Disorders - Social phobia
Whiteside, S. P., Ale, C. M., Young, B., Dammann, J. E., Tiede, M. S., Biggs, B. K.
This preliminary randomized controlled
trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls)
ages 7 to 14 (m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6
sessions of either a) the pre-exposure anxiety management strategies presented in traditional CBT, or b) parent-coached exposure therapy. The sample
was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts,
and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with
pre-post effect sizes generally in the large range for both conditions. Between-group effect sizes indicating greater improvement with parent-coached
exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re-evaluation after three months of open treatment suggested
that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments. (PsycINFO Database Record (c) 2015
APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 73 : 83-
89
- Year: 2015
- Problem: Anxiety Disorders (any), Panic
Disorder, 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
Yao, N., Yu, H., Qian, M., Li, S.
Attention bias modification (ABM) is designed to modify threat-related
attention bias and thus alleviate anxiety. The current research examined whether consistently directing attention towards targeted goals per se
contributes to ABM efficacy. We randomly assigned 68 non-clinical college students with elevated social anxiety to non-valence-specific attend-to-
geometrics (AGC), attention modification (AMC), or attention control (ACC) conditions. We assessed subjective, behavioral, and physiological
reactivity to a speech task and self-reported social anxiety symptoms. After training, participants in the AMC exhibited an attention avoidance from
threat, and those in the AGC responded more rapidly toward targeted geometrics. There was a significant pre- to post-reduction in subjective speech
distress across groups, but behavioral and physiological reactivity to speech, as well as self-report social anxiety symptoms, remained unchanged.
These results lead to questions concerning effectiveness of ABM training for reducing social anxiety. Further examination of the current ABM protocol
is required. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of
Anxiety Disorders, 36 : 52-62
- Year: 2015
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Thorgeirsdottir, M. T., Bjornsson, A. S., Arnkelsson, G. B.
This study was designed to explore differences in group climate development
between 2 brief group therapies, cognitive-behavioral group therapy (CBGT) and group psychotherapy (GPT), using multilevel growth curve analysis.
Participants were 45 university students with a primary diagnosis of social anxiety disorder (SAD), randomly assigned to either of the 2 treatment
conditions. Each group consisted of 8 weekly 2-hr sessions and members completed the Group Climate Questionnaire after each session. Similar patterns
were found in both treatment conditions; engagement increased throughout the sessions, avoidance decreased, and conflict was overall low. The results
support the hypothesis that brief group therapies (consisting of less than 10 sessions) will stay in the engagement phase of MacKenzie's 4-stage
developmental model. There was less conflict in the CBGT groups compared with GPT, reflecting the more dynamic and interactive nature of the latter
treatment. Conflict was lower than reported in previous studies, which may be attributable to the SAD diagnosis of group members. Future directions
involve comparing group climate development between treatments of varying duration, between different treatment orientations and with members
diagnosed with different disorders. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Group Dynamics: Theory, Research, & Practice, 19(3) : 200-
209
- Year: 2015
- 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), Other Psychological Interventions
Reimer, S.
G., Moscovitch, D. A.
Negative mental images in social anxiety disorder (SAD)
are often rooted in autobiographical memories of formative, distressing life events. In the present study, 25 participants with SAD retrieved an
idiosyncratic negative mental image and associated autobiographical memory. Participants were then randomly assigned either to a single-session of
imagery rescripting (IR) targeting the retrieved autobiographical memory or to a non-intervention control condition (no-IR). Outcomes were assessed
one week later. Compared to control participants, those who received IR experienced substantial reduction in SAD symptoms accompanied by more
positive and less negative appraisals of their autobiographical memories. Moreover, IR relative to no-IR participants reported marked shifts in the
content, validity, and accuracy of their memory-derived negative core beliefs about self and others, but not about the world. Results support the
promise of IR as a stand-alone intervention for SAD and suggest important directions for future research to enhance our understanding of the
cognitive mechanisms that underlie its effects.
Behaviour Research & Therapy, 75 : 48-59
- Year: 2015
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Nowakowski, M.E., Antony, M. M., Koerner, N.
