Mindfulness-Based Exposure Strategies as a Transdiagnostic Mechanism of Change: An Exploratory Alternating Treatment Design
Mindfulness-Based Exposure Strategies as a Transdiagnostic Mechanism of Change: An Exploratory Alternating Treatment Design
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DOI：
10.1016/j.beth.2015.10.008
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发表时间：
2016-03-01
期刊：
影响因子：
3.7
通讯作者：
Barlow, David H.
中科院分区：
文献类型：
--
作者：
Brake, C. Alex;Sauer-Zavala, Shannon;Barlow, David H.
本研究探索了正念策略是否促进了对强烈负面情绪反应的痛苦减轻，这是一种假定的跨诊断行为机制。7名患有异质性焦虑症的患者(平均年龄31.14岁，SD=12.28，19-48岁，43%女性，86%高加索人)被分配到一个为期一周的随机分组顺序，采用正念或回避策略，同时上升6周的情绪暴露等级。参与者每组完成三次暴露，并在每次暴露后提供痛苦和回避使用评级。焦虑严重程度、痛苦厌恶和分心/压抑倾向也在基线和每个区块的结束时被评估。视觉、描述性和效果大小的结果显示，与使用回避的人相比，使用正念的暴露与更高的总体痛苦水平相关。在区块内，大多数参与者在使用正念策略时表现出下降的痛苦水平，而不是在回避条件下表现出更静态的痛苦水平。没有观察到焦虑严重程度、痛苦厌恶和分心/压抑的系统性变化。这些结果表明，正念策略在促进情绪暴露方面可能是有效的；然而，可能需要最小剂量来克服最初的痛苦提升。潜在的跨诊断变化机制和临床意义进行了讨论。
The present study explored whether distress reduction in response to strong negative emotions, a putative transdiagnostic mechanism of action, is facilitated by mindfulness strategies. Seven patients (mean age = 31.14 years, SD = 12.28, range 19-48 years, 43% female, 86% Caucasian) with heterogeneous anxiety disorders (i.e., panic disorder with or without agoraphobia, social anxiety, generalized anxiety) were assigned a randomized order of weeklong blocks utilizing either mindfulness- or avoidance-based strategies while ascending a 6-week emotion exposure hierarchy. Participants completed three exposures per block and provided distress and avoidance use ratings following each exposure. Anxiety severity, distress aversion, and distraction/suppression tendencies were also assessed at baseline and the conclusion of each block. Visual, descriptive, and effect size results showing exposures utilizing mindfulness were associated with higher overall distress levels, compared with those utilizing avoidance. Within blocks, the majority of participants exhibited declining distress levels when employing mindfulness strategies, as opposed to more static distress levels in the avoidance condition. Systematic changes in anxiety severity, distress aversion, and distraction/suppression were not observed. These results suggest mindfulness strategies may be effective in facilitating emotion exposure; however, a minimum dosage may be necessary to overcome initial distress elevation. Potential transdiagnostic change mechanisms and clinical implications are discussed.