Disorders - Social phobia
Sportel, B. Esther, de-Hullu, Eva, de-Jong,
Peter J., Nauta, Maaike H.
Unlabelled: Social anxiety is a common mental
disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible
early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n?=?86) was compared to a
school-based cognitive behavioral group training (CBT; n?=?84) and a control group (n?=?70) in reducing symptoms of social and test anxiety in high
socially and/or test anxious adolescents aged 13-15 years. Participants (n?=?240) were randomized at school level over the three conditions. CBM
consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control
group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT
resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this
initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long
term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both
other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point
of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive
automatic threat-related associations.; Trial Registration: TrialRegister.nl NTR965.;
PLoS ONE, 8(5) : e64355-
e64355
- Year: 2013
- Problem: Anxiety Disorders (any), 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), Attention/cognitive bias
modification
Huang, Xiao, Li, Chao, Li, Wei-Hui, Luo, Yan-Li, Wang, Biao, Zhang, Wei, Gan, Jian-Jun, Ji, Jian-Lin
Objective: Although selective serotonin reuptake inhibitors are now established as
first-line pharmacotherapy for social anxiety disorder (SAD), other agents with different mechanisms have shown promise in treating SAD. The aim of
this study was to examine the efficacy and safety of tandospirone in treating adolescents with SAD.; Methods: Adolescent patients meeting the
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for SAD were randomly assigned (1:1) to open-label treatment
with either tandospirone or sertraline for 8?weeks. The primary outcome measures were changes from baseline in the Hamilton Anxiety (HAM-A) scale and
response using the Clinical Global Impression of Improvement (CGI-I) scale.; Results: The adjusted mean change in HAM-A scores from baseline was
indicating a significant improvement over baseline in both treatment arms (p?
Human Psychopharmacology, 28(6) : 594-
599
- Year: 2013
- 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), Anxiolytics including benzodiazepines
Possis, E. A., Kemp, J. J., Lickel, J. J., Sy, J. T., Dixon, L.
J., Deacon, B. J.
Cognitive-behavioral theories
suggest that anxiety is maintained in part by estimates of the probability and cost of feared negative outcomes. Social phobia may be unique among
the anxiety disorders in that it is characterized by overestimates of the cost of events that are objectively noncatastrophic (e.g., committing
social mishaps). As such, treatment approaches that target cost bias may be particularly effective in reducing social phobia symptoms. This study
examined the efficacy of 2 cost-specific techniques in a single-session intervention for social anxiety. Individuals (n = 61) with elevated social
interaction anxiety were randomly assigned to an expressive writing control condition, a cognitive restructuring condition, or a behavioral
experiment condition. Results demonstrated that the cognitive restructuring condition produced significantly greater improvement in indices of social
anxiety than the other conditions. Reduction in cost bias fully mediated the significantly greater improvement in social interaction anxiety in the
cognitive restructuring condition relative to the behavioral experiment condition. The present findings highlight the value of techniques designed to
reduce cost biases in social anxiety. Clinical implications are discussed. (copyright) 2013 Springer Publishing Company.
Journal of Cognitive Psychotherapy, 27(3) : 210-
220
- Year: 2013
- 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), Psychoeducation
Olivares-Olivares, P., Macia, D., Olivares, J.
The objective of this study is to adapt and validate for use
in the adult Spanish population the treatment known as social effectiveness therapy (Turner, Beidel, Cooley, Woody, and Messer, 1994). We present
results that were obtained by comparing an experimental-treatment group consisting of 16 participants with a waiting list control group, all with
generalized social phobia (APA, 2000). The evaluation was carried out before and after the treatment in both groups as well as in two follow-ups with
the experimental group. The results in the experimental group show the short and long-term efficacy of social effectiveness therapy for all measures
that assess social anxiety and avoidance. In contrast, the members of the control group did not experience improvement in any of the variables
evaluated. (copyright) 2012 by Sociedad Chilena de Psicologia Clinica.
Terapia Psicologica, 30(3) : 57-67
- Year: 2012
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Khedmatgozar, H., Birashk, B., Ashayeri, H., Farid, A. A.
