Disorders - Social phobia
Rakowska, Jadwiga Malgorzata
The aim of this study was to test the effects of brief strategic therapy in people with social phobia distinguished
by the presence or absence of DSM anxious personality disorder. A group of 120 outpatients with social phobia, 60 of them with comorbid DSM anxious
personality disorder, were randomly assigned to 10 weeks of brief strategic therapy or minimal supportive therapy. Outcome analyses were conducted on
the intent-to-treat sample at posttreatment and 3-month follow-up using self-report interpersonal sensitivity and phobic anxiety measures, and at 6-
month follow-up using social phobia diagnostic status. Brief strategic therapy was superior to minimal supportive therapy in patients with social
phobia only. It was not significantly better in patients with comorbid personality disorder. It was concluded that 10 weeks of brief strategic
therapy shows promise as a cost-effective method for management of social phobia. It has limited value as a method for management of social phobia
with personality disorder.
Psychotherapy Research, 21(4) : 462-
471
- Year: 2011
- 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
Schneier, Franklin R.
INTRODUCTION: Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with a lifetime prevalence of 5-
12%. Fears of scrutiny and embarrassment in social and public situations are accompanied by anxiety symptoms, avoidance behavior, and impairment in
social and work functioning. Several classes of medication, as well as cognitive-behavioral therapies, have evidence for efficacy in the treatment of
SAD, but only a minority of individuals with the disorder receives treatment. AREAS COVERED: This review focuses on the evidence-based treatment of
SAD with medications including serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, other
antidepressants, benzodiazepines, alpha-delta calcium-channel agents, and beta-adrenergic blockers. It discusses clinical considerations in the
selection and monitoring of treatments, including issues of safety, duration of treatment, comorbidity, and integration of medication with
psychotherapeutic treatment. For this review, a PubMed literature search was conducted during July, 2010. EXPERT OPINION: Medications in several
classes have been demonstrated efficacious in the treatment of SAD. Treatment selection and implementation require attention to clinical diagnosis,
patient education, and appropriate monitoring.
Expert Opinion on Pharmacotherapy, 12(4) : 615-
625
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Scharfstein, Lindsay A., Beidel,
Deborah C., Finnell, Laura Rendon, Distler, Aaron, Carter, Nathan T.
In a randomized
trial for children with social phobia (SP), Social Effectiveness Therapy for Children (SET-C; a treatment consisting of exposure and social skills
training) and fluoxetine were more effective than pill placebo in reducing social distress and behavioral avoidance, but only SET-C demonstrated
significantly improved overall social skill and social competence. In the current study, the authors examined the specific social skills enhanced by
SET-C using a recently developed coding schema. At posttreatment, children treated with SET-C displayed a more effective ability to manage the
conversational topic (pragmatic social behaviors) and more appropriate motor movement, facial orientation, and posture (paralinguistic social
behaviors) than children treated with fluoxetine or placebo. In contrast, children treated with fluoxetine displayed no more pragmatic or
paralinguistic skill than children given a pill placebo. There were no group differences on ratings of voice volume and vocal inflection (speech and
prosodic social behaviors). Furthermore, only children treated with SET-C improved from pre- to posttreatment on all three skill variables. Findings
suggest that pharmacological interventions that only target reduction in anxious arousal may not have an impact on social skill deficits and may not
be adequate to optimally treat SP. The relationship of social skill to social avoidance and the importance of social skills training to enhance
social competence in the treatment of childhood SP are discussed.
Behavior Modification, 35(5) : 451-467
- Year: 2011
- 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), Other Psychological Interventions
Tillfors, Maria, Andersson, Gerhard, Ekselius, Lisa, Furmark, Tomas, Lewenhaupt, Susanne, Karlsson, Anders, Carlbring, Per
Internet-based cognitive behavior
therapy (CBT) has been shown effective for university students with social anxiety disorder (SAD) and public speaking fears. The aim of this study
was to investigate whether the promising results can be transferred to high school students suffering from this condition. A total of 19 speech-
anxious high school students with SAD were randomized either into 9 weeks of Internet-delivered CBT or to a wait-list control group. Significant
improvements were found on measures of social anxiety, general anxiety, and depression. Effects were maintained at 1-year follow-up. The average
within- and between-group effect sizes (Cohen’s d) for the primary social anxiety scales at posttest were 0.98 and 1.38, respectively. However, the
average number of completed modules in the CBT program was low. Although compliance can be improved, the results suggest that Internet-based guided
self-help is effective in the treatment of high school students with SAD. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal
abstract)
Cognitive Behaviour Therapy, 40(2) : 147-
157
- Year: 2011
- 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)