Background and objectives: The present
study investigated the effects of computerized interpretation training and cognitive restructuring on symptomatology, behavior, and physiological
reactivity in an analogue social anxiety sample. Methods: Seventy-two participants with elevated social anxiety scores were randomized to one session
of computerized interpretation training (n = 24), cognitive restructuring (n = 24), or an active placebo control condition (n = 24). Participants
completed self-report questionnaires focused on interpretation biases and social anxiety symptomatology at pre and posttraining and a speech task at
posttraining during which subjective, behavioral, and physiological measures of anxiety were assessed. Results: Only participants in the
interpretation training condition endorsed significantly more positive than negative interpretations of ambiguous social situations at posttraining.
There was no evidence of generalizability of interpretation training effects to self-report measures of interpretation biases and symptomatology or
the anxiety response during the posttraining speech task. Participants in the cognitive restructuring condition were rated as having higher quality
speeches and showing fewer signs of anxiety during the posttraining speech task compared to participants in the interpretation training condition.
Limitations: The present study did not include baseline measures of speech performance or computer assessed interpretation biases. Conclusions: The
results of the present study bring into question the generalizability of computerized interpretation training as well as the effectiveness of a
single session of cognitive restructuring in modifying the full anxiety response. Clinical and theoretical implications are discussed. (PsycINFO
Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Behavior Therapy & Experimental Psychiatry, 49(Part A) : 44-
52
- Year: 2015
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Nordmo, M., Sinding, A.
I., Carlbring, P., Andersson, G., Havik, O. E., Nordgreen, T.
Background: Guided
Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment of social anxiety disorder (SAD). However, the treatment is not
effective for all. The amount and type of therapist contact have been highlighted as a possible moderator of treatment outcome. Objective: The aim of
this study was to examine whether treatment effects of ICBT are enhanced with an initial 90. min face-to-face psychoeducation (PE) session for
university students with SAD. Method: University students with SAD (N=37) were randomized into one out of two conditions: 1) an initial therapist-led
face-to-face PE session followed by guided ICBT, 2) guided ICBT without an initial PE session. Data was analysed with an intent-to-treat approach.
Results: Eight participants (21.6%) dropped out of treatment. A statistically significant reduction in symptoms was found for all outcome measures
for both groups. There were no significant additional effects of adding the initial face-to-face PE. Moderate to large within-group effect sizes on
self-rated social anxiety symptoms were found at post-treatment (d=0.70-0.95) and at a six month follow-up (d=0.70-1.00). Nearly half of the
participants were classified as recovered. Conclusions: Notwithstanding limitations due to the small sample size, the findings indicate that guided
ICBT is an effective treatment for students with SAD. Adding an initial face-to-face PE session to the guided ICBT did not lead to enhanced outcomes
in the present study.
Internet Interventions, 2(4) : 429-
436
- Year: 2015
- 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), Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Ost, L. G., Cederlund, R., Reuterskiold, L.
Social phobia is one of the most common anxiety disorders in children and adolescents, and it runs a fairly chronic course if left
untreated. The goals of the present study were to evaluate if a parent education course would improve the outcome for children with a primary
diagnosis of social phobia and if comorbidity at the start of treatment would impair the outcome of the social phobia. A total of 55 children, 8-14
years old, were randomly assigned to one of three conditions: 1) Child is treated, 2) Child is treated and parent participates in the course, or 3) A
wait-list for 12 weeks. The treatment consisted of individual exposure and group social skills training based on the Beidel, Turner, and Morris
(2000) SET-C. Children and parents were assessed pre-, post-, and at one year follow-up with independent assessor ratings and self-report measures.
Results showed that there was no significant difference between the two active treatments and both were better than the wait-list. The treatment
effects were maintained or furthered at the follow-up. Comorbidity did not lead to worse outcome of social phobia. Comorbid disorders improved
significantly from pre-to post-treatment and from post-to follow-up assessment without being targeted in therapy.
Behaviour Research
& Therapy, 67 : 19-29
- Year: 2015
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Psychoeducation, Skills training, Other Psychological Interventions
Piacentini,
J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., March, J., Sherrill, J., Sakolsky, D., Ginsburg,
G., Rynn, M., Bergman, R. L., Gosch, E., Waslick, B., Iyengar, S., McCracken, J., Walkup, J.
Objective We report active treatment group differences on response and
remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N =
488; 74% (less-than or equal to)12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of
cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly
booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT,
and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if
nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity,
functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results The majority (>80%) of acute
responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which
did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth
in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus
psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained
indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among
youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced
sustained treatment benefit. Clinical trial registration information - Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials.
gov. Unique identifier: NCT00052078.
