Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands.
J Behav Ther Exp Psychiatry. 2013 Dec;44(4):361-7. doi: 10.1016/j.jbtep.2013.03.005. Epub 2013 Apr 4.
Exposure therapy is often used as treatment for anxiety disorders. However, a change in context after exposure can result in fear renewal. This renewal can be attenuated by using retrieval cues stemming from the exposure context. The present study investigated the effect of such a cue in spider-fearful persons.
Thirty-three participants underwent an in vivo exposure session while wearing a bracelet (retrieval cue). After exposure, half of the participants continued to wear the bracelet at home until follow-up (cue groups); the other half handed over the bracelet after exposure (no cue groups). Half of the participants in each group received the follow-up in the exposure context (AAcue and AAnocue); for the other half follow-up was conducted in a novel environment (ABcue and ABnocue).
A switch in context at follow-up resulted in more self-reported anxiety and arousal compared to no switch. However, the retrieval cue did not attenuate this renewed responding.
The number of participant per condition was limited, which might have obscured possible retrieval cue effects due to a lack of power. Additionally, information about the retrieval cue was provided after exposure, which might have weakened the association between the cue and exposure therapy. Furthermore, no autonomic measures were incorporated, restricting the effect to self-report measures. For future studies we would recommend to explicitly link the retrieval cue before onset of the exposure session and to incorporate autonomic measures.
Our findings indicate that a switch in context resulted in more self-reported anxiety and arousal, but that a cue stemming from the exposure context did not attenuate this renewal.
暴露疗法常被用于治疗焦虑障碍。然而，暴露后情境的改变可能会导致恐惧的重现。通过使用源于暴露情境的提取线索，可以减轻这种重现。本研究调查了这种线索对蜘蛛恐惧者的影响。
33 名参与者在佩戴手链（提取线索）的情况下进行了现场暴露。暴露后，一半参与者继续在家中佩戴手链直到随访（线索组）；另一半参与者在暴露后交出手链（无线索组）。每组中的一半参与者在暴露情境中接受随访（AAcue 和 AAnocue）；另一半参与者在新环境中接受随访（ABcue 和 ABnocue）。
与不转换情境相比，随访时情境的转换导致更多的自我报告焦虑和唤醒。然而，提取线索并没有减轻这种重新出现的反应。
每个条件的参与者数量有限，由于缺乏效力，可能会掩盖可能的检索线索效应。此外，在暴露后提供了有关检索线索的信息，这可能削弱了线索与暴露疗法之间的联系。此外，没有纳入自主测量，限制了自我报告测量的效果。对于未来的研究，我们建议在暴露治疗开始前明确链接检索线索，并纳入自主测量。
我们的发现表明，情境的转换导致了更多的自我报告焦虑和唤醒，但源于暴露情境的线索并没有减轻这种重现。
