Disorders - Social phobia
Crawley, S. A., Caporino, N. E., Birmaher, B., Ginsburg, G., Piacentini, J., Albano, A. M., Sherrill, J, Sakolsky, D., Compton, S. N., Rynn,
M., McCracken, J., Gosch,
E., Keeton, C., March, J., Walkup, J. T., Kendall, P. C.
This study examined (a) demographic and clinical characteristics
associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication
(sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7 - 17 years) with a principal diagnosis of generalized
anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received
treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and
severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing
disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical
symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research
are discussed (ClinicalTrials.gov number, NCT00052078). (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Child Psychiatry & Human Development, 45(4) : 398-
407
- Year: 2014
- Problem: Anxiety Disorders (any), 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)
De-Voogd, E. L., Wiers, R. W., Prins, P. J. M., Salemink, E.
Background and objectives An attentional bias for
negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in
adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated
whether visual search ABM might affect attentional bias and emotional functioning in adolescents. Methods A visual search task was used as a training
paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 null 4 matrix of negative emotional
faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version
of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and
self-esteem were measured pre- and post-training. Results After two sessions of training, the ABM group showed a significant decrease in attentional
bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood
or self-esteem. Limitations No correlation between attentional bias and social phobia was found, which raises questions about the validity of the
attentional bias assessment task. Also, the small sample size precludes strong conclusions. Conclusions Visual search ABM might be beneficial in
changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed. (copyright)
2013 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 45(2) : 252-259
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Garcia-Lopez, L. J.
The role that parents' involvement
may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high
expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13-18 years),
whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training
component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month
follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant
reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings
suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.
Journal of Anxiety Disorders, 28(8) : 812-
822
- Year: 2014
- 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
Gimenez, M., Ortiz, H., Soriano-Mas, C., Lopez-Sola,
M., Farre, M., Deus, J., Martin-Santos, R., Fernandes, S., Fina, P., Bani, M., Zancan,
S., Pujol, J., Merlo-Pich, E.
Recent studies suggest that pharmacologic
effects of anxiolytic agents can be mapped as functional changes in the fear, stress and anxiety brain circuit. In this work we investigated the
effects of a standard treatment, paroxetine (20. mg/day), in subjects with Social Anxiety Disorder (SAD) versus placebo using different fMRI
paradigms. The fMRI sessions, performed before and after the treatment, consisted of a public exposition of recorded performance task (PERPT), an
emotional face processing task (EFPT) and a 6-min resting state followed by an off-scanner public speaking test. Paroxetine significantly improved
the clinical conditions of SAD patients (n=17) vs. placebo (n=16) as measured with Clinical Global Inventory - Improvement (CGI-I) while no change
was seen when using Liebowitz Social Anxiety Scale, as expected given the small size of the study population. Paroxetine reduced the activation of
insula, thalamus and subgenual/anterior cingulate cortex (ACC) in PERPT. Resting-state fMRI assessment using Independent Component Analysis indicated
that paroxetine reduced functional connectivity in insula, thalamus and ACC when compared with placebo. Both paradigms showed significant correlation
with CGI-I in rostral prefrontal cortex. Conversely, paroxetine compared to placebo produced activation of right amygdala and bilateral insula and no
effects in ACC when tested with EFPT. No treatment effects on distress scores were observed in the off-scanner Public Speaking Test. Overall this
study supports the use of fMRI as sensitive approach to explore the neurobiological substrate of the effects of pharmacologic treatments and, in
particular, of resting state fMRI given its simplicity and task independence. (copyright) 2013 Elsevier B.V. and ECNP.
European
Neuropsychopharmacology, 24(1) : 105-116
- Year: 2014
- Problem: 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)
Ginsburg, G. S., Becker, E. M., Keeton, C. P., Sakolsky, D., Piacentini, J., Albano, A. M., Compton, S. N., Iyengar, S., Sullivan, K., Caporino, N., Peris, T., Birmaher, B., Rynn, M., March,
J., Kendall, P. C.
IMPORTANCE
Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems.
Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents,
particularly those treated with medication., OBJECTIVE To determine whether acute clinical improvement and treatment type (ie, cognitive behavioral
therapy, medication, or their combination) predicted remission of anxiety and improvement in global functioning at a mean of 6 years after
randomization and to examine predictors of outcomes at follow-up., DESIGN, SETTING, AND PARTICIPANTS This naturalistic follow-up study, as part of
the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), was conducted at 6 academic sites in the United States and included 288
youths (age range, 11-26 years; mean age, 17 years). Youths were randomized to 1 of 4 interventions (cognitive behavioral therapy, medication,
combination, or pill placebo) in the Child/Adolescent Anxiety Multimodal Study (CAMS) and were evaluated a mean of 6 years after randomization.
