de Jong P J, Vorage I, van den Hout M A
Department of Medical, Clinical and Experimental Psychology, Maastricht University, Netherlands.
Behav Res Ther. 2000 Nov;38(11):1055-69. doi: 10.1016/s0005-7967(99)00135-7.
From the perspective that disgust is a core feature of spider phobia, we investigated whether the treatment efficacy could be improved by adding a counterconditioning procedure. Women with a clinically diagnosed spider phobia (N = 34) were randomly assigned to the regular one-session exposure condition (EXP) or to the exposure with counterconditioning condition (CC). In the CC-condition tasty food-items were used during the regular exposure exercises and the participants' favourite music was played. Both treatment conditions appeared very effective in reducing avoidance behaviour and self-reported fear of spiders, strongly attenuated the disgusting properties of spiders and altered the affective evaluations in a positive direction. CC was not more effective in altering the affective valence of spiders than EXP and was not superior with respect to the long term treatment efficacy at 1 year follow up. Apparently, regular exposure treatment is already quite effective in altering the affective-evaluative component of spider phobia and it remains to be seen whether it is possible to further improve treatment outcome by means of procedures which are specifically designed to reduce the spiders' negative affective valence.
从厌恶是蜘蛛恐惧症的核心特征这一角度出发，我们研究了通过添加对抗条件作用程序是否可以提高治疗效果。临床诊断为蜘蛛恐惧症的女性（N = 34）被随机分配到常规单节暴露组（EXP）或暴露与对抗条件作用组（CC）。在CC组中，在常规暴露练习期间使用美味的食物，并播放参与者最喜欢的音乐。两种治疗条件在减少回避行为和自我报告的对蜘蛛的恐惧方面都显得非常有效，极大地减弱了蜘蛛的令人厌恶的特性，并使情感评价朝着积极的方向改变。CC在改变蜘蛛的情感效价方面并不比EXP更有效，并且在1年随访时的长期治疗效果方面也不更优越。显然，常规暴露治疗在改变蜘蛛恐惧症的情感评价成分方面已经相当有效，通过专门设计用于降低蜘蛛负面情感效价的程序是否有可能进一步改善治疗结果还有待观察。
