Disorders - Social phobia
Salemink, E., de Jong, S. R., Notebaert, L., MacLeod, C., Van Bockstaele,
B.
Background and objectives: Interpretation bias plays a crucial role in anxiety. To test the causal role and potential clinical
benefits, training procedures were developed to experimentally change interpretation bias. However, these procedures are monotonous and plain, which
could negatively affect motivation and adherence. The aim of this study was to make the interpretation training more engaging and enjoyable, without
compromising its effectiveness, through gamification. Methods: The training was gamified by including extrinsically and intrinsically motivating
elements such as points, scores, time-pressure, fun and adaptive elements (training at an individually challenging level). A 2 (Type: Gamified vs.
Standard) x 2 (Training Valence: Positive vs. Placebo) between-subjects design was used with random allocation of 79 above-average anxious
individuals. Post-training, we assessed the liking and recommendation of the training task, interpretation bias (Recognition task and the Scrambled
Sentence Task) and anxiety. Results: Participants experienced the gamified training tasks as more engaging and enjoyable than the standard tasks,
although it was not recommend more to fellow-students. Both positive training conditions (gamified and standard) were successful in eliciting a
positive interpretation bias when assessed with the Recognition task, while only the standard positive training impacted on interpretations when
assessed with the Scrambled Sentence Task. No differential effects were observed on anxiety. Limitations: The study involved only a single-session
training and participants were selected for high trait (and not social) anxiety. Conclusions: The gamified training was evaluated more positively by
the participants, while maintaining the effectiveness of eliciting positive interpretations when assessed with the Recognition task. This suggests
that gamification might be a promising new approach.
Journal of Behavior Therapy and Experimental Psychiatry, 76 : 1-
8
- Year: 2022
- 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), Attention/cognitive bias
modification
Salama, A., Abdel-Latif, S., Omar, T., El-Wafa, H. A.
Introduction. The present study aimed to evaluate the effectiveness of neurofeedback (NF) and cognitive-behavioral therapy (CBT) on
the reduction of anxiety symptoms in children and adolescents with generalized anxiety disorder. Methods. The current pseudo-experimental study with
a pre-posttest design was conducted on a population of patients with a generalized anxiety disorder (GAD) referring to the child psychiatry clinic in
Alexandria's University Hospital, Egypt. The sample size comprised of 30 children and adolescents selected by random sampling method and assigned to
groups of NF and CBT. Data elicited from the State-Trait Anxiety Inventory (STAI), which is a self-report scale for measuring two distinct anxiety
concepts. Data were analyzed with SPSS. Student t-test was performed on CBT and NF groups. Results. The current study showed that both CBT and NF are
effective in reducing the level of anxiety in the study subjects with no significant differences between the two groups. The obtained results also
showed that NF therapy is an effective method with more improvement on state anxiety score, while CBT showed more improvement in trait anxiety score.
Conclusion. Both treatments were significantly effective, and therefore neurofeedback training can be effectively used as a treatment approach for
children and adolescents with GAD. Copyright: © 2022. Salama et al.
NeuroRegulation, 9(1) : 29-
38
- Year: 2022
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Biofeedback, neurofeedback, audio/video feedback
Rubin, M., Muller, K., Hayhoe, M. M., Telch, M. J.
Biased attention to social threats has been
implicated in social anxiety disorder. Modifying visual attention during exposure therapy offers a direct test of this mechanism. We developed and
tested a brief virtual reality exposure therapy (VRET) protocol using 360degree-video and eye tracking. Participants (N = 21) were randomized to
either standard VRET or VRET + attention guidance training (AGT). Multilevel Bayesian models were used to test (1) whether there was an effect of
condition over time and (2) whether post-treatment changes in gaze patterns mediated the effect of condition at follow-up. There was a large overall
effect of the intervention on symptoms of social anxiety, as well as an effect of the AGT augmentation on changes in visual attention to audience
members. There was weak evidence against an effect of condition on fear of public speaking and weak evidence supporting a mediation effect, however
these estimates were strongly influenced by model priors. Taken together, our findings suggest that attention can be modified within and during VRET
and that modification of visual gaze avoidance may be casually linked to reductions in social anxiety. Replication with a larger sample size is
needed.
, : 1-
17
- Year: 2022
- 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, Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Redden, S. A., Patel, T. A., Cougle, J. R.
