Disorders - Social phobia
Lee, S. W., Kwon, J. H.
Background and objectives There is a need for brief effective treatment of social phobia and Imagery Rescripting (IR) is a potential candidate. The purpose of this study was to examine the efficacy of IR preceded by cognitive restructuring as a stand-alone brief treatment using a randomized controlled design. Methods Twenty-three individuals with social phobia were randomly assigned to an IR group or to a control group. Participants in the IR group were provided with one session of imagery interviewing and two sessions of cognitive restructuring and Imagery Rescripting. Those in the control group had one session of clinical interviewing and two sessions of supportive therapy. Outcome measures including the Korean version of the Social Avoidance and Distress Scale (K-SADS) were administered before and after treatment, and at three-month follow-up. The short version of the Questionnaire upon Mental Imagery and the Traumatic Experience Scale were also administered before treatment. Results Participants in the IR group improved significantly on K-SADS and other outcome measures, compared to the control group. The beneficial effects of IR were maintained at three-month follow-up. It was also found that mental imagery ability and the severity of the traumatic experience did not moderate the outcome of IR. Limitations Further studies are needed to replicate the findings of our study using a large sample. Conclusions The efficacy of IR as a stand-alone brief treatment was demonstrated for social phobia. The findings indicate that IR could be utilized as a cost-effective intervention for social phobia. (copyright) 2013 Elsevier B.V. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 44(4) : 351-360
- Year: 2013
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Supportive therapy, Other Psychological Interventions
Diemer, J., Domschke, K., Muhlberger, A., Winter, B., Zavorotnyy, M., Notzon, S., Silling, K., Arolt, V., Zwanzger, P.
Anxiety disorders are among the most frequent psychiatric disorders. With regard to pharmacological treatment, antidepressants, the calcium modulator pregabalin and benzodiazepines are recommended according to current treatment guidelines. With regard to acute states of anxiety, so far practically only benzodiazepines provide an immediate anxiolytic effect. However, the risk of tolerance and dependency limits the use of this class of medication. Therefore, there is still a need for alternative pharmacologic strategies. Increasing evidence points towards anxiety-reducing properties of atypical antipsychotics, particularly quetiapine. Therefore, we aimed to evaluate the putative acute anxiolytic effects of this compound, choosing the induction of acute anxiety in patients with specific phobia as a model for the evaluation of ad-hoc anxiolytic properties in a proof-of-concept approach. In a randomized, double-blind, placebo-controlled study, 58 patients with arachnophobia were treated with a single dose of quetiapine XR or placebo prior to a virtual reality spider challenge procedure. Treatment effects were monitored using rating scales for acute anxiety as well as measurements of heart rate and skin conductance. Overall, quetiapine showed significant anxiolytic effects compared to placebo. However, effects were not seen on the primary outcome measure (VAS Anxiety), but were limited to somatic anxiety symptoms. Additionally, a significant reduction of skin conductance was observed. Further exploratory analyses hint towards a mediating role of the (COMT) val158met genotype on treatment response. The present results thus suggest a possible suitability of quetiapine in the acute treatment of anxiety, particularly with regard to somatic symptoms. (copyright) 2013 Elsevier B.V. and ECNP.
European Neuropsychopharmacology, 23(11) : 1551-1560
- Year: 2013
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
Bunnell, Brian E., Beidel, Deborah C., Mesa, Franklin
The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations is overreliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n=31) were randomly assigned to eight sessions of attention training (n=15) or placebo/control (n=16). Participants were assessed at pre- and posttreatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at posttreatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD. ; Copyright © 2013. Published by Elsevier Ltd.
Behavior Therapy, 44(4) : 662-673
- Year: 2013
- 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
Shafiei-Amiri, M., Daryabari, S. M.
Aim: The present research has a goal tostudy self-imaginationlevel and to determine the effect of cognitive-behavioral therapeutic group in treatment of social anxiety disorder of the adolescents (teen-agers). Methods: This research is of sub-empirical plans (designs) which were performed as pre-testing, past-testing and threemonth (quarterly) pursuance.two experimental and control groups are used in it. Group CBT therapy (treatment) is independent variable which was performed during 12 sessions weekly and the scores of anxiety symptoms in the patients developed by social anxiety disorder were considered as dependent variable. Statistical population of this research includes 1135 11-14 year-old girl students in state schools of Babol city which among this series, 368 students were randomized, clustered, stagebased selected during second academic (educational) semester of 2011-2012 as the samplegroup by the mean of 12.8 yearold and standard deviation of 4.05. After sampling, by help of social phobia structured recognition (determinant) interview based on DSM-IV recognition criteria and using of Kanver et.al. Social anxiety questionnaire and cooper smith's self stem questionnaire, data collection was performed. Findings: The scores difference of two experimental and control groups in social anxiety is meaningful in two stages (steps) of pre-mediation (before manipulation) and after it based on Mann-Whitney Yu test. Conclusion: The scales of evitable behaviors and fear from negative evaluation of social anxiety test have shown that cognitive-behavioral therapeutic group has meaningfully reduced the level of evitable behaviors and fear from negative evaluator.
