Effects of post-exposure naps on exposure therapy for social anxiety

PSYCHIATRY RESEARCH

卷:270

Article

Pace-Schott, Edward F.¹  Bottary, Ryan M.^1,5  Kim, Se-Yun¹  Rosencrans, Peter L.¹  Vijayakumar, Shilpa¹  Orr, Scott P.¹  Lasko, Natasha B.¹  Goetter, Elizabeth M.¹  Baker, Amanda W.¹  Bianchi, Matt T.²  Gannon, Karen²  Hoeppner, Susanne S.¹  Hofmann, Stefan G.³  Simon, Naomi M.^1,4 

[1] Univ Washington, Dept Psychol, Seattle, WA 98195 USA

[2] Harvard Med Sch, Massachusetts Gen Hosp, Dept Neurol, Boston, MA USA

[3] Boston Univ, Dept Psychol & Brain Sci, Boston, MA 02215 USA

[4] NYU, Sch Med, Dept Psychiat, New York, NY USA

[5] Boston Coll, Dept Psychol, Chestnut Hill, MA 02167 USA

关键词: Sleep;    Social anxiety disorder;    Exposure therapy;    Extinction;    Psychophysiology;    Cortisol;   

DOI  :  10.1016/j.psychres.2018.10.015

来源: Elsevier

【 摘 要 】

Exposure therapy for social anxiety disorder (SAD) utilizes fear extinction, a memory process enhanced by sleep. We investigated whether naps following exposure sessions might improve symptoms and biomarkers in response to social stress in adults undergoing 5-week exposure-based group SAD therapy. Thirty-two participants aged 18-39 (18 females) with SAD were randomized. Before and after treatment, participants completed the Liebowitz Social Anxiety Scale (LSAS) and underwent a Trier Social Stress Test with psychophysiological monitoring (mpTSST) that included skin conductance (SCL), electromyographic (EMG) and electrocardiographic recording, and an auditory startle procedure while anticipating the social stressor. At sessions 3 and 4, exposure was followed by either a 120-min polysomnographically monitored sleep opportunity (Nap, N = 17) or wakefulness (Wake, N = 15). Primary hypotheses about SAD symptom change (LSAS) and EMG blink-startle response failed to differ with naps, despite significant symptom improvement (LSAS) with therapy. Some secondary biomarkers, however, provided preliminary support for enhanced extinction learning with naps, with trend-level Time (pre-, post-treatment) x Arm interactions and significant reduction from pre- to post treatment in the Nap arm alone for mpTSST SCL and salivary cortisol rise. Because of the small sample size and limited sleep duration, additional well-powered studies with more robust sleep interventions are indicated.

【 授权许可】

Free