There is a longstanding debate in the cognitive behavioral literature whether exposure-based methods produce more sustainable outcomes relative to cognitive methods or vice versa. This debate concerns particularly the time after treatment termination (at follow-up assessments), also referred to as the sleeper effect. Therefore, the aim of the current meta-analysis was to examine the enduring efficacy of Exposure Therapy (ET) in comparison to Cognitive Therapy (CT) from treatment termination to follow-up in anxiety disorders. Available literature also allowed for the assessment of their long-term additive benefits relative to ET only. Traditional random effects analyses with restricted maximum likelihood estimators and multilevel longitudinal analyses were conducted on 39 randomized controlled trials (N = 1878). Traditional analyses revealed no differential efficacy at post-treatment or follow-up. Similarly, the multilevel longitudinal analyses identified no differential growth in efficacy from treatment termination to follow-up. The majority of the variables investigated did not moderate the results. However, there was evidence suggesting that CT was superior to ET when treatment was delivered individually, while ET was superior to CT when delivered as group therapy. Overall, the findings did not validate a number of assumptions, such as the existence of a sleeper effect. Several strengths and limitations are further discussed in the paper.

认知行为文献中存在一个长期争论，即基于接触的方法相对于认知方法能否产生更可持续的结果，反之亦然。这场辩论特别涉及治疗终止后的时间（在随访评估中），也称为睡眠效应。因此，目前的荟萃分析的目的是要检查暴露疗法（ET）与认知疗法（CT）从焦虑症终止治疗到随访的持久疗效。现有文献还允许评估其相对于仅ET的长期附加效益。对39个随机对照试验进行了传统的带有最大似然估计值受限的随机效应分析和多级纵向分析（N  = 1878）。传统分析显示，在后处理或随访中疗效无差异。同样，多级纵向分析发现，从治疗终止到随访，疗效均无差异。所研究的大多数变量并未使结果适中。但是，有证据表明，当单独进行治疗时，CT优于ET，而作为集体疗法进行时ET优于CT。总体而言，这些发现并不能验证许多假设，例如是否存在卧铺效应。本文进一步讨论了一些优点和局限性。