Disorders - Social phobia
Parr, C. J., Cartwright-Hatton, S.
Background: A negative self-
generated image is thought to play a role in the development and maintenance of social anxiety. Video feedback (VF) is an effective therapeutic
technique for correcting this distorted image with adults during stressful social tasks. This study investigated the effectiveness of VF with
adolescents. Method: Thirty-six highly socially anxious adolescents (13 to 17-year-olds) were randomly assigned to one of two groups: VF or no VF.
Both groups gave two brief speeches to a video camera. Self-rated measures of anticipatory anxiety, predicted performance and actual performance
during the speeches were completed at several time points. The speeches were also rated by two independent observers. Results: Adolescents who
received VF, in comparison with control participants, developed more positive appraisals of their performance during the first speech. Predictions of
their performance on the second speech also improved, and a reduction in state anxiety was observed. Furthermore, a more positive appraisal of
performance was generalized to the second speech. The independent observers could not distinguish between the participants who received VF and those
who did not. Conclusions: When used with socially anxious adolescents, VF may be a benefi cial therapeutic technique in correcting a distorted self-
perception of performance, reducing anxiety prior to entering a stressful social task and enhancing predictions of performance for future tasks.
Copyright (copyright) 2009 John Wiley & Sons, Ltd.
Clinical Psychology & Psychotherapy, 16(1) : 46-
54
- Year: 2009
- 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
Vassilopoulos, S.
P., Banerjee, R., Prantzalou, C.
We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10-11-
year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially
threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than
children in a test-retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported
significantly less anxiety about an anticipated interpersonal encounter, compared with the control group. (copyright) 2009 Elsevier Ltd.
Behaviour Research & Therapy, 47(12) : 1085-1089
- Year: 2009
- 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
Schmidt, Norman B., Richey, J. Anthony, Buckner, Julia D., Timpano, Kiara R.
Attentional bias toward negative social cues is thought to serve an etiological and/or maintaining
role in social anxiety disorder (SAD). The current study tested whether training patients to disengage from negative social cues may ameliorate
social anxiety in patients (N = 36) with a primary diagnosis of generalized SAD. Patients were randomly assigned to either an attention training
condition (n = 18), in which patients completed a modified dot-probe task designed to facilitate attentional disengagement from disgusted faces, or a
control dot-probe task condition (n = 18). As predicted, patients in the attention training condition exhibited significantly greater reductions in
social anxiety and trait anxiety, compared with patients in the control condition. At termination, 72% of patients in the active treatment condition,
relative to 11% of patients in the control condition, no longer met Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for SAD.
At 4-month follow-up, patients in the attention training condition continued to maintain their clinical improvement, and diagnostic differences
across conditions were also maintained. Results support attention-based models of anxiety and suggest that attention training is a promising
alternative or complementary intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
Journal of Abnormal Psychology, 118(1) : 5-14
- Year: 2009
- 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
Walkup, J. T., Albano, A.
M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J.
T., Ginsburg, G. S., et-al
Background: Anxiety disorders are common psychiatric conditions affecting children and adolescents. Although cognitive behavioral
therapy and selective serotonin-reuptake inhibitors have shown efficacy in treating these disorders, little is known about their relative or combined
efficacy. Methods: In this randomized, controlled trial, we assigned 488 children between the ages of 7 and 17 years who had a primary diagnosis of
separation anxiety disorder, generalized anxiety disorder, or social phobia to receive 14 sessions of cognitive behavioral therapy, sertraline (at a
dose of up to 200 mg per day), a combination of sertraline and cognitive behavioral therapy, or a placebo drug for 12 weeks in a 2:2:2:1 ratio. We
administered categorical and dimensional ratings of anxiety severity and impairment at baseline and at weeks 4, 8, and 12. Results: The percentages
of children who were rated as very much or much improved on the Clinician Global Impression-Improvement scale were 80.7% for combination therapy
(P<0.001), 59.7% for cognitive behavioral therapy (P<0.001), and 54.9% for sertraline (P<0.001); all therapies were superior to placebo (23.7%).
Combination therapy was superior to both monotherapies (P<0.001). Results on the Pediatric Anxiety Rating Scale documented a similar magnitude and
pattern of response; combination therapy had a greater response than cognitive behavioral therapy, which was equivalent to sertraline, and all
therapies were superior to placebo. Adverse events, including suicidal and homicidal ideation, were no more frequent in the sertraline group than in
the placebo group. No child attempted suicide. There was less insomnia, fatigue, sedation, and restlessness associated with cognitive behavioral
therapy than with sertraline. Conclusions: Both cognitive behavioral therapy and sertraline reduced the severity of anxiety in children with anxiety
disorders; a combination of the two therapies had a superior response rate. (ClinicalTrials.gov number, NCT00052078.) Copyright (copyright) 2008
Massachusetts Medical Society.
