High patient emotional arousal during rationale development for in vivo exposure in CBT for panic disorder with agoraphobia might endanger comprehension of the exposure rationale. Since therapists are supposed to coregulate patients' emotions, this study investigated whether there was evidence of coregulation of vocally encoded emotional arousal, assessed by fundamental frequency (f0), during rationale development. Furthermore, the association of patient f0 stability and therapist coregulation with patients' perceived rationale plausibility was analyzed. N = 197 therapy videos-used to deduct f0-from a multicenter randomized controlled trial evaluating therapist-guided exposure on CBT outcome were analyzed post hoc. Plausibility of the exposure rationale was assessed by patients after its development. This trial-specific rating aggregates plausibility ratings for every manual component in the development of the exposure rationale and showed good internal consistency (Cronbach's alpha = .85). Stability in f0 and its coregulation were calculated using cross-lagged Actor-Partner Interdependence Models (APIMs), and APIM dyad estimates were associated with plausibility using linear regression analyses. Analyses indicated a relative stability in emotional arousal within both patients and therapists. Therapists' f0 had a significant effect on patients in that with therapist covariation, patients' f0 departed from their equilibrium level, while patients' f0 had no effect on therapists. Therapists' f0 covariation was positively associated with rationale plausibility. This study sheds light on interpersonal regulation mechanisms of patients' and therapists' emotional arousal during development of the exposure rationale. It suggests that coregulation of patients' emotional arousal supports patients' perceived rationale plausibility. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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使用声音编码和演员-伴侣相互依赖模型研究基于暴露的 CBT 期间情绪唤醒的协同调节。

在患有广场恐惧症的恐慌症的 CBT 体内暴露的基本原理发展过程中，患者的高情绪唤醒可能会危及对暴露基本原理的理解。由于治疗师应该共同调节患者的情绪，因此本研究调查了在基本频率 (f0) 的基本频率 (f0) 评估过程中，是否有证据表明声音编码的情绪唤起协同调节。此外，还分析了患者 f0 稳定性和治疗师协同调节与患者感知的合理性之间的关联。N = 197 个治疗视频——用于从一项评估治疗师指导暴露对 CBT 结果的多中心随机对照试验中扣除 f0——进行了事后分析。暴露原理的合理性在其发展后由患者评估。该试验特定评级汇总了暴露基本原理制定过程中每个手动组件的合理性评级，并显示出良好的内部一致性（Cronbach's alpha = .85）。f0 的稳定性及其协同调节是使用交叉滞后的参与者-合作伙伴相互依赖模型 (APIM) 计算的，并且 APIM 二元估计与使用线性回归分析的合理性相关联。分析表明，患者和治疗师的情绪唤醒相对稳定。治疗师的 f0 对患者有显着影响，因为治疗师协变，患者的 f0 偏离了他们的平衡水平，而患者的 f0 对治疗师没有影响。治疗师的 f0 协变与合理性正相关。这项研究揭示了暴露原理发展过程中患者和治疗师情绪唤醒的人际调节机制。这表明患者情绪唤醒的协同调节支持患者感知的合理性。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。