Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-27T01:46:18.624Z Has data issue: false hasContentIssue false

Behaviour Therapy and Benzodiazepines: Allies or Antagonists?

Published online by Cambridge University Press:  02 January 2018

Jane Wardle*
Affiliation:
Psychology Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Abstract

Behaviour therapy and benzodiazepines are directed towards common problems and are often used in combination. At present we know little about the beneficial or adverse interactions of these two treatments. This paper reviews the available literature and suggests that there are important theoretical and clinical issues to be resolved.

Type
Review Article
Copyright
Copyright © Royal College of Psychiatrists, 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Paper presented at the World Congress of Behaviour Therapy, Edinburgh, September 1988.

References

Breier, A., Charney, D. S. & Henninger, G. R. (1986) Agoraphobia with panic attacks. Development, diagnostic stability, and course of illness. Archives of General Psychiatry, 43, 10291036.10.1001/archpsyc.1986.01800110015003CrossRefGoogle ScholarPubMed
Butler, G., Cullington, A., Hibbert, G., et al (1987) Anxiety management for persistent generalized anxiety. British Journal of Psychiatry, 151, 535542.10.1192/bjp.151.4.535CrossRefGoogle Scholar
Chambless, D. L., Foa, E. B., Groves, G. A., et al (1979) Flooding with brevital in the treatment of agoraphobia: countereffective? Behaviour Research and Therapy, 17, 243251.CrossRefGoogle ScholarPubMed
Covi, L., Lipman, R. S., Pattison, J. H., et al (1973) Length of treatment with anxiolytic sedatives and responses to their sudden withdrawal. Acta Psychiatrica Scandinavica, 49, 5164.10.1111/j.1600-0447.1973.tb04398.xCrossRefGoogle ScholarPubMed
Cox, D. J., Ballenger, J. C., Laraia, M., et al (1988) Different rates of improvement of different symptoms in combined pharmacological and behavioral treatment of agoraphobia. Journal of Behaviour Therapy and Experimental Psychiatry, 19, 119126.10.1016/0005-7916(88)90025-0CrossRefGoogle ScholarPubMed
Davison, G. C. & Valins, S. (1969) Maintenance of self-attributed and drug-attributed behavior change. Journal of Personality and Social Psychology, 11, 2533.CrossRefGoogle ScholarPubMed
Dunner, D. L., Ishiki, D., Avery, D. H., et al (1986) Effect of alprazolam and diazepam on anxiety and panic attacks in panic disorder: a controlled study. Journal of Clinical Psychiatry, 47, 458460.Google ScholarPubMed
Durham, R. C. & Turvey, A. A. (1987) Cognitive therapy vs. behaviour therapy in the treatment of chronic general anxiety. Behaviour Research and Therapy, 25, 229234.10.1016/0005-7967(87)90051-9CrossRefGoogle ScholarPubMed
Gorman, J. E., Dyak, J. D. & Reid, L. D. (1979) Methods of deconditioning persisting avoidance: diazepam as an adjunct to response prevention. Bulletin of the Psychonomic Society, 14, 4648.CrossRefGoogle Scholar
Gray, J. A. (1982) The Neuropsychology of Anxiety: an Enquiry into the Functions of the Septo-Hippocampal System. Oxford Psychology Series. Oxford: Clarendon Press.Google Scholar
Gray, J. A. (1987) Interactions between drugs and behaviour therapy. In Theoretical Foundations of Behaviour Therapy (eds Eysenck, H. J. & Martin, I.). New York: Plenum.Google Scholar
Hafner, J. & Marks, I. (1976) Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation. Psychological Medicine, 6, 7188.CrossRefGoogle ScholarPubMed
Hayward, P., Wardle, J. & Higgitt, A. (1989) Benzodiazepine research: current findings and practical consequences. British Journal of Clinical Psychology, 28, 307327.CrossRefGoogle ScholarPubMed
Higgitt, A., Fonagy, P. & Lader, M. (1988) The development of tolerance to the BDZs and its long term persistence. Psychological Medicine, Suppl. 13.Google Scholar
Hussain, M. Z. (1971) Desensitization and flooding (implosion) in treatment of phobias. American Journal of Psychiatry, 127, 8590.10.1176/ajp.127.11.1509CrossRefGoogle ScholarPubMed
Jensen, H. H. & Poulsen, J. C. (1982) Amnesic effects of diazepam: ‘drug dependence” explored by state-dependent learning. Scandinavian Journal of Psychology, 23, 107111.10.1111/j.1467-9450.1982.tb00420.xCrossRefGoogle Scholar
Johnston, D. & Gath, D. (1973) Arousal levels and attribution effects in diazepam-assisted flooding. British Journal of Psychiatry, 123, 463466.10.1192/bjp.123.4.463CrossRefGoogle ScholarPubMed
Kamano, D. K. (1972) Using drugs to modify the effect of response prevention on avoidance extinction. Behaviour Research and Therapy, 10, 367370.CrossRefGoogle ScholarPubMed
Lader, M. H. & Mathews, A. M. (1968) A psychological model of phobic anxiety and desensitization. Behaviour Research and Therapy, 6, 411421.CrossRefGoogle ScholarPubMed
Lader, M. & Petursson, H. (1983) Long term effects of benzodiazepines. Neuropharmacology, 22, 527533.CrossRefGoogle ScholarPubMed
Marks, I. M., Viswanathan, R., Lipsedge, M. S., et al (1972) Enhanced relief of phobias by flooding during waning diazepam effect. British Journal of Psychiatry, 121, 493505.CrossRefGoogle ScholarPubMed
Mathews, A. M., Gelder, M. G. & Johnston, D. W. (1981) Agoraphobia. Nature and Treatment. London: Tavistock Publications.Google Scholar
Mavissakalian, M. & Michelson, L. (1986) Agoraphobia: relative and combined effectiveness of therapist-assisted in vivo exposure and imipramine. Journal of Clinical Psychiatry, 47, 117122.Google ScholarPubMed
Munby, M. & Johnston, D. W. (1980) Agoraphobia: the long-term follow-up of behavioural treatment. British Journal of Psychiatry, 137, 418427.CrossRefGoogle ScholarPubMed
Rickels, K., Case, W. G., Downing, R. W., et al (1983) Long-term diazepam therapy and clinical outcome. Journal of the American Medical Association, 250, 767771.CrossRefGoogle ScholarPubMed
Rickels, K., Case, W. G., Schweizer, E. E., et al (1986) Low-dose dependence in chronic benzodiazepine users: a preliminary report on 119 patients. Psychopharmacology Bulletin, 22, 407415.Google ScholarPubMed
Sartory, G. (1983) Benzodiazepines and behavioural treatment of phobic anxiety. Behavioural Psychotherapy, 11, 204217.CrossRefGoogle Scholar
Sheehan, D. V. (1987) Benzodiazepines in panic disorder and agoraphobia. Journal of Affective Disorders, 13, 169181.CrossRefGoogle ScholarPubMed
Whitehead, W., Robinson, A., Blackwell, B., et al (1978) Flooding treatment of phobias: does chronic diazepam increase effectiveness? Journal of Behaviour Therapy and Experimental Psychiatry, 9, 219225.CrossRefGoogle Scholar
Winokur, A., Rickels, K., Greenblatt, D. J., et al (1980) Withdrawal reaction from long-term, low-dosage administration of diazepam: a double-blind placebo-controlled case study. Archives of General Psychiatry, 37, 101105.10.1001/archpsyc.1980.01780140103012CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.