Journal of Behavior Therapy and Experimental Psychiatry最新文献_第4页

A feasibility study of an add-on psychomotor body-image protocol during CBT-E in female patients with an eating disorder 在饮食失调症女性患者的 CBT-E 治疗过程中采用附加心理运动身体形象方案的可行性研究

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-03-29 DOI: 10.1016/j.jbtep.2025.102034

Suzanne H.W. Mares , Marjon Voskamp , Elke Wezenberg , Annemarie A. van Elburg

Background and objectives

Disturbed body image is a potential precursor and maintaining factor when it comes to eating disorders. One of the dominant treatment approaches for eating disorders, enhanced cognitive-behaviour therapy (CBT-E), includes the cognitive-affective body image dimension as a core treatment target. Adding a component that focuses on the lived body dimension, could improve body image. In the current study, the feasibility of a psychomotor body image treatment as an add-on to CBT-E was examined.

Methods

In this pilot study, 115 primarily female patients with different eating disorders in outpatient CBT-E treatment participated. They were asked to complete questionnaires examining body image before and after the psychomotor body image treatment.

Results

Results showed good satisfaction with the treatment, and a significant improvement in body attitude and body satisfaction after the psychomotor body image treatment, with large effect sizes and clinical relevance. Results also showed that, overall, pre-treatment levels and changes over the course of treatment in body attitude and body satisfaction did not differ between patients within anorexia nervosa, bulimia nervosa or binge eating disorder diagnostic subgroups.

Limitations

Limitations were lack of a control group, and the fact that the body image treatment was complementary to CBT-E. This means that it is unclear whether other factors contributed to the change in body image as shown in the current study.

Conclusions

These results indicate that an experiential psychomotor approach in addition to a more cognitive-behavioral approach is feasible, and warrants future research.

背景与目的当涉及到饮食失调时，身体形象失调是一个潜在的前兆和维持因素。强化认知行为疗法（CBT-E）是饮食失调的主要治疗方法之一，它将认知情感身体形象维度作为核心治疗目标。添加一个专注于生活身体维度的组件，可以改善身体形象。在目前的研究中，研究了精神运动性身体图像治疗作为CBT-E附加治疗的可行性。方法本研究纳入115例门诊CBT-E治疗的不同饮食失调患者，主要为女性。他们被要求在精神运动身体形象治疗前后完成身体形象调查问卷。结果患者对治疗满意程度较高，精神运动性身体意象治疗后身体态度和身体满意度均有显著改善，效果量大，具有临床意义。结果还显示，总体而言，神经性厌食症、神经性贪食症和暴食症诊断亚组患者的治疗前水平和治疗过程中身体态度和身体满意度的变化没有差异。局限性：缺乏对照组，身体形象治疗是CBT-E的补充。这意味着目前尚不清楚是否有其他因素导致了当前研究中所显示的身体形象的变化。结论在认知行为方法的基础上，结合体验性精神运动方法是可行的，值得进一步研究。

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引用次数: 0

Mental imagery abilities in different modalities moderate the efficacy of cognitive bias modification for interpretation bias in social anxiety 不同模式的心理意象能力调节认知偏见矫正对社交焦虑解释偏见的效果

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-03-16 DOI: 10.1016/j.jbtep.2025.102031

Charlene L.M. Lam , Andy S. Hin , Luciana N.S. Lau , Zhiqi Zhang , Chantel J. Leung

Objectives

Cognitive bias modification for interpretation bias (CBM-I) is an effective low-intensity intervention that targets interpretation biases associated with the development and maintenance of social anxiety. Few studies to-date have examined the extent to which individual mental imagery ability affects the efficacy of CBM-I.

Methods

A total of 666 individuals were screened. Seventy-two participants with high levels of social anxiety and elevated baseline interpretation bias were randomly assigned to either CBM-I (n = 36) or control groups (n = 36). They completed 5-day internet-delivered training in modifying their interpretation bias associated with ambiguous social scenarios (CBM-I) or reading neutral text passages (control).

