Influences of Interpersonal Rejection Sensitivity and Depressive Symptoms on Social Anxiety Symptoms in Severe Social Anxiety Disorder Patients

Comorbid social anxiety and alcohol use disorders (SAD-AUD) in the community and the complex interactions that occur between these disorders have emerged as a significant clinical, public health, and research issue. The authors examined (a) the rates of comorbid SAD-AUD, (b) the impact of comorbid SAD-AUD on outcomes targeting social anxiety disorder, and (c) the effect of pretreatment alcohol consumption and alcohol use before, during, and after social situations on a composite measure of social anxiety in 172 adults presenting with social anxiety disorder. There was low incidence of AUD in this sample of individuals with SAD. Results indicated that alcohol consumption did not lead to worse social anxiety symptoms; however, alcohol use before and during social situations was associated with more severe social anxiety symptoms. These findings suggest that the function of alcohol use may be more important than the overall level of alcohol use and has implications for treatment.

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Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

Psychological Medicine ◽

10.1017/s0033291703007414 ◽

2003 ◽

Vol 33 (4) ◽

pp. 611-622 ◽

Cited By ~ 154

Author(s):

T. I. ZAIDER ◽

R. G. HEIMBERG ◽

D. M. FRESCO ◽

F. R. SCHNEIER ◽

M. R. LIEBOWITZ

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Anxiety Disorders ◽

Social Anxiety Disorder ◽

Clinical Global Impression ◽

Severity Of Illness ◽

Anxiety Symptoms ◽

Self Report ◽

Clinical Global Impression Scale ◽

Additional Variance

Background. The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders.Method. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment.Results. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms.Conclusions. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.

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The Effect of Rumination and Reappraisal on Social Anxiety Symptoms During Cognitive-Behavioral Therapy for Social Anxiety Disorder

Journal of Clinical Psychology ◽

10.1002/jclp.22132 ◽

2014 ◽

Vol 71 (3) ◽

pp. 208-218 ◽

Cited By ~ 20

Author(s):

Faith A. Brozovich ◽

Philippe Goldin ◽

Ihno Lee ◽

Hooria Jazaieri ◽

Richard G. Heimberg ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioral Therapy ◽

Social Anxiety Disorder ◽

Behavioral Therapy ◽

Anxiety Symptoms ◽

Cognitive Behavioral

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The Prevalence and Correlates of Social Anxiety Symptoms among People with Schizophrenia in Ethiopia: An Institution-Based Cross-Sectional Study

Schizophrenia Research and Treatment ◽

10.1155/2020/3934680 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Boki Kibru ◽

Getachew Tesfaw ◽

Demeke Demilew ◽

Endalamaw Salelew

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Addis Ababa ◽

Statistical Significance ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Systematic Sampling ◽

Sectional Study ◽

Cross Sectional

Background. The comorbidity of social anxiety disorder is very common in schizophrenia patients and affects almost all age groups. This social anxiety disorder negatively impacts the quality of life, medication adherence, and treatment outcomes of people with schizophrenia. It is not well recognized in clinical settings. Therefore, assessing social anxiety symptoms and its associated factors was significant to early intervention and management of schizophrenia patients in Ethiopia. Methods. An institution-based cross-sectional study was conducted at Amanuel Mental Specialized Hospital in Addis Ababa, Ethiopia. Data collectors randomly recruited 423 schizophrenic patients by using the systematic sampling technique. A face-to-face interviewer-administered questionnaire was used to collect data. The standardized Liebowitz Social Anxiety Scale (LSAS) was employed to assess individual social anxiety symptoms. We computed bivariate and multivariate binary logistic regressions to identify factors associated with social anxiety symptoms. Statistical significance was declared at p<0.05. Results. The prevalence of social anxiety symptoms was 36.2% (95% CI: 31.50, 40.80). Male sex (AOR=2.03, 95% CI: 1.20, 3.44), age of onset of schizophrenia (AOR=1.91, 95% CI:1.17, 3.12), positive symptoms (AOR=0.75, 95% CI:0.67, 0.83), depression/anxiety symptoms (AOR=1.29, 95% CI: 1.18, 1.41), number of hospitalizations (AOR=2.80, 95% CI:1.32, 5.80), and suicidal ideation (AOR=0.44, 95% CI: 0.26, 0.74) were factors significantly associated with social anxiety symptoms at p<0.001, whereas poor social support (AOR=5.23, 95% CI:2.03, 14.70) and suicide attempts (AOR=1.93, 95% CI: 1.14, 3.26) were statistically associated with social anxiety symptoms at p<0.01. Conclusion. The prevalence of social anxiety symptoms among schizophrenia patients was found to be high. Timely treatment of positive and depression/anxiety symptoms and suicide risk assessments and interventions need to be done to manage the problems.