New England Journal of Medicine, 359(26) : 2753-
2766
- Year: 2008
- 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)
Segool, N.
K., Carlson, J. S.
Childhood social anxiety is associated
with significant social and academic impairment. The purpose of this study was to compare and contrast the efficacy of two major treatments for
social anxiety disorders in children: cognitive-behavioral therapy and selective serotonin reuptake inhibitor (SSRI) drug treatment. Treatment
studies in the literature were evaluated using meta-analytic techniques to compare pre- and post-treatment measures of social anxiety symptoms,
general anxiousness, social competency, and impairment. Results indicate that the core symptoms of social anxiety and impairment were reduced by both
cognitive-behavioral treatment (ES = 0.86 and 1.56) and SSRI treatment (ES = 1.30 and 2.29), respectively. Similarly, peripheral symptoms of general
anxiousness were reduced by both cognitive-behavioral treatment (ES = 0.75) and SSRI treatment (ES = 1.29). Finally, both cognitive-behavioral (ES =
0.68) and SSRI treatment (ES = 0.68) resulted in moderate improvements in social competence. Implications and the limitations of these meta-analytic
findings are discussed with respect to the evidence-based intervention movement. copyright 2007 Wiley-Liss, Inc.
Depression &
Anxiety., 25(7) : 620-631
- Year: 2008
- 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), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Silverman, W. K., Pina, A. A., &
Viswesvaran, C.
The article reviews psychosocial treatments for phobic
and anxiety disorders in youth. Using criteria from Nathan and Gorman (2002), 32 studies are evaluated along a continuum of methodological rigor. In
addition, the treatments evaluated in each of the 32 studies are classified according to Chambless et al.'s (1996) and Chambless and Hollon's
(1998) criteria. Findings from a series of meta-analyses of the studies that used waitlists also are reported. In accordance with Nathan and Gorman,
the majority of the studies were either methodologically robust or fairly rigorous. In accordance with Chambless and colleagues, although no
treatment was well-established, Individual Cognitive Behavior Therapy, Group Cognitive Behavior Therapy (GCBT), GCBT with Parents, GCBT for social
phobia (SOP), and Social Effectiveness Training for children with SOP each met criteria for probably efficacious. The other treatments were either
possibly efficacious or experimental. Meta-analytic results revealed no significant differences between individual and group treatments on diagnostic
recovery rates and anxiety symptom reductions, as well as other youth symptoms (i.e., fear, depression, internalizing and externalizing problems).
Parental involvement was similarly efficacious as parental noninvolvement in individual and group treatment formats. The article also provides a
summary of the studies that have investigated mediators, moderators, and predictors of treatment outcome. The article concludes with a discussion of
the clinical representativeness and generalizability of treatments, practice guidelines, and future research directions.
Journal of Clinical Child & Adolescent
Psychology, 37(1) : 105-130
- Year: 2008
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Specific
Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Olivares-Olivares, PJ, Rosa-Alcazar, AI, Olivares-Rodríguez, J
The objective of this experimental study is to provide empirical evidence on the efficacy-efficiency of individual attention in the
treatment of adolescents with generalized social phobia. Individual attention is one of the components of the structured psychological treatment
program known as IAFS (Intervenciv=n en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia). Fifty-seven subjects (63%
female) between 14 and 18 years of age participated in this study. They were randomly assigned to three experimental conditions: a) the IAFS without
individual attention, b) the IAFS with 6 sessions of individual attention, and c) the IAFS with 12 sessions of individual attention. The results show
that the groups that included individual attention obtained better results in most of the measures assessing anxiety and social avoidance at 6- and
12-month follow-up, but not at posttest. The same trend was also found for the variables self-esteem and adaptation. However, costs are much higher
in both treatment conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
International
Journal of Clinical & Health Psychology, 8(2) : 465-481
- Year: 2008
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Psychoeducation, Skills training, Other service delivery and improvement
interventions
Liber, J. M., VanWidenfelt, B. M., Utens, E.
M. W. J., Ferdinand, R. F., VanDerLeeden, A. J. M., Gastel, W. V., Treffers, P. D. A.
Background: The present study compares an individual versus a group format in the delivery of
manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with
Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n = 37), Social Phobia (n = 22) or Specific Phobia (n = 16) were randomly
assigned to individual (n = 65) or group (n = 62) treatment. Method: Analyses were conducted separately for the intent-to-treat sample and the sample
of children who completed treatment. Analyses included chi-square comparisons and regression analyses with treatment format as a predictor. Results:
Forty-eight percent of the children in the individual versus 41% in the group treatment were free of any anxiety disorder at post-treatment; 62%
versus 54% were free of their primary anxiety disorder. Regression analyses showed no significant difference in outcome between individual and group
treatment. Conclusions: Children improved in both conditions. Choice between treatments could be based on pragmatic considerations such as
therapeutic resources, referral rates, and the preference of the parents and the child. copyright 2008 The Authors.
