Disorders - Social phobia
Zainal, N. H., Chan, W. W., Saxena, A. P., Taylor, C. B., Newman, M. G.
Background: Virtual reality exposure therapy (VRE) has shown promising efficacy for the treatment of social anxiety disorder (SAD) and
related comorbidities. However, most trials conducted to date were therapist-led, and little is known about the efficacy of self-guided VRE.
Therefore, this randomized controlled trial (RCT) aimed to determine the efficacy of a self-directed VRE for SAD. Method(s): Forty-four community-
dwelling or undergraduate adults diagnosed with SAD based on the Mini International Neuropsychiatric Interview were randomly assigned to VRE designed
to last four sessions or more (n = 26) or waitlist (WL; n = 18). Self-reported SAD severity (Social Phobia Diagnostic Questionnaire and Social
Interaction Anxiety Scale), job interview anxiety (Measure of Anxiety in Selection Interviews), trait worry (Penn State Worry Questionnaire), and
depression symptoms (Patient Health Questionnaire-9) were administered at baseline, post-treatment, 3-month-follow-up (3MFU), and 6-month-follow-up
(6MFU). Piecewise multilevel modeling analyses were conducted to manage clustering in the data. Result(s): VRE vs. WL resulted in greater reductions
in SAD symptom severity, job interview fear, and trait worry, with moderate-to-large effect sizes (Hedge's g = -0.54 to -1.11) from pre-to-post
treatment. Although significant between-group differences did not emerge for change in depression, VRE led to change in depression, whereas waitlist
did not. These gains were also maintained at 3MFU and 6MFU. Further, facets of presence increased during the course of VRE (g = 0.36-0.45), whereas
cybersickness decreased (g = -0.43). Discussion(s): Brief, self-guided VRE might ameliorate SAD and comorbid worry, for young-to-middle-aged adults
with SAD. Other theoretical and practical implications were also discussed. Copyright © 2021 Elsevier Ltd
Behaviour Research and Therapy, 147 (no
pagination) :
- Year: 2021
- 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)
Yu, D.
BACKGROUND: College
freshmen, as a special group who are far away from their parents and begin to study and live independently, will face psychological stress in
adaption to the college life, which may affect their working and living conditions in the university and even after entering the society if not
solved reasonably. Hence, it is necessary to explore how to relieve the psychological stress of freshmen. OBJECTIVE(S): The study aimed to analyze
the intervention effects of cognitive behavioral therapy on social psychological stress of freshmen under different demographic variables. METHOD(S):
108 freshmen of Northeast Agricultural University were divided into the experimental group and control group. The correlation between psychological
stress and impulse, self-esteem, and loneliness was analyzed using structural equation model and multiple regression. The experimental group received
group training for one month, while the control group did not accept any intervention. The Fear of Negative Evaluation (FNE) Scale, Interaction
Anxiousness Scale (IAS), and Interpersonal Efficacy Scale (IES) were used to score students before and after activities and three months after
activities. The relevant information was collected for students' self-evaluation and the evaluation results from group teachers. RESULT(S): The
subjects' social psychological stress was positively correlated with loneliness and unplanned impulse, and negatively correlated with self-esteem (P
< 0.001); the IAS and FNE scores of the experimental group after test were greatly lower than those of the control group, while the scores of
affinity efficacy, communication efficacy, and emotional control were greatly higher than those of the control group (P < 0.05); the tracking IAS and
FNE scores of the experimental group were greatly lower than those of the control group, while the scores of affinity efficacy, self-impression
efficacy, communication efficacy, and emotional control were greatly higher than those of the control group (P < 0.05). All students in the
experimental group were satisfied with the cognitive behavioral group training. Under the positive guidance of the team teacher, the students'
psychological stress was released. CONCLUSION(S): The cognitive behavior group training based on impulse, self-esteem, and loneliness can effectively
improve the affinity efficacy, self-impression efficacy, communication efficacy, and negative evaluation fear of freshmen, which is instrumental in
easing the psychological stress of students and can maintain long-term effects.
