actual live burials, 10 cases of live dissection and 2 cases of awakening while being embalmed.
The 18th century had seen the development of mouth-to-mouth resuscitation and crude defibrillation techniques to revive persons considered dead, and the Royal Humane Society had been formed as the Society for the Recovery of Persons Apparently Drowned. In 1896, an American funeral director, T. M. Montgomery, reported that "nearly 2% of those exhumed were no doubt victims of suspended animation", although folklorist Paul Barber has argued that the incidence of burial alive has been overestimated, and that the normal effects of decomposition are mistaken for signs of life.
There have been many urban legends of people being accidentally buried alive. Legends included elements such as someone entering into the state of sopor or coma, only to wake up years later and die a horrible death. Other legends tell of coffins opened to find a corpse with a long beard or corpses with the hands raised and palms turned upward. Of note is a legend about the premature burial of Ann Hill Carter Lee, the wife of Henry Lee III. On his deathbed in 1799, George Washington made his attendants promise not to bury him for two days.
Literature found fertile ground in exploring the natural fear of being buried alive. One of Edgar Allan Poe's horror stories, "The Premature Burial", is about a person suffering from taphophobia. Other Poe stories about premature burial are "The Fall of the House of Usher" and "The Cask of Amontillado"—and to a lesser extent, “The Black Cat”.
Fear of being buried alive was elaborated to the extent that those who could afford it would make all sorts of arrangements for the construction of a safety coffin to ensure this would be avoided (e.g., glass lids for observation, ropes to bells for signaling, and breathing pipes for survival until rescued).
An urban legend states that the sayings "Saved by the bell" and "Dead ringer" are both derived from the notion of having a rope attached to a bell outside the coffin that could alert people that the recently buried person is not yet deceased; these theories have been proven a hoax.
Fear of fish or ichthyophobia ranges from cultural phenomena such as fear of eating fish, fear of touching raw fish, or fear of dead fish, up to irrational fear (specific phobia). Galeophobia is the fear specifically of sharks.
Fear of surgery or other invasive medical procedure may be known as tomophobia. Fear of surgery is not a fear experienced often, but is still just as harmful as those that are more common. Since surgery is not a common occurrence, the fear is more based on inexperience or something that is out of the ordinary. This fear is one of those categorized under all fears of medical procedures that can be experienced by anyone, all ages, and have little need for actual psychological treatment, unless it is uncharacteristically causing the patient to react in a way that would be harmful to his or her health.
Flight experience with the use of anti-anxiety medications like benzodiazepines or other relaxant/depressant drugs varies from person to person. Medication decreases the person's reflective function. Though this may reduce anxiety caused by inner conflict, reduced reflective function can cause the anxious flier to believe what they are afraid will happen is actually happening.
A double-blind clinical study at the Stanford University School of Medicine suggests that anti-anxiety medication can keep a person from becoming accustomed to flight. In the research, two flights were conducted. In the first flight, though patients given alprazolam (Xanax) reported less anxiety than those receiving a placebo, their measurable stress increased. The heart rate in the alprazolam group was 114 versus 105 beats per minute in the placebo group. Those who received alprazolam also had increased respiration rates (22.7 vs 18.3 breaths/min).
On the second flight, no medication was given. Seventy-one percent of those who received alprazolam on the first flight experienced panic as compared with only 29% of those who received a placebo on the first flight. This suggests that the participants who were not medicated on the first flight benefited from the experience via some degree of desensitization.
Typical pharmacologic therapy is 0.5 or 1.0 mg of alprazolam about an hour before every flight, with an additional 0.5-1.0 mg if anxiety remains high during the flight. The alternative is to advise patients not to take medication, but encourage them to fly without it, instructing them in the principles of self-exposure.
The alternative view is that the dangers, such as from spiders, are overrated and not sufficient to influence evolution. Instead, inheriting phobias would have restrictive and debilitating effects upon survival, rather than being an aid. For some communities such as in Papua New Guinea, Cambodia and South America (except Chile, Colombia, Brazil, Uruguay, Argentina and Bolivia), spiders are included in traditional foods. This suggests arachnophobia may be a cultural, rather than genetic trait.
Thalassophobia (Greek: θάλασσα, "thalassa", "sea" and φόβος, "phobos", "fear") is an intense and persistent fear of the sea or of sea travel.
Thalassophobia can include fear of being in large bodies of water, fear of the vast emptiness of the sea, and fear of distance from land. It can also include fear of the unknown, of what lurks beneath.
Systematic desensitization therapy was introduced by Joseph Wolpe in 1958 and employs relaxation techniques with imagined situations. In a controlled environment, usually the therapist's office, the patient will be instructed to visualize a threatening situation (i.e., being in the same room with a dog). After determining the patient's anxiety level, the therapist then coaches the patient in breathing exercises and relaxation techniques to reduce their anxiety to a normal level. The therapy continues until the imagined situation no longer provokes an anxious response.
