Maximizing exposure therapy: an inhibitory learning approach.
Maximizing exposure therapy: an inhibitory learning approach.
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DOI：
10.1016/j.brat.2014.04.006
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发表时间：
2014-07
影响因子：
4.1
通讯作者：
Vervliet, Bram
中科院分区：
文献类型：
--
作者：
Craske, Michelle G.;Treanor, Michael;Conway, Christopher C.;Zbozinek, Tomislav;Vervliet, Bram
关键词：
暴露疗法是治疗焦虑症的有效方法，尽管相当多的人在治疗后未能受益或经历恐惧的回归。研究表明，焦虑的个体在被认为是暴露疗法基础的机制中表现出缺陷，例如抑制性学习。针对这些过程可能有助于提高基于手术的疗效。虽然证据支持一个抑制学习模型的灭绝，有很少的讨论如何在临床实践中实施这一模型。本文的主要目的是为临床医生提供如何应用该模型优化暴露疗法与焦虑的客户，在方式上区分它从一个“恐惧习惯化”的方法和“信念不确认”的方法在标准的认知行为治疗的例子。暴露优化策略包括1）预期违反，2）加深灭绝，3）偶尔强化灭绝，4）删除安全信号，5）变异性，6）检索线索，7）多个上下文，以及8）影响标签。案例研究说明了将这些技术应用于各种焦虑症的方法，包括强迫症，创伤后应激障碍，社交恐惧症，特定恐惧症和恐慌症。
Exposure therapy is an effective approach for treating anxiety disorders, although a substantial number of individuals fail to benefit or experience a return of fear after treatment. Research suggests that anxious individuals show deficits in the mechanisms believed to underlie exposure therapy, such as inhibitory learning. Targeting these processes may help improve the efficacy of exposure-based procedures. Although evidence supports an inhibitory learning model of extinction, there has been little discussion of how to implement this model in clinical practice. The primary aim of this paper is to provide examples to clinicians for how to apply this model to optimize exposure therapy with anxious clients, in ways that distinguish it from a ‘fear habituation’ approach and ‘belief disconfirmation’ approach within standard cognitive-behavior therapy. Exposure optimization strategies include 1) expectancy violation, 2) deepened extinction, 3) occasional reinforced extinction, 4) removal of safety signals, 5) variability, 6) retrieval cues, 7) multiple contexts, and 8) affect labeling. Case studies illustrate methods of applying these techniques with a variety of anxiety disorders, including obsessive-compulsive disorder, posttraumatic stress disorder, social phobia, specific phobia, and panic disorder.
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影响因子：
4.1
作者：
Deacon, Brett;Kemp, Joshua J.;Zhang, Annie R.
通讯作者：
Zhang, Annie R.
影响因子：
10.3
作者：
Culver, Najwa C.;Stoyanova, Milena;Craske, Michelle G.
通讯作者：
Craske, Michelle G.
影响因子：
4.1
作者：
Balooch, Siavash Bandarian;Neumann, David L.;Boschen, Mark J.
通讯作者：
Boschen, Mark J.
影响因子：
1.4
作者：
Bouton, ME;Woods, AM;Pineño, O
通讯作者：
Pineño, O
DOI：
10.1016/0146-6402(92)90010-l
发表时间：
1992-01-01
期刊：
ADVANCES IN BEHAVIOUR RESEARCH AND THERAPY
影响因子：
--
作者：
DAVEY, GCL
通讯作者：
DAVEY, GCL