Overall effectiveness and cognitive mediators of a brief intensive treatment for social anxiety
Renner, Kerry Ann
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The study examined the overall effectiveness and cognitive mediators of the effects of a brief intensive treatment for social anxiety. This treatment was based on a longer term treatment and included three targets: self-focused attention, safety behaviors, and social cost overestimation. Accordingly, we examined the mediating role of these three variables as well as the mediating role of social-ineptness. A large group (N~ 1224) of incoming college freshmen was screened using a social anxiety screening questionnaire. Students (n =127) with elevated scores were invited for individual interview assessment sessions. Thirty-six students completed the assessment, which included interviews to confirm a diagnosis of social anxiety disorder and to assess the severity of social anxiety symptoms. The assessment session also included the administration of measures of the four proposed mediators. Eligible study participants (n = 30) were matched based on gender and approximate social anxiety symptom severity. One member of each yoked pair was randomly assigned to a brief social anxiety intervention (SAI) treatment condition versus an applied relaxation training control (RTC) treatment condition. Thus, 15 participants were assigned to each of the two conditions. Participants in the SAI and RTC groups attended two treatment sessions. The SAI treatment involved construction of a personal model of social anxiety, engagement in a self-focus of attention experiment, completion of a cost estimation task, and in vivo exposures to reevaluate social cost estimates. The RTC treatment involved training in applied relaxation techniques. Both treatment conditions included encouragement to engage in self-directed exposure using the treatment skills. The post-treatment assessment included a re-administration of pre-treatment measures. Results indicated that the treatment (SAI vs. RTC) had a significant effect on ADIS fear ratings (t = 2.24, p < .05 one-tailed), which was mediated by the social cost and social ineptness, but not self-focused attention and safety behaviors. The treatment (SAI vs. RTC) also had a significant effect on ADIS avoidance ratings (t = 3.35,p < .01 one-tailed), which was also mediated by the social cost and social ineptness, but not selffocused attention and safety behaviors. Limitations of the study and future directions for research are discussed.