Search

To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated 91% of the improvements in depression over time. Conversely, decreases in depression only accounted for 6% of the decreases in social anxiety over time. Changes in social anxiety fully mediated changes in depression during the course of treatment. The theoretical and clinical implications of these findings for the relationship between anxiety and depression are discussed.

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.

The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive--behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment. Keywords: sudden gains, social anxiety disorder, social phobia, cognitive--behavioral therapy, exposure therapy

To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive-behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated 91% of the improvements in depression over time. Conversely, decreases in depression only accounted for 6% of the decreases in social anxiety over time. Changes in social anxiety fully mediated changes in depression during the course of treatment. The theoretical and clinical implications of these findings for the relationship between anxiety and depression are discussed. Keywords: Social anxiety, social phobia, depression, cognitive-behavior therapy, treatment mechanisms, mediator of change

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.