Abstract：
Fear of enclosed spaces prevents many people from receiving magnetic resonance imaging (MRI) scans. Although exposure therapy can effectively treat such fears, reductions in fear during exposure often do not generalize beyond the context in which they took place. This study tested a strategy designed to increase generalization, which involved revisiting the memory of a prior exposure to enhance retrieval of extinction learning. Forty-five participants with claustrophobia that included fear of MRI scans underwent a series of exposures lying inside a narrow cabinet. One week later, participants were randomly assigned to enhanced mental reinstatement (EMR) or control procedures. Prior to entering a mock MRI scanner, EMR participants recalled the memory of exposure training and listened to an audio recording of themselves describing what they learned, whereas control participants recalled a neutral memory. Compared to the control condition, EMR led to significantly reduced heart rate reactivity in the mock MRI scanner, but not self-reported fear or avoidance. There were no differences between conditions in claustrophobia symptoms or MRI fear at 1-month follow-up. Results suggest some benefits of mental reinstatement for improving generalization of gains following exposure training for claustrophobia, with measures of subjective fear and physiological arousal showing discordant outcomes.
摘要：
对封闭空间的恐惧使许多人无法接受磁共振成像（MRI）扫描。虽然暴露疗法可以有效治疗这种恐惧，暴露期间恐惧的减少通常不会超越它们发生的背景。这项研究测试了一种旨在增加泛化的策略，这涉及重新审视先前暴露的记忆，以增强灭绝学习的检索。45名患有幽闭恐惧症（包括对MRI扫描的恐惧）的参与者在狭窄的柜子内进行了一系列暴露。一周后,参与者被随机分配到强化精神复职(EMR)或控制程序组.在进入模拟核磁共振扫描仪之前，EMR参与者回忆起暴露训练的记忆，并听自己的录音，描述他们学到了什么，而对照参与者回忆的是中性记忆。与控制条件相比，EMR导致模拟MRI扫描仪的心率反应性大大降低，但不是自我报告的恐惧或回避。在1个月的随访中，幽闭恐惧症症状或MRI恐惧状况之间没有差异。结果表明，在接受幽闭恐惧症的暴露训练后，心理恢复对改善增益的概括有一些好处。主观恐惧和生理唤醒的测量结果不一致。