Participants in this study constituted 59.0%of the original CAMS sample. EXPOSURES Participants were assessed by independent evaluators using a
semistructured diagnostic interview to determine the presence of anxiety disorders, the severity of anxiety, and global functioning. Participants and
their parents completed questionnaires about mental health symptoms, family functioning, life events, and mental health service use., MAIN OUTCOMES
AND MEASURES Remission, defined as the absence of all study entry anxiety disorders. RESULTS Almost half of the sample (46.5%) were in remission a
mean of 6 years after randomization. Responders to acute treatment were significantly more likely to be in remission (odds ratio, 1.83; 95%CI, 1.08-
3.09) and had less severe anxiety symptoms and higher functioning; the assigned treatment arm was unrelated to outcomes. Several predictors of
remission and functioning were identified., CONCLUSIONS AND RELEVANCE Youths rated as responders during the acute treatment phase of CAMS were more
likely to be in remission a mean of 6 years after randomization, although the effect size was small. Relapse occurred in almost half (48%) of acute
responders, suggesting the need for more intensive or continued treatment for a sizable proportion of youths with anxiety disorders. (copyright) 2014
American Medical Association.
JAMA Psychiatry, 71(3) : 310
-318
- 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)
Ingul, J. M., Aune, T., Nordahl, H. M.
Background: Very few studies have
investigated the effects of individual disorder-specific treatment of social phobia (SP) in adolescents. The objective of this study was to compare
the effects of individual cognitive therapy for SP, group cognitive behavioural therapy (CBTG) and attentional placebo (AP) among adolescents with a
primary diagnosis of SP. Methods: A randomized controlled design was used, and a total of 279 adolescents were assessed. Fifty-seven adolescents,
between 13 and 16 years old, were allocated to individual cognitive therapy, CBTG or AP. The participants were assessed before treatment, at the end
of treatment and at a 12-month follow-up using both self-report and a semi-structured interview. Results: The individual cognitive therapy showed
significant reductions in symptoms, impairment and diagnostic criteria both at the end of treatment and at the 12-month follow-up. Compared with CBTG
and AP, the individual cognitive therapy group demonstrated significantly greater effects on both symptom reduction and impairment. There were no
significant differences between CBTG and AP. Conclusions: In a direct comparison between the most commonly used treatments for adolescent SP, we
found that individual therapy was the most effective, yielding better effects than both CBTG and AP.
Psychotherapy & Psychosomatics, 83(1) : 54-61
- Year: 2014
- 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)
Rajiah, K., Saravanan, C.
OBJECTIVE: To
analyze the effect of psychological intervention on reducing performance anxiety and the consequences of the intervention on first-year pharmacy
students. METHODS: In this experimental study, 236 first-year undergraduate pharmacy students from a private university in Malaysia were approached
between weeks 5 and 7 of their first semester to participate in the study. The completed responses for the Westside Test Anxiety Scale (WTAS), the
Kessler Perceived Distress Scale (PDS), and the Academic Motivation Scale (AMS) were received from 225 students. Out of 225 students, 42 exhibited
moderate to high test anxiety according to the WTAS (score ranging from 30 to 39) and were randomly placed into either an experiment group (n=21) or
a waiting list control group (n=21). RESULTS: The prevalence of test anxiety among pharmacy students in this study was lower compared to other
university students in previous studies. The present study's anxiety management of psychoeducation and systematic education for test anxiety reduced
lack of motivation and psychological distress and improved grade point average (GPA). CONCLUSION: Psychological intervention helped significantly
reduce scores of test anxiety, psychological distress, and lack of motivation, and it helped improve students' GPA.
American journal of pharmaceutical
education, 78(9) : 163
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions, Relaxation
Reuland, M. M., Teachman, B. A.
Social anxiety is the most prevalent anxiety
disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments
are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially
anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding
social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in
youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N=18) and their
mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-
only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth
and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between
the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy
of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents
holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger
trial. Copyright © 2014 Elsevier Ltd. All rights reserved.
Journal of Anxiety Disorders, 28(8) : 851-
864
- Year: 2014
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions
Lee, S. W., Kwon, J. H.
Background and objectives There is a need for brief effective treatment of social phobia and Imagery Rescripting (IR) is a potential
candidate. The purpose of this study was to examine the efficacy of IR preceded by cognitive restructuring as a stand-alone brief treatment using a
randomized controlled design. Methods Twenty-three individuals with social phobia were randomly assigned to an IR group or to a control group.
Participants in the IR group were provided with one session of imagery interviewing and two sessions of cognitive restructuring and Imagery
Rescripting. Those in the control group had one session of clinical interviewing and two sessions of supportive therapy. Outcome measures including
the Korean version of the Social Avoidance and Distress Scale (K-SADS) were administered before and after treatment, and at three-month follow-up.
