Patients’ perspectives on imagery rescripting for aversive memories in social anxiety disorder

2019 ◽  
Vol 48 (2) ◽  
pp. 229-242 ◽  
Author(s):  
Rieko Takanashi ◽  
Naoki Yoshinaga ◽  
Keiko Oshiro ◽  
Satoshi Matsuki ◽  
Mari Tanaka ◽  
...  

AbstractBackground:Imagery rescripting (IR) for early aversive memories in patients with social anxiety disorder (SAD) has shown promising results, but no study has investigated the reactions and perspectives of patients who received IR.Aims:This study aimed to gain understanding of patients’ experiences/perspectives on IR as an adjunct to cognitive behavioural therapy (CBT) for SAD.Method:Twenty-five individuals with SAD received one or two sessions of IR over 16 CBT sessions. Contents of recurrent images and linked memories were identified during IR. Outcome measures included social anxiety, image and memory distress and vividness, and encapsulated belief. Patients completed a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyse the qualitative data.Results:IR resulted in significant within-session improvement in most outcome measures. Linked memories to negative recurrent images in social situations were categorized into nine groups. Common memories were ‘Being criticized by others’, ‘Being made fun of’, ‘Failing or not doing something well’ and ‘Being left out in a group’. Most patients (82%) experienced IR as impressive, and more than half of patients (59%) found IR effective. Themes of reasons of impressiveness and effectiveness were categorized as ‘Results of IR session’ and ‘Processes of IR session’. The theme ‘Results of IR session’ included six subthemes, and the theme ‘Processes of the IR session’ included five subthemes.Conclusions:Regarding patients’ perspectives, although they may experience negative emotions in the process of an IR session, our results suggest that many patients with SAD found IR sessions effective.

2017 ◽  
Vol 10 (2) ◽  
pp. 236-246 ◽  
Author(s):  
George Varvatsoulias

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.


2020 ◽  
Vol 48 (6) ◽  
pp. 745-750
Author(s):  
Justin W. Weeks ◽  
M. Taylor Wilmer ◽  
Carrie M. Potter ◽  
Elizabeth M. Waldron ◽  
Mark Versella ◽  
...  

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.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018345 ◽  
Author(s):  
Martina Nordh ◽  
Sarah Vigerland ◽  
Lars-Göran Öst ◽  
Brjánn Ljótsson ◽  
David Mataix-Cols ◽  
...  

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.


Author(s):  
Matthew Jones ◽  
Sarah Rakovshik

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.


Author(s):  
Mia Romano ◽  
Lorna Peters

Abstract Background: One reason that motivational interviewing (MI) is thought to translate well to a variety of treatment domains is due to the focus on client ambivalence. Aims: Therefore, the current study aimed to explore the construct of ambivalence in the context of MI and cognitive behavioural therapy (CBT) for social anxiety disorder (SAD). Method: Participants were 147 individuals diagnosed with SAD who were randomised to receive either MI or supportive counselling prior to receiving group CBT for SAD. Results: The results suggested that MI was not related to decreases in general ambivalence or treatment ambivalence, although an indicator of treatment ambivalence was found to predict worse treatment outcome. Conclusions: The findings suggest that three sessions of MI prior to CBT may not decrease ambivalence in participants with SAD, which may underscore the potential importance of tackling ambivalence as it arises during CBT.


2020 ◽  
Vol 13 (10) ◽  
pp. e235307
Author(s):  
Maximus Berger ◽  
Emily Li ◽  
Günter Paul Amminger

Anxiety disorders in young people are frequently comorbid with other mental disorders and respond unsatisfactorily to first-line treatment in many cases. Here, we report the case of a 20-year-old man with severe social anxiety disorder, major depressive disorder, insomnia and attenuated psychotic symptoms despite ongoing treatment with cognitive behavioural therapy and mirtazapine who was treated with adjunctive cannabidiol (CBD) in doses between 200 and 800 mg/day for 6 months. During treatment with CBD, he experienced subjective benefits to his anxiety, depression and positive symptoms during treatment that were confirmed by clinicians and by standardised research instruments. Findings from this case study add to existing evidence in support of the safety of CBD and suggest that it may be useful for young people with treatment refractory anxiety and for attenuated psychotic symptoms.


Sign in / Sign up

Export Citation Format

Share Document