Results

Intent-to-treat analyses revealed that participants in the CBM-I group had a significant reduction in their interpretation bias compared to the controls. They had a reduction of 11 %–18 % on the social anxiety measures. Participants’ mental imagery ability was significantly associated with the reduction of interpretation bias and social anxiety symptoms in the CBM-I group. Specifically, participants with higher mental imagery ability in emotional feelings benefited the most from the intervention.

Conclusions

CBM-I is an efficacious intervention for modulating social anxiety-related biases and symptoms. Mental imagery ability facilitated the efficacy of CBM-I.

目的认知偏见修正解释偏见（CBM-I）是一种有效的低强度干预，针对与社交焦虑的发展和维持相关的解释偏见。迄今为止，很少有研究调查了个体心理意象能力在多大程度上影响CBM-I的疗效。方法共筛查666例。72名高水平社交焦虑和高基线解释偏差的参与者被随机分配到CBM-I组（n = 36）或对照组（n = 36）。他们完成了为期5天的网络培训，以改变与模棱两可的社会情景（CBM-I）或阅读中性文本段落（对照组）相关的解释偏见。结果从治疗到治疗的分析显示，与对照组相比，cbm - 1组的参与者的解释偏差显著减少。他们的社交焦虑测试结果降低了11% - 18%。在CBM-I组中，参与者的心理意象能力与解释偏差和社交焦虑症状的减少显著相关。具体而言，情绪意象能力较高的参与者从干预中获益最多。结论scbm - i是调节社交焦虑相关偏见和症状的有效干预措施。心理意象能力促进了CBM-I的疗效。

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引用次数: 0

Inducing dissociative states: A (re)view from the laboratory 诱导解离状态：来自实验室的（重新）观点。

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-03-14 DOI: 10.1016/j.jbtep.2025.102032

Fiona G. Sleight, Charlie W. McDonald, Richard Mattson, Steven Jay Lynn

Laboratory-based inductions of dissociative states promise to facilitate understanding of the etiology, maintenance, and treatment of dissociation and dissociative disorders. In the present scoping review, we identified articles via a systematic search of PsycINFO, PsycARTICLES, PubMed, and Google Scholar, resulting in 59 articles that met a priori inclusion criteria. Of the 19 techniques described, numerous elicited changes in dissociative symptoms. However, studies were highly heterogeneous regarding their definition and measurement of dissociation. We call attention to relevant validity concerns presented by laboratory-based inductions and offer directions and recommendations for future research.

基于实验室的分离状态诱导有望促进对分离和分离障碍的病因、维持和治疗的理解。在本次范围界定综述中，我们通过对 PsycINFO、PsycARTICLES、PubMed 和 Google Scholar 进行系统检索，确定了 59 篇符合先验纳入标准的文章。在所描述的 19 种技术中，许多都能引起分离症状的变化。然而，这些研究在解离的定义和测量方面存在很大差异。我们呼吁大家关注基于实验室的诱导所带来的相关有效性问题，并为未来的研究提供方向和建议。

引用次数: 0

Can attentional biases predict outcome of CBT in children with social anxiety disorder? 注意偏倚能否预测社交焦虑障碍儿童CBT治疗的结果？

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-27 DOI: 10.1016/j.jbtep.2025.102029

Steffen Schmidtendorf , Julia Asbrand , Brunna Tuschen-Caffier , Nina Heinrichs

Background

Many studies have investigated differences in attention allocation to threat between socially anxious individuals and healthy controls in adult and child samples. The extent to which differences exist within the group of socially anxious individuals and whether these have a predictive value for the extent of symptom reduction after cognitive-behavioral therapy (CBT) has been studied less until to date and yielded inconsistent findings, particularly in child samples.

Methods

The present study investigated whether three different indices of biased attention, measured at pretreatment by eye-tracking, were associated with differences in response to a 12-session exposure-based group CBT in a sample of 41 children with social anxiety disorder (SAD).

Results

In linear regression analyses neither initial vigilance nor initial maintenance nor attentional avoidance predicted symptom reductions after CBT. Children who no longer met diagnostic criteria after treatment did not differ from those who did not fully remit in terms of initial vigilance and attentional avoidance (d < .36). With regard to initial maintenance of attention to threat, the analysis revealed a large but statistically non-significant effect between both groups (d = .81).

