Merluzzi T V, Taylor C B, Boltwood M, Götestam K G
University of Notre Dame.
J Consult Clin Psychol. 1991 Jun;59(3):425-30. doi: 10.1037//0022-006x.59.3.425.
Exposure is a rapid and effective treatment for simple phobias. This study tested the assumption that endorphin release may be involved in exposure to a feared situation. Thirty spider-phobic Ss underwent exposure to 17 phobic-related, graded performance tasks. Half the Ss were randomly assigned to naltrexone, an opioid antagonist, and half to a placebo. Measures of heart rate, blood pressure, self-efficacy, anxiety, and cognitions were obtained during treatment. Six of the 15 Ss in the naltrexone group dropped out after the 10th step in the treatment compared with 1 of the 15 Ss in the placebo group, chi 2(1, N = 30) = 4.7, p = .03. The naltrexone group took significantly longer to complete the first 10 steps (the last step that included all Ss) compared with the placebo group, F(9, 252) = 2.17, p = .024. Maximum heart rate and anxiety were significantly greater at Step 10 in the naltrexone group, but no differences were found for self-efficacy or cognitions. The study provides further evidence that the endogenous opioid system may be involved in the process of exposure.
暴露疗法是治疗单纯恐惧症的一种快速有效的方法。本研究检验了内啡肽释放可能与暴露于恐惧情境有关这一假设。30名蜘蛛恐惧症患者接受了17项与恐惧相关的分级表现任务的暴露治疗。其中一半患者被随机分配服用阿片类拮抗剂纳曲酮，另一半服用安慰剂。在治疗过程中获取心率、血压、自我效能感、焦虑及认知方面的测量数据。纳曲酮组15名患者中有6名在治疗的第10步后退出，而安慰剂组15名患者中只有1名退出，卡方检验χ2(1, N = 30) = 4.7，p = .03。与安慰剂组相比，纳曲酮组完成前10步（包括所有患者的最后一步）所需时间显著更长，F(9, 252) = 2.17，p = .024。纳曲酮组在第10步时的最高心率和焦虑水平显著更高，但在自我效能感或认知方面未发现差异。该研究进一步证明内源性阿片系统可能参与了暴露过程。
