Fordham University, United States.
Fordham University, United States.
J Anxiety Disord. 2020 Aug;74:102270. doi: 10.1016/j.janxdis.2020.102270. Epub 2020 Jul 1.
The coronavirus disease 2019 (COVID-19) pandemic sparked significant anxiety regarding viral rates and means of transmission. Heightened concerns about contamination have prompted new hygienic strategies to vigilantly guard against infection, including hand washing immediately after touching foreign objects or suspected contaminants. This has presented a critical challenge for the delivery of exposure and response prevention (ERP) therapy to individuals with contamination fears due to Obsessive Compulsive Disorder (OCD), as providers must manage not only their clients' attitudes and reactions but their own as well. In this investigation, self-identified anxiety and OCD treatment specialists (N = 139) provided demographic information, including their anxiety and OCD caseloads, and completed measures related to intolerance of uncertainty (IUS-SF; Carlton et al., 2007), beliefs about exposure therapy (TBES; Deacon et al., 2013), and emotional reactions to physical sensations (The Chills; Maruskin et al., 2012). We tested the hypothesis that intolerance of uncertainty and activation of the behavioral immune system (BIS; Schaller & Park, 2011), a mechanism theoretically activated by the prominent emergence of pathogens to protect against illness would predict attitudes toward exposure. The Chills Scale was used to assess BIS activation, a broad assessment of vasoconstriction responses associated with different emotional reactions, and includes a subscale (coldness) that evaluates vasoconstriction associated with defense against pathogens. Both coldness and OCD caseload, but not anxiety caseload or subscales of intolerance of uncertainty, emerged as significant predictors of clinicians' beliefs about exposure; increases in OCD caseload were also related to decreases in negative beliefs about exposure. Findings are useful in determining methods for aiding clinicians in developing effective approaches to contamination fears during and post-pandemic that include addressing their own BIS-related concerns and mapping out means for social behavioral norms associated with engaging in exposure treatment.
新型冠状病毒病 2019（COVID-19）大流行引发了人们对病毒率和传播途径的极大焦虑。对污染的高度关注促使人们采取新的卫生策略来警惕感染，包括接触外来物体或疑似污染物后立即洗手。这对提供接触和反应预防（ERP）治疗带来了重大挑战，因为提供者不仅必须管理客户的态度和反应，还要管理自己的态度和反应。在这项研究中，自我认定的焦虑和强迫症治疗专家（N=139）提供了人口统计学信息，包括他们的焦虑和强迫症患者人数，并完成了与不确定性容忍度（IUS-SF；Carlton 等人，2007）、暴露治疗信念（TBES；Deacon 等人，2013）和对身体感觉的情绪反应（寒战；Maruskin 等人，2012）相关的测量。我们检验了以下假设：不确定性容忍度和行为免疫系统（BIS；Schaller 和 Park，2011）的激活，这是一种理论上由病原体的突出出现激活以保护免受疾病的机制，会预测对暴露的态度。寒战量表用于评估 BIS 的激活，这是一种与不同情绪反应相关的血管收缩反应的广泛评估，包括一个子量表（寒冷），用于评估与防御病原体相关的血管收缩。寒冷和强迫症患者人数，但不是焦虑患者人数或不确定性容忍度的子量表，都是临床医生对暴露的信念的重要预测因素；强迫症患者人数的增加也与对暴露的负面信念的减少有关。这些发现有助于确定方法，帮助临床医生在大流行期间和之后制定针对污染恐惧的有效方法，包括解决他们自己与 BIS 相关的担忧，并制定与参与暴露治疗相关的社会行为规范的方法。
