Exposure therapy has been investigated as a treatment for eating disorders, but prior research has largely neglected core fears underlying the disorder such as rejection, abandonment, disgust, and loss of control. We tested the feasibility and acceptability of using imaginal exposure to target disordered eating related fears by randomizing participants (N = 47) with disordered eating to: imaginal exposure (IE), imaginal exposure preceded by a brief food exposure (IE + Food), or an assessment control. Participants attended two in-person visits and completed pretreatment, posttreatment, and one-month follow-up questionnaires. IE was rated more acceptable than IE + Food. Retention was high across conditions. Habituation occurred for subjective distress and believability of feared outcomes, suggesting that imaginal exposure effectively activates core fears. Distress tolerance and confidence in ability to change improved. Disordered eating symptoms, fears, preoccupations, and rituals decreased in all conditions, indicating that IE was not specifically responsible for improvement.

暴露疗法已被研究作为治疗饮食失调的一种方法，但之前的研究在很大程度上忽略了这种疾病背后的核心恐惧，如拒绝、遗弃、厌恶和失控。我们通过随机化参与者来测试使用想象暴露来应对与饮食失调相关的恐惧的可行性和可接受性（N = 47) 饮食失调：想象暴露 (IE)、短暂食物暴露之前的想象暴露 (IE + 食物)，或评估控制。参与者参加了两次面对面访问，并完成了治疗前、治疗后和一个月的随访问卷调查。IE 比 IE + Food 更容易被接受。各种条件下的保留率都很高。习惯化发生在主观痛苦和恐惧结果的可信度上，这表明想象暴露有效地激活了核心恐惧。抗压能力和对改变能力的信心得到提高。饮食失调症状、恐惧、专注和仪式在所有情况下都减少了，表明 IE 并不是专门负责改善的。