scholarly journals Does cognitive flexibility predict treatment gains in Internet-delivered psychological treatment of social anxiety disorder, depression, or tinnitus?

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1934 ◽  
Author(s):  
Philip Lindner ◽  
Per Carlbring ◽  
Erik Flodman ◽  
Amanda Hebert ◽  
Stephanie Poysti ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Cognitive Flexibility ◽  
Psychological Treatment ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Psychological Treatments ◽  
Perseverative Errors ◽  
Treatment Gains

Little is known about the individual factors that predict outcomes in Internet-administered psychological treatments. We hypothesized that greater cognitive flexibility (i.e. the ability to simultaneously consider several concepts and tasks and switch effortlessly between them in response to changes in environmental contingencies) would provide a better foundation for learning and employing the cognitive restructuring techniques taught and exercised in therapy, leading to greater treatment gains. Participants in three trials featuring Internet-administered psychological treatments for depression (n = 36), social anxiety disorder (n = 115) and tinnitus (n = 53) completed the 64-card Wisconsin Card Sorting Test (WCST) prior to treatment. We found no significant associations between perseverative errors on the WCST and treatment gains in any group. We also found low accuracy in the classification of treatment responders. We conclude that lower cognitive flexibility, as captured by perseverative errors on the WCST, should not impede successful outcomes in Internet-delivered psychological treatments.

Differences in Conceptual Flexibility with Age as Measured by a Modified Version of the Visual Verbal Test

1994 ◽  
Vol 13 (3) ◽  
pp. 368-377 ◽  
Author(s):  
Barbara Collins ◽  
Andrée Tellier
Keyword(s):  
Cognitive Flexibility ◽  
The Elderly ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Healthy Elderly ◽  
Age Related ◽  
Perseverative Errors ◽  
Verbal Test ◽  
The Individual ◽  
Conceptual Flexibility

ABSTRACTAge-related changes in the capacity for cognitive flexibility should be considered in social planning for the expanding elderly population and in the functional assessment of the individual geriatric patient. Current means for assessing conceptual flexibility are not particularly appropriate for use with the elderly. In the current study, a briefer and more tolerable measure of conceptual flexibility was derived from the Visual Verbal Test (VVT). This index correlated significantly with the number of perseverative errors but not the number of nonperseverative errors on the Wisconsin Card Sorting Test (WCST), attesting to its validity as a specific measure of the ability to shift mental set. A significant relationship between age and both this VVT measure of conceptual shift and the number of perseverative errors on the WCST was observed in a sample of 60 healthy elderly volunteers between the ages of 55 and 84, suggesting that cognitive flexibility is indeed negatively associated with age.

Psychological Treatments for Social Anxiety Disorder

2018 ◽  
Author(s):  
Simona C. Kaplan ◽  
Michaela B. Swee ◽  
Richard G. Heimberg
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Psychodynamic Psychotherapy ◽  
Behavioral Therapy ◽  
The Body ◽  
Cognitive Behavioral ◽  
Psychological Treatments ◽  
Added Benefit ◽  
Effectiveness Studies

Social anxiety disorder (SAD) is characterized by fear of being negatively evaluated by others in social situations. Multiple psychological interventions have been developed to treat SAD. The most widely studied of these interventions stem from cognitive-behavioral, acceptance-based, interpersonal, and psychodynamic conceptualizations of SAD. In cognitive-behavioral therapy (CBT), patients learn to identify and question maladaptive thoughts and engage in exposures to feared situations to test the accuracy of biased beliefs. Mindfulness and acceptance-based approaches to treating SAD focus on mindful awareness and acceptance of distressing internal experiences (i.e., psychological and physiological symptoms) with the ultimate goal of behavior change and living a meaningful life based on identified values. Interpersonal psychotherapy links SAD to interpersonal problem areas and aims to reduce symptoms by targeting interpersonal difficulties. Psychodynamic psychotherapy for SAD focuses on identifying unresolved conflicts that lead to SAD symptoms, fostering insight and expressiveness, and forming a secure helping alliance. Generally, CBT is the most well-studied of the psychological treatments for SAD, and research demonstrates greater reductions in social anxiety than pill placebo and waitlist controls. Results from randomized controlled trials (RCTs) suggest that mindfulness—and acceptance-based therapies may be as efficacious as CBT, although the body of research remains small; four of five RCTs comparing these approaches to CBT found no differences. RCTs comparing CBT to IPT suggest that CBT is the more efficacious treatment. Two RCTs comparing CBT to psychodynamic psychotherapy suggest that psychodynamic psychotherapy may have efficacy similar to CBT, but that it takes longer to achieve similar outcomes. RCTs examining CBT and pharmacotherapy suggest that the medications phenelzine and clonazepam are as efficacious as CBT for treating SAD and are faster acting, but that patients receiving these medications may be more likely to relapse after treatment is discontinued than patients who received CBT. Research generally does not indicate added benefit of combining psychotherapy with pharmacotherapy above each monotherapy alone, although this body of research is quite variable. Effectiveness studies indicate that CBT is equally effective in community clinics and controlled research trials, but studies of this nature are lacking for other psychological approaches.

scholarly journals Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder

2021 ◽  
Vol 18 (7) ◽  
pp. 3642
Author(s):  
Ana Isabel Rosa-Alcázar ◽  
Ángel Rosa-Alcázar ◽  
Inmaculada C. Martínez-Esparza ◽  
Eric A. Storch ◽  
Pablo J. Olivares-Olivares
Keyword(s):  
Working Memory ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Obsessive Compulsive Disorder ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Cognitive Flexibility ◽  
Generalized Anxiety ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.

