Wells Adrian, Clark David M, Salkovskis Paul, Ludgate John, Hackmann Ann, Gelder Michael
University of Oxford.
Behav Ther. 2016 Sep;47(5):669-674. doi: 10.1016/j.beth.2016.08.010.
One of the puzzles surrounding social phobia is that patients with this problem are often exposed to phobic situations without showing a marked reduction in their fears. It is possible that individuals with social phobia engage in behaviors in the feared situation that are intended to avert feared catastrophes but that also prevent disconfirmation of their fears. This hypothesis was tested in a single case series of eight socially phobic patients. All patients received one session of exposure alone and one session of exposure plus decrease in "safety" behaviors in a counterbalanced within-subject design. Exposure plus decreased safety behaviors was significantly better than exposure alone in reducing within-situation anxiety and belief in the feared catastrophe. Other factors that may moderate exposure effects are also discussed.
社交恐惧症的一个谜题在于，患有此问题的患者经常暴露于恐惧情境中，但其恐惧并未显著减轻。社交恐惧症患者有可能在恐惧情境中采取一些行为，这些行为旨在避免可怕的灾难，但同时也阻碍了对其恐惧的证伪。这一假设在一个包含八名社交恐惧症患者的单病例系列中得到了验证。在被试内平衡设计中，所有患者均单独接受了一次暴露治疗以及一次暴露治疗加减少“安全”行为的治疗。在减轻情境内焦虑和对可怕灾难的信念方面，暴露加减少安全行为显著优于单独暴露治疗。文中还讨论了其他可能调节暴露效果的因素。