European Psychiatry, 28 :
- Year: 2013
- 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)
Sportel, B. Esther, de-Hullu, Eva, de-Jong, Peter J., Nauta, Maaike H.
Unlabelled: Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n = 86) was compared to a school-based cognitive behavioral group training (CBT; n = 84) and a control group (n = 70) in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13-15 years. Participants (n = 240) were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations.; Trial Registration: TrialRegister.nl NTR965.;
PLoS ONE, 8(5) : e64355-e64355
- Year: 2013
- 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)
, Cognitive & behavioural therapies (CBT)
, Attention/cognitive bias modification
Huang, Xiao, Li, Chao, Li, Wei-Hui, Luo, Yan-Li, Wang, Biao, Zhang, Wei, Gan, Jian-Jun, Ji, Jian-Lin
Objective: Although selective serotonin reuptake inhibitors are now established as first-line pharmacotherapy for social anxiety disorder (SAD), other agents with different mechanisms have shown promise in treating SAD. The aim of this study was to examine the efficacy and safety of tandospirone in treating adolescents with SAD.; Methods: Adolescent patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for SAD were randomly assigned (1:1) to open-label treatment with either tandospirone or sertraline for 8 weeks. The primary outcome measures were changes from baseline in the Hamilton Anxiety (HAM-A) scale and response using the Clinical Global Impression of Improvement (CGI-I) scale.; Results: The adjusted mean change in HAM-A scores from baseline was indicating a significant improvement over baseline in both treatment arms (p < 0.0001). The mean CGI-I scale score at week was with no significant difference between the two arms (p = 0.42). Rates of response were 48.6% for tandospirone and 55.6% for sertraline using the CGI-I. Response rates were 37.1% for tandospirone and 41.7% for sertraline using a HAM-A response criterion (≥50% reduction). The adjusted mean change in Social Phobia Inventory scores from baseline was indicating a significant improvement over baseline in both treatment arms (p < 0.0001).; Conclusions: Tandospirone is safe and effective and appears non-inferior to sertraline for SAD in youths.; Copyright © 2013 John Wiley & Sons, Ltd.
Human Psychopharmacology, 28(6) : 594-599
- Year: 2013
- 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), Anxiolytics including benzodiazepines
Possis, E. A., Kemp, J. J., Lickel, J. J., Sy, J. T., Dixon, L. J., Deacon, B. J.
Cognitive-behavioral theories suggest that anxiety is maintained in part by estimates of the probability and cost of feared negative outcomes. Social phobia may be unique among the anxiety disorders in that it is characterized by overestimates of the cost of events that are objectively noncatastrophic (e.g., committing social mishaps). As such, treatment approaches that target cost bias may be particularly effective in reducing social phobia symptoms. This study examined the efficacy of 2 cost-specific techniques in a single-session intervention for social anxiety. Individuals (n = 61) with elevated social interaction anxiety were randomly assigned to an expressive writing control condition, a cognitive restructuring condition, or a behavioral experiment condition. Results demonstrated that the cognitive restructuring condition produced significantly greater improvement in indices of social anxiety than the other conditions. Reduction in cost bias fully mediated the significantly greater improvement in social interaction anxiety in the cognitive restructuring condition relative to the behavioral experiment condition. The present findings highlight the value of techniques designed to reduce cost biases in social anxiety. Clinical implications are discussed. (copyright) 2013 Springer Publishing Company.
Journal of Cognitive Psychotherapy, 27(3) : 210-220
- Year: 2013
- 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)
, Psychoeducation
Olivares-Olivares, P., Macia, D., Olivares, J.
The objective of this study is to adapt and validate for use in the adult Spanish population the treatment known as social effectiveness therapy (Turner, Beidel, Cooley, Woody, and Messer, 1994). We present results that were obtained by comparing an experimental-treatment group consisting of 16 participants with a waiting list control group, all with generalized social phobia (APA, 2000). The evaluation was carried out before and after the treatment in both groups as well as in two follow-ups with the experimental group. The results in the experimental group show the short and long-term efficacy of social effectiveness therapy for all measures that assess social anxiety and avoidance. In contrast, the members of the control group did not experience improvement in any of the variables evaluated. (copyright) 2012 by Sociedad Chilena de Psicologia Clinica.
Terapia Psicologica, 30(3) : 57-67
- Year: 2012
- Problem: Social phobia (social anxiety disorder)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Khedmatgozar, H., Birashk, B., Ashayeri, H., Farid, A. A.