Introduction: Although the effectiveness of
paroxetine and Attention Modification Program has been studied separately in treating social anxiety disorder, there has been no research comparing
them according to the literature. The aim of this study was to compare the effectiveness of paroxetine, Attention Modification Program (AMP) and
combination of both on improving the Social Anxiety Symptoms. Methods: 33 patients meeting DSM-IV-TR criteria for social anxiety disorder were
randomly assigned in 3 groups: 11 in paroxetine group, 11 in AMP group and 11 in combined group. Treatment intervention was done during 8 weeks
period. Social Phobia Inventory (SPIN), Beck Depression Inventory (BDI-II) and Sheehan Disability Scale (SDS) were administered before and after
treatment intervention. One-way Analysis of Covariance (ANCOVA) was used to determine the differences and efficacy of treatment interventions between
groups. Data analysis was done by SPSS-16 software. Results: 28 participants completed the treatment period. One-way ANCOVA results showed
statistically significant differences in post-treatment scores of social phobia (p=0/007), depressive symptoms (p=0.007) and daily life functioning
(p=0.011) between three groups. Bonferroni correction showed that combined treatment is significantly more effective than AMP in reducing social
phobia symptoms (p=0.007), depressive symptoms (p=0.022) and enhancing daily life functioning (0.019). Yet, there were no significant differences
between Paroxetine and combined treatment in all post-treatment scores (p=0.890, p=1.000, p=1.000 for social phobia, depressive symptoms and daily
life functioning respectively). Paroxetine showed more significant improvement of depressive symptoms (p=0.016) and enhancing daily life functioning
(p=0.045) than AMP. Also, there were no significant differences between paroxetine and AMP in reducing social anxiety symptoms. Discussion: It seems
that paroxetine has wider effect in reducing social anxiety symptoms, depressive symptoms and enhancing daily life functioning than AMP and adding
the AMP to paroxetine does not make significant changes than medicating with paroxetine alone.
Basic & Clinical Neuroscience, 3(4) : 36-44
- Year: 2012
- 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), Psychological Interventions
(any), Attention/cognitive bias
modification
Drake, K. L., Ginsburg, G. S.
It is
now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to
anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We
focus on three anxiety disorders in youth, namely, generalized, separation, and social anxiety as they often co-occur both at the symptom and
disorder level and respond to similar treatments. We begin by presenting an overview of a broad range of family factors associated with anxiety
disorders. Findings from these studies have informed intervention and prevention strategies that are discussed next. Throughout the paper we shed
light on the challenges that plague this research and look toward the future by proposing directions for much needed study and discussing factors
that may improve clinical practice and outcomes for affected youth and their families. (copyright) 2012 Springer Science+Business Media, LLC.
Clinical Child &
Family Psychology Review, 15(2) : 144-162
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Culver, Najwa
C., Stoyanova, Milena, Craske, Michelle G.
Background and Objectives: In traditional exposure therapy for phobias and anxiety disorders, reduction of
fear responding is used as an index of learning. However, recent evidence in animal models suggests that sustained arousal and enhanced fear
responding throughout exposure may actually predict better long-term outcomes (Rescorla, 2000).; Methods: The effects of sustained arousal during
exposure were investigated in a clinical analog sample of 59 participants fearful of public speaking. Participants completed exposure with or without
the presence of additional excitatory stimuli which were intended to enhance arousal and fear responding throughout exposure.; Results: Group
assignment (exposure versus exposure with additional excitatory stimuli) did not significantly predict outcome at 1-week follow-up testing, as
measured physiologically, subjectively, and behaviorally. A set of regression analyses investigating whether any exposure process measures predicted
outcome indicated that sustained arousal throughout exposure as well as variability in subjective fear responding throughout exposure (e.g.,
Kircanski et al., 2011) predicted lower levels of fear at follow-up testing (p < 0.05; p < 0.001) after controlling for demographic variables
as well as pre-exposure fear levels.; Limitations: The excitatory stimuli used failed to produce the intended effects. However, some participants did
maintain elevated arousal throughout exposure and this predicted better outcomes at 1-week follow-up testing.; Conclusions: Sustained arousal
throughout exposure as well as variability in subjective fear responding during exposure may be better predictors of long-term outcomes than
habituation of fear across exposure.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy &
Experimental Psychiatry, 43(2) : 787-793
- Year: 2012
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Other Psychological Interventions
Galla, B. M., Wood, J. J., Chiu, A. W., Langer, D. A., Jacobs, J., Ifekwunigwe,
M., Larkins, C.
The current study sought to evaluate the relative long-term efficacy of a
modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned
to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment condition conducted
structured diagnostic interviews, and caregivers and children completed symptom checklists at pre- and post-, and 1 year follow-up assessments.
Analyses revealed that 71.4% of children who received CBT demonstrated a positive treatment response 1 year following treatment, and 83.3% were free
of any anxiety diagnosis at 1 year follow-up. Analyses further revealed robust effects of intervention on diagnostic outcomes, caregiver- and child-
report measures of anxiety at 1 year follow-up. Results provide evidence of an ongoing advantage on anxiety-specific outcomes for this modularized
school-based CBT program 1 year post-treatment.
