Extinction theory & anorexia nervosa: Deepening therapeutic mechanisms
Extinction theory & anorexia nervosa: Deepening therapeutic mechanisms
复制标题
DOI：
10.1016/j.brat.2016.08.017
复制
发表时间：
2016-12-01
影响因子：
4.1
通讯作者：
Le Grange, Daniel
中科院分区：
文献类型：
--
作者：
Murray, Stuart B.;Treanor, Michael;Le Grange, Daniel
通过采用核心症状恐惧（即，对体重增加的恐惧）作为主要治疗目标，AN的治疗主要涉及焦虑驱动的过程。然而，针对AN体重增加恐惧的暴露试验很少，迄今为止产生了混合结果。在将灭绝理论转化为AN的治疗时，很可能是由于缺乏对核心恐惧线索和核心恐惧结果的明确区分，阻碍了暴露治疗在AN中的应用。这篇评论认为，在AN的核心恐惧协会的几种配置，注意到不同的治疗策略，可能会允许更精确的努力，违反基于恐惧的期望。具体的指导提供了在临床决策过程中，哪些策略可能最好地促进抑制性学习，并讨论了一个临床病例，其中调整治疗，特别是违反核心的潜在的恐惧协会。(C)2016爱思唯尔有限公司版权所有。
By virtue of adopting the core symptomatic fear (i.e., a fear of weight gain) as a primary treatment target, the treatment of AN centrally involves exposure-driven processes. However, exposure trials targeting the fear of weight gain in AN have been sparse, yielding mixed results to date. In translating extinction theory to the treatment of AN, it is likely that the absence of a clear distinction between what constitutes the core feared cue and the core feared outcome has stymied the application of exposure treatments in AN. This review considers several configurations of the core fear association in AN, noting distinct therapeutic strategies which may allow for more precise efforts in violating fear-based expectancies. Specific guidance is offered in the clinical decision making process as to which strategies might best promote inhibitory learning, and a clinical case is discussed, in which treatment was adjusted to specifically violate the core underlying fear association. (C) 2016 Elsevier Ltd. All rights reserved.