Tran, G. Q., Zaturenskaya, M., Black,
J. J., Heffner, J. L., Smith, J. P.
Introduction:
Co-occurring hazardous drinking and social anxiety are prevalent co-occurring problems among college students. Competing causal models have been
proposed to account for the high comorbidity of social anxiety disorder and alcohol dependence in epidemiological studies. With data from a
randomized clinical trial (Tran, 2008), we tested two competing causal models: change in social anxiety temporally preceding change in alcohol
problems in Model 1 and change in alcohol problems temporally preceding change in social anxiety in Model 2. Methods: Forty-one undergraduate
hazardous drinkers with moderate-to-high social anxiety (39% women, 90% Caucasian, median age = 19), comprised our intention-to-treat (ITT) sample,
of whom 34 began their interventions. Participants were randomized to receive either an integrated alcohol-anxiety intervention (n = 21) or an
alcohol psychoeducation (n = 20). Two multiple regression models were conducted to test two competing causal models. In Model 1, change in social
anxiety between pretreatment and 1-month follow-up was tested as a predictor of change in alcohol problems between pretreatment and 4-month follow-
up. In Model 2, change in alcohol problems between pretreatment and 1-month was tested as a predictor of change in social anxiety between
pretreatment and 4-month follow-up. In both regression models, treatment condition was entered as a covariate to control for the greater efficacy of
the integrated alcohol-anxiety intervention compared to the alcohol psychoeducation. Results: The results provided support for both social anxiety
and alcohol problems as temporal predictor of each other's symptom change in socially anxious hazardous drinkers who received a brief intervention.
In Model 1, there were significant main effects of pre-1 month social anxiety change and treatment condition on pre-4 month alcohol problem change.
In Model 2, there was a significant main effect of pre-1 month alcohol problem change but not treatment condition on pre-4 month social anxiety
change. Conclusion: Study findings suggest that social anxiety and alcohol problems have reciprocal effects on each other. These results support the
need to provide integrated brief interventions for both problem areas on college campuses where social anxiety and hazardous drinking are both
prevalent and frequently co-occur.
Alcoholism: Clinical & Experimental
Research, 35 : 146A
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Southam-Gerow, M. A., Weisz, J. R., Chu, B. C., McLeod,
B. D., Gordis, E. B., Connor-Smith, J. K.
Objective: Most tests of cognitive behavioral
therapy (CBT) for youth anxiety disorders have shown beneficial effects, but these have been efficacy trials with recruited youths treated by
researcher-employed therapists. One previous (nonrandomized) trial in community clinics found that CBT did not outperform usual care (UC). The
present study used a more stringent effectiveness design to test CBT versus UC in youths referred to community clinics, with all treatment provided
by therapists employed in the clinics. Method: A randomized controlled trial methodology was used. Therapists were randomized to training and
supervision in the Coping Cat CBT program or UC. Forty-eight youths (56% girls, 8 to 15 years of age, 38% Caucasian, 33% Latino, 15% African-
American) diagnosed with DSM-IV anxiety disorders were randomized to CBT or UC. Results: At the end of treatment more than half the youths no longer
met criteria for their primary anxiety disorder, but the groups did not differ significantly on symptom (e.g., parent report, eta-square = 0.0001;
child report, eta-square = 0.09; both differences favoring UC) or diagnostic (CBT, 66.7% without primary diagnosis; UC, 73.7%; odds ratio 0.71)
outcomes. No differences were found with regard to outcomes of comorbid conditions, treatment duration, or costs. However, youths receiving CBT used
fewer additional services than UC youths ((chi)21 = 8.82, p = .006). Conclusions: CBT did not produce better clinical outcomes than usual community
clinic care. This initial test involved a relatively modest sample size; more research is needed to clarify whether there are conditions under which
CBT can produce better clinical outcomes than usual clinical care.
Journal of the American Academy of Child & Adolescent Psychiatry, 49(10) : 1043-
1052
- Year: 2010
- 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: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Piet, J., Hougaard, E., Hecksher, M. S. & Rosenberg, N. K.
Twenty-six
young participants, 18-25 years, with social phobia (SP) were randomly assigned to eight 2-hour sessions of group mindfulness-based cognitive therapy
(MBCT) and twelve 2-hour sessions of group cognitive-behavioral therapy (CBT) in a crossover design with participants receiving treatments in
reversed order. Outcome was assessed after treatments, and at 6- and 12-month follow-ups. MBCT achieved moderate-high pre-post effect sizes (d=0.78
on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d=1.15). Participants in both groups
further improved in the periods following their first and second treatment until 6-months follow-up (pre-follow-up ds = 1.42 and 1.62). Thus, MBCT
might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.
Scandinavian Journal of Psychology, 51 : 403 - 410
- Year: 2010
- 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), Mindfulness based
therapy
Orr, E.
