Disorders - Social phobia
Frayeh, A. L., Lewis, B. A.
Objectives: Yoga is a promising strategy for promoting positive body image. However, certain physical environmental factors, such as mirrors, might undermine yoga's benefits. The present study examined the effect of mirrors on women's state body image and appearance comparisons during yoga. Design: Randomized experimental design. Method: Ninety-seven college-aged females were randomly assigned to a 60-min group yoga class in either a mirrored or non-mirrored setting. Surveys were completed prior to and immediately after class. Results: As hypothesized, the mirrored condition reported significantly higher state social physique anxiety and appearance comparisons after yoga than the non-mirrored condition. Mediator analysis indicated that within the mirrored condition, participants who engaged in more appearance comparisons reported higher state social physique anxiety than participants who engaged in fewer comparisons. There were no between-group differences on state body satisfaction and self-objectification. Conclusions: In the presence of mirrors, young women who reported engaging in more appearance comparisons during yoga reported higher social physique anxiety than women who engaged in fewer comparisons. Participants were perhaps using the mirrors as a tool for comparison, which assists learning yoga poses, but can also impact body image. Additional research examining the longer-term effects of regularly practicing yoga with mirrors is merited. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Psychology of Sport and Exercise, 35 : 47-54
- Year: 2018
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other Psychological Interventions, Mind-body exercises (e.g. yoga, tai chi, qigong)
Giusti, L., Ussorio, D., Salza, A., Malavolta, M., Aggio, A., Bianchini, V., Casacchia, M., Roncone, R.
Background: People with anxiety disorders tend to focus on unpleasant and threatening stimuli. Our aims were to evaluate: (1) the presence of paranoid ideation, and the jumping to conclusions (JTC) bias in young suffering from an anxiety disorder and (2) the effectiveness of a cognitive-behavioural intervention (CBT) to manage anxiety combined with 2 modules to reduce the JTC bias. Methods: Psychopathology, social functioning, metacognition and the JTC bias were investigated in 60 subjects, randomly assigned to the experimental CBT group + treatment-as-usual (TAU) (n = 35) or to a wait-list group (n = 25) receiving only TAU. Each group was divided into 2 subgroups based on the score of the SCL-90 subscale paranoid ideation (high paranoid ideation, HP; low paranoid ideation, LP). The experimental group received a weekly session of a CBT for a 3-month period. Results: At baseline, 46.7% of our sample showed a HP and 38% showed a JTC biasAt the end of the intervention, greater effectiveness in improving anxious symptoms, paranoid ideation, interpersonal sensitivity and interpersonal relationship was reported in the experimental CBT + TAU group, with a statistically significant reduction of the JTC bias, displayed by 14.3% of the experimental group versus the 36% of the TAU group. In the same variables, greater benefits were reported for the HP experimental subgroup. Conclusions: Our study suggests the gains to integrate an anxiety CBT with modules to reduce the JTC bias in subjects with paranoid ideation, which may negatively impact the course of the disease. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Early Intervention in Psychiatry, 12(6) : 1072-1080
- Year: 2018
- Problem: Generalized Anxiety Disorder, Panic 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
Homer, S. R., Deeprose, C.
N/A
Journal of Behavior Therapy & Experimental Psychiatry, 59 : 87-91
- Year: 2018
- 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
Rawdon, C., Murphy, D., Motyer, G., Munafo, M. R., Penton-Voak, I., Fitzgerald, A.
This study aimed to examine the effect of emotion recognition training on social anxiety symptoms among adolescents, aged 15-18 years. The study included a screening session, which identified participants who scored above a cut-off on a self-report measure of social anxiety for enrolment into a randomized controlled trial (Clinical Trials ID: NCT02550379). Participants were randomized to an intervention condition designed to increase the perception of happiness over disgust in ambiguous facial expressions or a sham intervention control condition, and completed self-report measures of social anxiety, fear of negative evaluation, anxiety-related disorders, and depressive symptoms. The intervention group demonstrated a strong shift in the balance point at which they perceived happiness over disgust in ambiguous facial expressions. This increase in positive perception was not associated with any changes in the primary outcome of social anxiety; however, some evidence of improvement in symptomatology was observed on one of a number of secondary outcomes. Those in the intervention group had lower depression symptoms at 2-week follow-up, compared to those in the control group who received the sham intervention training. Potential reasons for why the shift in balance point measurement was not associated with a concurrent shift in symptoms of social anxiety are discussed. Copyright © 2018 Elsevier B.V.