Work, 06 :
- 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), Cognitive & behavioural therapies (CBT)
Samantaray, N. N., Nath, B., Behera,
N., Mishra, A., Singh, P., Sudhir, P.
Objective: To compare brief cognitive behavior group therapy (bCBGT) for social anxiety
disorder (SAD) to a credible placebo, psychoeducational-supportive therapy (PST), in a sample of medical students. Method(s): This was a single-
center, rater-blind, randomized, attention placebo-controlled, parallel-group study. Participants were 50 consenting undergraduate medical students
of a state government medical college in Cuttack, India having a primary diagnosis of SAD, who recieved 6 weekly 2-h group sessions. Assessments were
carried out at baseline, post intervention and at two-month follow. Independent raters assessed the participants on the Liebowitz Social Anxiety
Scale and Clinical Global Impression- Improvement scale (CGI-I). Social Phobia Inventory (SPIN), a self-rated measure, was administered in the same
periods. Result(s): bCBGT group improved significantly across periods from pre-treatment to post-treatment and from pre-treatment to two-month
follow-up. bCBGT was statistically superior to PST at the post-treatment and follow-up assessments and showed large effect sizes at both post-
treatment and follow-up. Conclusion(s): A 6-session bCBGT is an efficacious treatment for SAD among medical students. A longer follow-up and
replication in other groups, and clinical settings are necessary for generalization to a broader SAD population. Copyright © 2020 Elsevier B.V.
Asian Journal of Psychiatry, 55 (no
pagination) :
- Year: 2021
- 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
Reeves, R., Elliott, A., Curran, D., Dyer, K., Hanna, D.
Public speaking anxiety (PSA) is a prevalent
condition which is highly interrelated with social anxiety. PSA can be effectively treated with exposure therapy. Virtual reality exposure therapy
(VRET) is increasingly being explored as a novel and cost-effective mode of treatment. No previous randomized controlled trial has examined whether
stand-alone 360degree video VRET is an effective intervention for treating PSA and interrelated disorder relevant fears. Further, studies have not
explored whether 360degree video content influences VRET outcomes. Participants with high PSA (n = 51) were randomly allocated to: 360degree video
VRET incorporating stimuli of audiences (360degreeAudience) (n = 17), 360degree video VRET incorporating stimuli of empty rooms (360degreeEmpty) (n =
16) and no treatment control (n = 18). Outcomes were measured over five time-points. Mixed ANOVA revealed a significant interaction between time and
intervention group for PSA, social anxiety and fear of negative evaluation (FNE). Within-group analysis demonstrated there was a significant pre-
intervention to post-intervention reduction across measures for both 360degree video VRET groups: PSA 360degreeAudience (etap2
= .90, p<.001), 360degreeEmpty (etap2 = .71, p < .001); social anxiety 360degreeAudience (etap2 = .49,
p=.002), 360degreeEmpty (etap2 = .39, p = .009); FNE 360degreeAudience (etap2 = .59, p<.001),
360degreeEmpty (etap2 = .43, p = .006). Active intervention participants showed significant improvement from pre-intervention
to 10-week follow-up on all measures. Findings illustrate that 360degree video VRET is an efficacious way to significantly reduce PSA, social anxiety
and FNE.
, 83 : 102451
- Year: 2021
- Problem: Social phobia (social anxiety disorder), Specific
Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected 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)
Lidle, L. R., Schmitz, J.
