Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, Ghent, Belgium.
J Anxiety Disord. 2011 Oct;25(7):964-71. doi: 10.1016/j.janxdis.2011.06.003. Epub 2011 Jun 15.
It is well established that exposure therapy is an effective treatment for anxiety disorders. It is less clear, however, which mechanisms are crucial in explaining its success. In previous studies, cognitive change has been identified as a mediating variable. Several theorists have argued that the addition of cognitive interventions will, therefore, result in enhanced treatment effects. We tested this hypothesis by examining cognitive mediation of treatment in a purely behavioral versus a cognitive-behavioral exposure format. Thirty-one spider phobics were randomly assigned to either behavioral exposure or to exposure as a test for maladaptive cognitions (i.e., behavioral experiments). Both treatment formats showed large treatment effects and strong cognitive mediation of these effects. This indicates that, even when cognitions are not explicitly targeted, exposure effects are cognitively mediated. This challenges the idea that cognitions have to be explicitly challenged to elicit cognitive change in exposure treatment.
暴露疗法是治疗焦虑症的有效方法，这一点已得到充分证实。然而，哪种机制对于解释其成功更为关键尚不清楚。在之前的研究中，认知改变被确定为中介变量。一些理论家认为，因此，增加认知干预将导致治疗效果增强。我们通过检查纯行为与认知行为暴露形式的治疗中的认知中介作用来检验这一假设。三十一名蜘蛛恐惧症患者被随机分配到行为暴露组或暴露作为适应不良认知的测试（即行为实验）组。两种治疗方法均显示出较大的治疗效果和对这些效果的强烈认知中介作用。这表明，即使认知没有被明确针对，暴露效果也是通过认知中介的。这挑战了这样一种观点，即必须明确挑战认知才能在暴露治疗中引起认知改变。
