Farris Samantha G, Derby Lilly, Kibbey Mindy M
Department of Psychology, School of Arts and Sciences, Rutgers, The State University of New Jersey.
Psychol Bull. 2025 Feb;151(2):131-191. doi: 10.1037/bul0000464.
Interoceptive exposure (IE) involves the use of exercises, activities, or tasks to intentionally induce (or exacerbate) physical symptoms in the body, to challenge misconceptions about the harmful nature of the physical symptoms that maintain fear and problematic avoidance. IE was originally developed for the cognitive behavioral treatment and prevention of panic disorder. Bodily sensations and concern about physical symptoms are common features in many conditions, not limited to panic disorder. For this reason, IE could be theoretically relevant to cognitive behavioral intervention for many psychological, behavioral, and medical conditions. Yet, IE remains relatively underrecognized and underused as an intervention. Exposure involves feeling discomfort before experiencing relief; thus, it is often perceived as an aversive, unsafe, and illogical intervention because of the seemingly paradoxical approach. We conducted a systematic literature search for a scoping review with the aim of locating published studies on IE to understand how it has been studied beyond panic disorder. Studies focused solely on panic disorder were excluded. We were able to identify and extract data from 132 studies (published between 1992 and 2022), though this published literature is difficult to find. The use of IE has been widely investigated in conditions beyond panic disorder, although evidence for its efficacy is difficult to isolate from other forms of exposure and cognitive behavioral features. There is the strongest evidence for the efficacy of IE as a part of multicomponent cognitive behavioral treatments for posttraumatic stress disorder, health anxiety, irritable bowel syndrome, and to aid in benzodiazepine discontinuation. Interventions that were primarily or exclusively IE-based did not consistently or directly influence claustrophobia fear, separation anxiety, suicidality, insomnia symptoms, cigarette or drug abstinence, or pain-related fear. No serious adverse events were reported in any study. Studies of IE require larger sample sizes, detailed descriptions and rationale of IE exercises, higher IE dosing, extended follow-up assessment, and documentation of safety. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
内感受暴露（IE）涉及运用练习、活动或任务来有意诱发（或加剧）身体症状，以挑战关于维持恐惧和问题回避行为的身体症状有害本质的错误观念。IE最初是为惊恐障碍的认知行为治疗和预防而开发的。身体感觉以及对身体症状的担忧是许多病症的常见特征，不限于惊恐障碍。因此，从理论上讲，IE可能与针对多种心理、行为和医学病症的认知行为干预相关。然而，IE作为一种干预措施，仍然相对未得到充分认识和利用。暴露意味着在体验到缓解之前会感到不适；因此，由于这种看似矛盾的方法，它常常被视为一种厌恶、不安全且不合逻辑的干预措施。我们进行了一项系统的文献检索，以进行范围综述，目的是找到关于IE的已发表研究，了解其在惊恐障碍之外是如何被研究的。仅关注惊恐障碍的研究被排除。我们能够从132项研究（发表于1992年至2022年之间）中识别并提取数据，但这些已发表的文献很难找到。IE的应用已在惊恐障碍之外的病症中得到广泛研究，尽管其疗效证据难以与其他形式的暴露和认知行为特征区分开来。作为多成分认知行为治疗的一部分，IE对创伤后应激障碍、健康焦虑、肠易激综合征以及辅助苯二氮䓬类药物停药的疗效有最有力的证据。主要或完全基于IE的干预措施并未始终如一地或直接影响幽闭恐惧症恐惧、分离焦虑、自杀倾向、失眠症状、戒烟或戒毒，或与疼痛相关的恐惧。在任何研究中均未报告严重不良事件。对IE进行研究需要更大的样本量、对IE练习的详细描述和原理说明、更高的IE剂量、更长时间的随访评估以及安全性记录。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