Conclusion

Initial maintenance of attention to threat may be beneficial for the treatment of social anxiety. However, the evidence in our study is only weak and further research is needed before clear implications can be drawn.

许多研究调查了在成人和儿童样本中，社交焦虑个体与健康对照之间对威胁的注意分配的差异。在社交焦虑个体群体中存在差异的程度，以及这些差异是否对认知行为治疗（CBT）后症状减轻的程度具有预测价值，迄今为止的研究较少，并且得出了不一致的结果，特别是在儿童样本中。方法本研究以41名社交焦虑障碍（SAD）儿童为研究对象，调查了在前处理时通过眼动追踪测量的三种不同的偏注意指数是否与他们对基于暴露的12期群体CBT的反应差异有关。结果在线性回归分析中，初始警觉、初始维持和注意回避均不能预测CBT后症状的减轻。治疗后不再符合诊断标准的儿童与未完全缓解的儿童在初始警觉性和注意回避方面没有区别(d <；36)。关于对威胁的注意的初始维持，分析显示两组之间有很大但统计学上不显著的影响（d = 0.81）。结论初期维持对威胁的注意可能有利于社交焦虑的治疗。然而，我们的研究证据还很薄弱，需要进一步的研究才能得出明确的结论。

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引用次数: 0

A psycholinguistic investigation of biased semantic networks in contamination-related obsessive-compulsive disorder 污染相关强迫症中偏颇语义网络的心理语言学研究

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-24 DOI: 10.1016/j.jbtep.2025.102028

Schauenburg Gesche, Moritz Steffen, Hottenrott Birgit, Miegel Franziska, Scheunemann Jakob, Jelinek Lena

Background and objectives

Increasing evidence confirms the significant involvement of disgust in contamination-related obsessive-compulsive disorder (C-OCD). More insights into the role of disgust within cognitive biases in OCD may illuminate the psychopathology and corresponding subdimensions or subtypes. The present study introduces a new approach adopted from psycholinguistic research to investigate biases in word association networks in C-OCD versus other OCD symptom dimensions (nC-OCD).

Method

Individuals with OCD (N = 70; N = 42 with C-OCD, N = 28 with nC- OCD) and healthy controls (HC; N = 36) were asked to produce up to five verbal associations with cue words. Written forms of the recorded associations were analyzed with word lexica providing rating norms for valence, arousal, potency, fear, and disgust. We examined bivariate correlations between OCI-R subscale “Washing” and affective variables across all participants. We investigated group differences in semantic biases in the association responses to these five variables given to standardized (three-group comparison: C-OCD vs. nC-OCD vs. HC) and individual (two-group comparison: C-OCD vs. nC-OCD) cue words.

Results

“Washing” and disgust showed the strongest correlation. The three-group comparison revealed more negative valence and disgust-related associations for C-OCD as compared to HC and nC-OCD. Associations generated by the C-OCD group were more pronounced in all emotion variables as compared to the nC-OCD group. Limitations: Rating norms did not cover all word associations, resulting in missing data. The OCD groups were unbalanced due to post-hoc allocation.

Conclusions

Results support the assumption of differentially biased semantic networks across the OCD spectrum, with greater negativity and disgust in C-OCD.

背景与目的越来越多的证据证实了厌恶在污染相关强迫症（C-OCD）中的重要作用。对厌恶在强迫症认知偏差中的作用的进一步了解，可能有助于阐明强迫症的精神病理学及其相应的子维度或亚型。本研究引入了一种新的心理语言学研究方法来研究C-OCD与其他强迫症症状维度（nC-OCD）的词关联网络偏差。方法强迫症患者70例；C-OCD组N = 42， nC- OCD组N = 28)和健康对照(HC；N = 36)被要求与提示词产生最多五个口头联想。对记录的联想的书面形式进行了分析，词汇词典提供了效价、唤起、效力、恐惧和厌恶的评级标准。我们检查了所有参与者的OCI-R子量表“洗涤”和情感变量之间的双变量相关性。我们研究了标准化（三组比较：C-OCD vs. nC-OCD vs. HC）和个体（两组比较：C-OCD vs. nC-OCD）提示词对这五个变量的关联反应中语义偏差的组间差异。结果“洗涤”与厌恶的相关性最强。三组比较发现C-OCD的负效价和厌恶相关的关联比HC和nC-OCD更多。与nC-OCD组相比，C-OCD组在所有情绪变量中产生的关联更为明显。局限性：评分规范没有涵盖所有的词关联，导致数据缺失。强迫症组由于事后分配而不平衡。结论研究结果支持了强迫症谱系中存在差异偏倚语义网络的假设，C-OCD中存在更多的消极和厌恶情绪。

