Abstract The tripartite model of working alliance, including the therapeutic bond and agreement on tasks and goals, was examined in 54 patients who received individual or group cognitive behavior ...therapy (CBT) for social anxiety disorder (SAD) in a randomized trial. Alliance was significantly stronger in individual relative to group CBT but generally not related to outcome.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
A growing body of research has acknowledged the heterogeneity of subclinical social anxiety, identifying a subgroup of individuals who exhibit high levels of impulsivity. In a sample of Swedish early ...adolescents (N = 2,509, Mage = 13.64; 52.8% girls), we conducted latent transition analyses (LTA) to identify four classes of subclinical social anxiety-impulsivity across three time points. We identified a Low Social Anxiety-Low Impulsivity class, as well as a High Anxiety-High Impulsivity class for girls and boys, which had high levels of Time-4 internalizing problems. The latter class was less stable but larger for boys. There was also a more typical High Anxiety-Low Impulsivity class for both genders. Nevertheless, Low Anxiety-High Impulsivity girls and boys fared the worst in terms of both internalizing and externalizing problems later on. To our knowledge, this is the first study to adopt an LTA framework to investigate trajectories of early adolescent social anxiety-impulsivity over time.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Abstract A link has been suggested between Autism Spectrum Disorder (ASD) and anxiety disorders. The aim of the study was to examine the severity of social anxiety measured by the Liebowitz Social ...Anxiety Scale Self-Report and prevalence of Social Anxiety Disorder (SAD) in adults with ASD, with SAD and a non-ASD comparison group. Individuals with ASD showed significantly higher scores of social anxiety and social avoidance relative to the comparison group, but significantly lower scores relative to the SAD sample.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The Borg centiMax Scale, is a psychophysically composed general intensity ratio scale, which could enable more precise inter‐ and intraindividual comparisons of the intensity of depressive symptoms. ...In the present study, the properties of the centiMax scale were examined in 38 patients with clinical depression and 109 students. Additionally, preliminary centiMax cut‐off scores for mild, moderate and severe depression were estimated. The psychometric properties of the centiMax were found to be satisfactory regarding internal consistency, convergent, discriminative and predictive validity. Moreover, the centiMax was demonstrated to provide meaningful comparisons of symptom intensity, which makes it possible to evaluate the relative importance of individual symptoms in a profile and make more precise comparisons within and between individuals. With regard to intraindividual comparisons, patients rated , for example, the intensity of feeling “guilt” twice as strong as feelings of “being punished,” and the intensity of “loss of pleasure” almost three times as strong as “being punished.” With regard to interindividual comparisons, patients rated e.g., the intensity of “being punished” as 12 times stronger than controls, and the intensity of “worthlessness” about nine times stronger. In conclusion, the centiMax was shown to be reliable and valid for assessing depressive symptoms. The centiMax with level anchored ratio data, appears to be highly advantageous as it permits rather precise values of symptom intensity for intra‐ and interindividual comparisons that could be useful in the diagnostic process and in treatment planning.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Social anxiety is common in the general population, as well as among students in higher education. For screening of social anxiety, there is a need for brief scales. In the present study, the ...psychometric properties were examined in a Swedish version of the Social Phobia Inventory (SPIN) and the Mini-Social Phobia Inventory (Mini-SPIN) in a university student sample (n = 161). In addition to the SPIN and Mini-SPIN, participants completed measures of fear of public speaking, general anxiety, depression, and quality of life. Exploratory factor analyses were used to investigate the underlying dimensions of the SPIN, and reliability, convergent, and divergent validity of SPIN and Mini-SPIN were examined by Cronbach’s alpha and correlation analyses. It was found that a shorter eight-item version of the SPIN was associated with two solid factors (fear and avoidance of social interaction and fear and avoidance of criticism), and acceptable internal consistency, convergent, and divergent validity. In addition, the Mini-SPIN was associated with satisfactory convergent validity, but the reliability was not acceptable. It is concluded that the SPIN-8 is a viable screening tool for social anxiety in a university student population.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Research on the association between social anxiety and social media usage remains inconclusive: despite the preference for computer‐mediated communication there is currently no clear empirical ...support for social anxiety being associated with longer duration of social media use. Self‐report measures for social anxiety that are adapted for the context of social media could facilitate further research. The current study aimed to develop a Swedish version of the recently developed Social Anxiety Scale for Social Media Users (SAS‐SMU), evaluate its psychometric properties, and explore associations between different uses of social media and social anxiety. Three factors were retained for SAS‐SMU with excellent internal consistency. SAS‐SMU evidenced convergent validity with measures of social anxiety, negative convergent validity with satisfaction with life, and divergent validity with measures of obsessive‐compulsive disorder, depression and generalized anxiety disorder. Results indicated that higher levels of social anxiety were associated with passive and active use as well as longer duration of social media use in general, which is at odds with a previous study where passive use remained the only significant predictor for social anxiety.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Objectives
Increased knowledge of factors that predict treatment outcome is important for planning and individualizing of treatment. This study analysed predictors of response to individual cognitive ...therapy (ICT), and intensive (3‐week) group cognitive treatment (IGCT) for social phobia.
