Rachman S, Shafran R, Mitchell D, Trant J, Teachman B
Department of Psychology, University of British Columbia, Vancouver, Canada.
Behav Res Ther. 1996 Nov-Dec;34(11-12):889-98. doi: 10.1016/s0005-7967(96)00051-4.
Many patients with obsessive-compulsive problems engage in neutralizing activity to reduce or "cancel out" the effects of the obsession. In many cases, neutralization is covert and therefore difficult to assess or manipulate experimentally. We hypothesize that neutralization resembles overt compulsions. In particular, it was predicted that: (i) neutralization reduces the anxiety evoked by unacceptable thoughts, and (ii) if neutralization is delayed, anxiety and the urge to neutralize will decay naturally. To test the hypothesis, 63 Ss prone to a cognitive bias known to be associated with obsessional complaints (thought-action fusion) were asked to write a sentence that would evoke anxiety. Measures of anxiety (and other variables of interest such as guilt, responsibility and the likelihood of harm) were taken. Subjects were then instructed to either immediately neutralize (n = 29) or delay for 20 min (n = 34), after which time anxiety and urge to neutralize were re-assessed. The Ss who had neutralized were then instructed to delay, and the Ss who had delayed were now instructed to neutralize, after which time the final assessments were taken. The results confirmed the predictions and supported the hypothesis that neutralization resembles overt compulsions. Of note, there were no differences between anxiety reduction after a 20-min delay, and after immediate neutralization. The problems involved in designing and conducting experiments on covert phenomena are discussed, and the clinical implications of the study are considered.
许多患有强迫问题的患者会进行中和行为，以减少或“抵消”强迫观念的影响。在许多情况下，中和行为是隐蔽的，因此很难通过实验进行评估或操控。我们假设中和行为类似于公开的强迫行为。具体而言，我们预测：（i）中和行为会减轻由不可接受的想法引发的焦虑，以及（ii）如果中和行为被延迟，焦虑和中和的冲动会自然衰减。为了验证这一假设，我们让63名倾向于出现一种已知与强迫性抱怨（思维 - 行动融合）相关的认知偏差的受试者，写下一个会引发焦虑的句子。我们测量了焦虑（以及其他相关变量，如内疚感、责任感和伤害可能性）。然后，受试者被指示要么立即进行中和行为（n = 29），要么延迟20分钟（n = 34），之后再次评估焦虑和中和的冲动。那些已经进行过中和行为的受试者随后被指示延迟，而那些延迟过的受试者现在被指示进行中和行为，之后进行最终评估。结果证实了预测，并支持了中和行为类似于公开的强迫行为这一假设。值得注意的是，20分钟延迟后焦虑的减轻与立即进行中和行为后焦虑的减轻之间没有差异。我们讨论了设计和开展关于隐蔽现象的实验所涉及的问题，并考虑了该研究的临床意义。
