University of Wyoming, Department of Psychology, Laramie, WY 82071, USA.
Behav Res Ther. 2011 May;49(5):305-14. doi: 10.1016/j.brat.2011.02.005. Epub 2011 Feb 17.
The current study attempted to replicate the finding obtained by Powers, Smits, and Telch (2004; Journal of Consulting and Clinical Psychology, 72, 448-545) that both the availability and utilization of safety behaviors interfere with the efficacy of exposure therapy. An additional goal of the study was to evaluate which explanatory theories about the detrimental effects of safety behaviors best account for this phenomenon. Undergraduate students (N=58) with high claustrophobic fear were assigned to one of three treatment conditions: (a) exposure only, (b) exposure with safety behavior availability, and (c) exposure with safety behavior utilization. Participants in each condition improved substantially, and there were no significant between-group differences in fear reduction. Unexpectedly, exposure with safety behavior utilization led to significantly greater improvement in self-efficacy and claustrophobic cognitions than exposure only. The extent to which participants inferred danger from the presence of safety aids during treatment was associated with significantly less improvement on all outcome measures. The findings call into question the hypothesized deleterious effects of safety behaviors on the outcome of exposure therapy and highlight a possible mechanism through which the mere presence of safety cues during exposure trials might affect treatment outcomes depending on participants' perceptions of the dangerousness of exposure stimuli.
本研究试图复制 Powers、Smits 和 Telch（2004；《咨询与临床心理学杂志》，72，448-545）的发现，即安全行为的可用性和使用都会干扰暴露疗法的效果。该研究的另一个目的是评估关于安全行为的有害影响的哪些解释性理论可以最好地解释这一现象。有高度幽闭恐惧症恐惧的大学生（N=58）被分配到以下三种治疗条件之一：（a）仅暴露，（b）暴露时提供安全行为，（c）暴露时使用安全行为。每个条件中的参与者都有了显著的改善，并且在恐惧减少方面没有显著的组间差异。出乎意料的是，与仅暴露相比，使用安全行为会导致自我效能感和幽闭恐惧认知的显著改善。参与者在治疗过程中从安全辅助工具的存在中推断出危险的程度与所有结果测量的改善程度显著相关。研究结果对安全行为对暴露疗法结果的假设有害影响提出了质疑，并强调了在暴露试验期间安全线索的存在可能会根据参与者对暴露刺激的危险性的看法影响治疗结果的可能机制。
