对于患有特定恐惧症的人来说,这是个好消息:皮质醇可能会提高暴露疗法的疗效。

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本文发表于《大众科学》的前博客网络,反映了作者的观点,不一定代表《大众科学》的观点


最初发布于 2011 年 4 月 21 日的 Field of Science,当时是Research Blogging 编辑的选择

本周早些时候,我分享了我对呕吐的特定恐惧症的故事,今天我将写一篇关于最近发表在《美国国家科学院院刊》(PNAS)上(开放获取!)的文章,内容是关于在特定恐惧症的暴露疗法中补充皮质醇的疗效。

皮质醇,我之前写过博客提到过,是人类压力反应中涉及的主要内分泌激素(皮质酮,一种密切相关的类固醇,在许多其他动物中起着相同的作用)。对于许多人来说,压力体验也是一种学习体验(“我再也不会做事了...”等等),而皮质醇似乎对记忆的构建和检索有影响。具体来说,它似乎能促进新记忆的存储,同时抑制已存储记忆的检索。这使得它成为暴露疗法中一种潜在的有益补充剂,暴露疗法的基础是用反复非创伤性的暴露来“解除”对物体、事件或情况的创伤性记忆。


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在这项研究中,作者比较了两组正在接受恐高症暴露疗法的人:一组是接受安慰剂的对照组,另一组是接受 20 毫克皮质醇(在治疗前一小时服用)的实验组。(两组的基线皮质醇水平没有差异,实验组的循环皮质醇水平确实较高,这两者都通过唾液样本得到验证。)

暴露疗法降低了两组的自我报告恐惧感,但在皮质醇组中,这种效果被放大,无论是在治疗后 3-5 天还是在 一个月后的随访中。 这表明,补充皮质醇可以提高暴露疗法在患有特定恐高症的人中的疗效。 但是,还需要进行更多的研究,以了解皮质醇治疗是否对恐惧反应具有持续的长期影响。

我不敢高兴得太早,因为我不知道对于我的特定恐惧症,暴露疗法(无论是否使用皮质醇)是否有效,甚至是否可行。我不确定这些结果能在多大程度上推及到其他特定的恐惧症,尽管之前的研究表明它可能对蜘蛛恐惧症和社交恐惧症也有益。


de Quervain, D., Bentz, D., Michael, T., Bolt, O., Wiederhold, B., Margraf, J., & Wilhelm, F. (2011). 糖皮质激素增强基于消退的心理疗法《美国国家科学院院刊》DOI: 10.1073/pnas.1018214108

"Life creates [the Force], makes it grow. Its energy surrounds us and binds us. Luminous beings are we, not this crude matter," Yoda explains in The Empire Strikes Back, gesturing to Luke's physical body. This quote is striking because of the apt juxtaposition of the wonder of life with its often disgusting vessel. Like many other animals, we secrete, excrete, expectorate, defecate, flatulate, regurgitate, urinate, circulate, masticate, menstruate, ejaculate, and ventilate. We are filled with gas and feces and blood and guts and mucus and any number of rude things. Life as we know it is possible because of the countless impolite things we do every day. Are we luminous beings? Perhaps, but that's neither here nor there. This blog is about the crude matter that keeps us alive.

Michelle Clement has a B.Sc. in zoology (with a minor in American culture studies) and a M.Sc. in organismal biology from The Ohio State University. Her thesis research was on the ecophysiology of epidermal lipids and water homeostasis in house sparrows. She now works as a technical editor for The American Chemical Society. Her broader interests include weird human and animal physiology, obesity and enteric physiology, endocrinology, sexual and reproductive health, personal genomics, anthropology (physical and cultural), sociology, and science education and communication. She lives in Ohio with her boyfriend and two cats.

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