This method was use in the above-mentioned study done by Drs. Hoffmann and Human whereby twelve female students at the Arcadia campus of Technikon Pretoria College in South Africa were found to possess symptoms of cynophobia. These twelve students were provided with systematic desensitization therapy one hour per week for five to seven weeks; after eight months, the students were contacted again to evaluate the effectiveness of the therapy. Final results indicated the study was fairly successful with 75% of the participants showing significant improvement eight months after the study.
However, in his book, "Virtual Reality Therapy for Anxiety Disorders", Dr. Wiederhold questions the effectiveness of systematic desensitization as the intensity of the perceived threat is reliant on the patient's imagination and could therefore produce a false response in regards to the patient's level of anxiety. His research into recent technological developments has made it possible to integrate virtual reality into systematic desensitization therapy in order to accurately recreate the threatening situation. At the time of publication, there had been no studies done to determine its effectiveness.
Ichthyophobia is described in "Psychology: An International Perspective" as an "unusual" specific phobia. Both symptoms and remedies of ichthyophobia are common to most specific phobias.
John B. Watson, a renowned name of behaviorism, describes an example, quoted in many books in psychology, of conditioned fear of a goldfish in an infant and a way of unconditioning of the fear by what is called now graduated exposure therapy:
In contrast, radical exposure therapy was used successfully to cure a man with a "life affecting" fish phobia on the 2007 documentary series, "The Panic Room".
Of the simple phobias, aquaphobia is among the more common subtypes. In an article on anxiety disorders, Lindal and Stefansson suggest that aquaphobia may affect as many as 1.8% of the general Icelandic population, or roughly one in fifty people.
The medical literature suggests a number of treatments that have been proven effective for specific cases of needle phobia, but provides very little guidance to predict which treatment may be effective for any specific case. The following are some of the treatments that have been shown to be effective in some specific cases.
- Ethyl Chloride Spray (and other freezing agents). Easily administered, but provides only superficial pain control.
- Jet Injectors. Jet Injectors work by introducing substances into the body through a jet of high pressure gas as opposed to by a needle. Though these eliminate the needle, some people report that they cause more pain. Also, they are only helpful in a very limited number of situations involving needles i.e. insulin and some inoculations.
- Iontophoresis. Iontophoresis drives anesthetic through the skin by using an electric current. It provides effective anesthesia, but is generally unavailable to consumers on the commercial market and some regard it as inconvenient to use.
- EMLA. EMLA is a topical anesthetic cream that is a eutectic mixture of lidocaine and prilocaine. It is a prescription cream in the United States, and is available without prescription in some other countries. Although not as effective as iontophoresis, since EMLA does not penetrate as deeply as iontophoresis-driven anesthetics, EMLA provides a simpler application than iontophoresis. EMLA penetrates much more deeply than ordinary topical anesthetics, and it works adequately for many individuals.
- Ametop. Ametop gel appears to be more effective than EMLA for eliminating pain during venepuncture.
- Lidocaine/tetracaine patch. A self-heating patch containing a eutectic mixture of lidocaine and tetracaine is available in several countries, and has been specifically approved by government agencies for use in needle procedures. The patch is sold under the trade name "Synera" in the United States and "Rapydan" in European Union. Each patch is packaged in an air-tight pouch. It begins to heat up slightly when the patch is removed from the packaging and exposed to the air. The patch requires 20 to 30 minutes to achieve full anesthetic effect. The Synera patch was approved by the United States Food and Drug Administration on 23 June 2005.
- Behavioral therapy. Effectiveness of this varies greatly depending on the person and the severity of the condition. There is some debate as to the effectiveness of behavioral treatments for specific phobias (like blood, injection, injury type phobias), though some data are available to support the efficacy of approaches like exposure therapy. Any therapy that endorses relaxation methods may be contraindicated for the treatment of fear of needles as this approach encourages a drop in blood pressure that only enhances the vasovagal reflex. In response to this, graded exposure approaches can include a coping component relying on applied tension as a way to prevent complications associated with the vasovagal response to specific blood, injury, injection type stimulus.
- Nitrous Oxide (Laughing Gas). This will provide sedation and reduce anxiety for the patient, along with some mild analgesic effects.
- Inhalation General Anesthesia. This will eliminate all pain and also all memory of any needle procedure. On the other hand, it is often regarded as a very extreme solution. It is not covered by insurance in most cases, and most physicians will not order it. It can be risky and expensive and may require a hospital stay.
- Benzodiazepines, such as diazepam (Valium) or lorazepam, may help alleviate the anxiety of needle phobics, according to Dr. James Hamilton. These medications have an onset of action within 5 to 15 minutes from ingestion. A relatively large oral dose may be necessary.
In 2009, a study investigated the impact of anthropophobia in specific cultures. 50 patients diagnosed with anthropophobia, 50 patients diagnosed with neurasthenia, and 50 control subjects were recruited from hospitals in Beijing, China. Measures of anthropophobic and anxiety symptoms were administered to the subjects. The patients with anthropophobia could not even make eye contact with others and were afraid of being watched. The conclusion drawn was that anthropophobics, like neurasthenics, experience anxiety and depression, but "more cognitively and less somatically".