A randomized controlled trial comparing two processes of exposure therapy: Extinction learning and habituation.

IF 6 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2025-10-01 DOI:10.1037/ccp0000970

Michael Treanor,Tomislav D Zbozinek,Benjamin M Rosenberg,Amy Sewart,Christina F Sandman,Julian Ruiz,Michelle G Craske

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引用次数: 0

Abstract

OBJECTIVE To investigate the role of extinction learning and habituation by comparing inhibitory retrieval to habituation-focused exposure for social anxiety and panic disorder. METHOD In this assessor-blinded, parallel-group, two-arm randomized controlled clinical superiority trial, 89 treatment-seeking adults with social anxiety (n = 77) or panic disorder (n = 12) received nine weekly therapy sessions of inhibitory retrieval or habituation-focused exposure therapy. Outcomes were client-reported symptoms, interviewer-rated client distress and impairment, and a behavioral approach task. RESULTS Modified intent-to-treat analyses were conducted using multilevel modeling. There were no group differences on principal outcomes of interviewer-rated distress and impairment, nor significant pairwise differences on symptom scores at posttreatment or follow-up (ps > .11). However, secondary and exploratory analyses revealed that relative to the habituation condition, participants in the inhibitory retrieval condition demonstrated significantly steeper decreases in self-reported anxiety from baseline to posttreatment, b = 0.05, 95% CI [0.01, 0.08], χ2(1) = 6.67, p = .010; session-by-session self-reported anxiety, b = 0.01, 95% CI [0.004, 0.02], χ2(1) = 12.33, p = .001; and distress during a behavioral approach task, f = .134, χ2(1) = 4.75, p = .029. Additionally, a higher percentage of participants in the inhibitory condition achieved clinically significant change on self-reported anxiety at posttreatment (43% vs. 13%), although there were no group differences on interviewer-rated indices of clinically significant change (ps > .42). CONCLUSION Both methods of exposure therapy were effective. Exposure therapy targeting extinction learning modestly improved outcomes on secondary and exploratory measures although, aside from reliable and clinically significant change, group differences at posttreatment and follow-up were not significant. Habituation-focused exposure therapy was not superior on any measure. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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一项比较暴露疗法两个过程的随机对照试验：消退学习和习惯化。

目的探讨消退学习和习惯化对社交焦虑和恐慌障碍的影响。方法在这项评估盲、平行组、两组随机对照临床优势试验中，89名患有社交焦虑（n = 77）或惊恐障碍（n = 12）的寻求治疗的成年人接受了每周9次的抑制检索或习惯聚焦暴露治疗。结果是客户报告的症状，访谈者评定的客户痛苦和损害，以及行为方法任务。结果采用多级模型进行改进的意向治疗分析。在访谈者评定的痛苦和损害的主要结局上没有组间差异，在治疗后或随访的症状评分上也没有显著的两两差异（ps >.11）。然而，二次分析和探索性分析显示，相对于习惯化条件，抑制检索条件的参与者自报告焦虑从基线到治疗后的下降幅度明显更大，b = 0.05, 95% CI [0.01, 0.08], χ2(1) = 6.67, p = 0.010；逐次自我报告焦虑，b = 0.01, 95% CI [0.004, 0.02], χ2(1) = 12.33, p = .001；行为接近任务中的痛苦程度，f = .134, χ2(1) = 4.75, p = .029。此外，更高比例的抑制条件下的参与者在治疗后自我报告的焦虑方面取得了临床显着变化（43%对13%），尽管在访谈者评定的临床显着变化指数上没有组间差异（ps >.42）。结论两种暴露治疗方法均有效。针对消退学习的暴露疗法适度改善了次要和探索性措施的结果，尽管除了可靠和临床显著的变化外，治疗后和随访的组间差异并不显著。以习惯为中心的暴露疗法在任何方面都没有优势。（PsycInfo Database Record (c) 2025 APA，版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.