The short version of the Questionnaire upon Mental Imagery and the Traumatic Experience Scale were also administered before treatment. Results
Participants in the IR group improved significantly on K-SADS and other outcome measures, compared to the control group. The beneficial effects of IR
were maintained at three-month follow-up. It was also found that mental imagery ability and the severity of the traumatic experience did not moderate
the outcome of IR. Limitations Further studies are needed to replicate the findings of our study using a large sample. Conclusions The efficacy of IR
as a stand-alone brief treatment was demonstrated for social phobia. The findings indicate that IR could be utilized as a cost-effective intervention
for social phobia. (copyright) 2013 Elsevier B.V. All rights reserved.
Journal of Behavior Therapy & Experimental
Psychiatry, 44(4) : 351-360
- Year: 2013
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Supportive
therapy, Other Psychological Interventions
Diemer, J., Domschke, K., Muhlberger, A., Winter, B., Zavorotnyy, M., Notzon, S., Silling, K., Arolt, V., Zwanzger, P.
Anxiety disorders are among the most frequent psychiatric disorders. With regard to pharmacological treatment,
antidepressants, the calcium modulator pregabalin and benzodiazepines are recommended according to current treatment guidelines. With regard to acute
states of anxiety, so far practically only benzodiazepines provide an immediate anxiolytic effect. However, the risk of tolerance and dependency
limits the use of this class of medication. Therefore, there is still a need for alternative pharmacologic strategies. Increasing evidence points
towards anxiety-reducing properties of atypical antipsychotics, particularly quetiapine. Therefore, we aimed to evaluate the putative acute
anxiolytic effects of this compound, choosing the induction of acute anxiety in patients with specific phobia as a model for the evaluation of ad-hoc
anxiolytic properties in a proof-of-concept approach. In a randomized, double-blind, placebo-controlled study, 58 patients with arachnophobia were
treated with a single dose of quetiapine XR or placebo prior to a virtual reality spider challenge procedure. Treatment effects were monitored using
rating scales for acute anxiety as well as measurements of heart rate and skin conductance. Overall, quetiapine showed significant anxiolytic effects
compared to placebo. However, effects were not seen on the primary outcome measure (VAS Anxiety), but were limited to somatic anxiety symptoms.
Additionally, a significant reduction of skin conductance was observed. Further exploratory analyses hint towards a mediating role of the (COMT)
val158met genotype on treatment response. The present results thus suggest a possible suitability of quetiapine in the acute treatment of anxiety,
particularly with regard to somatic symptoms. (copyright) 2013 Elsevier B.V. and ECNP.
European Neuropsychopharmacology, 23(11) : 1551-1560
- Year: 2013
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Bunnell, Brian E., Beidel, Deborah C., Mesa, Franklin
The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing
increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One
significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by
using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n=31) were
randomly assigned to eight sessions of attention training (n=15) or placebo/control (n=16). Participants were assessed at pre- and posttreatment via
self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no
differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The
results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for
patients with SAD. ; Copyright © 2013. Published by Elsevier Ltd.
Behavior Therapy, 44(4) : 662-
673
- Year: 2013
- 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
Shafiei-Amiri, M., Daryabari, S. M.
Aim: The present research has a goal
tostudy self-imaginationlevel and to determine the effect of cognitive-behavioral therapeutic group in treatment of social anxiety disorder of the
adolescents (teen-agers). Methods: This research is of sub-empirical plans (designs) which were performed as pre-testing, past-testing and threemonth
(quarterly) pursuance.two experimental and control groups are used in it. Group CBT therapy (treatment) is independent variable which was performed
during 12 sessions weekly and the scores of anxiety symptoms in the patients developed by social anxiety disorder were considered as dependent
variable. Statistical population of this research includes 1135 11-14 year-old girl students in state schools of Babol city which among this series,
368 students were randomized, clustered, stagebased selected during second academic (educational) semester of 2011-2012 as the samplegroup by the
mean of 12.8 yearold and standard deviation of 4.05. After sampling, by help of social phobia structured recognition (determinant) interview based on
DSM-IV recognition criteria and using of Kanver et.al. Social anxiety questionnaire and cooper smith's self stem questionnaire, data collection was
performed. Findings: The scores difference of two experimental and control groups in social anxiety is meaningful in two stages (steps) of pre-
mediation (before manipulation) and after it based on Mann-Whitney Yu test. Conclusion: The scales of evitable behaviors and fear from negative
evaluation of social anxiety test have shown that cognitive-behavioral therapeutic group has meaningfully reduced the level of evitable behaviors and
fear from negative evaluator.
European Psychiatry, 28 :
- Year: 2013
- 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)