Maximizing the discrepancy between expected and actual outcomes during exposure (i.e., expectancy violation) is thought to optimize inhibitory learning. The current study examined Craske et al.’s suggestion that engaging in cognitive restructuring (CR) before exposure prematurely reduces expectancy and mitigates outcomes. Participants (N = 93) with claustrophobia were randomly assigned to either 15 minutes of CR before exposure (CR Before) or 15 minutes of CR after exposure (CR After). Although the CR Before condition experienced greater expectancy reduction before exposure than the CR After condition, both groups experienced similar overall expectancy reduction by the end of the intervention. Groups experienced similar gains, with large significant improvement at posttreatment and follow-up. Results suggest that both cognitive therapy and exposure therapy lead to expectancy reduction, but that the order of these interventions does not impact outcome. Clinicaltrials.org registration #NCT03628105.

最大化暴露过程中预期结果和实际结果之间的差异（即违反预期）被认为可以优化抑制性学习。当前的研究检查了 Craske 等人的建议，即在暴露之前进行认知重构 (CR) 会过早地降低预期并减轻结果。患有幽闭恐惧症的参与者 ( N  = 93) 被随机分配到暴露前 15 分钟的 CR ( CR Before ) 或暴露后 15 分钟的 CR ( CR After )。尽管CR Before条件比CR After在暴露前经历了更大的预期减少条件下，两组在干预结束时经历了相似的整体预期下降。小组经历了类似的收获，在治疗后和随访中有很大的显着改善。结果表明，认知疗法和暴露疗法都会导致预期降低，但这些干预措施的顺序不会影响结果。Clinicaltrials.org 注册#NCT03628105。