Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial
Maximizing the efficacy of interoceptive exposure by optimizing inhibitory learning: A randomized controlled trial
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DOI：
10.1016/j.brat.2013.06.006
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发表时间：
2013-09-01
影响因子：
4.1
通讯作者：
Zhang, Annie R.
中科院分区：
文献类型：
--
作者：
Deacon, Brett;Kemp, Joshua J.;Zhang, Annie R.
惊恐障碍（PD）的认知行为治疗强调内感受性暴露（IE）对目标焦虑敏感性（AS）的作用，但其治疗方式差异很大。这项随机对照试验的目的是比较治疗方案中经常规定的低剂量IE练习与假设优化抑制性学习的强化IE形式的疗效。AS升高的参与者（N = 120）被随机分配到四个单次干预中的一个：（a）Barlow和Craske恐慌控制治疗中规定的低剂量IE，（B）低剂量IE，不控制呼吸或试验间休息时间过长，（c）强化IE，或（d）表达性书写控制。与其他条件相比，从预处理到后处理，强化IE显著降低了AS和对吸管呼吸任务的恐惧。在随访期间，不同条件下的增益维持没有差异。恐惧耐受和负面结果预期的变化完全介导强化IE优于低剂量IE的上级疗效。这两个低强度IE条件下产生特别高的率之间的试验和结果变量的恐惧敏感化。研究结果表明，IE运动的密集交付有可能提高PD的基于胰岛素的治疗的疗效。(C)2013爱思唯尔有限公司保留所有权利。
Cognitive-behavioral treatments for panic disorder (PD) emphasize interoceptive exposure (IE) to target anxiety sensitivity (AS) but vary considerably in its manner of delivery. This randomized controlled trial was conducted to compare the efficacy of the low-dose delivery of IE exercises often prescribed in treatment protocols to an intensive form of IE hypothesized to optimize inhibitory learning. Participants (N = 120) with elevated AS were randomly assigned to one of four single-session interventions: (a) low-dose IE as prescribed in Barlow and Craske's Panic Control Treatment, (b) low-dose IE without controlled breathing or a lengthy between-trial rest period, (c) intensive IE, or (d) expressive writing control. Compared to the other conditions, intensive IE produced significantly greater reductions in AS and fearful responding to a straw breathing task from pretreatment to posttreatment. Maintenance of gains during the follow-up period did not differ between conditions. Changes in fear toleration and negative outcome expectancies fully mediated the superior efficacy of intensive IE over low-dose IE. The two low intensity IE conditions produced particularly high rates of fear sensitization on between-trial and outcome variables. The findings suggest that the intensive delivery of IE exercises has the potential to improve the efficacy of exposure-based treatments for PD. (C) 2013 Elsevier Ltd. All rights reserved.