Disorders - Social phobia
Kim, P. W., Kim, S. A., Jung, K. H.
The present study was to set out in efforts to determine the effect of electrocardiographic (ECG) feedback on the performance in speech anxiety. Forty-six high school students participated in a speech performance educational program. They were randomly divided into two groups, an experimental group with ECG feedback (N = 21) and a control group (N = 25). Feedback was given with video recording in the control, whereas in the experimental group, an additional ECG feedback was provided. Speech performance was evaluated by the Korean Broadcasting System (KBS) speech ability test, which determines the 10 different speaking categories. ECG was recorded during rest and speech, together with a video recording of the speech performance. Changes in R-R intervals were used to reflect anxiety profiles. Three trials were performed for 3-week program. Results showed that the subjects with ECG feedback revealed a significant improvement in speech performance and anxiety states, which compared to those in the control group. These findings suggest that visualization of the anxiety profile feedback with ECG can be a better cognitive therapeutic strategy in speech anxiety. (copyright) Springer Science+Business Media, LLC 2012.
Applied Psychophysiology Biofeedback, 37(4) : 261-267
- 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)
, Biofeedback, neurofeedback, audio/video feedback
Julian, K.: Beard, C., Schmidt, N. B., Powers, M. B., Smits, J. A. J.
Cognitive theories suggest that social anxiety is maintained, in part, by an attentional bias toward threat. Recent research shows that a single-session of attention modification training (AMP) reduces attention bias and vulnerability to a social stressor (Amir, Weber, Beard, Bomyea, & Taylor, 2008). In addition, exercise may augment the effects of attention training by its direct effects on attentional control and inhibition, thereby allowing participants receiving the AMP to more effectively disengage attention from the threatening cues and shift attention to the neutral cues. We attempted to replicate and extend previous findings by randomizing participants (N = 112) to a single-session of: a) Exercise + attention training (EX + AMP); b) Rest + attention training (REST + AMP); c) Exercise + attention control condition (EX + ACC); or d) Rest + attention control condition (REST + ACC) prior to completing a public speaking challenge. We used identical assessment and training procedures to those employed by Amir et al. (2008). Results showed there was no effect of attention training on attention bias or anxiety reactivity to the speech challenge and no interactive effects of attention training and exercise on attention bias or anxiety reactivity to the speech challenge. The failure to replicate previous findings is discussed. (copyright) 2012 Elsevier Ltd.
Behaviour Research & Therapy, 50(5) : 350-358
- Year: 2012
- 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)
, Attention/cognitive bias modification
, Physical activity, exercise
Goldbeck, L., Ellerkamp, T.
Background: Music therapy has been shown to be effective for children with psychopathology, providing an alternative nonverbal approach to the treatment of children with anxiety disorders. Objective: This pilot study investigates the efficacy of Multimodal Music Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU). Methods: Thirty-six children aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and dimensional outcome variables were assessed at the end of treatment and 4 months later. Results: MMT was superior compared to TAU according to the remission rates after treatment (MMT 67%; TAU 33%; x2 5 4.0; p 5 0.046) and remissions persisted until four months post-treatment. Dimensional measures showed equivalent improvement after either MMT or TAU. Conclusions: The results regarding the efficacy of MMT are promising for children with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended. (copyright) 2012 by the American Music Therapy Association.
Journal of Music Therapy, 49(4) : 395-413
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Heeren, A., Reese, H. E., McNally, R. J., Philippot, P.
Social phobics exhibit an attentional bias for threat in probe detection and probe discrimination paradigms. Attention training programs, in which probes always replace nonthreatening cues, reduce attentional bias for threat and self-reported social anxiety. However, researchers have seldom included behavioral measures of anxiety reduction, and have never taken physiological measures of anxiety reduction. In the present study, we trained individuals with generalized social phobia (n = 57) to attend to threat cues (attend to threat), to attend to positive cues (attend to positive), or to alternately attend to both (control condition). We assessed not only self-reported social anxiety, but also behavioral and physiological measures of social anxiety. Participants trained to attend to nonthreatening cues demonstrated significantly greater reductions in self-reported, behavioral, and physiological measures of anxiety than did participants from the attend to threat and control conditions. (copyright) 2011 Elsevier Ltd.
Behaviour Research & Therapy, 50(1) : 30-39
- Year: 2012
- 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
Bowler, J. O., MacKintosh, B., Dunn, B. D., Mathews, A., Dalgleish, T., Hoppitt, L.
