Wolpe J
J Behav Ther Exp Psychiatry. 1981 Mar;12(1):35-42. doi: 10.1016/0005-7916(81)90027-6.
This paper describes how fears develop on the basis of one or other of two distinct processes--direct autonomic conditioning or the establishment of new cognitive associations to already existing fears. The dichotomy relates both to the appropriate fears of everyday life and to neurotic fears. In the case of the latter, the appropriate treatment procedure should be dictated by the fear basis that behavior analysis reveals. Failure to carry out such analysis is the reason for much confusion and inconclusiveness in therapeutic outcome studies. A retrospective survey of anxiety cases revealed that one-third of their fears were cognitively based and two-thirds due to autonomic conditioning. A study of a clinical population on the basis of a questionnaire designed to separate between cognitively based and conditioned fears has shown the expected bi-modal distribution. These findings undercut the conditioning versus cognition controversy on the causation of neurotic fears.
本文描述了恐惧是如何基于两个不同过程中的一个或另一个而产生的——直接自主神经条件作用，或在已有恐惧基础上建立新的认知关联。这种二分法既适用于日常生活中的适当恐惧，也适用于神经症性恐惧。就后者而言，适当的治疗程序应由行为分析揭示的恐惧基础来决定。未能进行此类分析是治疗结果研究中诸多困惑和不确定性的原因。一项对焦虑症病例的回顾性调查显示，其中三分之一的恐惧基于认知，三分之二是自主神经条件作用所致。一项基于旨在区分基于认知的恐惧和条件性恐惧的问卷对临床人群进行的研究显示了预期的双峰分布。这些发现削弱了关于神经症性恐惧病因的条件作用与认知之争。
