National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Behav Res Ther. 2011 Nov;49(11):763-70. doi: 10.1016/j.brat.2011.08.004. Epub 2011 Aug 31.
Models of social phobia highlight the importance of anticipatory anxiety in the experience of fear during a social situation. Anticipatory anxiety has been shown to be highly correlated with performance anxiety for a variety of social situations. A few studies show that average ratings of anxiety during the anticipation and performance phases of a social situation decline following treatment. Evidence also suggests that the point of confrontation with the feared stimulus is the peak level of fear. No study to date has evaluated the pattern of anxious responding across the anticipation, confrontation, and performance phases before and after treatment, which is the focus of the current study. Socially phobic individuals (N = 51) completed a behavioral avoidance task before and after two types of manualized cognitive behavioral therapy, and gave ratings of fear during the anticipation and performance phases. Results from latent growth curve analysis were the same for the two treatments and suggested that before treatment, anxiety sharply increased during the anticipation phase, was highly elevated at the confrontation, and gradually increased during the performance phase. After treatment, anxiety increased during the anticipation phase, although at a much slower rate than at pretreatment, peaked at confrontation, and declined during the performance phase. The findings suggest that anticipatory experiences are critical to the experience of fear for public speaking and should be incorporated into exposures.
社交恐惧症模型强调了在社交情境中体验恐惧时预期焦虑的重要性。预期焦虑与各种社交情境中的表现焦虑高度相关。一些研究表明，在社交情境的预期和表现阶段，焦虑的平均评分在治疗后会下降。证据还表明，与恐惧刺激对峙的时刻是恐惧的峰值水平。迄今为止，没有研究评估治疗前后预期、对峙和表现阶段的焦虑反应模式，这是当前研究的重点。社交恐惧症患者（N=51）在两种手动认知行为疗法前后完成了行为回避任务，并在预期和表现阶段对恐惧进行评分。两种治疗方法的潜在增长曲线分析结果相同，表明治疗前，焦虑在预期阶段急剧增加，在对峙时高度升高，并在表现阶段逐渐增加。治疗后，预期阶段的焦虑增加，尽管速度比治疗前慢得多，在对峙时达到峰值，并在表现阶段下降。研究结果表明，预期体验对公开演讲的恐惧体验至关重要，应将其纳入暴露治疗中。