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引用次数: 0

Attend to the positive while feeling anxious: The effect of state anxiety on the effectiveness of Attentional Bias Modification 焦虑中关注积极：状态焦虑对注意偏差修正效果的影响

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-21 DOI: 10.1016/j.jbtep.2025.102030

M.D. Nuijs , H. Larsen , B. Grafton , C. MacLeod , S.M. Bögels , R.W. Wiers , E. Salemink

Background and objectives

Elevating state anxiety during Attentional Bias Modification (ABM) may improve its effectiveness by matching the emotional state experienced during the training with the emotional state under which it is intended that the learned pattern of attentional bias will subsequently operate. This study examined whether inducing elevated levels of state anxiety during ABM enhanced the effectiveness in modifying an attentional bias to socially threatening information.

Methods

Participants (n = 160) were randomized to a single session of attend-negative or attend-positive dot-probe training which was interspersed with either a state anxiety induction or control condition. Attentional bias was assessed post-training by means of a dot-probe task and a visual search task.

Results

ABM was effective in modifying attentional bias in the direction of the allocated training condition as assessed with a dot-probe task, but did not generalize to a visual search task. Importantly, state anxiety did not moderate ABM's training effects.

Limitations

Although the state anxiety manipulation successfully induced state anxiety, state anxiety levels were modest which potentially limited the chance to detect a moderating effect of state anxiety.

Conclusions

Although these findings suggest that inducing state anxiety during ABM does not improve its effectiveness, more studies are needed to confirm this preliminary conclusion. Future studies should examine whether larger state anxiety elevations and state anxiety manipulations that are more integrated into the ABM procedure do enhance training effects.

背景与目的注意偏置修正过程中状态焦虑的提升可以通过将训练过程中体验到的情绪状态与学习到的注意偏置模式随后运行的情绪状态相匹配来提高注意偏置修正的有效性。本研究考察了在ABM期间诱导状态焦虑水平升高是否能增强对社会威胁性信息的注意偏见的修正效果。方法160名被试随机分为出席阴性或出席阳性的点探针训练组，并辅以状态焦虑诱导或对照条件。通过点探测任务和视觉搜索任务评估训练后的注意偏倚。结果在点探测任务中，abm对训练条件分配方向的注意偏倚有改善作用，但对视觉搜索任务的注意偏倚效果不明显。重要的是，状态焦虑并没有调节ABM的训练效果。虽然状态焦虑操纵成功地诱导了状态焦虑，但状态焦虑水平是适度的，这可能限制了检测状态焦虑调节作用的机会。结论虽然这些发现提示在ABM过程中诱导状态焦虑并不能提高其疗效，但这一初步结论还需要更多的研究来证实。未来的研究应该检查是否更大的状态焦虑升高和状态焦虑操纵更整合到ABM程序中，以提高训练效果。

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引用次数: 0

Examining two of the ingredients of Cognitive therapy for adolescent social anxiety disorder: Back-translation from a treatment trial 研究青少年社交焦虑障碍的认知疗法的两个组成部分：从治疗试验的回译

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-15 DOI: 10.1016/j.jbtep.2025.102020

Eleanor Leigh , David Clark , Kenny Chiu

Background

Cognitive Therapy for Social Anxiety Disorder (CT-SAD) based on the Clark & Wells model is a complex intervention comprised of a series of therapeutic elements. Two of the key ingredients are the self-focused attention and safety behaviour experiment and video feedback. The present study examined the effects of these two therapeutic procedures in adolescents with SAD, as well as common themes of the young people's social fears and negative self-images.

