Temple University, Philadelphia, PA, USA.
Behav Modif. 2023 Jan;47(1):46-70. doi: 10.1177/01454455221091783. Epub 2022 Apr 19.
Exposure therapy has been investigated as a treatment for eating disorders, but prior research has largely neglected core fears underlying the disorder such as rejection, abandonment, disgust, and loss of control. We tested the feasibility and acceptability of using imaginal exposure to target disordered eating related fears by randomizing participants ( = 47) with disordered eating to: imaginal exposure (IE), imaginal exposure preceded by a brief food exposure (IE + Food), or an assessment control. Participants attended two in-person visits and completed pretreatment, posttreatment, and one-month follow-up questionnaires. IE was rated more acceptable than IE + Food. Retention was high across conditions. Habituation occurred for subjective distress and believability of feared outcomes, suggesting that imaginal exposure effectively activates core fears. Distress tolerance and confidence in ability to change improved. Disordered eating symptoms, fears, preoccupations, and rituals decreased in all conditions, indicating that IE was not specifically responsible for improvement.
暴露疗法已被研究用于治疗饮食失调，但先前的研究在很大程度上忽视了该障碍的核心恐惧，如拒绝、抛弃、厌恶和失控。我们通过随机分配有饮食失调的参与者（n=47）接受想象暴露治疗，以检验针对与饮食失调相关的恐惧的想象暴露的可行性和可接受性：想象暴露（IE）、想象暴露前进行短暂的食物暴露（IE+食物）或评估对照。参与者参加了两次面对面的访问，并在治疗前、治疗后和一个月随访时完成了问卷调查。想象暴露比想象暴露加食物暴露更被认为是可以接受的。在所有条件下，保留率都很高。主观困扰和对恐惧结果的可信度的适应发生了，这表明想象暴露有效地激活了核心恐惧。痛苦耐受力和改变能力的信心提高了。在所有条件下，饮食失调症状、恐惧、困扰和仪式都减少了，这表明想象暴露并不是改善的唯一原因。