Journal of Child Psychology & Psychiatry & Allied
Disciplines., 49(8) : 886-893
- Year: 2008
- 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)
Amir, N., Weber, G., Beard, C., Bomyea, J., Taylor, C. T.
Research suggests that individuals with social anxiety show an attention bias for threat-
relevant information However, few studies have directly manipulated attention to examine its effect on anxiety. In the current article, the authors
tested the hypothesis that an attention modification program would be effective in reducing anxiety response and improving performance on a public-
speaking challenge. Socially anxious participants completed a probe detection task by identifying letters (E or F) replacing one member of a pair of
faces (neutral or disgust). The authors trained attention by including a contingency between the location of the neutral face and the probe in one
group (Attention Modification Program; AMP). Participants in the AMP group showed significantly less attention bias to threat after training and
lower levels of anxiety in response to a public-speaking challenge than did the participants in the Attention Control Condition (ACC) group.
Moreover, blind raters judged the speeches of those in the AMP group as better than those in the ACC group. These results are consistent with the
hypothesis that attention plays a causal role in the maintenance of social anxiety. (copyright) 2008 American Psychological Association.
Journal of Abnormal Psychology, 117(4) : 860-
868
- Year: 2008
- 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
Bernstein, G. A., Bernat, D. H., Victor, A. M., Layne,
A. E.
Objective: To follow 61 participants (7-
11 years old) from a study that compared three school-based interventions for anxious children: group cognitive-behavioral therapy (CBT) for
children, group CBT for children plus parent training, and no-treatment control to determine whether posttreatment benefits are sustained
longitudinally. Method: Parent, child, and clinician report measures of child anxiety were completed at 3, 6, and 12 months posttreatment.
Semistructured diagnostic interviews were administered at 6- and 12-month follow-ups. For initial analyses, the group CBT and group CBT plus parent
training conditions were collapsed into one group and compared to control. When significant results were found, each active treatment group was
compared to control. Results: Across several measures, the collapsed CBT group sustained significant improvement in anxiety severity and impairment
across a 12-month period compared to control. There were no significant differences between the three groups on remission of baseline anxiety
disorders or incidence of new anxiety disorders during the follow-up. Several parent-report measures at 3 and 6 months posttreatment suggested that
group CBT for children plus parent training provided additional benefit over the group CBT for children when each was compared to the control group.
Conclusions: School-based CBT appears effective in decreasing anxiety symptoms up to 12 months posttreatment for anxious children. copyright2008 by
the American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent
Psychiatry., 47(9) : 1039-1047
- Year: 2008
- 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), Other Psychological Interventions
Beard, C., Amir, N.
Previous research suggests that socially anxious individuals
interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally
modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation
biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a
computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms. Twenty-seven socially anxious individuals
were randomly assigned to the IMP or a control condition. Participants completed eight computer sessions over four weeks. The IMP modified
interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat
interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms
compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests
that interpretation modification may have clinical utility when applied as a multi-session intervention. (copyright) 2008 Elsevier Ltd. All rights
reserved.
Behaviour
Research & Therapy, 46(10) : 1135-1141
- Year: 2008
- 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)
Beidel, D. C., Turner, S. M., Sallee, F. R., Ammerman, R. T., Crosby, L. A., Pathak, S.
OBJECTIVE: To determine the efficacy of fluoxetine, pill placebo, and Social Effectiveness Therapy for Children (SET-C) for
children and adolescents with social phobia. METHOD: Youths ages 7 to 17 were randomly assigned to one of the treatment conditions. Outcome was
evaluated using self-reports, parent ratings, independent evaluator ratings, and behavioral assessment. RESULTS: Both fluoxetine and SET-C were more
efficacious than placebo in reducing social distress and behavioral avoidance and increasing general functioning. SET-C was superior to fluoxetine on
each of these measures and was the only treatment superior to placebo in terms of improving social skills, decreasing anxiety in specific social
interactions, and enhancing ratings of social competence. Furthermore, whereas fluoxetine appears to exert maximum effect by 8 weeks, SET-C provides
continued improvement through week 12. CONCLUSIONS: Both fluoxetine and SET-C are efficacious for social phobia, although SET-C appears to provide
added benefit by enhancing social skills. Copyright 2007 copyright American Academy of Child and Adolescent Psychiatry.
Journal of the
American Academy of Child & Adolescent Psychiatry., 46(12) : 1622-1632
- Year: 2007
- 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), Skills training