Disorders - Social phobia
Zhang, S., Tao, Y., Chen, Y., Zhang, P., Liu, X.
BACKGROUND: Although the clinical utility of attachment security priming has been suggested in recent years, the effect of attachment
security priming on social anxiety and its core symptoms (i.e., attention bias) remains unspecified. Therefore, the present study explored the
potential effectiveness of repeated attachment security priming in alleviating social anxiety and attention bias among Chinese college students.
\rMETHODS: Fifty-six college students with high social anxiety were randomly assigned to the attachment security priming group (n = 30) or control
group (n = 26). The priming group completed seven attachment security priming sessions over 2 weeks (every 2 days), and the control group was
assigned to a waitlist for 2 weeks.\rRESULTS: The results revealed that individuals in the priming group reported less social anxiety after 2 weeks
of security attachment priming, and those in the control group did not change significantly. The results also showed that there was no significant
change in the attention bias of individuals with social anxiety before and after the intervention.\rCONCLUSIONS: Our findings indicate that
attachment security priming is a promising alternative intervention option for social anxiety. The potential clinical implications of security
attachment priming are discussed.
Behavioral Sciences, 13(5) : 16
- Year: 2023
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Zaizar, E. D., Papini, S., Gonzalez-Lima, F., Telch, M. J.
BACKGROUND: Preclinical findings suggest that transcranial infrared laser stimulation (TILS)
improves fear extinction learning and cognitive function by enhancing prefrontal cortex (PFC) oxygen metabolism. These findings prompted our
investigation of treating pathological fear using this non-invasive stimulation approach either alone to the dorsolateral PFC (dlPFC), or to the
ventromedial PFC (vmPFC) in combination with exposure therapy. METHOD(S): Volunteers with pathological fear of either enclosed spaces, contamination,
public speaking, or anxiety-related bodily sensations were recruited for this randomized, single-blind, sham-controlled trial with four arms: (a)
Exposure + TILS_vmPFC (n = 29), (b) Exposure + sham TILS_vmPFC (n = 29), (c) TILS_dlPFC alone (n = 26), or (d) Sham TILS _dlPFC alone (n = 28).
Post-treatment assessments occurred immediately following treatment. Follow-up assessments occurred 2 weeks after treatment. RESULT(S): A total of
112 participants were randomized [age range: 18-63 years; 96 females (85.71%)]. Significant interactions of Group x Time and Group x Context
indicated differential treatment effects on retention (i.e. between time-points, averaged across contexts) and on generalization (i.e. between
contexts, averaged across time-points), respectively. Among the monotherapies, TILS_dlPFC outperformed SHAM_dlPFC in the initial context, b = -13.44,
95% CI (-25.73 to -1.15), p = 0.03. Among the combined treatments, differences between EX + TILS_vmPFC and EX + SHAM_vmPFC were non-significant
across all contrasts. CONCLUSION(S): TILS to the dlPFC, one of the PFC regions implicated in emotion regulation, resulted in a context-specific
benefit as a monotherapy for reducing fear. Contrary to prediction, TILS to the vmPFC, a region implicated in fear extinction memory consolidation,
did not enhance exposure therapy outcome.
Psychological medicine, 53(3) : 908-917
- Year: 2023
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Specific
Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention
Stefansdottir, I. H., Ivarsson, T., Skarphedinsson, G.
Purpose: To assess the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and
selective noradrenaline reuptake inhibitors (SNRIs) in comparison with various control contingencies (e.g. pill placebo and cognitive behavioral
treatment) for pediatric anxiety disorders. Additionally, we wanted to investigate whether serious adverse events or adverse events are more common
with medication treatment compared with pill placebo. Material(s) and Method(s): Studies were selected if they were randomized controlled trials
evaluating SSRIs or SNRIs. Eligible studies included participants aged 17 years or younger. Eleven studies were included, with 2122 participants.
Primary outcomes were (1) remission, (2) a continuous scale such as the Social Phobia and Anxiety Inventory for Children and (3) serious adverse
events. We also calculated number needed to treat and number needed to harm. Result(s): SSRIs and SNRIs are an effective treatment of childhood
anxiety disorders and are superior to pill placebo. While the risk of serious adverse events was low with SSRI/SNRI treatment, there was an increased
risk of experiencing behavioral activation with SSRI/SNRI treatment. Conclusion(s): SSRI and SNRI treatment is effective for childhood anxiety
disorders, with positive effect of treatment outweighing the negative effects. Copyright © 2022 The Nordic Psychiatric Association.
, 77(2) : 137-146
- Year: 2023
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs), Antidepressants
(any)
Mueller, N. E., Cougle, J. R.