Method

35 participants with a diagnosis of SAD completed internet-delivered CT-SAD as part of a randomised controlled trial. We conducted a series of paired samples t-tests to evaluate the effects of the self-focused attention and safety behaviour experiment and video feedback. We applied Latent Dirichlet Allocation to identify latent topics based on participants' description of their social fears and negative self-images that were elicited during the course of these therapy procedures.

Results

Participants reported lower anxiety and more positive self-appraisals when focusing externally and dropping safety behaviours, compared to when focusing internally and using safety behaviours (ps < 0.0025). After they watched the videos compared to before, they reported more positive appraisals of their appearance and performance (ps < 0.0025). The differences in these outcomes were significantly larger when they focused internally and used safety behaviours, compared to focusing externally and dropping safety behaviours (ps < 0.0025). Topic modelling identified six social fear topics and five negative self-image topics.

Conclusions

Self-focused attention, safety behaviours, and negative self-imagery are modifiable with the ‘self-focused attention and safety behaviour experiment’ and ‘video feedback’ as part of internet delivered CT-SAD.

背景：基于Clark &；的社交焦虑障碍认知治疗（CT-SAD）Wells模型是由一系列治疗元素组成的复杂干预。两个关键成分是自我关注和安全行为实验和视频反馈。本研究考察了这两种治疗方法对患有SAD的青少年的影响，以及年轻人的社会恐惧和消极自我形象的共同主题。方法35名被诊断为SAD的参与者完成了网络传递的CT-SAD，作为随机对照试验的一部分。我们进行了一系列配对样本t检验来评估自我关注和安全行为实验和视频反馈的效果。我们运用潜在狄利克雷分配方法，根据参与者在治疗过程中对社会恐惧和消极自我形象的描述来识别潜在话题。结果：与专注于内部并使用安全行为(ps <；0.0025)。在他们看完视频后，与之前相比，他们对自己的外表和表现有了更积极的评价(ps <；0.0025)。当他们专注于内部并使用安全行为时，与专注于外部并放弃安全行为相比，这些结果的差异显著更大(ps <；0.0025)。话题建模确定了6个社会恐惧话题和5个消极自我形象话题。结论“自我关注与安全行为实验”和“视频反馈”可以改变自我关注、安全行为和消极自我意象，作为网络传递CT-SAD的一部分。

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引用次数: 0

Counterfactual thinking is associated with impoverished attentional control in women prone to self-critical rumination 反事实思维与倾向于自我批判反刍的女性注意力控制能力低下有关

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-04 DOI: 10.1016/j.jbtep.2025.102017

Jens Allaert , Rudi De Raedt , Alvaro Sanchez-Lopez , Marie-Anne Vanderhasselt

Background and objectives

Excessive engagement in counterfactual thinking (CFT), where individuals imagine alternative outcomes to past events, is associated with rumination, a process characterized by repetitive negative self-referential thoughts. Attentional control difficulties are closely linked with rumination, and negative thoughts can negatively impact attentional control among rumination-prone individuals. This study aimed to investigate the relationship between CFT and emotional and non-emotional attentional control among individuals with varying levels of self-critical rumination.

Methods

A sample of 100 female participants, characterized by varying levels of self-critical rumination, completed a choice task resulting in goal failure, during which they reported their levels of CFT. Subsequently, participants performed an attentional control task involving eye-tracking measures to assess emotional attentional engagement, emotional attentional disengagement, and emotional and non-emotional attentional shifting.

Results

Among women with high (but not low) self-critical rumination tendencies, increased levels of CFT were associated with slower attentional shifting from emotional stimuli of opposing valence, as well as between non-emotional stimuli.

Limitations

The correlational design of the study prevents causal interpretations of the findings. Additionally, the exclusive inclusion of female participants may limit the generalizability of the results.

Conclusions

This study underscores the association of CFT with subsequent attentional control among women prone to self-critical rumination, aligning with prior research suggesting a link between negative thoughts and attentional processes. Future research should explore these relationships in diverse populations and consider longitudinal designs to elucidate causal pathways.

