Abstract：
Although exposure therapy is an efficacious treatment for anxiety disorders, fear often returns after treatment. From an inhibitory learning perspective, long-term improvement depends not only on learning that feared stimuli are safe, but also that it is safe to experience the emotional response triggered by these stimuli. Accordingly, the current study examined the effects of occasional threat reinforcement during repeated exposure to multiple cues on the return of fear in snake phobia by incorporating reminders of the feared outcome.
Snake fearful community adults (N = 74) were randomized to either repeated exposure to multiple cues or exposure to multiple cues that also explicitly depicted the feared outcome (snake biting someone). A measure of self-reported threat expectancy and a threat-relevant behavioral approach task (BAT) were administered pre-exposure, post-exposure, and at a one-week follow-up.
Compared to the multiple-cue exposure group, the multiple-cue + fear-outcome group showed significantly less subjective expectancy for a snake to bite and increased behavioral approach of snake images at one-week follow-up. The fear-outcome group also reported significantly greater variability in distress during exposure than the multiple-cue exposure group and this difference mediated the intervention effect on behavioral approach at follow-up.
Findings are limited by the use of videos as an analogue to exposure and a computer-delivered BAT.
These findings suggest presentation of the feared outcome may result in more variability in distress during exposure therapy and this may partially explain the maintenance of behavioral gains.
Snake fearful community adults (N = 74) were randomized to either repeated exposure to multiple cues or exposure to multiple cues that also explicitly depicted the feared outcome (snake biting someone). A measure of self-reported threat expectancy and a threat-relevant behavioral approach task (BAT) were administered pre-exposure, post-exposure, and at a one-week follow-up.
Compared to the multiple-cue exposure group, the multiple-cue + fear-outcome group showed significantly less subjective expectancy for a snake to bite and increased behavioral approach of snake images at one-week follow-up. The fear-outcome group also reported significantly greater variability in distress during exposure than the multiple-cue exposure group and this difference mediated the intervention effect on behavioral approach at follow-up.
Findings are limited by the use of videos as an analogue to exposure and a computer-delivered BAT.
These findings suggest presentation of the feared outcome may result in more variability in distress during exposure therapy and this may partially explain the maintenance of behavioral gains.
摘要：
虽然暴露疗法是焦虑症的有效治疗方法，恐惧往往在治疗后复发。从抑制性学习的角度来看，长期改善不仅取决于学习恐惧刺激是安全的，而且体验这些刺激引发的情绪反应是安全的。因此，当前的研究通过结合对恐惧结果的提醒，研究了在反复暴露于多种线索期间偶尔的威胁强化对蛇恐惧症恐惧回归的影响。
蛇恐惧的社区成年人（N=74）被随机分配到重复暴露于多个线索或暴露于多个线索，这些线索也明确描述了恐惧的结果（蛇咬人）。在暴露前，对自我报告的威胁预期和威胁相关的行为方法任务（BAT）进行了测量，暴露后，在一周的随访中。
与多线索暴露组相比，在1周的随访中,多线索+恐惧-结局组显示蛇咬人的主观预期显著降低,蛇图像的行为方法增加.与多线索暴露组相比，恐惧结果组还报告了暴露期间痛苦的变异性明显更大，并且这种差异介导了随访时对行为方法的干预作用。
调查结果受到使用视频作为曝光模拟和计算机提供的BAT的限制。
这些研究结果表明，在暴露治疗期间，恐惧结果的表现可能会导致更多的痛苦变化，这可能部分解释了行为增益的维持。
蛇恐惧的社区成年人（N=74）被随机分配到重复暴露于多个线索或暴露于多个线索，这些线索也明确描述了恐惧的结果（蛇咬人）。在暴露前，对自我报告的威胁预期和威胁相关的行为方法任务（BAT）进行了测量，暴露后，在一周的随访中。
与多线索暴露组相比，在1周的随访中,多线索+恐惧-结局组显示蛇咬人的主观预期显著降低,蛇图像的行为方法增加.与多线索暴露组相比，恐惧结果组还报告了暴露期间痛苦的变异性明显更大，并且这种差异介导了随访时对行为方法的干预作用。
调查结果受到使用视频作为曝光模拟和计算机提供的BAT的限制。
这些研究结果表明，在暴露治疗期间，恐惧结果的表现可能会导致更多的痛苦变化，这可能部分解释了行为增益的维持。