BACKGROUND AND OBJECTIVES: Perfectionism has important implications for self-worth,
personal standards, and psychopathology. The aim of this study was to test the efficacy of a novel two-week, computerized, exposure-based treatment
for perfectionism (ETP).\rMETHODS: Seventy-one university students with elevated perfectionism were randomized to either the ETP group (n = 36) or
the waitlist (WL) control group (n = 35). The ETP group was asked to complete the intervention at home, every three days for two weeks for a total of
five treatment sessions. The tasks in the ETP condition were engineered to have participants repeatedly make mistakes. All participants returned two
weeks after the baseline visit for a post-treatment assessment.\rRESULTS: Compared to WL, ETP led to lower overall perfectionism, concern over
mistakes, personal standards, depressive symptoms, social anxiety symptoms, and error sensitivity at post-treatment. No effects of treatment were
found on trait anxiety, obsessive-compulsive symptoms, or eating disorder symptoms.\rLIMITATIONS: Participants were university students of similar
age and education level, which restricts generalizability. Additionally, the study relied on a waitlist control condition.\rCONCLUSIONS: This study
provided preliminary evidence for a novel online intervention for perfectionism.
Journal of Behavior Therapy & Experimental
Psychiatry, 77 : 101771
- Year: 2022
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Social phobia (social anxiety disorder), Depressive Disorders, Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Technology, interventions delivered using technology (e.g. online, SMS)
Neophytou, K., Panayiotou, G.
According to cognitive models, preferential attention to social threat contributes to maintenance of social anxiety.
Socially anxious individuals are known to show attention biases to threatening stimuli, although there is inconsistency in the literature with
regards to the type of attentional biases they present. This study examines the effect of attention bias modification (ABM) for social anxiety in
non-treatment-seeking college students meeting social anxiety disorder criteria, taking into consideration previous mixed results regarding its
effectiveness. Attention bias levels and types (i.e. vigilance vs avoidance) at baseline were examined and considered as potential moderators of ABM
effects. Sixty-eight socially anxious individuals were randomly allocated to ABM vs placebo groups. A structured interview and self-report assessment
were completed at pre-treatment and post-treatment. Results showed half of the participants presented few attention biases at baseline, and the rest
presented either vigilance or avoidance. Participants with low attention biases scored higher in social anxiety than those showing avoidance and
there was no difference between those showing vigilance vs avoidance. No significant effects from pre to post treatment were observed in attention
biases, self-report or structured interview of anxiety in the ABM group. Baseline attention biases did not moderate these effects. Results are
discussed with regards to implications for future research towards the creation of more effective protocols, based on the needs of heterogeneous
social anxiety sub-groups.
, 17(2) : e0264256
- Year: 2022
- 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
Landkroon, E., Salemink, E., Meyerbroker, K., Barzilay, S., Kalanthroff, E., Huppert, J. D., Engelhard, I. M.
Background and
objectives: Negative mental imagery appears to play a role in anxiety disorders and can involve aversive memories or anticipated future threats.
Modulating aversive memories through imagery rescripting generally reduces negative memory appraisals and associated anxiety. This pre-registered
two-day analog study investigated whether imagery rescripting of aversive memories also reduces negative imagery of future threats. Method(s): On Day
1, socially anxious individuals (N = 52) were randomly assigned to imagery rescripting of an aversive memory or progressive relaxation (control
condition). Before each intervention, they were asked to imagine a feared social situation that may happen in their future and evaluate this
situation. They also rated the aversive memory before and after the intervention phase. The feared future situation was again evaluated at follow-up
on Day 2. Result(s): Unexpectedly, no group differences were found on the main outcome measures. That is, negative memory appraisals reduced after
both interventions. Likewise, in both groups, negative details decreased, and positive details increased in prospective mental imagery, and anxiety
and avoidance towards the imagined event decreased. On the exploratory measures, the imagery rescripting group showed increased positive appraisals
of memory and future threat, and decreased negative future-threat appraisals, compared to the progressive relaxation group. Limitation(s): No passive
control group was included, so potential time or placebo effects cannot be precluded. Conclusion(s): The interventions had similar effects on the
main outcomes and influenced mental imagery of future threats. Some differences were found on the exploratory measures that warrant further
investigation with a passive control condition. Copyright © 2022 The Authors
Journal of Behavior Therapy and Experimental Psychiatry, 77 (no
pagination) :
- Year: 2022
- 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), Relaxation
Kim, H., Kim, B. H., Kim, M. K., Eom, H., Kim, J. J.