BACKGROUND AND OBJECTIVES: Loneliness is an important factor in mental and physical health.
People with social anxiety disorder (SAD) often report high levels of loneliness, which may be maintained by difficulties with intimacy. Building
Closer Friendships (BCF) is a technology-based intervention we developed to reduce loneliness through reducing fear of intimacy in individuals with
SAD.\rMETHODS: A sample of individuals with current SAD (N = 55), were randomized to BCF or waitlist control conditions and completed self-report
assessments of loneliness, fear of intimacy, social anxiety and other outcomes throughout the study. An in vivo conversation task was also
administered at post-treatment to assess distress and perceived disclosure, warmth, and friendliness of participants when interacting with a
stranger.\rRESULTS: In the intent-to-treat analyses, the BCF group reported lower fear of intimacy at post-treatment compared to the control group.
Among completers, BCF led to lower fear of intimacy at post-treatment and follow-up, and lower loneliness and depression at follow-up compared to the
waitlist control. No treatment effects were found in the conversation task or for other symptom outcomes, including social anxiety. Analyses of
treatment components revealed that the frequency of emotional check-ins with friends was associated with reductions in loneliness and depression.
\rLIMITATIONS: The study was limited by the sample of primarily undergraduate college students, and use of self-report measures.\rCONCLUSIONS: This
preliminary study found modest support for BCF as a computerized intervention to reduce fear of intimacy and loneliness in individuals with SAD.
Journal of Behavior Therapy & Experimental
Psychiatry, 78 : 101799
- Year: 2023
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Skills training, Creative expression: music, dance, drama, art, Technology, interventions delivered using technology (e.g. online, SMS)
Lepage, M., Bowie, C. R., Montreuil,
T., Baer, L., Percie-Du-Sert, O., Lecomte, T., Joober, R., Abdel-Baki, A., Jarvis, G.
E., Margolese, H. C., De-Benedictis, L., Schmitz, N., Malla, A. K.
BACKGROUND: Social anxiety (SA), a prevalent comorbid condition in psychotic disorders with a negative impact on functioning, requires
adequate intervention relatively early. Using a randomized controlled trial, we tested the efficacy of a group cognitive-behavioral therapy
intervention for SA (CBT-SA) that we developed for youth who experienced the first episode of psychosis (FEP). For our primary outcome, we
hypothesized that compared to the active control of group cognitive remediation (CR), the CBT-SA group would show a reduction in SA that would be
maintained at 3- and 6-month follow-ups. For secondary outcomes, it was hypothesized that the CBT-SA group would show a reduction of positive and
negative symptoms and improvements in recovery and functioning.\rMETHOD: Ninety-six patients with an FEP and SA, recruited from five different FEP
programs in the Montreal area, were randomized to 13 weekly group sessions of either CBT-SA or CR intervention.\rRESULTS: Linear mixed models
revealed that multiple measures of SA significantly reduced over time, but with no significant group differences. Positive and negative symptoms, as
well as functioning improved over time, with negative symptoms and functioning exhibiting a greater reduction in the CBT-SA group.\rCONCLUSIONS:
While SA decreased over time with both interventions, a positive effect of the CBT-SA intervention on measures of negative symptoms, functioning, and
self-reported recovery at follow-up suggests that our intervention had a positive effect that extended beyond symptoms specific to
SA.ClinicalTrials.gov identifier: NCT02294409.
Psychological medicine, 53(8) : 3335-3344
- Year: 2023
- Problem: Social phobia (social anxiety disorder), Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Cognitive remediation
therapy
Leigh, E.,
Background: Cognitive therapy for SAD (CT-SAD) is a first-line
recommended treatment for adult social anxiety disorder (SAD) and shows considerable promise for youth. However, the high prevalence of adolescent
SAD and limited number of therapists presents an implementation challenge. Delivery of CT-SAD via the Internet may offer part of the solution.
Method: Forty-three youth (14 - 18 years) with SAD recruited through schools were randomly allocated to therapist-assisted Internet-delivered CT-SAD
(called OSCA) or waitlist for 14 weeks (ISRCTN15079139). Results: OSCA outperformed waitlist on all measures and was associated with large effects
that were maintained at 6-month follow-up. In the OSCA arm, 77% of adolescents lost their SAD diagnosis at post (vs. 14% in the waitlist arm),
increasing to 91% at 6-months. Beneficial effects of OSCA were mediated through changes in cognitions and safety behaviours as predicted by cognitive
models of SAD. OSCA was associated with high credibility and therapeutic alliance. Conclusions: This preliminary trial suggests OSCA holds promise as
an effective, accessible treatment for adolescent SAD. Future definitive trials could compare OSCA to active comparators to examine specificity of
effects. Keywords: Social anxiety disorder; adolescent; CBT; cognitive therapy; internet; digital.