According to cognitive models of social anxiety disorder (SAD), both anticipatory processing and post-event processing are core
mechanisms in disorder maintenance leading to dysfunctional coping with social situations through negative self-evaluation and increased anxiety. To
date, little is known about these processes during late childhood, a critical period for disorder development. Further, it remains unclear if
dysfunctional rumination in children can be altered through psychotherapeutic interventions such as cognitive distraction. In the current study,
children aged 9 to 13 years with SAD and age- and gender-matched healthy controls (HCs, each: n=30) participated in an experimental laboratory social
stress task while anticipatory processing, post-event processing, subjective anxiety, self-evaluations, and autonomic arousal (skin conductance
level) were assessed. Further, the impact of a brief cognitive distraction intervention on post-event processing was assessed. Children with SAD
reported more negative anticipatory and post-event processing compared to HC children. Further, negative anticipatory processing was associated with
higher subjective anxiety and reduced subjective performance ratings during the social stress task. In the aftermath of the stressor, distraction led
to reduced subjective anxiety in the group with SAD and lower autonomic arousal in all children but did not alter post-event processing. The current
study suggests that both anticipatory and post-event processing already play a key role in the maintenance of SAD in childhood. While distraction may
be beneficial in reducing prolonged subjective anxiety and autonomic arousal after social situations, more research on interventions targeting
ruminative processes is needed.
Research on child and adolescent psychopathology., 18 :
- Year: 2021
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Lewis, E. M., Gilroy, S. P., Buckner, J. D., Heimberg, R. G.
Postevent processing (PEP), the engagement in detailed and repetitive self-focused review of one's performance in social
situations, is theorized to maintain pathological social anxiety. However, little is known about interventions that may impact this maintenance
factor. The current study examined the impact of brief mindfulness training (BMT) on PEP among socially anxious individuals. There were 77
participants (75.32% female, 63.64% non-Hispanic/Latinx White) with clinically elevated social anxiety who attended one appointment in the laboratory
during which they were randomized to receive a brief mindfulness-based training (n = 37) or no training (i.e., thinking as usual control group; n =
40). After the training period, participants underwent a 3-minute social anxiety induction task, after which they were instructed to apply their
thinking strategy. Participants were then asked to complete 2 weeks of daily online surveys that included a PEP induction task, instructions to use
their thinking strategy following PEP induction, and a measure of state PEP. Individuals in the BMT condition reported a significant reduction in
state anxiety posttraining compared to individuals in the control condition. Conditions did not differ on state PEP after the social anxiety
induction task. However, compared to those in the control condition, participants in the BMT condition reported significantly greater decreases in
state PEP over the 14-day follow-up period. Thus, this brief mindfulness-based strategy may be useful for individuals with clinically elevated social
anxiety who engage in PEP, a cognitive vulnerability factor implicated in the maintenance of social anxiety. Copyright © 2021
, 52(4) : 785-796
- 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), Mindfulness based
therapy
Kinney, K. L., Burkhouse, K. L., Chang, F., MacNamara,
A., Klumpp, H., Phan, K. L.
Anxiety disorders (ADs) are common and difficult to treat. While research suggests ADs are
characterized by an imbalance between bottom-up and top-down attention processes and that effective treatments work by correcting this dysfunction,
there is insufficient data to explain how and for whom treatments work. The late positive potential (LPP), an event-related potential reflecting
elaborative processing of motivationally salient stimuli, is sensitive to both bottom-up and top-down processes. The present study examines the LPP
in healthy controls (HC) and patients with ADs under low and high working memory (WM) load to assess its utility as a predictor and index of symptom
reduction in patients who underwent cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The LPP when
viewing negative and neutral distractor images and WM performance were assessed in 96 participants (40 HC, 32 CBT, 24 SSRI) during a letter recall
task at Week 0 and in a subset of the study sample (23 CBT, 16 SSRI) at Week 12. Patients were randomly assigned to twelve weeks of CBT or SSRI
treatment. Participants completed self-reported symptom measures at each time point. Greater Week 0 LPP to negative images under low WM load
predicted greater symptom reduction in the SSRI, but not the CBT, group. Regression analyses examining the LPP to negative images as an index of
symptom reduction revealed a smaller decrease in the LPP to negative images under low WM load was associated with less anxiety reduction across
treatment modalities. Findings suggest the LPP during low WM load may serve as a cost-effective predictor and index of treatment outcome in ADs.
