van den Hout M, Arntz A, Hoekstra R
Department of Experimental Abnormal Psychology, Limburg University, Maastricht, The Netherlands.
Behav Res Ther. 1994 May;32(4):447-51. doi: 10.1016/0005-7967(94)90008-6.
Earlier studies showed that cognitive therapy has anti-panic effects and exposure has anti-agoraphobic effects while other studies suggest that agoraphobia is a secondary complication of panic disorder. It was therefore hypothesized that cognitive therapy not only reduces panic but also agoraphobia and that it potentiates the effects of exposure in vivo. Two groups of 12 severe agoraphobics were treated with 4 sessions of cognitive therapy followed by 8 sessions of cognitive therapy combined with in vivo exposure. The other 12 received 4 sessions of 'associative therapy', a presumably inert treatment that controls for therapist attention, followed by 8 sessions of in vivo exposure that was framed in common behavioral terms. The initial cognitive therapy produced a significant reduction in panic frequency, while associative therapy did not affect panic. Neither cognitive therapy alone, nor associate therapy alone significantly reduced depression, state or trait anxiety, self-rated agoraphobia or behavioral avoidance. After adding exposure however, these parameters were clearly and significantly reduced. Cognitive therapy did not potentiate exposure effects. The results are discussed.
早期研究表明，认知疗法具有抗惊恐作用，暴露疗法具有抗广场恐惧症作用，而其他研究则表明广场恐惧症是惊恐障碍的一种继发性并发症。因此，有人提出假设，认知疗法不仅能减轻惊恐症状，还能减轻广场恐惧症，并且能增强体内暴露疗法的效果。两组各12名重度广场恐惧症患者接受了4节认知疗法治疗，随后进行8节认知疗法与体内暴露疗法相结合的治疗。另外12名患者接受了4节“联想疗法”，这是一种假定无活性的治疗方法，用于控制治疗师的关注，随后进行8节以常见行为术语表述的体内暴露疗法。最初的认知疗法使惊恐发作频率显著降低，而联想疗法对惊恐没有影响。单独的认知疗法或联想疗法都没有显著降低抑郁、状态或特质焦虑、自我评定的广场恐惧症或行为回避。然而，在加入暴露疗法后，这些参数明显且显著降低。认知疗法并没有增强暴露疗法的效果。对结果进行了讨论。