Objective: Computerized cognitive behavioral therapy (cCBT) and cognitive bias modification for interpretation (CBM-I) both have demonstrated efficacy in alleviating social anxiety, but how they compare with each other has not been investigated. The present study tested the prediction that both interventions would reduce anxiety relative to a no-intervention comparison condition, but CBM-I would be particularly effective at modifying threat-related cognitive bias under high mental load. Method: Sixty-three primarily Caucasian adults (mean age = 22.7, SD = 5.87; 68.3% female) with high social anxiety, randomly allocated to 3 groups: CBM-I (n = 21), cCBT (n = 21), and a no-intervention control group (n = 21) provided complete data for analysis. Pre-and postintervention (4 sessions lasting 2 weeks, control participants only attended the pre-post sessions) self-report measures of anxiety, depression, attentional control, and threat-related interpretive bias were completed. In addition, interpretive bias under high versus low cognitive load was measured using the Scrambled Sentences Test. Results: Both CBM-I and cCBT groups reported significantly reduced levels of social anxiety, trait anxiety, and depression and improved attentional control, relative to the control group, with no clear superiority of either active intervention. Although both active conditions reduced negative bias on the Scrambled Sentences Test completed under mental load, CBM-I was significantly more effective at doing so. Conclusions: The results suggest that although not differing in therapeutic efficacy, CBM-I and cCBT might differ in the resilience of their effects when under mental load. (copyright) 2012 American Psychological Association.
Journal of Consulting & Clinical Psychology, 80(6) : 1021-1033
- Year: 2012
- 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)
, Cognitive & behavioural therapies (CBT)
, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Bjornsson, Andri S., Bidwell, L. Cinnamon, Brosse, Alisha L., Carey, Gregory, Hauser, Monika, Mackiewicz-Seghete, Kristen L., Schulz-Heik, R. Jay, Weatherley, Donald, Erwin, Brigette A., Craighead, W. Edward
Objective: Methods: Results: Conclusions: In this randomized controlled trial, cognitive-behavioral group therapy (CBGT) for social anxiety disorder (SAD) was compared to group psychotherapy (GPT), a credible, structurally equivalent control condition that included only nonspecific factors of group treatment (such as group dynamics).Participants were 45 college students at the University of Colorado with a primary diagnosis of SAD. Each treatment condition comprised eight group sessions lasting 2‚Äâhr each. Independent assessors (blind to treatment assignment) assessed participants at baseline and posttreatment with the Clinical Global Impression Scale (CGI) and the Liebowitz Social Anxiety Scale (LSAS).Both treatments were found to be equally credible. There were five noncompleters in the CBGT condition (21.7%) and only one in the GPT condition (4.3%). There were no statistically significant differences posttreatment (controlling for pretreatment scores) between the two treatment conditions, and both treatments were found to be efficacious. Effect sizes for CBGT were similar to earlier studies, and adherence ratings revealed excellent adherence.Treatment of SAD appears to be moving toward individual CBT, partly because of high attrition rates and underutilization of group dynamics in group CBT. However, group therapy has unique therapeutic ingredients, and it may be too early to give up on group treatment altogether. Discussion of these findings included future directions with this treatment modality, especially whether these two types of group treatment could be combined and whether such combination might serve to decrease attrition, enhance efficacy, and facilitate dissemination.
© 2011 Wiley Periodicals, Inc.
Depression & Anxiety, 28(11) : 1034-1042
- Year: 2011
- 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)
, Other Psychological Interventions
Bergamaschi, Mateus M., Queiroz, Regina Helena Costa, Chagas, Marcos Hortes Nisihara, de-Oliveira, Danielle Chaves Gomes, De-Martinis, Bruno Spinosa, Kapczinski, Flavio, Quevedo, Joao, Roesler, Rafael, Schroder, Nadja, Nardi, Antonio E., Martin-Santos, Rocio, Hallak, Jaime Eduardo Cecilio, Zuardi, Antonio Waldo, Crippa, Jose Alexandre S.
Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naive SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC.
Neuropsychopharmacology, 36(6) : 1219-1226
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions
Heiervang, E, Wergeland, G. J., Fjermestad, K., Haugland, B. S. M., Ost, L. G., Havik, O. E., Oeding, K., Bjanullstad, J. F.