Social anxiety disorder (SAD) is a mental disorder characterized by excessive anxiety in social situations. This
study aimed to examine the alteration of resting-state functional connectivity in SAD patients related to the virtual reality-based self-training
(VRS) which enables exposure to social situations in a controlled environment. Fifty-two SAD patients were randomly assigned to the experimental
group who received the VRS, or the control group who did not. Self-report questionnaires and resting-state functional magnetic resonance imaging
(fMRI) were performed to assess clinical symptoms and analyze the resting-state network properties, respectively. Significant decrease in social
anxiety and an increase in self-esteem was found in the experimental group. From the resting-state fMRI analysis, alteration of local network
properties in the left dorsolateral prefrontal gyrus (-10.0%, p = 0.025), left inferior frontal gyrus (-32.3%, p = 0.044), left insula (-17.2%, p =
0.046), left Heschl's gyrus (-21.2%, p = 0.011), bilateral inferior temporal gyrus (right: +122.6%, p = 0.045; left:-46.7%, p = 0.015), and right
calcarine sulcus (+17.0%, p = 0.010) were found in the experimental group. Average shortest path length (+8.3%, p = 0.008) and network efficiency (-
7.6%, p = 0.011) are found to be altered from the global network property analysis. In addition, the experimental group displayed more positive and
more negative changes in the correlation trend of average shortest path length (p = 0.004) and global network efficiency (p = 0.014) with the
severity of social anxiety, respectively. These results suggest potential effectiveness of the VRS, which is possibly related to the change of
aberrant processing and control of visual and auditory linguistic stimuli and the adaptive change in rumination pattern. Copyright © 2022 Kim, Kim,
Kim, Eom and Kim.
Frontiers in Psychiatry, 13 (no
pagination) :
- Year: 2022
- 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, Technology, interventions delivered using technology (e.g. online, SMS)
Garay, J. P. P., Malca, W. B., Guillen, D. E. F., Oliver, J. M. Z.
The objective of the research was to establish the influence of socio-emotional skills for the reduction of social anxiety in
university students. Quantitative methodology was used to collect the information data, using the survey as a technique and the questionnaire as an
instrument. The population consisted of 600 university students, divided into two groups, the control group was considered 300 students and the
experimental group was considered 300 students. The socio-emotional skills intervention program decreases levels of social anxiety, reduces the
levels of anxiety that is generated in the interaction with people who exercise authority, in the anxiety in the interaction with the opposite sex;
Likewise, it decreases in the assertive expression of annoyance, decreases anxiety due to displeasure or anger. making a fool of yourself or making a
fool of yourself and decreased anxiety about interacting with strangers; Therefore, socio-emotional skills facilitate relationships and promote
emotional balance, enabling the ability to recognize, understand and manage their emotions. Copyright © 2022 Wolters Kluwer Medknow Publications. All
rights reserved.
Journal of Pharmaceutical Negative Results, 13 : 435-441
- Year: 2022
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Daniel, K.
E., Mendu, S., Baglione, A., Cai, L., Teachman, B. A., Barnes, L. E., Boukhechba, M.
BACKGROUND: Social anxiety disorder is associated with distinct mobility patterns (e.g., increased time spent at home compared to
non-anxious individuals), but we know little about if these patterns change following interventions. The ubiquity of GPS-enabled smartphones offers
new opportunities to assess the benefits of mental health interventions beyond self-reported data.\rOBJECTIVES: This pre-registered study
(https://osf.io/em4vn/?view_only=b97da9ef22df41189f1302870fdc9dfe) assesses the impact of a brief, online cognitive training intervention for threat
interpretations using passively-collected mobile sensing data.\rDESIGN: Ninety-eight participants scoring high on a measure of trait social anxiety
completed five weeks of mobile phone monitoring, with 49 participants randomly assigned to receive the intervention halfway through the monitoring
period.\rRESULTS: The brief intervention was not reliably associated with changes to participant mobility patterns.\rCONCLUSIONS: Despite the lack of
significant findings, this paper offers a framework within which to test future intervention effects using GPS data. We present a template for
combining clinical theory and empirical GPS findings to derive testable hypotheses, outline data processing steps, and provide human-readable data
processing scripts to guide future research. This manuscript illustrates how data processing steps common in engineering can be harnessed to extend
our understanding of the impact of mental health interventions in daily life.
Anxiety, Stress, & Coping, 35(3) : 298-
312
- Year: 2022
- 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)
Borghese, F., Henckaerts, P., Guy, F., Perez
Mayo, C., Delplanque, S., Schwartz, S., Perogamvros, L.
Background: Social anxiety disorder (SAD) is characterized by a significant amount of fear
when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on
evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR)
during REM sleep to enhance extinction learning in SAD. Method(s): Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR
group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk
in front of a virtual jury. At the end of each session, and only in the TMR group (N = 24), a sound was paired to the positive feedback phase of
therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with
a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was
assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-
specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation
phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.
