Kolko D J
J Behav Ther Exp Psychiatry. 1984 Mar;15(1):51-7. doi: 10.1016/0005-7916(84)90123-x.
The case is described of a 16-yr-old girl whose agoraphobia was of recent onset. In the light of a rapidly increasing pattern of escape and avoidance behavior associated with several phobic situations, treatment consisted of a paradoxical instruction to embellish subjective anxiety and elicit anticipated negative consequences during prolonged in vivo exposure. Treatment was associated with the elimination of avoidance behavior and a dramatic reduction in self-reported anxiety, and obsessive-compulsive complaints, as well as anxiety ratings during exposure. These improvements were maintained and enhanced at both 3- and 9-month follow-up. The implications of this approach with severe fears and the need for additional empirical evaluations are discussed.
本文描述了一名16岁女孩的病例，她的广场恐惧症是近期才出现的。鉴于与多种恐惧情境相关的逃避和回避行为迅速增加，治疗方法是给予一种矛盾指令，即在长时间的现场暴露过程中强化主观焦虑并引发预期的负面后果。治疗与回避行为的消除以及自我报告的焦虑、强迫性抱怨以及暴露期间的焦虑评分显著降低相关。这些改善在3个月和9个月的随访中得以维持并进一步增强。讨论了这种针对严重恐惧的方法的意义以及进行更多实证评估的必要性。