Journal of the American Academy of Child & Adolescent Psychiatry, 53(3) : 297-
310
- Year: 2014
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Khalili-Torghabeh, S., Fadardi, J. S., Mackintosh, B., Reynolds, S., Mobini, S.
This study examines the effects of a multi-session
Cognitive Bias Modification (CBM) program on interpretative biases and social anxiety in an Iranian sample. Thirty-six volunteers with a high score
on social anxiety measures were recruited from a student population and randomly allocated into the experimental and control groups. In the
experimental group, participants received 4 sessions of positive CBM for interpretative biases (CBM-I) over 2 weeks in the laboratory. Participants
in the control condition completed a neutral task matched the active CBM-I intervention in format and duration but did not encourage positive
disambiguation of socially ambiguous scenarios. The results indicated that after training the positive CBM-I group exhibited more positive (and less
negative) interpretations of ambiguous scenarios and less social anxiety symptoms relative to the control condition at both 1 week post-test and 7
weeks follow-up. It is suggested that clinical trials are required to establish the clinical efficacy of this intervention for social anxiety.
(PsycINFO Database Record (c) 2015 APA, all rights reserved). (journal abstract)
Journal of Experimental Psychopathology, 5(4) : 514-
527
- Year: 2014
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Wergeland,
G. J. H., Fjermestad, K. W., Marin, C. E., Haugland, BS-M., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Ost, L-G., Havik, O.
E., Heiervang, E. R.
Objective: Conducted a randomized controlled trial to
investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT)
treatment approaches for anxiety disorders in children and adolescents.; Methods: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53%
girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in
community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures.
After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement,
and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.; Results: Significantly more youth lost all
anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly
different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and
ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.;
Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences
between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their
transportability from university to community settings.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Behaviour
Research & Therapy, 57 : 1-12
- Year: 2014
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, 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), Other service delivery and improvement
interventions
Stevanovic, D., Tadic, I., Knez, R.
There is some evidence indicating that
psychotropic medications might lead to health-related quality of life (QOL) improvements among children and adolescents with psychiatric disorders.
The aim of this systematic review is to assess evidence regarding whether antidepressant treatment improves QOL among children and adolescents with
depressive or anxiety disorders. A comprehensive search resulted in 5 clinical trials to be included in this review: 4 trials with major depressive
disorder (MDD) and 1 trial with social anxiety disorder (SAD). In one MDD trial, fluoxetine combined with cognitive behavior therapy (CBT)
significantly improved QOL compared to fluoxetine or CBT alone (effect sizes were 0.53 and 0.69, respectively). In 2 combined trials, sertraline
alone significantly improved QOL among adolescents with MDD (effect size was 0.29), but not among children with MDD. Essentially, it was observed
that antidepressants in these trials had minor positive effects on QOL improvement, which were lower than their potential to improve depressive
symptoms. Although fluoxetine with CBT or sertraline monotherapy were shown to have some potential to improve QOL, this systematic review found
inconclusive evidence that antidepressant treatments improve QOL among children and adolescents with depressive or anxiety disorders. More research
is required, considering that QOL is currently under-evaluated in clinical trials with antidepressants among children and adolescents and available
trials have limited methodological quality when reporting QOL data.
CNS Spectrums, 19(2) : 134-141
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Shikatani, B., Antony, M. M., Kuo, J. R., Cassin, S. E.
Postevent processing (PEP; reviewing a past social event in detail) is a key maintenance factor of social
anxiety disorder (SAD). The current study examined the efficacy of a single session cognitive restructuring or mindfulness strategy on decreasing PEP
and its associated effects, and investigated the cognitive processes involved. Fifty-six individuals with SAD completed a speech task to elicit PEP
and were taught a cognitive restructuring, mindfulness, or control strategy to manage their negative thoughts. Participants in the cognitive
restructuring and mindfulness conditions reported significantly reduced PEP and improved affect as compared to the control condition. There were no
significant differences between the cognitive restructuring and mindfulness conditions. Participants in the cognitive restructuring condition
reported decreased probability and cost biases. Regardless of study condition, decreases in cost biases and maladaptive beliefs significantly
predicted reductions in PEP. Cognitive restructuring and mindfulness appear to be promising strategies to decrease PEP and improve affect.
(copyright) 2014 Elsevier Ltd.
Journal of Anxiety Disorders, 28(6) : 570-
579
- Year: 2014
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Mindfulness based
therapy