Clinical Trials Registration: ClinicalTrials.gov (Identifier: NCT01903447) Copyright © 2021 Elsevier Ltd
, 82 (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any), Panic
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), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Hutschemaekers, M. H. M., de-Kleine, R. A., Hendriks, G. J., Kampman, M., Roelofs, K.
Individuals with a social anxiety disorder (SAD)
show hypofunctioning of the hypothalamus-pituitary-gonadal (HPG) axis, which is linked to social fear and avoidance behavior. As testosterone
administration has been shown to facilitate social-approach behavior in this population, it may enhance the effectiveness of exposure treatment. In
this proof-of-concept study, we performed a randomized clinical assay in which 55 women diagnosed with SAD received two exposure therapy sessions.
Session 1 was supplemented with either testosterone (0.50 mg) or placebo. Next, transfer effects of testosterone augmentation on within-session
subjective fear responses and SAD symptom severity were assessed during a second, unenhanced exposure session (session 2) and at a 1-month follow-up,
respectively. The participants having received testosterone showed a more reactive fear pattern, with higher peaks and steeper reductions in fear
levels in session 2. Post-hoc exploration of moderating effects of endogenous testosterone levels, revealed that this pattern was specific for women
with high basal testosterone, both in the augmented and in the transfer session. In contrast, the participants with low endogenous testosterone
showed reduced peak fear levels throughout session 1, again with transfer to the unenhanced session. Testosterone did not significantly affect self-
reported anxiety. The effects of testosterone supplementation on fear levels show transfer to non-enhanced exposure, with effects being modulated by
endogenous testosterone. These first preliminary results indicate that testosterone may act on important fear mechanisms during exposure, providing
the empirical groundwork for further exploration of multi-session testosterone-enhanced exposure treatment for SAD. Copyright © 2021, The Author
(s).
Translational Psychiatry, 11(1) (no pagination) :
- Year: 2021
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention
Gorisse, G., Senel, G., Banakou, D., Beacco, A., Oliva, R., Freeman, D., Slater, M.
The proportion of the
population who experience persecutory thoughts is 10-15%. People then engage in safety-seeking behaviours, typically avoiding social interactions,
which prevents disconfirmatory experiences and hence paranoia persists. Here we show that persecutory thoughts can be reduced if prior to engaging in
social interaction in VR participants first see their virtual body-double doing so. Thirty non-clinical participants were recruited to take part in a
study, where they were embodied in a virtual body that closely resembled themselves, and asked to interact with members of a crowd. In the Random
condition (n=15) they observed their body-double wandering around but not engaging with the crowd. In the Targeted condition the body-double
correctly interacted with members of the crowd. The Green Paranoid Thoughts Scale was measured 1 week before and 1 week after the exposure and
decreased only for those in the Targeted condition. The results suggest that the observation of the body-double correctly carrying out a social
interaction task in VR may lead to anxiety-reducing mental rehearsal for interaction thus overcoming safety behaviours. The results also extend
knowledge of the effects of vicarious agency, suggesting that identification with the actions of body-double can influence subsequent psychological
state. Copyright © 2021. The Author(s).
Scientific reports, 11(1) : 23923
- Year: 2021
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Ezenwaji, C. O., Aloh, H. E., Okeke, P. M. D., Osilike, C. C., Ekwealor, N.
E., Koledoye, U. L., Ilechukwu, L. C., Onwuadi, C. C.
BACKGROUND/OBJECTIVE: Anxiety is a significant problem affecting University students including undergraduate adult education and
extra-mural studies students. This research evaluated the impact of a group rational-emotive behavioral education intervention (group rational-
emotive behavioral education intervention [REBEI]) on social anxiety symptoms among undergraduate adult education and extra-mural studies students.
METHOD(S): Eighty six students participated in the study by belonging to either treatment group (n = 43) or control group (n = 43). A REBEI treatment
program was developed by the researchers was used to implement the experiment and data was collected using a 22-item questionnaire on social anxiety.