Psychiatry Research, 263 : 257-267
- Year: 2018
- 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
Salzer, S., Stefini, A., Kronmuller, K. T., Leibing, E., Leichsenring, F., Henningsen, P., Peseschkian, H., Reich, G., Rosner, R., Ruhl, U., Schopf, Y., Steinert, C., Vonderlin, E., Steil, R.
BACKGROUND: Although social anxiety disorder (SAD) has an early onset and is frequently found in adolescence, evidence for psychotherapeutic treatments of SAD in adolescents is rather scarce. Within the Social Phobia Psychotherapy Research Network (SOPHO-NET), we examined the efficacy of cognitive-behavioral (CBT) and psychodynamic therapy (PDT) compared to a waiting list (WL) in these patients.
METHODS: In a multicenter randomized controlled superiority trial, 107 patients, aged 14-20 years, were randomized to CBT (n = 34), PDT (n = 34), or WL (n = 39). Assessments were made at baseline, at the end of treatment, and 6 and 12 months after termination. The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) applied by raters masked to the treatment condition was used as the primary outcome. As secondary outcomes, rates of response and remission and the Social Phobia Anxiety Inventory (SPAI) were used.
RESULTS: Both treatments were superior to WL in the LSAS-CA (CBT: p = 0.0112, d = 0.61, 95% CI 0.14-1.08; PDT: p = 0.0261, d = 0.53, 95% CI 0.06-1.00). At the end of treatment, response rates were 66, 54, and 20% for CBT, PDT, and WL. The corresponding remission rates were 47, 34, and 6%, respectively. CBT and PDT were significantly superior to WL regarding remission (CBT: p = 0.0009, h = 1.0; PDT: p = 0.0135, h = 0.74), response (CBT: p = 0.0004, h = 0.97; PDT: p = 0.0056, h = 0.72), and the SPAI (CBT: p = 0.0021, d = 0.75, 95% CI 0.27-1.22; PDT: p = 0.0060, d = 0.66, 95% CI 0.19-1.13). Treatment effects were stable at 6- and 12-month follow-ups.
CONCLUSIONS: These results are comparable to the large SOPHO-NET trial in adults (n = 495). Early treatments for social anxiety are needed in order to prevent chronic manifestation of SAD.
Psychotherapy & Psychosomatics, 87(4) : 223-233
- Year: 2018
- 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)
, Psychodynamic/Psychoanalysis
Stefan, C.A., Capraru, C., Szilagyi, M.
The aims of this study were two-fold: (1) to investigate the effectiveness of a 6-week mindfulness-based stress reduction (MBSR) program in a sample of college students at risk for social anxiety and (2) to investigate whether emotion regulation strategies and self-compassion act as mechanisms of MBSR effectiveness. Participants in this study were predominantly female college students identified as at risk for social anxiety, who were randomly assigned to either the MBSR intervention or to the wait list control group. The final sample included 22 participants in the MBSR group and 24 in the wait list control group for whom pre-intervention and post-intervention (1 week after the MBSR intervention was finalized) data were gathered on self-report measures. The results showed that MBSR participation lead to significant reductions in social anxiety and perceived stress. Also, significant post-intervention differences in favor of the MBSR group compared to the wait list control group were found for self-compassion and acceptance, but not for positive reinterpretation. Mediation analyses employing a bootstrap procedure with 95% confidence intervals were conducted to test the potential MBSR intervention mechanisms. The results revealed that acceptance and self-compassion mediated the relationship between MBSR participation and social anxiety, as well as MBSR participation and perceived stress. The current findings indicated that mindfulness-based interventions might work by: (1) reducing self-identification with successes and failures in social and stressful situations and (2) deactivating appraisals concerning anxiety provoking situations. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Mindfulness, 9(5) : 1509-1521
- Year: 2018
- 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
Stevens, E. S., Behar, E., Jendrusina, A. A.
Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Behavior Therapy, 49(6) : 995-1007
- Year: 2018
- 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, Attention/cognitive bias modification
, Relaxation
Busa, S., Janssen, A., Lakshman, M.
In addition to the high prevalence of gender dysphoria among transgender youth, this population is at greater risk of suffering from additional mental health disorders, including social anxiety disorder, compared to their cisgender peers. Cognitive behavioral therapy (CBT) has been established as an effective form of treatment for social anxiety disorder. It is recommended that therapists modify and adapt CBT when working with minority groups such as transgender youth to ensure that the treatment is efficacious and culturally sensitive. However, literature assessing the efficacy of CBT for transgender youth with mental health issues is scant. As a result, there is no empirical literature on effective treatment for transgender youth who meet criteria for social anxiety disorder alone or youth who meet criteria for social anxiety disorder and gender dysphoria. This literature review aims to identify current research related to prevalence of mental health disorders in transgender youth, the current literature on adaptations of cognitive behavioral techniques, and the need for treatment research on adaptation of CBT for transgender individuals, specifically those with social anxiety disorder and gender dysphoria. Copyright © Samantha Busa et al. 2018.
Transgender Health, 3(1) : 27-33
- Year: 2018
- Problem: Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Liu, H., Li, X., Han, B., Liu, X.
BACKGROUND: Cognitive bias modification (CBM), a set of techniques for modifying bias in information processing-is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects.
AIMS: We conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test.
METHOD: Through a systematic literature search by two independent raters, 34 articles (36 randomized studies) including 2,550 participants were identified. A multilevel modeling approach was employed to assess the effects of CBM on SAD, and to explore the potentially crucial procedures and sample characteristics that enhance the effectiveness of benign training.
RESULTS: In general, there were small but significant effects of CBM on the primary symptoms of SAD (g = 0.17), cognitive bias (CB) toward threat (g = 0.32), and reactivity in stressful situations (g = 0.25), but non-significant effects on secondary symptoms. However, the interpretation modification program was more effective than was attentional bias modification in reducing SAD primary symptoms and negative CB. Laboratory training procedures produced larger primary symptom reductions compared to Internet-based training, whereas the percentage of contingency and feedback about training performance boosted cognitive effects only. Finally, the following groups were more likely to benefit from CBM: younger participants (primary symptoms and cognitive effects), women (primary symptom effects), and samples with stronger CB (stressor effects). The quality of the randomized controlled trials was less than desirable, as there was some indication of publication bias in our study.
CONCLUSIONS: Current findings broadly supported cognitive theories of SAD that consider a bidirectional or mutually reinforcing relationship between symptoms and CBs. However, the small therapeutic effect observed here indicates that it is necessary to develop more reliable and efficient CBM interventions that are specific to SAD.
PLoS ONE, 12(4) : e0175107
- Year: 2017
- Problem: Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Weersing, V. R., Brent, D. A., Rozenman, M. S., Gonzalez, A., Jeffreys, M., Dickerson, J. F., Lynch, F. L., Porta, G., Iyengar, S.
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations.
Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care.
Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8.0-16.9 years) from 9 pediatric clinics in San Diego, California, and Pittsburgh, Pennsylvania, recruited from October 6, 2010, through December 5, 2014. Youths who met DSM-IV criteria for full or probable diagnoses of separation anxiety disorder, generalized anxiety disorder, social phobia, major depression, dysthymic disorder, and/or minor depression; lived with a consenting legal guardian for at least 6 months; and spoke English were included in the study. Exclusions included receipt of alternate treatment for anxiety or depression, presence of a suicidal plan, bipolar disorder, psychosis, posttraumatic stress disorder, substance dependence, current abuse, intellectual disability, or unstable serious physical illness.