M. J., Moscovitch, D. A.
Video feedback (VF) with cognitive preparation (CP) has been widely integrated into
cognitive-behavioral therapy (CBT) protocols for social anxiety disorder (SAD) due to its presumed efficacy in improving negative self-perception.
However, previous experimental studies have demonstrated that improvements in negative self-perception via VF. +. CP do not typically facilitate
anxiety reduction during subsequent social interactions - a troubling finding for proponents of cognitive models of social anxiety. We examined
whether VF. +. CP could be optimized to enhance participants' processing of corrective self-related information through the addition of a post-VF
cognitive review (CR). Sixty-eight socially anxious individuals were randomly assigned to perform two public speeches in one of the following
conditions: a) exposure alone (EXP); b) CP. +. VF; and c) CP. +. VF. +. CR. Those in the CP. +. VF. +. CR condition demonstrated marginally
significant reductions in anxiety from speech 1 to speech 2 relative to those who received EXP - an improvement not shown for those in the CP. +. VF
condition. Furthermore, only those who received CP. +. VF. +. CR demonstrated significant improvements in self-perception and performance
expectations relative to EXP. Decreases in anxiety among participants who received CP. +. VF. +. CR relative to EXP were fully mediated by
improvements in self-perception. Implications are discussed in the context of cognitive models of social anxiety and mechanisms of exposure-based
learning. (copyright) 2010 Elsevier Ltd.
Behaviour Research & Therapy, 48(8) : 728-737
- Year: 2010
- 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, Biofeedback, neurofeedback, audio/video feedback
Botella, C., Gallego, M. J., Garcia-Palacios, A., Guillen, V., Banos, R. M., Quero, S., Alcaniz, M.
This
study offers data about the efficacy of \"Talk to Me,\" an Internet-based telepsychology program for the treatment of fear of public speaking that
includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-
seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b)
the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In
addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were
maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number
of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.
Cyberpsychology, Behavior & Social Networking, 13(4) : 407-
421
- Year: 2010
- 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)
Anari, A., Ddadsetan, P., Saleh-Sedghpour, B.
The effectiveness of Drama therapy on decreasing of the symptoms of
Social Anxiety Disorder (Performance Anxiety, Performance Avoidance , Social Anxiety & Social Performance Subtests) in 10- 11 years old children was
investigated in this study. 2 schools were randomly selected from elementary schools of Tehran city. First, Validation the Liebowitz Social Anxiety
Scale for Children and Adolescents (Liebowitz, Klein & Masia-Warner, 2003) is done in one of that school; Then, in two schools, from 300 children
ages 10- 11, 32 children whose had received the highest scores on the Liebowitz Social Anxiety Scale for Children and Adolescents (LSASCA) were
selected. Subjects were divided into control and experimental groups. Experimental group received Drama therapy intervention for 6 weeks, twice a
week sessions lasting two hours. The results were analyzed using covariance and indicated the children in experimental group reported a significant
decrease in symptoms of Social Anxiety Disorder (Performance Anxiety, Performance Avoidance, Social Anxiety & Social Performance Subtests) as
compared to the control group. In addition, in 3 month follow up, results had stabilized in experimental group as compared to the control group. The
emerged findings can have clinical application in prevention and treatment of social anxiety disorder in children.
European Psychiatry, 24 : S514
- Year: 2009
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Aune, T., Stiles, T. C.
This article reports results from a universal preventive program aimed at (a) reducing social
anxiety and (b) preventing the development of syndromal social anxiety among a population-based sample of older children and young adolescents during
a 1-year period. Pupils (N = 1,748) from 2 counties were cluster randomized to either an intervention or a control condition. In the intervention
condition, the Norwegian Universal Preventive Program for Social Anxiety (NUPP-SA)-which educates pupils, parents/guardians, teachers/school staff,
and county health workers-was administered. The results indicate that NUPP-SA had a significant specific intervention effect for reducing social
anxiety in the total sample as well as among the syndromal subjects. Further, significantly fewer subjects from the intervention county developed
syndromal social anxiety during the 1-year period, thus showing a prevention effect. The results demonstrate the value of an intervention
specifically aimed at reducing social anxiety and preventing the development of syndromal social anxiety among young people. (copyright) 2009
American Psychological Association.
Journal of Consulting & Clinical Psychology, 77(5) : 867-
879
- Year: 2009
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Herbert, J. D., Gaudiano, B. A., Rheingold, A.
A., Moitra, E., Myers, V. H., Dalrymple, K. L., Brandsma, L. L.
Early identification and
treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and
progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behavior therapy (CBT) for anxiety
disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents
with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were
associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments
emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are
discussed. (copyright) 2008 Elsevier Ltd. All rights reserved.
Journal of Anxiety
Disorders, 23(2) : 167-177
- Year: 2009
- 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), Psychoeducation, Supportive
therapy