Salkovskis Paul M, Kobori Osamu
Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
Centre for Forensic Mental Health, Chiba University, Japan.
J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt B):203-208. doi: 10.1016/j.jbtep.2015.09.002. Epub 2015 Sep 10.
The perception of threat and associated feelings of anxiety typically prompt people to seek safety; reassurance seeking is an interpersonal strategy almost universally used to reduce the immediate perception of risk. Excessive Reassurance Seeking (ERS) is considered to be particularly prominent and unequivocally counter-productive in people suffering from anxiety disorders in general and OCD in particular, producing short term relief but a longer term return and worsening of the original anxiety. We evaluated the extent and specificity of the effects of ERS in OCD and mechanisms involved in both anxiety relief and the hypothesized later return of anxiety..
Self rated effects of reassurance seeking were investigated in 153 individuals with OCD, 50 with panic disorder, and 52 healthy controls, evaluating reactions to the provision and non-provision of reassurance.
Reassurance is associated with short term relief then longer term return of both discomfort and the urge to seek further reassurance in both anxious groups; healthy controls do not experience significant resurgence. Greater return of anxiety and urge to seek more reassurance were associated with higher levels of overall reassurance seeking..
The findings were based on retrospective self-report of naturally occurring episodes of ERS; prospective studies and induced behaviours are now needed.
Not only is reassurance a quick fix for people experiencing OCD, but in the absence of treatment the only fix! The findings explain why reassurance seeking continues despite advice that it will worsen anxiety problems. Such advice is potentially harmful to patients and their loved ones..
对威胁的感知以及相关的焦虑情绪通常会促使人们寻求安全感;寻求安慰是一种几乎被普遍采用的人际策略,用于降低对风险的即时感知。过度寻求安慰(ERS)在一般焦虑症患者尤其是强迫症患者中被认为尤为突出且明显适得其反,它能带来短期缓解,但从长远来看,最初的焦虑会卷土重来且愈发严重。我们评估了ERS在强迫症中的影响程度和特异性,以及焦虑缓解和推测的后期焦虑复发所涉及的机制。
对153名强迫症患者、50名惊恐障碍患者和52名健康对照者进行了寻求安慰的自评效果调查,评估他们对提供和不提供安慰的反应。
在两个焦虑组中,安慰与短期缓解相关,随后不适和寻求更多安慰的冲动会在较长时期内再次出现;健康对照组未出现明显的复发情况。焦虑和寻求更多安慰冲动的更大程度复发与总体寻求安慰的较高水平相关。
研究结果基于对ERS自然发生事件的回顾性自我报告;现在需要进行前瞻性研究和诱导行为研究。
安慰不仅是强迫症患者的权宜之计,而且在没有治疗的情况下是唯一的解决办法!这些发现解释了为什么尽管有建议称寻求安慰会使焦虑问题恶化,但人们仍继续这样做。这种建议可能对患者及其亲人有害。