Interventions: The BBT consisted of 8 to 12 weekly 45-minute sessions of behavioral therapy delivered in pediatric clinics by master's-level clinicians. The ARC families received personalized referrals to mental health care and check-in calls to support accessing care from master's-level coordinators.
Main Outcomes and Measures: The primary outcome was clinically significant improvement on the Clinical Global Impression-Improvement scale (score <=2). Secondary outcomes included the Pediatric Anxiety Rating Scale, Children's Depression Rating Scale-Revised, and functioning.
Results: A total of 185 patients were enrolled in the study (mean [SD] age, 11.3 [2.6] years; 107 [57.8%] female; 144 [77.8%] white; and 38 [20.7%] Hispanic). Youths in the BBT group (n=95), compared with those in the ARC group (n=90), had significantly higher rates of clinical improvement (56.8% vs 28.2%; chi21=13.09, P<.001; number needed to treat, 4), greater reductions in symptoms (F2,146=5.72; P=.004; Cohen f=0.28), and better functioning (mean [SD], 68.5 [10.7] vs 61.9 [11.9]; t156=3.64; P<.001; Cohen d=0.58). Ethnicity moderated outcomes, with Hispanic youth having substantially stronger response to BBT (76.5%) than ARC (7.1%) (chi21=14.90; P<.001; number needed to treat, 2). Effects were robust across sites.
Conclusions and Relevance: A pediatric-based brief behavioral intervention for anxiety and depression is associated with benefits superior to those of assisted referral to outpatient mental health care. Effects were especially strong for Hispanic participants, suggesting that the protocol may be a useful tool in addressing ethnic disparities in care.
Trial Registration: clinicaltrials.gov Identifier: NCT01147614.
JAMA Psychiatry, 74(6) : 571-578
- Year: 2017
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Ye, H.
The purpose of this study was to examine the effects of a Mindfulness-Based Stress Reduction (MBSR) program on reduced stress and perceived anxiety. 27 students with social anxiety, aged 16-40 years, from a China university were randomized to MBSR with routine care group (MBSR group, n = 14) and routine care group (non-MBSR group, n = 13). As expected, an increase in anxiety symptoms during the social situations led to more perceived anxiety in the non-MBSR group, but not in the MBSR group, due to the MBSR program. However, the MBSR group had significantly decreased anxiety and avoidance symptoms compared to the non-MBSR group. The results in this trial show that MBSR can protect students with social anxiety from an increase in perceived anxiety during the social situations. Copyright © 2018, Anka Publishers. All rights reserved.
NeuroQuantology, 15(4) : 101-106
- Year: 2017
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Sanchez, R., Brown, E., Kocher, K., DeRosier, M.
OBJECTIVE: The purpose of this study was to investigate whether a computer-based game to improve social skills and mental health in children with social skills deficits would be efficacious. The program, Adventures aboard the S.S. GRIN, translates a proven in-person intervention into a nine-episode interactive online adventure game that provides opportunity for knowledge acquisition and skill practice. MATERIALS AND METHODS: Participants (children aged 7-11 years with social skills challenges) were randomly assigned to immediate treatment group (n=33) or waitlist control group (n=36). Children in the immediate treatment condition completed the game at home over the course of 9 weeks. Before playing the game and again within 1 week of game completion, children completed surveys about social literacy, social anxiety, bullying, social self-efficacy, and social satisfaction. RESULTS: Children who played Adventures improved significantly more from pretest to posttest than children who did not play the game in social literacy, social anxiety, bullying victimization, and social satisfaction. CONCLUSION: Online interactive games can be effective in improving mental health for children who struggle with social skills. For children who can access them, serious games have the potential to increase the reach of effective programs by overcoming the logistical and implementation barriers (such as cost, travel, and accessibility) that limit traditionally delivered mental health interventions.
Games for health journal, 6(1) : 19-27
- Year: 2017
- 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)
, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)