Post-Event Processing across Multiple Anxiety Presentations: Is it Specific to Social Anxiety Disorder?

2015 ◽  
Vol 44 (5) ◽  
pp. 568-579 ◽  
Author(s):  
Stefan Perera ◽  
Karen Rowa ◽  
Randi E. McCabe
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
State Anxiety ◽  
Behavioural Therapy ◽  
Event Processing ◽  
Principal Diagnosis ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Cognitive Rumination ◽  
First Session

Background: Post-event processing (PEP) occurs when individuals engage in cognitive rumination following an event or interaction. Although the relation between PEP and social anxiety has been clearly demonstrated, it remains unclear whether PEP is limited to individuals with elevated social anxiety, or if it is also problematic among people with other anxiety presentations. Aims: The present study assessed PEP after the first session of group cognitive behavioural therapy (CBT) in individuals with a variety of anxiety presentations. Method: Participants with a principal diagnosis of SAD (N = 25), those diagnosed with a principal other anxiety disorder with comorbid SAD (N = 18), and those with principal other anxiety diagnoses with no SAD (N = 43) completed baseline measures of social anxiety severity and state anxiety at their first session of CBT and measures of PEP one week later. Results: Participants with a principal diagnosis of SAD experienced the most PEP in the week following the first CBT session, while those with no comorbid SAD experienced the least. Those with comorbid SAD experienced intermediate levels of PEP. The strongest predictor of PEP was state anxiety during the first session. Conclusions: Results suggest that PEP is more problematic for clients with SAD as part of their clinical presentation. Clinical and theoretical implications are discussed.

scholarly journals Performance anxiety disorder: Developing a proposal for an inventory, according to the cognitive-behavioural therapy rationale

2017 ◽  
Vol 10 (2) ◽  
pp. 236-246 ◽  
Author(s):  
George Varvatsoulias
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Performance Anxiety ◽  
Behavioural Therapy ◽  
External Shame ◽  
Cognitive Behavioural ◽  
The Future

This editorial aims at the presentation of a proposal regarding an inventory about performance anxiety disorder in a cognitive-behavioural therapy (CBT) framework. It provides some initial understanding as to that condition and how CBT could assist in the consideration of it counter to social anxiety disorder. At first, there is an introduction to performance anxiety in line to social anxiety/phobia and some questionnaires that have been developed which include performance anxiety as an element of social anxiety/phobia. Then, I am presenting the proposal, both in view to the rationale for that and the construction of an inventory with items drawn from elements that performance anxiety is related with, such as uneasiness about worry, self-focus issues of perfectionism and internal/external shame ideas. The statements in the inventory refer to hypothetical examples in life so inventory to be easily responded to, when administered to participants. This proposal closes with the conclusion that the questionnaire will be pilot-studied in the future by the author so the feasibility of it and/or possible changes to be considered when empirically studied.

Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study

2020 ◽  
Vol 48 (6) ◽  
pp. 745-750
Author(s):  
Justin W. Weeks ◽  
M. Taylor Wilmer ◽  
Carrie M. Potter ◽  
Elizabeth M. Waldron ◽  
Mark Versella ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Proof Of Principle ◽  
Fear Of Positive Evaluation ◽  
Positive Evaluation

AbstractBackground:Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.Aims:To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.Method:Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.Results:A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.Conclusions:Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

The acceptability and feasibility of group cognitive behavioural therapy for older adults with generalised anxiety disorder

2020 ◽  
Vol 48 (5) ◽  
pp. 621-625
Author(s):  
Jo Hall ◽  
Stephen Kellett ◽  
Manreesh Kaur Bains ◽  
Heather Stonebank ◽  
Shonagh Scott
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Cognitive Behavioural Therapy ◽  
Group Treatment ◽  
Behavioural Therapy ◽  
Generalised Anxiety Disorder ◽  
Group Setting ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Therapy Protocol

AbstractBackground:Group psychotherapy for older adults with generalised anxiety disorder is an under-researched area.Aim:This report describes a mixed method evaluation of the acceptability and feasibility of an Overcoming Worry Group.Method:The Overcoming Worry Group was a novel adaptation of a cognitive behavioural therapy protocol targeting intolerance-of-uncertainty for generalised anxiety disorder, tailored for delivery to older adults in a group setting (n = 13).Results:The adapted protocol was found to be acceptable and feasible, and treatment outcomes observed were encouraging.Conclusions:This proof-of-concept study provides evidence for an Overcoming Worry Group as an acceptable and feasible group treatment for older adults with generalised anxiety disorder.