Introduction: Efficacy studies of CBT for childhood anxiety disorders have found significant effects for up to 70% of the patients, but less is known about the effectiveness with youths in routine clinical care. We have therefore studied the effectiveness of the FRIENDS for Life program in seven child and adolescent mental health outpatient clinics in Western Norway. Method: Subjects were randomized to group or individual treatment, some with a preceding wait-list period with a mean duration equal to the treatment period of 10 weeks. A total of 183 referred youths aged 8-15 years with separation anxiety, generalized anxiety or social anxiety disorder were included. There were few exclusion criteria. Pre-, post- and 1 year follow-up assessments included the Anxiety Disorder Interview Schedule for children and parents, Spence Children's Anxiety Scale and the Short Mood and Feelings Questionnaire. Results: Significant improvement was observed both for individual and group treatment with regard to diagnostic status, anxiety symptoms and depressive symptoms, with little change after the wait-list period. Post-treatment around had recovered from their principal diagnosis. There was a moderate effect size on anxiety and depressive symptoms. Preliminary data show continuing effects at 1 year follow-up, with no significant effect of treatment format. Discussion: The study is one of the largest studies of CBT for anxiety in children carried out in regular clinics with regular clinicians. The FRIENDS for Life CBT program seems to be an effective treatment when delivered in ordinary clinical settings, with equal effects for individual and group formats. Conclusion: Manualised CBT is effective for childhood anxiety disorders in ordinary clinical care both at short- and long-term (1 year) and may be recommended for clinical use.
European Child & Adolescent Psychiatry, 20 : S45
- Year: 2011
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, 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)
Ginsburg, Golda S., Kendall, Philip C., Sakolsky, Dara, Compton, Scott N., Piacentini, John, Albano, Anne Marie, Walkup, John T., Sherrill, Joel, Coffey, Kimberly A., Rynn, Moira A., Keeton, Courtney P., McCracken, James T., Bergman, Lindsey, Iyengar, Satish, Birmaher, Boris, March, John
Objective: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7–17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). Method: The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. Results: Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. Conclusions: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Consulting & Clinical Psychology, 79(6) : 806-813
- Year: 2011
- Problem: Anxiety Disorders (any), Generalized Anxiety 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), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Lester, K. J., Field, A. P., & Muris, P. E. H. M.
Using an experimental bias modification task, an interpretation bias towards or away from threat was induced about animal or social situations in a sample of 103 children split into a young (7-10 years) and old age group (11-15 years). Children rapidly learned to select outcomes of ambiguous situations which were congruent with their assigned modification condition. Following positive modification, children's threat interpretation biases significantly decreased, while threat biases increased (non-significantly) after negative modification. Bias modification effects also varied as a function of age with children appearing particularly vulnerable to acquiring biases about stimuli that were congruent with the normative fears for their age group. Weak age-related modification-congruent effects on younger but not older children's anxiety vulnerability in response to a behavioral task were also observed. However, no consistent effects of bias modification on avoidance behavior were found.
Journal of Anxiety Disorders, 25(5) : 697-705
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Davis-III, TE., May, Anna., Whiting, Sara E.
Research on treatments for childhood anxiety disorders has increased greatly in recent decades. As a result, it has become increasingly necessary to synthesize the findings of these treatment studies into reviews in order to draw wider conclusions on the efficacy of treatments for childhood anxiety. Previous reviews of this literature have used varying criteria to determine the evidence base. For the current review, stricter criteria consistent with the original Task Force (1995) guidelines were used to select and evaluate studies. Studies were divided by anxiety disorder; however, many studies combine various anxiety disorders in their samples. As a result, these were included in a combined anxiety disorder group. Using more traditional guidelines, studies were assigned a status of well-established, probably efficacious, or experimental based on the available literature and the quality of the studies. While some treatments do meet the criteria for well-established status, it is clear from this examination that gaps remain and replication is necessary to establish many of these treatments as efficacious. In addition, there still appears to be a lack of research on the effects of treatment on the physiological and cognitive aspects of fear and anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Clinical Psychology Review, 31(4) : 592-602
- Year: 2011
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Dogaheh, Ebrahim Rezaei, Mohammadkhani, Parvaneh, Dolatshahi, Behrooz
Previous studies have established the efficacy of group and individual formats of cognitive-behavioral therapy in reducing fear of negative evaluation in social anxiety disorder, but the effectiveness of the group and individual therapies has not been widely assessed. This study was conducted to compare the effectiveness of cognitive-behavior group therapy to individual cognitive-behavioral therapy in social anxiety disorder. 28 patients were randomly allocated to two groups of 14. Each group participated in 12 weekly sessions. The final sample was 22 participants after drop-out. Pretest and posttest data were collected using the Brief Fear of Negative Evaluation Scale and the Beck Depression Inventory-II. Controlling for pretest fear of negative evaluation and depression, cognitive-behavioral group therapy was more effective than individual cognitive-behavioral therapy in reducing fear of negative evaluation, but the clinical significance and improvement rates of the two treatment formats were equivalent. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Psychological Reports, 108(3) : 943-954
- Year: 2011
- Problem: Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other service delivery and improvement interventions