Analyzes of data were done using repeated measures ANOVA and paired t-test. RESULT(S): Results showed that despite the social anxiety experienced
before exposure to the intervention, the social anxiety symptoms of the undergraduate adult education and extra-mural studies students in the
treatment group reduced significantly at post-treatment and follow-up compared to students in the control group. CONCLUSION(S): REBEI demonstrated
its clinical usefulness in treating undergraduate adult education and extra-mural studies students with social anxiety problem. Copyright © 2021 the
Author(s). Published by Wolters Kluwer Health, Inc.
, 100
(42) : e27596
- 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)
Cordier, R., Speyer, R., Mahoney, N., Arnesen, A., Mjelve, L. H., Nyborg, G.
In school, shyness is associated with psychosocial difficulties and has negative impacts on children's academic
performance and wellbeing. Even though there are different strategies and interventions to help children deal with shyness, there is currently no
comprehensive systematic review of available interventions. This systematic review and meta-analysis aim to identify interventions for shy children
and to evaluate the effectiveness in reducing psychosocial difficulties and other impacts. The methodology and reporting were guided by the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. A total of 4,864 studies were identified and 25 of these met the
inclusion criteria. These studies employed interventions that were directed at school-aged children between six and twelve years of age and described
both pre- and post-intervention measurement in target populations of at least five children. Most studies included an intervention undertaken in a
school setting. The meta-analysis revealed interventions showing a large effect in reducing negative consequences of shyness, which is consistent
with extant literature regarding shyness in school, suggesting school-age as an ideal developmental stage to target shyness. None of the
interventions were delivered in a classroom setting, limiting the ability to make comparisons between in-class interventions and those delivered
outside the classroom, but highlighting the effectiveness of interventions outside the classroom. The interventions were often conducted in group
sessions, based at the school, and involved activities such as play, modelling and reinforcement and clinical methods such as social skills training,
psychoeducation, and exposure. Traditionally, such methods have been confined to a clinic setting. The results of the current study show that, when
such methods are used in a school-based setting and involve peers, the results can be effective in reducing negative effects of shyness. This is
consistent with recommendations that interventions be age-appropriate, consider social development and utilise wide, school-based programs that
address all students.
, 16(7) : e0254117
- Year: 2021
- Problem: Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any)
Comer, J. S., Furr, J. M., del-Busto, C., Silva, K., Hong, N., Poznanski, B., Sanchez, A., Cornacchio,
D., Herrera, A., Coxe, S., Miguel, E., Georgiadis, C., Conroy, K., Puliafico, A.
Despite recent advances in
the treatment of early child social anxiety, the broad accessibility of brick-and-mortar services has been limited by traditional barriers to care,
and more recently by new obstacles related to efforts to slow the spread of COVID-19. The present waitlist-controlled trial examined the preliminary
efficacy of a family-based behavioral parenting intervention (i.e., the iCALM Telehealth Program) that draws on Parent-Child Interaction Therapy and
videoconferencing to remotely deliver clinician-led care for anxiety in early childhood. Young children (3-8 years) with a diagnosis of social
anxiety disorder (N = 40; 65% from ethnic/racial minority backgrounds) were randomly assigned to iCALM or waitlist. Intent-to-treat analyses found
that at post, independent evaluators classified roughly half of the iCALM-treated children, but only 6% of waitlist children, as \"Responders\" (Wald
test = 4.51; p =.03). By Post, iCALM led to significantly greater reductions than waitlist in child anxiety symptoms, fear, discomfort, and anxiety-
related social impairment, and also led to greater improvements in child soothability. By 6-month follow-up, the percentage of iCALM-treated children
classified as \"Responders\" rose to roughly 60%. Exploratory moderation tests found iCALM was particularly effective in reducing life impairments
and parental distress among families presenting with higher, relative to lower, levels of baseline parental accommodation. The present findings add
to a growing body of research supporting the promise of technology-based strategies for broadening the portfolio of options for delivering
clinician-led mental health services. Copyright © 2021 Association for Behavioral and Cognitive Therapies
Behavior
Therapy., :
- Year: 2021
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)