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Comorbid social anxiety disorder in clients with depressive disorders: Predicting changes in depressive symptoms, therapeutic relationships, and focus of attention in group treatment

Behaviour Research and Therapy ◽

10.1016/j.brat.2011.10.002 ◽

2011 ◽

Vol 49 (12) ◽

pp. 875-884 ◽

Cited By ~ 12

Author(s):

Todd B. Kashdan ◽

John E. Roberts

Keyword(s):

Depressive Symptoms ◽

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Group Treatment ◽

Depressive Disorders ◽

Focus Of Attention ◽

Therapeutic Relationships

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Group CBT versus MBSR for Social Anxiety Disorder: A Randomized Controlled Trial

10.31231/osf.io/3pxzd ◽

2017 ◽

Author(s):

philippe goldin ◽

Amanda Morrison ◽

Hooria Jazaieri ◽

faith brozovich ◽

richard heimberg ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Self Efficacy ◽

Cognitive Distortions ◽

Anxiety Symptoms ◽

Cognitive Behavioral Group Therapy ◽

Mindfulness Skills ◽

Avoidance Behaviors ◽

The Impact

Objective: To investigate treatment outcome and mediators of Cognitive-Behavioral Group Therapy (CBGT) vs. Mindfulness-Based Stress Reduction (MBSR) vs. Waitlist (WL) in patients with generalized social anxiety disorder (SAD). Method: 108 unmedicated patients (55.6% female; mean age = 32.7, SD = 8.0; 43.5% Caucasian, 39% Asian, 9.3% Hispanic, 8.3% other) were randomized to CBGT vs. MBSR vs. WL and completed assessments at baseline, post-treatment/WL, and at 1-year follow-up, including the Liebowitz Social Anxiety Scale – Self-Report (primary outcome) as well as measures of treatment-related processes. Results: Linear mixed model analysis showed that CBGT and MBSR both produced greater improvements on most measures compared to WL. Both treatments yielded similar improvements in social anxiety symptoms, cognitive reappraisal frequency and self-efficacy, cognitive distortions, mindfulness skills, attention focusing and rumination. There were greater decreases in subtle avoidance behaviors following CBGT than MBSR. Mediation analyses revealed that increases in reappraisal frequency, mindfulness skills, attention focusing and attention shifting, and decreases in subtle avoidance behaviors and cognitive distortions mediated the impact of both CBGT and MBSR on social anxiety symptoms. However, increases in reappraisal self-efficacy and decreases in avoidance behaviors mediated the impact of CBGT (vs. MBSR) on social anxiety symptoms. Conclusions: CBGT and MBSR both appear to be efficacious for SAD. However, their effects may be a result of both shared and unique changes in underlying psychological processes.

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The Effect of Shame on Patients With Social Anxiety Disorder in Internet-Based Cognitive Behavioral Therapy: Randomized Controlled Trial (Preprint)

10.2196/preprints.15797 ◽

2019 ◽

Author(s):

