Jayasinghe Nimali, Finkelstein-Fox Lucy, Sar-Graycar Lili, Ojie Mary-Jane, Bruce Martha L, Difede JoAnn
a Weill Cornell Medical College , New York , New York , USA.
b University of Connecticut , Storrs , Connecticut , USA.
Clin Gerontol. 2017 May-Jun;40(3):141-158. doi: 10.1080/07317115.2017.1291546. Epub 2017 Feb 6.
Although exposure techniques are a first-line intervention for anxiety, clear evidence is lacking for their efficacy in treating the prevalent and debilitating condition of late life anxiety. This study sought to review the current literature on use of exposure with community-dwelling older patients.
Searches of electronic databases were conducted to identify articles published through December 7, 2016. Inclusion criteria were: 1) sample age > 55, 2) therapy that included exposure, 3) anxiety as a target of the treatment. Exclusion criteria were: 1) not available in English, 2) no quantitative data, 3) inpatient setting. Methodological data and findings were extracted from the articles chosen for review.
The 54 eligible articles presented a total of 16 case studies, 9 uncontrolled trials, 24 controlled trials, and 6 secondary studies. A majority of the studies were conducted in the U.S.A with participants who received individual treatment. In vivo and imaginal exposure were the most frequently delivered techniques, and most treatments were multicomponent. Most studies found a reduction in anxiety symptoms.
Important research gaps need to be addressed.
The surveyed research provides a modest foundation of evidence for mental health practitioners who wish to incorporate exposure into treatment plans.
尽管暴露技术是治疗焦虑症的一线干预措施，但对于其治疗老年期常见且使人衰弱的焦虑症的疗效，仍缺乏明确证据。本研究旨在回顾当前关于对居住在社区的老年患者使用暴露疗法的文献。
检索电子数据库，以识别截至2016年12月7日发表的文章。纳入标准为：1）样本年龄>55岁，2）包括暴露疗法的治疗，3）以焦虑症作为治疗目标。排除标准为：1）非英文文献，2）无定量数据，3）住院环境。从选定用于综述的文章中提取方法学数据和研究结果。
54篇符合条件的文章共呈现了16项案例研究、9项非对照试验、24项对照试验和6项二次研究。大多数研究在美国进行，参与者接受个体治疗。实景暴露和想象暴露是最常采用的技术，且大多数治疗是多成分的。大多数研究发现焦虑症状有所减轻。
重要的研究空白有待填补。
对于希望将暴露疗法纳入治疗方案的心理健康从业者而言，所调查的研究提供了适度的证据基础。
