Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80302, USA.
Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80302, USA.
J Anxiety Disord. 2023 Dec;100:102788. doi: 10.1016/j.janxdis.2023.102788. Epub 2023 Oct 14.
Exposure therapy represents the gold-standard treatment for social anxiety, yet evidence indicates the need for improvement. One promising avenue involves linking exposures to a motivator. The current study examined the impact of intrinsically-rewarding, personal values-enhanced versus extrinsically-rewarding, monetary-enhanced exposure on short-term social anxiety fear and avoidance outcomes, and evaluated impacted initial treatment motivation and exposure generalization.
Sixty emerging adults ages 17-26 with significantly elevated social and public speaking anxiety were randomized to receive values-enhanced exposure, monetary reward-enhanced exposure, or exposure alone. They completed a laboratory session with a brief intervention and speech exposure, one-week follow-up with novel exposure, and online follow-up two weeks later. Subjective and behavioral anxiety measures were collected.
Linking exposures to values decreased self-reported anxiety following the speech exposure retest, which generalized to anticipatory anxiety prior to a novel speech task. Linking exposures to money temporarily increased speech length, but this difference did not remain during the novel task. Conditions showed similar improvements on other outcomes.
Extrinsic motivators can temporarily motivate exposure engagement, whereas a brief values intervention can enhance exposure learning and decrease subjective anxiety across feared situations compared to monetary enhancement. If replicated, this has pragmatic implications for exposure framing within social anxiety treatment.
目的：暴露疗法是治疗社交焦虑症的金标准，但现有证据表明该疗法需要改进。一种很有前途的方法是将暴露疗法与动机因素联系起来。本研究旨在探讨内在奖励（增强个人价值观）与外在奖励（金钱增强）的暴露疗法对短期社交焦虑恐惧和回避的影响，并评估其对初始治疗动机和暴露泛化的影响。
方法：60 名年龄在 17-26 岁之间、社交和公众演讲焦虑显著升高的成年人被随机分配到增强价值观的暴露组、增强金钱奖励的暴露组或单纯暴露组。他们完成了一个有简短干预和演讲暴露的实验室环节、一周后的新暴露随访，以及两周后的在线随访。收集了主观和行为焦虑测量数据。
结果：将暴露疗法与价值观联系起来，可以降低演讲暴露重测后的自我报告焦虑，这种效果还可以泛化到新演讲任务前的预期焦虑。将暴露疗法与金钱联系起来可以暂时增加演讲长度，但这种差异在新任务中并不持续。其他结果方面，三组条件均显示出相似的改善。
结论：外在动机可以暂时激发暴露治疗的参与度，而简短的价值观干预可以增强暴露学习，降低在各种恐惧情境下的主观焦虑，与金钱增强相比效果更持久。如果得到验证，这将对社交焦虑症治疗中的暴露疗法框架具有实际意义。