scholarly journals Psychological treatment of social anxiety disorder: a meta-analysis

2008 ◽  
Vol 39 (2) ◽  
pp. 241-254 ◽  
Author(s):  
C. Acarturk ◽  
P. Cuijpers ◽  
A. van Straten ◽  
R. de Graaf
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Placebo Control ◽  
Control Groups ◽  
Psychological Treatments ◽  
Randomized Studies ◽  
Meta Analyses

BackgroundOlder meta-analyses of the effects of psychological treatments of social anxiety disorder have found that these treatments have moderate to large effects. However, these earlier meta-analyses also included non-randomized studies, and there are many featured studies in this area which were published after the recent meta-analysis.MethodWe conducted a systematic literature search and identified 29 randomized studies examining the effects of psychological treatments, with a total of 1628 subjects. The quality of studies varied. For the analyses, we used the computer program comprehensive meta-analysis (version 2.2.021; Biostat, Englewood, NJ, USA).ResultsThe mean effect size on social anxiety measures (47 contrast groups) was 0.70, 0.80 on cognitive measures (26 contrast groups) and 0.70 both on depression (19 contrast groups) and general anxiety measures (16 contrast groups). We found some heterogeneity, so we conducted a series of subgroup analyses for different variables of the studies. Studies with waiting-list control groups had significantly larger effect sizes than studies with placebo and treatment-as-usual control groups. Studies aimed at subjects who met Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for social anxiety disorder had smaller effect sizes than studies in which other inclusion criteria were used.ConclusionsThis study once more makes it clear that psychological treatments of social anxiety disorder are effective in adults, but that they may be less effective in more severe disorders and in studies in which care-as-usual and placebo control groups are used.

scholarly journals Improvement in indices of cellular protection after psychological treatment for social anxiety disorder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristoffer N. T. Månsson ◽  
Daniel Lindqvist ◽  
Liu L. Yang ◽  
Cecilia Svanborg ◽  
Josef Isung ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Telomere Length ◽  
Social Anxiety Disorder ◽  
Psychological Treatment ◽  
Telomerase Activity ◽  
Cellular Aging ◽  
Symptom Improvement ◽  
Cellular Protection ◽  
Gpx Activity

AbstractTelomere attrition is a hallmark of cellular aging and shorter telomeres have been reported in mood and anxiety disorders. Telomere shortening is counteracted by the enzyme telomerase and cellular protection is also provided by the antioxidant enzyme glutathione peroxidase (GPx). Here, telomerase, GPx, and telomeres were investigated in 46 social anxiety disorder (SAD) patients in a within-subject design with repeated measures before and after cognitive behavioral therapy. Treatment outcome was assessed by the Liebowitz Social Anxiety Scale (self-report), administered three times before treatment to control for time and regression artifacts, and posttreatment. Venipunctures were performed twice before treatment, separated by 9 weeks, and once posttreatment. Telomerase activity and telomere length were measured in peripheral blood mononuclear cells and GPx activity in plasma. All patients contributed with complete data. Results showed that social anxiety symptom severity was significantly reduced from pretreatment to posttreatment (Cohen’s d = 1.46). There were no significant alterations in telomeres or cellular protection markers before treatment onset. Telomere length and telomerase activity did not change significantly after treatment, but an increase in telomerase over treatment was associated with reduced social anxiety. Also, lower pretreatment telomerase activity predicted subsequent symptom improvement. GPx activity increased significantly during treatment, and increases were significantly associated with symptom improvement. The relationships between symptom improvement and putative protective enzymes remained significant also after controlling for body mass index, sex, duration of SAD, smoking, concurrent psychotropic medication, and the proportion of lymphocytes to monocytes. Thus, indices of cellular protection may be involved in the therapeutic mechanisms of psychological treatment for anxiety.

Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model

2017 ◽  
Vol 26 (2) ◽  
pp. 540-556 ◽  
Author(s):  
Lisa Iverach ◽  
Ronald M. Rapee ◽  
Quincy J. J. Wong ◽  
Robyn Lowe
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Psychological Treatment ◽  
Behavioral Model ◽  
Psychological Needs ◽  
Negative Evaluation ◽  
Cognitive Behavioral ◽  
Treatment Programs ◽  
Cognitive Behavioral Model

Purpose Stuttering is a speech disorder frequently accompanied by anxiety in social-evaluative situations. A growing body of research has confirmed a significant rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a chronic and disabling anxiety disorder associated with substantial life impairment. Several influential models have described cognitive-behavioral factors that contribute to the maintenance of social anxiety in nonstuttering populations. The purpose of the present article is to apply these leading models to the experience of social anxiety for people who stutter. Method Components from existing models were applied to stuttering in order to determine cognitive-behavioral processes that occur before, during, and after social-evaluative situations, which may increase the likelihood of stuttering-related social fears persisting. Results Maintenance of social anxiety in stuttering may be influenced by a host of interrelated factors, including fear of negative evaluation, negative social-evaluative cognitions, attentional biases, self-focused attention, safety behaviors, and anticipatory and postevent processing. Conclusion Given the chronic nature of social anxiety disorder, identifying factors that contribute to the persistence of stuttering-related social fears has the potential to inform clinical practice and the development of psychological treatment programs to address the speech and psychological needs of people who stutter with social anxiety.

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