Rodriguez B I, Craske M G, Mineka S, Hladek D
University of California, Los Angeles, USA.
Behav Res Ther. 1999 Sep;37(9):845-62. doi: 10.1016/s0005-7967(98)00106-5.
Context-specificity of fear extinction was tested among 65 participants who were fearful of spiders by manipulating the contexts used for exposure treatment and two-week follow-up assessment. Context was defined by both meaningful (presence of a particular therapist) and incidental (room location and furnishings) environmental cues. Distinct phobic stimuli were used to examine interactions of context with stimulus. Physiological, behavioral and verbal indices of fear were measured. Results provided modest support for context-specific return of fear. With one stimulus, participants assessed in a non-treatment context at follow-up exhibited greater returns in heart rate levels. In addition, three of four participants who could not touch the stimulus at follow-up had been tested in a non-treatment context. Future investigations may benefit from greater distinctions between contexts or manipulation of contextual features more directly relevant to fear. Finally, post hoc analyses identified high trait anxiety, slow treatment response, recovery of phobic cognitions and long duration/high intensity phobic encounters post-treatment as significant predictors of increased return of fear.
通过操纵暴露治疗和两周随访评估所使用的情境，对65名害怕蜘蛛的参与者进行了恐惧消退的情境特异性测试。情境由有意义的（特定治疗师的在场）和偶然的（房间位置和家具）环境线索共同定义。使用不同的恐惧刺激来检验情境与刺激之间的相互作用。测量了恐惧的生理、行为和言语指标。结果为恐惧的情境特异性复发提供了适度支持。对于一种刺激，随访时在非治疗情境中接受评估的参与者心率水平回升幅度更大。此外，随访时无法触碰刺激物的四名参与者中有三名是在非治疗情境中接受测试的。未来的研究可能会受益于对情境进行更明确的区分，或更直接地操纵与恐惧更相关的情境特征。最后，事后分析确定，高特质焦虑、治疗反应缓慢、恐惧认知的恢复以及治疗后长时间/高强度的恐惧遭遇是恐惧复发增加的重要预测因素。