Journal of Child Psychology
and Psychiatry, 64(1) : 145-155
- Year: 2023
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Ferguson, R. J., Ouimet, A. J., Gardam, O.
BACKGROUND
AND OBJECTIVES: People with Social Anxiety Disorder (SAD) evaluate themselves negatively before, during, and after anxiety-provoking social
situations, which leads to negative consequences (e.g., performance deficits, memory impairments, and post-event processing). Despite decades of
research, little is known regarding whether these evaluations generalize to how they view others. Social projection theory-the belief that others are
similar to oneself-might further extend the basic Cognitive Behavioural Therapy (CBT) model. Our aim was to understand whether the degree to which
people negatively evaluate a visibly anxious person causes them to negatively evaluate themselves.\rMETHODS: 172 unselected participants completed
several baseline questionnaires. We then randomly assigned participants to provide high-, medium-, or no-evaluation of a videotaped anxious person
(i.e., other-evaluations) while we assessed their state anxiety. After, they evaluated the anxious person on multiple criteria. Participants then
participated in an impromptu conversation task and subsequently evaluated their own performance.\rRESULTS: Although our manipulation was effective,
we found no emotional or behavioural differences between conditions. However, people in the high-evaluation condition recalled significantly fewer
facts about their conversation partner than did people in the medium- and no-evaluation conditions.\rLIMITATIONS: After data cleaning, the sample
size was slightly smaller than planned; most analyses were nonetheless appropriately powered. Our findings may not generalize beyond unselected
undergraduate students; replication in a clinical sample is warranted.\rCONCLUSIONS: These findings highlight the cognitive consequences (i.e.,
memory impairments) of other-evaluations, which cognitive behavioural therapists should consider when treating individuals with SAD.
Journal of Behavior Therapy &
Experimental Psychiatry, 80 : 101763
- Year: 2023
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Fadardi, J. S., Memarian, S., Parkinson, J., Cox, W., Stacy, A. W.
Consistent with cognitive models of social anxiety, socially anxious
individuals show cognitive biases that magnify their perceived level of threat in the environment. Objectives: The first objective was to determine
whether attentional bias for socially threatening stimuli occurs after concomitant depression has been controlled. The second objective was to test
the effectiveness of the Attention Control Training Program for Social Anxiety (ACTP-SA) for reducing social anxiety attentional bias and improving
therapeutic indices in people with social anxiety. Method: In the first study, socially anxious (N = 30) and non-anxious individuals (N = 30)
completed the Beck Depression Inventory-II, Spielberger's State-Trait Anxiety Inventory, Conner's Social Phobia Inventory, a socialanxiety Stroop
test, and a clinical interview. In the second study, individuals with social anxiety (N = 30) were randomly assigned to an experimental group that
received 4 sessions of ACTP-SA, or to a sham-intervention control condition. At the post-test and a 3-month follow-up, both groups completed the same
measures as in Study 1. Results: In Study 1, socially anxious individuals showed higher attentional bias for threatening stimuli than the controls,
after depression had been controlled for. In Study 2, participants in the experimental group, compared with the controls, showed greater reductions
in attentional bias, social anxiety, and trait anxiety at post-test and follow-up. Conclusions: The results underscore the importance of information
processing biases in social anxiety and the benefits of attentional bias training as a complementary intervention for modifying symptoms of social
anxiety.
Journal of Psychiatric Research, 157 : 141-
151
- Year: 2023
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Bomyea, J., Sweet, A., Davey,
D. K., Boland, M., Paulus, M. P., Stein, M. B., Taylor, C. T.
Social
anxiety is associated with diminished automatic approach toward positive social cues that may limit the ability to connect with others. This
diminished approach bias may be a modifiable treatment target. We evaluated the effects of an approach avoidance training procedure on positive
emotions, social relationship outcomes, clinical symptoms, and neural indices of social approach and reward processing. Forty-five individuals with
social anxiety disorder were randomized (parallel 1:1 randomization) to complete computerized Approach Positive training (n = 21) or Balanced
training(n = 24). Sessions included a standardized social interaction task. Participants were blind to training group. Participants completed
clinical outcome measures and functional magnetic resonance imaging at baseline and post intervention with an MRI-compatible AAT and the social
incentive delay task (SID). Both groups displayed significant improvements of similar magnitude on the primary outcome of social connectedness
(between group post-treatment d = -0.21) but not positive affect (d = -0.09), from before to after treatment, persisting through follow-up. Groups
demonstrated significant improvements on additional outcomes including anxiety, depression, and anhedonia symptoms. Participants in Approach Positive
AAT demonstrated increased activation in the thalamus and medial prefrontal cortex during social versus neutral- approach relative to Balanced AAT
during the fMRI AAT. Participants in Balanced AAT showed increased activation in regions within an a priori-defined striatum region of interest mask
during anticipation of social reward (vs. baseline) in the SID relative to Approach Positive AAT. At a neural processing level AAT may influence the
valuation and motivations associated with positive social cues regulated by the mPFC and thalamus. NCT02136212, NIMH R00MH090243. Copyright © 2022
The Authors
, 324 : 36-
45
- Year: 2023
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Thomas-Alwa-Edison, K.