scholarly journals Therapist-guided internet-delivered cognitive–behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018345 ◽  
Author(s):  
Martina Nordh ◽  
Sarah Vigerland ◽  
Lars-Göran Öst ◽  
Brjánn Ljótsson ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Feasibility Trial ◽  
Cognitive Behavioural ◽  
Exposure Sessions

ObjectivesSocial anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%–4% and increased risk of adverse long-term outcomes, such as depression. Cognitive–behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT).DesignA proof-of-concept, open clinical trial with 6-month follow-up.ParticipantsThe trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13–17 years old (83% girls) with a principal diagnosis of SAD.Intervention12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents.ResultsAdolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD.ConclusionTherapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD.Trial registration numberNCT02576171; Results.

Can I Really Do This? An Examination of Anticipatory Event Processing in Social Anxiety Disorder

2016 ◽  
Vol 30 (2) ◽  
pp. 94-104 ◽  
Author(s):  
Judith M. Laposa ◽  
Neil A. Rector
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
State Anxiety ◽  
Behavioral Therapy ◽  
Social Situation ◽  
Anxiety State ◽  
Event Processing ◽  
Social Events ◽  
Anticipatory Processing

Clark and Wells (1995) posit that anticipatory processing before a social situation serves to maintain social anxiety. More specifically, ruminative processes similar to post-event processing (PEP) may occur in anticipation of anxiety provoking social events, and in this article, we have labelled this type of anticipatory rumination anticipatory event processing (AnEP). Participants (n = 75) with social anxiety disorder (SAD) completed measures of anticipatory event processing, trait anxious rumination, social anxiety, state anxiety, and PEP, in the context of completing videotaped exposures twice as part of manual-based group cognitive behavioral therapy. AnEP was significantly positively associated with trait anxious rumination and social anxiety and was associated with state anxiety during the first videotaping. AnEP at the two time points was significantly correlated and decreased across the two taped exposures. Greater AnEP at the first taping was associated with greater PEP the following week. PEP after the first videotaped exposure then significantly related to AnEP for the second videotaped exposure several weeks later. Discussion focuses on the similarities between PEP and AnEP as well as implications for cognitive models and treatment of SAD.

scholarly journals Inflated sense of responsibility, explanatory style and the cognitive model of social anxiety disorder: a brief report of a case control study

2019 ◽  
Vol 12 ◽  
Author(s):  
Matthew Jones ◽  
Sarah Rakovshik
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Explanatory Style ◽  
Causal Attribution ◽  
Cognitive Model ◽  
Behavioural Therapy ◽  
List Type ◽  
Cognitive Behavioural ◽  
Inflated Responsibility

AbstractWe sought to investigate situation-specific inflated sense of responsibility and explanatory style in social anxiety disorder (SAD) according to the cognitive model. Participants aged 17–68 years (mean = 31.9, SD = 11.1) included waiting list patients referred to a primary care mental health service for cognitive behavioural therapy for SAD (n = 18) and non-anxious control participants (n = 65). A battery of psychometric measures, including a bespoke measure of responsibility beliefs, was used. Compared with controls, participants with SAD were more likely to demonstrate an inflated sense of responsibility (p ≤ 0.001), and to adopt a negative explanatory style specific to social interaction (p ≤ 0.01). Inflated sense of responsibility was found to correlate with SAD symptomatology (r = 0.47, p ≤ 0.05), and with increased usage of safety behaviours (r = 0.47, p ≤ 0.05). Caseness (β = 1.45, p ≤ 0.01) and stability of causal attribution (β = 0.25, p ≤ 0.001) were found to predict inflated responsibility in our sample. To our knowledge this study represents the first attempt to investigate inflated responsibility within the context of SAD. Our results support the notion of inflated responsibility as a feature of SAD.Key learning aims(1)To understand the cognitive behavioural components of Clark and Wells’ model of SAD, and their bi-directional nature.(2)To understand what the term ‘inflated sense of responsibility’ refers to, and how it relates to CBT.(3)To understand what the term ‘explanatory style’ refers to, and how this concept can also relate to CBT.

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