背景和目的过度从事反事实思维（CFT），即个体想象过去事件的另一种结果，与反刍有关，反刍是一种以重复的消极自我参照思想为特征的过程。注意控制困难与反刍密切相关，消极思想会对反刍倾向个体的注意控制产生负面影响。本研究旨在探讨不同自我批评反刍水平个体的思维能力与情绪和非情绪注意控制的关系。方法100名具有不同程度自我批评反刍的女性参与者完成了一项导致目标失败的选择任务，在此过程中，她们报告了自己的CFT水平。随后，参与者进行了一项注意力控制任务，包括眼动追踪，以评估情绪注意力投入、情绪注意力脱离、情绪和非情绪注意力转移。结果在自我批判反刍倾向高（但不低）的女性中，CFT水平的增加与相反效价的情绪刺激以及非情绪刺激之间的注意力转移速度较慢有关。局限性：研究的相关设计防止了对研究结果的因果解释。此外，仅纳入女性参与者可能会限制结果的普遍性。本研究强调了在倾向于自我批评的反刍的女性中，CFT与随后的注意力控制之间的联系，与先前的研究一致，表明消极思想和注意力过程之间存在联系。未来的研究应该在不同的人群中探索这些关系，并考虑纵向设计来阐明因果关系。

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引用次数: 0

Special Issue Registered Report: Intentional suppression as a method to boost fear extinction 特刊注册报告：故意压制作为促进恐惧消除的方法

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-02-04 DOI: 10.1016/j.jbtep.2025.102018

C.W.E.M. Quaedflieg , S.M. Ashton , T. Beckers , I. Timmers

Fear is a universal experience and fuels our response to cope with threat. Persistent fear, after the threat is no longer present, is a central symptom seen in a number of clinical conditions. Exposure therapy, the most common treatment to target fear, aims to reduce fear responses through repeated, controlled exposures to feared situations in the absence of the negative consequence, thus promoting extinction. However, this treatment is by no means effective for all people. This may be due to impaired extinction and the underlying mechanism of inhibitory retrieval. Intentional memory suppression has been shown to be a promising strategy to enhance this underlying inhibitory mechanism. We employed a newly developed paradigm combining aspects of the Think/No-Think procedure with fear extinction. Sixty-eight healthy participants learned 36 strong naturalistic reminder objects for aversive scenes. After learning, half of the objects were paired with an aversive scream (unconditioned stimulus/US). During the extinction phase, while viewing the objects, participants were instructed to repeatedly retrieve (Think instruction) or suppress (No-Think instruction) the corresponding scenes, or passively view the objects (View instruction). We hypothesised that intentional suppression would boost fear extinction, as shown by a reduced US expectancy to threat-conditioned objects that had been subject to memory suppression during extinction training compared to threat-conditioned objects that were passively viewed. Both intentional memory suppression and passive viewing reduced negative valence for upsetting scenes over time. Contrary to our hypothesis, the results indicated that intentional suppression (No-Think instruction) was not more effective in reducing US expectancy and fear than standard extinction (View instruction). Future research should address the limitation of self-reports by using physiological measures and examine whether intentional suppression may impact fear recovery and generalization following a longer extinction delay. The current findings show that, although intentional suppression can support inhibition of memories and reduce their valence, it may not be as effective as standard extinction methods in diminishing fear responses.

