Ginat-Frolich Rivkah, Kara-Ivanov Anna, Strauss Asher Y, Myers Ayelet, Huppert Jonathan D
Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.
Cogn Behav Ther. 2023 Mar;52(2):132-145. doi: 10.1080/16506073.2022.2109511. Epub 2022 Oct 11.
Interoceptive exposure, or exposure to one's feared physical sensations, has been shown to be an important technique in cognitive behavioral therapies for anxiety disorders and related constructs, such as anxiety sensitivity (AS). The current study sought to further clarify the underlying cognitive-behavioral mechanisms of interoceptive exposure in a lab-based, analog study with individuals high in AS. Participants ( = 59) were randomized into three groups: a cognitive-behavioral intervention emphasizing belief disconfirmation (CbI), a behavioral intervention emphasizing exposure (BI), and a control condition. Self-report measures assessing AS, catastrophizing of bodily sensations, and subjective units of distress (SUDS) were collected before, during and after the intervention. Participants also completed online questionnaires at a one-month follow-up. Following the CbI but not BI, a decrease was observed in both AS and catastrophizing interpretations. Furthermore, only the CbI group exhibited a decrease in SUDS ratings, whereas the BI group exhibited a significant increase. Notably, these effects were not maintained at a one-month follow-up. Findings suggest that cognitive interventions without repeated behavioral exposure may be sufficient in reducing self-reported anxiety-related symptoms and catastrophic misinterpretations, though not at maintaining them. This raises questions regarding the role of pure behavioral mechanisms in exposure.
内感受暴露，即暴露于个体所恐惧的身体感觉，已被证明是焦虑症及相关概念（如焦虑敏感性）的认知行为疗法中的一项重要技术。本研究旨在通过一项基于实验室的模拟研究，进一步阐明内感受暴露在高焦虑敏感性个体中的潜在认知行为机制。参与者（n = 59）被随机分为三组：强调信念证伪的认知行为干预组（CbI）、强调暴露的行为干预组（BI）和对照组。在干预前、干预期间和干预后收集评估焦虑敏感性、身体感觉灾难化以及主观痛苦单位（SUDS）的自我报告测量数据。参与者还在一个月的随访时完成了在线问卷。与BI组不同，CbI组干预后焦虑敏感性和灾难化解释均有所下降。此外，只有CbI组的SUDS评分降低，而BI组则显著升高。值得注意的是，这些效果在一个月的随访时未得到维持。研究结果表明，没有重复行为暴露的认知干预可能足以减轻自我报告的焦虑相关症状和灾难性误解，但无法维持这些效果。这引发了关于纯粹行为机制在暴露中的作用的问题。