Introduction: Although the effectiveness of paroxetine and Attention Modification Program has been studied separately in treating social anxiety disorder, there has been no research comparing them according to the literature. The aim of this study was to compare the effectiveness of paroxetine, Attention Modification Program (AMP) and combination of both on improving the Social Anxiety Symptoms. Methods: 33 patients meeting DSM-IV-TR criteria for social anxiety disorder were randomly assigned in 3 groups: 11 in paroxetine group, 11 in AMP group and 11 in combined group. Treatment intervention was done during 8 weeks period. Social Phobia Inventory (SPIN), Beck Depression Inventory (BDI-II) and Sheehan Disability Scale (SDS) were administered before and after treatment intervention. One-way Analysis of Covariance (ANCOVA) was used to determine the differences and efficacy of treatment interventions between groups. Data analysis was done by SPSS-16 software. Results: 28 participants completed the treatment period. One-way ANCOVA results showed statistically significant differences in post-treatment scores of social phobia (p=0/007), depressive symptoms (p=0.007) and daily life functioning (p=0.011) between three groups. Bonferroni correction showed that combined treatment is significantly more effective than AMP in reducing social phobia symptoms (p=0.007), depressive symptoms (p=0.022) and enhancing daily life functioning (0.019). Yet, there were no significant differences between Paroxetine and combined treatment in all post-treatment scores (p=0.890, p=1.000, p=1.000 for social phobia, depressive symptoms and daily life functioning respectively). Paroxetine showed more significant improvement of depressive symptoms (p=0.016) and enhancing daily life functioning (p=0.045) than AMP. Also, there were no significant differences between paroxetine and AMP in reducing social anxiety symptoms. Discussion: It seems that paroxetine has wider effect in reducing social anxiety symptoms, depressive symptoms and enhancing daily life functioning than AMP and adding the AMP to paroxetine does not make significant changes than medicating with paroxetine alone.
Basic & Clinical Neuroscience, 3(4) : 36-44
- Year: 2012
- 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)
, Attention/cognitive bias modification
Drake, K. L., Ginsburg, G. S.
It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth, namely, generalized, separation, and social anxiety as they often co-occur both at the symptom and disorder level and respond to similar treatments. We begin by presenting an overview of a broad range of family factors associated with anxiety disorders. Findings from these studies have informed intervention and prevention strategies that are discussed next. Throughout the paper we shed light on the challenges that plague this research and look toward the future by proposing directions for much needed study and discussing factors that may improve clinical practice and outcomes for affected youth and their families. (copyright) 2012 Springer Science+Business Media, LLC.
Clinical Child & Family Psychology Review, 15(2) : 144-162
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
Culver, Najwa C., Stoyanova, Milena, Craske, Michelle G.
Background and Objectives: In traditional exposure therapy for phobias and anxiety disorders, reduction of fear responding is used as an index of learning. However, recent evidence in animal models suggests that sustained arousal and enhanced fear responding throughout exposure may actually predict better long-term outcomes (Rescorla, 2000).; Methods: The effects of sustained arousal during exposure were investigated in a clinical analog sample of 59 participants fearful of public speaking. Participants completed exposure with or without the presence of additional excitatory stimuli which were intended to enhance arousal and fear responding throughout exposure.; Results: Group assignment (exposure versus exposure with additional excitatory stimuli) did not significantly predict outcome at 1-week follow-up testing, as measured physiologically, subjectively, and behaviorally. A set of regression analyses investigating whether any exposure process measures predicted outcome indicated that sustained arousal throughout exposure as well as variability in subjective fear responding throughout exposure (e.g., Kircanski et al., 2011) predicted lower levels of fear at follow-up testing (p < 0.05; p < 0.001) after controlling for demographic variables as well as pre-exposure fear levels.; Limitations: The excitatory stimuli used failed to produce the intended effects. However, some participants did maintain elevated arousal throughout exposure and this predicted better outcomes at 1-week follow-up testing.; Conclusions: Sustained arousal throughout exposure as well as variability in subjective fear responding during exposure may be better predictors of long-term outcomes than habituation of fear across exposure.; Copyright © 2011 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 43(2) : 787-793
- Year: 2012
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Other Psychological Interventions
Galla, B. M., Wood, J. J., Chiu, A. W., Langer, D. A., Jacobs, J., Ifekwunigwe, M., Larkins, C.
The current study sought to evaluate the relative long-term efficacy of a modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment condition conducted structured diagnostic interviews, and caregivers and children completed symptom checklists at pre- and post-, and 1 year follow-up assessments. Analyses revealed that 71.4% of children who received CBT demonstrated a positive treatment response 1 year following treatment, and 83.3% were free of any anxiety diagnosis at 1 year follow-up. Analyses further revealed robust effects of intervention on diagnostic outcomes, caregiver- and child-report measures of anxiety at 1 year follow-up. Results provide evidence of an ongoing advantage on anxiety-specific outcomes for this modularized school-based CBT program 1 year post-treatment.
Child Psychiatry & Human Development, 43(2) : 219-226
- Year: 2012
- 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)