恐惧是一种普遍的体验，它激发了我们应对威胁的反应。在威胁不再存在后，持续的恐惧是许多临床病症的核心症状。暴露疗法是针对恐惧最常见的治疗方法，旨在通过在没有负面后果的情况下反复、有控制地暴露于恐惧情境来减少恐惧反应，从而促进消除。然而，这种治疗方法并不是对所有人都有效。这可能是由于受损的消退和潜在的机制抑制检索。有意记忆抑制已被证明是一种有希望的策略，以加强这种潜在的抑制机制。我们采用了一种新开发的范例，将思考/不思考过程的各个方面与恐惧消除相结合。68名健康的参与者学习了36个强烈的自然主义物体来提醒厌恶的场景。在学习后，一半的对象与令人厌恶的尖叫（非条件刺激/US）配对。在消退阶段，在观看物体时，参与者被要求反复检索（思考指令）或抑制（不思考指令）相应的场景，或被动地观看物体（观看指令）。我们假设故意抑制会促进恐惧消退，正如在消退训练中受到记忆抑制的威胁条件物体与被动观看的威胁条件物体相比，美国人对威胁条件物体的期望降低所表明的那样。随着时间的推移，有意记忆抑制和被动观看都降低了对令人不快的场景的负向效价。与我们的假设相反，结果表明，在减少美国人的期望和恐惧方面，故意抑制（不思考指令）并不比标准灭绝（观察指令）更有效。未来的研究应该通过使用生理测量来解决自我报告的局限性，并检查故意抑制是否会影响更长时间的消退延迟后的恐惧恢复和泛化。目前的研究结果表明，尽管有意抑制可以支持记忆的抑制并降低它们的效价，但在减少恐惧反应方面，它可能不如标准的消除方法有效。

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引用次数: 0

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy 认知行为疗法治疗前后强迫症患者的神经认知表现。

IF 1.7 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry

Pub Date : 2025-01-20 DOI: 10.1016/j.jbtep.2025.102019

Michael G. Wheaton , Eyal Kalanthroff , Micha Mandel , Rachel Marsh , H. Blair Simpson

Background

Cross-sectional studies have reported neurocognitive performance deficits in obsessive-compulsive disorder (OCD), particularly on tasks assessing response inhibition and proactive control over stimulus-driven behaviors (task control). However, it is not clear whether these deficits represent trait-like markers of OCD or are state-dependent.

Methods

This study examined performance on two neurocognitive tasks in OCD patients (N = 26) before and after cognitive behavioral therapy (CBT) and matched healthy controls (HCs, N = 19). Tasks included the stop-signal task (assessing response inhibition) and the Object Interference (OI) task (assessing a specific form of task control). OCD patients completed these tasks and clinical ratings before and after 17 sessions of CBT delivered by expert therapists over two months. HCs completed tasks before and after 2-months. This design used CBT as a tool to reduce OCD symptoms to determine whether neurocognitive performance similarly improves.

Results

Results showed that OCD patients and HCs did not significantly differ in their stop-signal performance at either time point. In contrast, OCD patients exhibited impaired performance on the OI task at baseline and their OI performance improved after treatment, resolving the deficit relative to HC.

Limitations

The sample size was small, particularly for the healthy control group. We also tested only two neurocognitive tasks. Future study with larger sample sizes and more tasks is warranted.

Conclusions

These results suggest that task control deficits in OCD may be sensitive to symptom state. The possibility that improving task control represents a neurocognitive mechanism of successful CBT represents an important direction for future research.

背景：横断面研究已经报道了强迫症（OCD）的神经认知表现缺陷，特别是在评估反应抑制和对刺激驱动行为的主动控制（任务控制）的任务上。然而，尚不清楚这些缺陷是否代表强迫症的特征标记或状态依赖。方法：本研究检测了认知行为治疗（CBT）前后强迫症患者（N = 26）和匹配健康对照（hc, N = 19）在两项神经认知任务上的表现。任务包括停止信号任务（评估反应抑制）和对象干扰（OI）任务（评估特定形式的任务控制）。强迫症患者在专家治疗师在两个月内提供的17次CBT治疗前后完成了这些任务和临床评分。hc在2个月前后完成任务。本设计使用CBT作为减少强迫症症状的工具，以确定神经认知能力是否同样得到改善。结果：结果显示强迫症患者和hc患者在任何时间点的停止信号表现均无显著差异。相比之下，强迫症患者在基线时在成骨不全任务中的表现受损，治疗后他们的成骨不全表现得到改善，解决了与HC相关的缺陷。局限性：样本量很小，特别是健康对照组。我们也只测试了两项神经认知任务。未来的研究需要更大的样本量和更多的任务。结论：强迫症的任务控制缺陷可能对症状状态敏感。改进任务控制可能是CBT成功的一种神经认知机制，这是未来研究的一个重要方向。

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