Haoyu Wang ◽

Qingxue Zhao ◽

Wenting Mu ◽

Marcus Rodriguez ◽

Mingyi Qian ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioral Therapy ◽

Social Anxiety Disorder ◽

Behavioral Therapy ◽

Anxiety Symptoms ◽

Cognitive Behavioral ◽

Mediation Effect ◽

Self Help ◽

Shame Proneness

BACKGROUND Prior research has demonstrated the efficacy of internet-based cognitive behavioral therapy (ICBT) for social anxiety disorder (SAD). However, it is unclear how shame influences the efficacy of this treatment. OBJECTIVE This study aimed to investigate the role shame played in the ICBT treatment process for participants with SAD. METHODS A total of 104 Chinese participants (73 females; age: mean 24.92, SD 4.59 years) were randomly assigned to self-help ICBT, guided ICBT, or wait list control groups. For the guided ICBT group, half of the participants were assigned to the group at a time due to resource constraints. This led to a time difference among the three groups. Participants were assessed before and immediately after the intervention using the Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), and Experience of Shame Scale (ESS). RESULTS Participants’ social anxiety symptoms (self-help: differences between pre- and posttreatment SIAS=−12.71; Cohen d=1.01; 95% CI 9.08 to 16.32; P<.001 and differences between pre- and posttreatment SPS=11.13; Cohen d=0.89; 95% CI 6.98 to 15.28; P<.001; guided: SIAS=19.45; Cohen d=1.20; 95% CI 14.67 to 24.24; P<.001 and SPS=13.45; Cohen d=0.96; 95% CI 8.26 to 18.64; P<.001) and shame proneness (self-help: differences between pre- and posttreatment ESS=7.34; Cohen d=0.75; 95% CI 3.99 to 10.69; P<.001 and guided: differences between pre- and posttreatment ESS=9.97; Cohen d=0.88; 95% CI 5.36 to 14.57; P<.001) in both the self-help and guided ICBT groups reduced significantly after treatment, with no significant differences between the two intervention groups. Across all the ICBT sessions, the only significant predictors of reductions in shame proneness were the average number of words participants wrote in the exposure module (β=.222; SE 0.175; t96=2.317; P=.02) and gender (β=−.33; SE 0.002; t77=−3.13; P=.002). We also found a mediation effect, wherein reductions in shame fully mediated the relationship between the average number of words participants wrote in the exposure module and reductions in social anxiety symptoms (SIAS: β=−.0049; SE 0.0016; 95% CI −0.0085 to −0.0019 and SPS: β=−.0039; SE 0.0015; 95% CI −0.0075 to −0.0012). CONCLUSIONS The findings of this study suggest that participants’ engagement in the exposure module in ICBT alleviates social anxiety symptoms by reducing the levels of shame proneness. Our study provides a new perspective for understanding the role of shame in the treatment of social anxiety. The possible mechanisms of the mediation effect and clinical implications are discussed.

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Social Anxiety and the Accuracy of Memory for Childhood Teasing Frequency

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.31.3.151 ◽

2017 ◽

Vol 31 (3) ◽

pp. 151-157

Author(s):

Stephanie Waechter ◽

Karen Rowa ◽

Irena Milosevic ◽

Philippe Shnaider ◽

Martin M. Antony ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Cognitive Behavioral Therapy ◽

Social Anxiety Disorder ◽

Behavioral Therapy ◽

Anxiety Symptoms ◽

Cognitive Behavioral ◽

Before And After ◽

Group Cbt

Adults’ recollections of how often they were teased as children are positively associated with their social anxiety symptoms. It has therefore been suggested that childhood teasing may play a role in the development of social anxiety disorder (SAD). However, existing studies have not determined whether adults with SAD were actually teased more as children or whether their current symptoms have distorted their memories of childhood events. This study examined reports of childhood teasing in adults with SAD before and after cognitive behavioral therapy (CBT). If recollections of childhood teasing are colored by SAD symptoms, then reported frequency of teasing might be more likely to decrease as symptoms improve after CBT. However, if individuals’ memories of teasing are unbiased, they should not substantially change with the reduction of symptoms after CBT. Ninety-one participants with SAD completed the Teasing Questionnaire-Revised (TQ-R) before and after 12 sessions of group CBT. CBT was effective in reducing SAD symptoms, whereas recollections of the frequency of childhood teasing did not change significantly after treatment. These results are consistent with the possibility that recollections of childhood teasing are not substantially biased by symptoms of SAD, and they lend support to previous studies which suggest that adults with SAD endured higher frequencies of teasing as children compared to controls.

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