Method
Participants (n = 54) met diagnostic criteria for social phobia within a randomized controlled trial. Predictors assessed were fear of negative evaluation, anticipatory worry, self‐directedness (SD) and cluster C personality disorder. Results were analysed by means of multiple regression analyses with both groups combined, and for each of the treatment groups.
Results
Anticipatory worry, an aspect of a harm‐avoidance personality trait, was the strongest negative predictor of outcome in ICT and IGCT both at post‐treatment and 1‐year follow‐up. Whereas low SD, signs of cluster C personality disorder and fear of negative evaluation were negative predictors of post‐treatment outcome in ICT, the corresponding pattern of results was not to be found in IGCT.
Conclusions
Anticipatory worry appears to be a particularly important trait for explaining variance in the outcome of social phobia. The finding is consistent with the assumed stability of such personality traits over time. Further studies are warranted to replicate the finding.
Practitioner Points
Anticipatory worry, an aspect of a harm‐avoidance personality trait was a strong negative predictor of outcome in a randomized trial of ICT and IGCT.
The results imply that this area of processing needs to be more carefully attended to in treatment and possibly, specific techniques for dealing with rumination might be of specific relevance.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Highlights • The effects of IGCT and ICT are maintained/improved at 5 years post-treatment. • Clinically significant improvement and loss of a social phobia diagnosis was shown by approximately ...50–70% of patients. • ICT was superior to IGCT on measures of depression but the two treatments did not differ on measures of social phobia. • Quality of life in treated patients with social phobia was inferior to a healthy population.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Cognitive therapy is an effective treatment for social anxiety disorder but little is known about the mechanisms by which the treatment achieves its effects.
This study investigated the potential ...role of self-focused attention and social phobia related negative automatic thoughts as mediators of clinical improvement.
Twenty-nine patients with social phobia received individual cognitive therapy (ICT) in a randomized controlled trial. Weekly process and outcome measures were analysed using multilevel mediation models.
Change from self-focused to externally focused attention mediated improvements in social anxiety one week later. In contrast, change in frequency of, or belief in, negative social phobia related negative automatic thoughts did not predict social anxiety one week later.
Change in self-focused attention mediate therapeutic improvement in ICT. Therapists should therefore target self-focused attention.
Cognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behavior therapy (ICBT) has ...the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical settings. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting.
We conducted a randomized controlled non-inferiority trial with allocation to ICBT (n=64) or CBGT (n=62) with blinded assessment immediately following treatment and six months post-treatment. Participants were 126 individuals with SAD who received CBGT or ICBT for a duration of 15 weeks. The Liebowitz Social Anxiety Scale (LSAS) was the main outcome measure. The following non-inferiority margin was set: following treatment, the lower bound of the 95 % confidence interval (CI) of the mean difference between groups should be less than 10 LSAS-points.
Both groups made large improvements. At follow-up, 41 (64%) participants in the ICBT group were classified as responders (95% CI, 52%-76%). In the CBGT group, 28 participants (45%) responded to the treatment (95% CI, 33%-58%). At post-treatment and follow-up respectively, the 95 % CI of the LSAS mean difference was 0.68-17.66 (Cohen's d between group=0.41) and -2.51-15.69 (Cohen's d between group=0.36) favoring ICBT, which was well within the non-inferiority margin. Mixed effects models analyses showed no significant interaction effect for LSAS, indicating similar improvement across treatments (F=1.58; df=2, 219; p=.21).
ICBT delivered in a psychiatric setting can be as effective as CBGT in the treatment of SAD and could be used to increase availability to CBT.
ClinicalTrials.gov NCT00564967.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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