Cougle Jesse R, Summers Berta J, Harvey Ashleigh M, Dillon Kirsten H, Allan Nicholas P
Florida State University,Tallahassee,USA.
Behav Cogn Psychother. 2016 Nov;44(6):640-651. doi: 10.1017/S1352465816000333. Epub 2016 Jul 28.
Disgust is thought to play a prominent role in multiple anxiety disorders and fears, including spider phobia, though little attention has been given to specific treatment strategies that may be effective for multiple disgust-based fears.
In the present study, we evaluated contamination-focused exposure as a potential transdiagnostic treatment strategy for disgust-based fears in a spider fearful sample.
Women with significant spider fear were randomized to three 30-minute sessions of exposure therapy involving repeated contact with a dirt mixture (n=17) or a waitlist control condition (n=17). Assessments of spider fear and disgust were administered at baseline and at one-week posttreatment.
At high (but not low) levels of pretreatment disgust propensity, exposure led to lower in vivo spider fear and perceived danger than waitlist, though exposure had no effects on spider-related disgust. Similar effects of exposure on spider fear were found at high levels of pretreatment spider-related disgust. Exposure also reduced fear and danger perceptions, but not disgust, related to a separate contamination assessment (touching a toilet). No effects of treatment were found on self-report measures of spider fear or disgust propensity.
These findings suggest contamination-focused exposure therapy may be an effective transdiagnostic treatment strategy for individuals with elevated disgust propensity. Limitations and directions for future research are discussed.
厌恶被认为在多种焦虑症和恐惧症中起重要作用,包括蜘蛛恐惧症,不过针对多种基于厌恶的恐惧可能有效的具体治疗策略却很少受到关注。
在本研究中,我们评估了以污染为重点的暴露疗法,将其作为对蜘蛛恐惧症样本中基于厌恶的恐惧的一种潜在跨诊断治疗策略。
对有明显蜘蛛恐惧的女性进行随机分组,一组接受为期三次、每次30分钟的暴露疗法,内容为反复接触污垢混合物(n = 17),另一组为等待名单对照组(n = 17)。在基线和治疗后一周对蜘蛛恐惧和厌恶进行评估。
在预处理厌恶倾向较高(而非较低)水平时,暴露组比等待名单对照组在实际生活中对蜘蛛的恐惧和感知到的危险更低,不过暴露对与蜘蛛相关的厌恶没有影响。在预处理时与蜘蛛相关的厌恶程度较高时,也发现了暴露对蜘蛛恐惧有类似效果。暴露还降低了与单独的污染评估(触摸马桶)相关的恐惧和危险感知,但没有降低厌恶。在蜘蛛恐惧或厌恶倾向的自我报告测量中未发现治疗效果。
这些发现表明,以污染为重点的暴露疗法可能是对厌恶倾向较高的个体有效的跨诊断治疗策略。讨论了研究的局限性和未来研究方向。