\"Apprehensive students experience fear and avoidance, which can result in severe anguish, poor speaking ability, and related
issues with psychosocial functioning. Most comprehensive speaking anxiety treatments place more of a focus on reducing anxiety than improving
behavioural performance\" (Hofmann et al. 2010, p.14). The effectiveness of two quick treatments was contrasted in this study. A sample of 140
anxious people received one of two treatments: cognitive-behavioural interventions and the other was standard instruction. An intervention lasting
fiveweeks was carried out randomly among the participants. Assessments were conducted both before and after therapy. According to experimental
findings, individuals in the CBT condition improved significantly more than those in the control condition. In general, these results indicate that
CBT counselling lowers speaking anxiety. Copyright © 2022, Anka Publishers. All rights reserved.
NeuroQuantology, 20
(6) : 9963-9972
- Year: 2022
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Stentz, L.
A., Cougle, J. R.
Individuals with social anxiety disorder commonly engage in safety behaviors (SBs), which are
behavioral and cognitive strategies employed in an effort to avoid or decrease the likelihood of a feared threat outcome and decrease anxiety in
social situations. These behaviors are thought to be dysfunctional and play a key role in contemporary models of the disorder. The current
experimental study sought to expand upon existing research by examining the role of SBs in social anxiety and self-disclosure. Participants with
elevated social anxiety symptoms (N = 115) were randomized to either a two-week SB fading manipulation or a no-instruction control. Self-report
measures were administered pre- and post-manipulation, and participants completed an in-vivo speech task at post. SB fading led to lower social
anxiety symptoms at post relative to the control. SB fading also led to greater self-reported openness to general self-disclosure and emotional
disclosure compared to the control, though these effects were modest. No condition effect on emotional reactivity to a speech task was observed. SB
fading led to greater observer-rated disclosure on the speech task than control, though this was only found among those high in dispositional self-
disclosure at baseline. The present study provides further evidence for the importance of SBs in social anxiety and suggests SB fading might lead to
greater comfort with self-disclosure. Limitations and directions for future research are discussed. Copyright © 2022
Behaviour Research and Therapy, 157 (no
pagination) :
- Year: 2022
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Singh, P., Samantaray, N.
N.
Background: Considering the need for developing and examining
evidenced-based programs using a brief group format for management of social anxiety disorder (SAD) at the community level, we studied the efficacy
of two brief versions of cognitive-behavioral therapy (CBT) programs, brief cognitive-behavioral group therapy (bCBGT), and verbal exposure augmented
cognitive behavioral therapy (VE-CBT), on social anxiety among university students.\rMethods: A single-center, randomized, parallel-group design was
adopted. We delivered six weekly two-hour group sessions, bCBGT and VE-CBT, to 41 university students diagnosed with SAD. An independent rater
assessed participants using the Liebowitz Social Anxiety Scale (LSAS) and Clinical Global Impression scale-Severity (CGI-S) at baseline,
postintervention, and two-month follow-up. A patient-rated measure, Social Phobia Inventory (SPIN), was assessed at the same time-points.\rResults:
There was a significant improvement in severity of social anxiety from baseline to posttreatment and baseline to two-month follow-up in both groups.
However, the treatment effects in bCBGT were statistically superior to VE-CBT at postintervention (SPIN, P = 0.038; LSAS, P = 0.028; CGI-S, P =
0.036) and follow-up (SPIN, P = 0.006; LSAS, P = 0.01; CGI-S, P = 0.04).\rConclusions: Brief CBT treatments, both bCBGT and VE-CBT, are efficacious
for SAD among university students. They have the potential to address barriers associated with SAD management. However, we recommend a longer
follow-up and replications in diverse settings.Clinical trial registration number: CTRI/2019/11/021954.
Indian Journal of Psychological Medicine, 44(6) : 552-
557
- Year: 2022
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention