Olatunji Bunmi O, Tomarken Andrew, Wentworth Brian, Fritzsche Laura
Vanderbilt University, United States.
Vanderbilt University, United States.
J Behav Ther Exp Psychiatry. 2017 Mar;54:270-277. doi: 10.1016/j.jbtep.2016.09.004. Epub 2016 Sep 30.
The current study examines effects of exposure in multiple contexts on fear reduction and renewal and the moderating effect of baseline threat-specific and nonspecific emotionality.
Snake-fearful participants received a negative or neutral emotion induction and were randomized to video exposure to a snake in a single context, multiple context, or a no exposure control group.
Anxiety in response to video presentations of a snake was significantly reduced in the two exposure groups compared to the control group, especially among those with heightened baseline threat-specific emotionality as indicated by snake anxiety ratings at baseline. Although the two exposure groups did not differ in responding when confronted with a novel snake, both exposure groups reported significantly lower snake anxiety and arousal than the control group. Subsequent analysis did show that compared to controls, the single context group demonstrated greater increase in anxiety and arousal from post-exposure to exposure to the novel snake among those with heightened snake anxiety at baseline. Furthermore, the multiple context group was less avoidant and less fearful than the single context group on a post-exposure behavioral test.
The study used an analogue exposure paradigm with an analogue sample and findings may not be generalizable to a clinical population.
These findings suggest that baseline threat-specific emotionality influences fear reduction and renewal. The benefits of exposure in multiple contexts are discussed in relation to a distinct pattern of symptom change that is in line with an inhibitory learning approach.
本研究考察了在多种情境下暴露对恐惧减轻和恢复的影响,以及基线时特定威胁性和非特定威胁性情绪的调节作用。
对蛇恐惧的参与者接受消极或中性情绪诱导,然后被随机分配到在单一情境、多种情境下观看蛇的视频暴露组,或无暴露对照组。
与对照组相比,两个暴露组对蛇视频呈现的焦虑显著降低,尤其是那些基线时蛇焦虑评分显示基线特定威胁性情绪增强的参与者。虽然两个暴露组在面对新蛇时的反应没有差异,但两个暴露组报告的蛇焦虑和唤醒水平均显著低于对照组。后续分析确实表明,与对照组相比,在基线时蛇焦虑增强的参与者中,单一情境组从暴露后到接触新蛇时焦虑和唤醒的增加更大。此外,在暴露后行为测试中,多种情境组比单一情境组更少回避和恐惧。
本研究使用了模拟暴露范式和模拟样本,研究结果可能无法推广到临床人群。
这些发现表明基线特定威胁性情绪会影响恐惧减轻和恢复。结合与抑制性学习方法一致的独特症状变化模式,讨论了在多种情境下暴露的益处。