Wald Jaye, Taylor Steven
Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada.
Cogn Behav Ther. 2005;34(1):34-40. doi: 10.1080/16506070510010648.
Trauma-related exposure therapy is a useful but not universally effective treatment for post-traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post-traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma-related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician-Administered Post-traumatic Stress Disorder Scale, a self-report measure of post-traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post-traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1- and 3-month follow-up. Symptoms of anxiety sensitivity and post-traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post-traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma-related exposure therapy as a means of boosting treatment efficacy.
创伤相关暴露疗法是治疗创伤后应激障碍的一种有用但并非普遍有效的疗法。焦虑敏感性可能在这种障碍中起重要作用，就像它在惊恐障碍中所起的作用一样。研究表明，内感受性暴露疗法可降低惊恐障碍患者的焦虑敏感性。本病例研究是一项初步调查，旨在探讨将内感受性暴露疗法纳入创伤后应激障碍治疗中的优点，以便改善一名无惊恐障碍或惊恐发作病史患者的治疗效果。内感受性暴露疗法（4节疗程）是治疗的一个组成部分，与创伤相关暴露疗法（4节疗程的想象暴露，随后是4节疗程的现场暴露）相结合。使用临床医生实施的创伤后应激障碍量表、创伤后应激障碍症状的自我报告测量方法以及通常与创伤后应激障碍相关的症状和认知测量方法对治疗效果进行评估。在治疗过程中，所有结果测量指标的得分均下降，且在1个月和3个月的随访中保持改善。在内感受性暴露疗法期间，焦虑敏感性和创伤后应激障碍的症状有所减轻。结果表明，内感受性暴露疗法是一种有前景的创伤后应激障碍辅助干预措施。需要进一步研究将内感受性暴露疗法和创伤相关暴露疗法相结合作为提高治疗效果手段的优点。
