Exposure therapy represents the gold-standard treatment for social anxiety, yet evidence indicates the need for improvement. One promising avenue involves linking exposures to a motivator. The current study examined the impact of intrinsically-rewarding, personal values-enhanced versus extrinsically-rewarding, monetary-enhanced exposure on short-term social anxiety fear and avoidance outcomes, and evaluated impacted initial treatment motivation and exposure generalization.

Methods

Sixty emerging adults ages 17–26 with significantly elevated social and public speaking anxiety were randomized to receive values-enhanced exposure, monetary reward-enhanced exposure, or exposure alone. They completed a laboratory session with a brief intervention and speech exposure, one-week follow-up with novel exposure, and online follow-up two weeks later. Subjective and behavioral anxiety measures were collected.

Results

Linking exposures to values decreased self-reported anxiety following the speech exposure retest, which generalized to anticipatory anxiety prior to a novel speech task. Linking exposures to money temporarily increased speech length, but this difference did not remain during the novel task. Conditions showed similar improvements on other outcomes.

Conclusion

Extrinsic motivators can temporarily motivate exposure engagement, whereas a brief values intervention can enhance exposure learning and decrease subjective anxiety across feared situations compared to monetary enhancement. If replicated, this has pragmatic implications for exposure framing within social anxiety treatment.

中文翻译：

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价值-与金钱奖励增强暴露疗法治疗成年初期社交焦虑

暴露疗法代表了社交焦虑的金标准治疗方法，但证据表明需要改进。一种有希望的途径是将暴露与激励因素联系起来。目前的研究考察了内在回报、个人价值观增强与外在回报、金钱增强暴露对短期社交焦虑恐惧和回避结果的影响，并评估了受影响的初始治疗动机和暴露泛化。

方法

60 名 17-26 岁、社交和公开演讲焦虑显着升高的新兴成年人被随机分配接受价值观增强暴露、金钱奖励增强暴露或单独暴露。他们完成了实验室会议，其中包括简短的干预和演讲暴露，为期一周的新颖暴露随访，以及两周后的在线随访。收集主观和行为焦虑测量。

结果

将暴露与价值观联系起来可以减少言语暴露重新测试后自我报告的焦虑，这种焦虑会泛化为新的言语任务之前的预期焦虑。将风险暴露与金钱联系起来暂时增加了演讲的长度，但这种差异在新任务中并没有保留。其他结果也显示出类似的改善。

结论

外在激励因素可以暂时激发暴露参与，而与金钱增强相比，简短的价值观干预可以增强暴露学习并减少对恐惧情况的主观焦虑。如果重复的话，这对于社交焦虑治疗中的暴露框架具有务实的意义。