Social anxiety disorder (SAD), characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated ...whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT) for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I) if persons with SAD differ from healthy controls on shame and guilt, (II) if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III) if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n = 67) with two samples of healthy controls, a main sample (n = 72) and a replication sample (n = 22). Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d = 0.44). Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Alcohol use disorder (AUD) is associated with cognitive deficits such as impaired executive functions, which are hypothesized to contribute to the progression of the disease and worsen ...treatment outcome. Training of working memory (WM) to improve cognitive functions and thereby reduce alcohol use has been proposed as a novel treatment strategy.
Methods
Patients with AUD (n = 50) who were recruited to an outpatient addiction clinic were randomized to receive 5 weeks of active WM training or control training. Participants had weekly follow‐up visits, and all cognitive training sessions were done online at home. Primary outcomes were WM function and change in self‐reported heavy drinking. Secondary outcomes were craving, other drinking outcomes, and performance on a range of neuropsychological tasks from the Cambridge Neuropsychological Test Automated Battery.
Results
The active training group demonstrated a significantly greater improvement in verbal WM compared with the control group. No statistically significant effect of training was found on the primary drinking outcome, but a trend was observed indicating that WM training reduces the number of drinks per drinking occasion. WM training had no statistically significant effect on any of the other neuropsychological tasks.
Conclusions
Cognitive training can improve WM function in individuals with AUD, suggesting that such interventions are feasible to administer in this patient population. The results do not support an effect of WM training on heavy drinking or transfer effects to other cognitive domains. Future studies should evaluate WM training as an adjunct to evidence‐based treatments for AUD to assess potential synergistic effects.
The study was a randomized controlled trial of working memory (WM) training in patients (n = 50) with alcohol use disorder (AUD), performed at an outpatient research clinic. The intervention group improved in verbal WM compared to the control group, but no significant transfer effect was found to drinking or other cognitive functions. These findings highlight the feasibility of utilizing WM training in AUD. Future studies should evaluate WM training as adjunct to evidence‐based treatments for AUD to assess potential synergistic effects.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Skam och skuld är två emotioner som empiriskt kopplats ihop med en rad olika psykopatologiska tillstånd, såsom depression, ångest, tvångssyndrom och social fobi. För att undersöka skam- och ...skuldbenägenhet hos klienter med social fobi samt studera om behandling med KBT påverkar graden av dessa emotioner distribuerades the Test of Self-Conscious Affect (TOSCA) hos 67 patienter med social fobi samt hos 73 friska studenter i en kontrollgrupp. Resultaten visar ingen skillnad i skambenägenhet, men för skuldbenägenhet visade kontrollgruppen högre värden än den kliniska gruppen. Skambenägenheten hade minskat signifikant efter behandling med individuell KBT. För skuldbenägenhet visades ingen skillnad efter behandling. I denna studie bekräftas inga kopplingar mellan social fobi och skam vilket motsäger tidigare forskning. Resultaten indikerar att en förbättring i social fobi leder till minskning av skam, och implikationer av detta diskuteras. Studiens generaliserbarhet begränsas av kontrollgruppens demografiska snedfördelning, och framtida studier bör inkludera en jämförelsegrupp som är matchad med avseende på demografiska faktorer.
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