Hermans Dirk, Dirikx Trinette, Vansteenwegen Debora, Baeyens Frank, Van den Bergh Omer, Eelen Paul
Department of Psychology, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
Behav Res Ther. 2005 Apr;43(4):533-51. doi: 10.1016/j.brat.2004.03.013.
The treatment of choice for a number of anxiety disorders is exposure therapy. However, successful reduction of fear through exposure is sometimes followed by a (partial) return of symptoms of fear (return of fear, ROF; Clin. Psychol. Rev. 9 (1989) 147). Several possible learning mechanisms have been suggested to explain ROF (e.g. mechanisms related to spontaneous recovery, renewal, reacquisition and reinstatement). The present study focuses on reinstatement, which refers to the observation that mere US-only presentations can 'reinstate' previously extinguished fear responses. Although animal research has repeatedly demonstrated this phenomenon, little is known about fear reinstatement in humans. The present study employed a differential aversive conditioning procedure: after acquisition and a subsequent extinction procedure, a series of four unpredicted US-only trials was scheduled in the reinstatement group. The control group did not receive additional US presentations. A significant reinstatement effect was observed for US-expectancy ratings and fear ratings in the reinstatement group, but not in the control group. No differences were observed in a reaction time measure of resource allocation to the conditioned stimuli. These findings constitute a first demonstration of reinstatement of conditioned fear responses in humans. Implications for exposure treatment and suggestions for future research are discussed.
多种焦虑症的首选治疗方法是暴露疗法。然而，通过暴露成功减轻恐惧后，有时恐惧症状会（部分）复发（恐惧复发，ROF；《临床心理学评论》9 (1989) 147）。人们提出了几种可能的学习机制来解释ROF（例如与自发恢复、更新、重新习得和恢复相关的机制）。本研究聚焦于恢复，即仅呈现无条件刺激就能“恢复”先前消退的恐惧反应这一现象。尽管动物研究反复证明了这一现象，但对于人类的恐惧恢复却知之甚少。本研究采用了差异厌恶条件作用程序：在习得和随后的消退程序之后，恢复组安排了一系列四次未预测的仅呈现无条件刺激的试验。对照组没有接受额外的无条件刺激呈现。在恢复组中，观察到无条件刺激预期评分和恐惧评分有显著的恢复效应，但对照组没有。在对条件刺激的资源分配的反应时间测量中未观察到差异。这些发现首次证明了人类条件性恐惧反应的恢复。讨论了对暴露治疗的影响以及对未来研究的建议。
