焦虑在疗程内和疗程间的变化与治疗结果有关吗？暴露治疗进食障碍的两项临床试验结果

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL Behaviour Research and Therapy Pub Date : 2024-06-01 DOI:10.1016/j.brat.2024.104577

Rachel M. Butler , Caroline Christian , Jeffrey M. Girard , Irina A. Vanzhula , Cheri A. Levinson

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引用次数: 0

摘要

目的意象暴露是一种治疗进食障碍（ED）的新型干预方法，已被研究为一种针对ED症状和恐惧的方法。需要进行研究以了解意象暴露治疗进食障碍过程中的变化机制，包括疗程内和疗程间痛苦的减轻是否与治疗结果有关。方法研究 1 测试了四个疗程的在线意象暴露（N = 143）。研究 2 测试了综合意象暴露和体内暴露，包括六个意象暴露疗程（N = 26）。对治疗前后的 ED 症状和恐惧进行了评估，并在治疗过程中收集了主观痛苦和状态焦虑。结果在两项研究中，主观痛苦在治疗过程中都有增加的趋势，而治疗过程中的痛苦减轻与 ED 症状或恐惧的变化无关。在研究 1 中，疗程间痛苦和状态焦虑的减轻与治疗前和治疗后 ED 症状和恐惧的减少有很大关系。在研究 2 中，会话间痛苦减轻发生了，但与治疗结果无关。结论会话内痛苦减轻可能不会促进 ED 暴露过程中的改变，而会话间痛苦减轻可能与更好的治疗结果有关。这些发现证实了有关焦虑症暴露过程中减轻痛苦的研究。临床医生可以考虑采用以暴露为基础的治疗方法，这种治疗方法注重对痛苦的耐受性，并促进治疗过程中痛苦的减轻。

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Are within- and between-session changes in distress associated with treatment outcomes? Findings from two clinical trials of exposure for eating disorders

Objective

Imaginal exposure is a novel intervention for eating disorders (EDs) that has been investigated as a method for targeting ED symptoms and fears. Research is needed to understand mechanisms of change during imaginal exposure for EDs, including whether within- and between-session distress reduction is related to treatment outcomes.

Method

Study 1 tested four sessions of online imaginal exposure (N = 143). Study 2 examined combined imaginal and in vivo exposure, comprising six imaginal exposure sessions (N = 26). ED symptoms and fears were assessed pre- and posttreatment, and subjective distress and state anxiety were collected during sessions.

Results

Subjective distress tended to increase within-session in both studies, and within-session reduction was not associated with change in ED symptoms or fears. In Study 1, between-session reduction of distress and state anxiety was associated with greater decreases in ED symptoms and fears pre-to posttreatment. In Study 2, between-session distress reduction occurred but was not related to outcomes.

Conclusions

Within-session distress reduction may not promote change during exposure for EDs, whereas between-session distress reduction may be associated with better treatment outcomes. These findings corroborate research on distress reduction during exposure for anxiety disorders. Clinicians might consider approaches to exposure-based treatment that focus on distress tolerance and promote between-session distress reduction.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.