Child Psychiatry &
Human Development, 43(2) : 219-226
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety 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)
Kim, P. W., Kim, S. A., Jung, K. H.
The present study was to set out in
efforts to determine the effect of electrocardiographic (ECG) feedback on the performance in speech anxiety. Forty-six high school students
participated in a speech performance educational program. They were randomly divided into two groups, an experimental group with ECG feedback (N =
21) and a control group (N = 25). Feedback was given with video recording in the control, whereas in the experimental group, an additional ECG
feedback was provided. Speech performance was evaluated by the Korean Broadcasting System (KBS) speech ability test, which determines the 10
different speaking categories. ECG was recorded during rest and speech, together with a video recording of the speech performance. Changes in R-R
intervals were used to reflect anxiety profiles. Three trials were performed for 3-week program. Results showed that the subjects with ECG feedback
revealed a significant improvement in speech performance and anxiety states, which compared to those in the control group. These findings suggest
that visualization of the anxiety profile feedback with ECG can be a better cognitive therapeutic strategy in speech anxiety. (copyright) Springer
Science+Business Media, LLC 2012.
Applied Psychophysiology
Biofeedback, 37(4) : 261-267
- Year: 2012
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback
Julian, K.: Beard, C., Schmidt, N. B., Powers, M. B., Smits, J. A. J.
Cognitive theories suggest that social anxiety is maintained, in part, by an attentional bias toward threat.
Recent research shows that a single-session of attention modification training (AMP) reduces attention bias and vulnerability to a social stressor
(Amir, Weber, Beard, Bomyea, & Taylor, 2008). In addition, exercise may augment the effects of attention training by its direct effects on
attentional control and inhibition, thereby allowing participants receiving the AMP to more effectively disengage attention from the threatening cues
and shift attention to the neutral cues. We attempted to replicate and extend previous findings by randomizing participants (N = 112) to a single-
session of: a) Exercise + attention training (EX + AMP); b) Rest + attention training (REST + AMP); c) Exercise + attention control condition (EX +
ACC); or d) Rest + attention control condition (REST + ACC) prior to completing a public speaking challenge. We used identical assessment and
training procedures to those employed by Amir et al. (2008). Results showed there was no effect of attention training on attention bias or anxiety
reactivity to the speech challenge and no interactive effects of attention training and exercise on attention bias or anxiety reactivity to the
speech challenge. The failure to replicate previous findings is discussed. (copyright) 2012 Elsevier Ltd.
Behaviour Research &
Therapy, 50(5) : 350-358
- Year: 2012
- Problem: 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), Attention/cognitive bias
modification, Physical activity, exercise
Goldbeck, L., Ellerkamp, T.
Background: Music therapy has been shown to be effective for children with psychopathology, providing an alternative
nonverbal approach to the treatment of children with anxiety disorders. Objective: This pilot study investigates the efficacy of Multimodal Music
Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU). Methods: Thirty-six children
aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and
dimensional outcome variables were assessed at the end of treatment and 4 months later. Results: MMT was superior compared to TAU according to the
remission rates after treatment (MMT 67%; TAU 33%; x2 5 4.0; p 5 0.046) and remissions persisted until four months post-treatment. Dimensional
measures showed equivalent improvement after either MMT or TAU. Conclusions: The results regarding the efficacy of MMT are promising for children
with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended. (copyright) 2012 by the American Music
Therapy Association.
Journal of Music Therapy, 49(4) : 395-413
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder), Specific
Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Heeren, A., Reese, H. E., McNally, R. J., Philippot,
P.
Social phobics exhibit an attentional bias for threat in probe detection and probe discrimination paradigms.
Attention training programs, in which probes always replace nonthreatening cues, reduce attentional bias for threat and self-reported social anxiety.
However, researchers have seldom included behavioral measures of anxiety reduction, and have never taken physiological measures of anxiety reduction.
In the present study, we trained individuals with generalized social phobia (n = 57) to attend to threat cues (attend to threat), to attend to
positive cues (attend to positive), or to alternately attend to both (control condition). We assessed not only self-reported social anxiety, but also
behavioral and physiological measures of social anxiety. Participants trained to attend to nonthreatening cues demonstrated significantly greater
reductions in self-reported, behavioral, and physiological measures of anxiety than did participants from the attend to threat and control
conditions. (copyright) 2011 Elsevier Ltd.
Behaviour Research & Therapy, 50(1) : 30-
39
- Year: 2012
- 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