Result(s): We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two
groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the
less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.
Conclusion(s): TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support
that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these
patients. Copyright © 2022 Borghese, Henckaerts, Guy, Perez Mayo, Delplanque, Schwartz and Perogamvros.
Frontiers in
Psychiatry, 13 (no pagination) :
- Year: 2022
- 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, Other Psychological Interventions, Biofeedback, neurofeedback, audio/video feedback, Technology, interventions delivered using technology (e.g. online, SMS)
Bilek, E., Tomlinson, R. C., Whiteman, A. S., Johnson, T. D., Benedict, C., Phan, K. L., Monk, C.
S., Fitzgerald, K. D.
OBJECTIVE: The
relative contribution of individual cognitive behavioral therapy (CBT) components to treatment outcomes for child anxiety disorders (CADs) is
unclear. Recent meta-analyses suggest that exposure may be the primary active ingredient in CBT for CADs, and that relaxation may be relatively less
effective. This brief report tests the hypothesis that exposure-focused CBT (EF-CBT) would outperform a relaxation-based active therapy control
(Relaxation Mentorship Training; RMT) for the treatment of CADs. METHOD(S): Participants were 102 youth with CADs (mean age = 11.91, 26 males; 76.4%
White, 14.7% Multiracial, 3.9% Black, 3.9% Asian, 0.9% other/do not wish to identify) as part of an ongoing neuroimaging randomized controlled trial.
Participants were randomly assigned (ratio 2:1) to receive 12 sessions of EF-CBT (n = 70) or RMT (n = 32). Clinical improvement was measured at Week
12 (Clinical Global Impression - Improvement scale; CGI-I); treatment response was defined as receiving a rating of \"very much\" or \"much improved
\" on the CGI-I. Anxiety severity was measured at Weeks 1, 6, 9, 12 (Pediatric Anxiety Rating Scale; PARS). Outcome measures were completed by an
independent evaluator unaware of condition. RESULT(S): EF-CBT exhibited 2.98 times higher odds of treatment completion than RMT; 13 treatment non-
completers were included in analyses. Estimated treatment response rates were higher for EF-CBT (57.3%) than for RMT (19.2%). Longitudinal analyses
indicated that EF-CBT was associated with faster and more pronounced anxiety reductions than RMT on the PARS (Hedges' g = .77). CONCLUSION(S):
Results suggest that EF-CBT without relaxation is effective for CADs, and more effective than a relaxation-based intervention.
Journal of Clinical Child and Adolescent Psychology, 51
(4) : 410-418
- Year: 2022
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention, Relaxation
Zhang, F., Huang,
C., Mao, X., Hou, T., Sun, L., Zhou, Y., Deng, G.
Training individuals to interpret ambiguous
information in positive ways might be an effective method of reducing social anxiety. However, little research had been carried out in Chinese
samples, and the effect of interpretation training on other processes such as attentional bias also remained unclear. This study examined the effect
of interpretation bias modification program (IMP) on interpretation bias, social anxiety and attentional bias, and the possible mediation effects. 51
healthy adults were randomly assigned to either a 5-session IMP training that guided them to endorse benign interpretation in ambiguous scenarios or
an interpretation control condition (ICC). Self-reported measures of social anxiety symptoms, attentional bias and interpretation bias were evaluated
before and after training. Results showed that compared to control group, IMP group generated more positive interpretations and less negative
interpretations after training (F(1,49) = 7.65, p<0.01, etap2 = 0.14; F(1,49) = 14.60, p<0.01, etap2 = 0.23respectively). IMP yielded greater
interpretation bias reduction (F(1,49) = 12.84, p<0.01, etap2 = 0.21) and social anxiety reduction (F(1,49) = 21.39, p<0.01, etap2 = 0.30) than ICC,
but change in attentional bias was not significant between IMP and the control group. Change in interpretation bias did not show a significant
mediation effect in the relationship between training condition and social anxiety reduction. This study provided preliminary evidence for the
efficacy of the Chinese version of IMP training. Possible methodological issues and interpretations underlying the findings were discussed. This
study was registered in Chinese Clinical Trial Registry (www.chitr.org.cn), a WHO approved registry. The title of registration trial was \"A Study on
the efficiency of cognitive bias and attentional bias training on fear and phobia\" and the registration number was ChiCTR2100045670.
, 16(7) : e0255224
- Year: 2021
- 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