Although Exposure Therapy (ET) is the first-line treatment of Specific Phobia (SP), there is no clear consensus on which factors influence its success, and thus on how to conduct it most efficiently. This review summarizes the current state of research regarding this topic. N = 111 studies were in accordance with our eligibility criteria: participants had at least symptoms of SP, the intervention was ET and the study investigated a factor influencing its success. Best evidence for positive effects was found for low trait anxiety, high motivation and high self-efficacy before the ET, high cortisol levels and heart rate variation, evoking disgust additionally to anxiety, avoiding relaxation, focusing on cognitive changes, context variation, sleep, and memory-enhancing drugs. These factors may be conceptualized as modulating different aspects of learning as suggested in current models of ET that focus on inhibitory learning mechanisms. Limitations lie in the great heterogeneity concerning operationalization of factors and success. Based on these findings, we make suggestions for improvements in ET conduction and which factors should be researched in the future.

中文翻译：

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影响特定恐惧症暴露疗法成功的因素：系统评价。

尽管暴露疗法（ET）是特异性恐惧症（SP）的一线治疗方法，但对于哪些因素影响其成功率以及如何最有效地进行治疗尚无明确的共识。这篇综述总结了有关该主题的研究现状。N = 111项研究符合我们的入选标准：参与者至少有SP症状，干预为ET，并且研究调查了影响其成功的因素。在ET发作前发现低性格焦虑，高动机和高自我效能感，高皮质醇水平和心率变化，对焦虑不禁引起厌恶，避免放松，专注于认知变化，情境变化，睡眠，和增强记忆力的药物。可以将这些因素概念化为调节学习的不同方面，如当前以抑制性学习机制为重点的ET模型所建议的那样。局限性在于因素操作和成功的巨大异质性。基于这些发现，我们提出了改善ET传导的建议，以及今后应研究哪些因素。