Royal Holloway, University of London, UK; Broadmoor Hospital, West London NHS Trust, UK.
Department of Psychiatry, University of Oxford, UK.
Behav Res Ther. 2021 Sep;144:103928. doi: 10.1016/j.brat.2021.103928. Epub 2021 Jul 3.
A key clinical issue is how to maximise the belief change central to cognitive therapy. Physiological arousal is a key internal cue confirming threat beliefs in anxiety disorders. Deeper extinction of anxiety may occur if catastrophizing responses to physiological arousal are inhibited prior to joint exposure with external phobic stimuli. The aim of the study was to test whether increasing physiological arousal using exercise increases the benefits of behavioural tests.
Sixty individuals with a fear of heights had one session of VR cognitive treatment. They were randomised to have the treatment either with periods of intense physical exercise (cycling at 80% of maximum heart rate) prior to exposures or without. Linear mixed effects models were used to check the manipulation and test the primary hypothesis of a group difference in degree of conviction in the phobic threat belief.
Heart rate was significantly higher in the exercise group throughout compared with the control group. Both groups showed significant reductions in threat beliefs after the VR treatment (d = 1.0, p < 0.001) but there was no significant group difference (d = 0.1, p = 0.56).
An increase in physiological arousal achieved via exercise did not enhance cognitive change in beliefs about feared stimuli.
一个关键的临床问题是如何最大限度地改变认知疗法中的核心信念。生理唤醒是焦虑障碍中确认威胁信念的关键内部线索。如果在与外部恐惧症刺激联合暴露之前抑制对生理唤醒的灾难性反应，可能会更深入地消除焦虑。本研究旨在测试使用运动增加生理唤醒是否会增加行为测试的益处。
60 名恐高症患者参加了一次虚拟现实认知治疗。他们被随机分为两组，一组在暴露前进行高强度的体育锻炼（以最大心率的 80%骑自行车），另一组则不进行。线性混合效应模型用于检查操作的有效性，并检验主要假设，即锻炼组在恐惧症威胁信念的置信度上的群体差异。
与对照组相比，运动组的心率在整个过程中都显著升高。两组在虚拟现实治疗后均显著降低了威胁信念（d=1.0，p<0.001），但组间无显著差异（d=0.1，p=0.56）。
通过运动增加的生理唤醒并没有增强对恐惧刺激的信念变化。
