Does fear reactivity during exposure predict panic symptom reduction?
Does fear reactivity during exposure predict panic symptom reduction?
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暴露期间的恐惧反应是否预示恐慌症状减轻？
DOI：
10.1037/a0028032
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发表时间：
2012
影响因子：
5.9
通讯作者：
Rosenfield,David
中科院分区：
文献类型：
--
作者：
Meuret,AliciaE;Seidel,Anke;Rosenfield,Benjamin;Hofmann,StefanG;Rosenfield,David
暴露过程中的Fear反应是学习和整体治疗结果的一个常用指标。这项研究的目的是使用多模式指标和先进的分析设计来评估暴露期间恐惧反应的预测价值。我们还调查了治疗条件(认知训练与呼吸技能训练)对恐惧反应和治疗结果的缓和程度。方法34例惊恐障碍和广场恐怖症患者在治疗完成2个月后完成了123次体内暴露，包括每周3次和第4次。会议的长度和恐惧性刺激各不相同。在暴露期间，除了每周对恐慌认知、回避和功能的评估外，心肺生理学(心率、二氧化碳分压[PCO2]、呼吸频率)和经验性症状(恐慌症状和焦虑)被重复评估。结果在治疗和随访期间，两种治疗条件下的症状显著减少。在所有暴露中观察到显著的心肺和经验性反应，特征是先激活后减少。焦虑和恐慌症状在会议期间的更大程度的激活与恐慌症状严重性的改善呈负相关，但无论是生理活动还是在会议期间或会议之间减少的生理或经验变量都不能预测结果。结论暴露过程中恐惧的激活和减少对矫正学习和恐惧消退的预测作用较弱。文中还讨论了暴露疗法的临床意义和未来研究的方向。(数据库记录(C)2022 APA，版权所有)
ObjectiveFear reactivity during exposure is a commonly used indicator of learning and overall therapy outcome. The objective of this study was to assess the predictive value of fear reactivity during exposure using multimodal indicators and an advanced analytical design. We also investigated the degree to which treatment condition (cognitive training vs. respiratory skill training) moderated fear reactivity and therapeutic outcome.MethodThirty-four patients with panic disorder and agoraphobia completed a total of 123 in-vivo exposure sessions, comprising 3 weekly sessions and a 4th session 2 months following therapy completion. Sessions varied in length and phobic stimuli. Cardiorespiratory physiology (heart rate, carbon dioxide partial pressure [PCO2], respiration rate) and experiential symptoms (panic symptoms and anxiety) were assessed repeatedly throughout exposure sessions, in addition to weekly assessments of panic cognitions, avoidance, and functioning.ResultsPanic symptomatology decreased substantially in both treatment conditions during therapy and follow-up. Significant cardiorespiratory and experiential reactivity was observed during all exposures, characterized by activation followed by reduction. Greater within-session activation of anxiety and panic symptoms was inversely related to improvement in panic symptoms severity, but neither physiological activation nor within-or between-session reduction of either physiological or experiential variables was predictive of outcome. No moderating effects of treatment condition were found.ConclusionsFear activation and reduction during exposure are weak predictors of corrective learning and fear extinction. Clinical implications for exposure therapy and directions for future research are discussed.(PsycInfo Database Record (c) 2022 APA, all rights reserved)