| 1. |
- Costache, Madalina Elena, et al.
(författare)
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Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder
- 2020
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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| 2. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Risk profiles for poor treatment response to internet-delivered CBT in people with social anxiety disorder
- 2015
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Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 33, s. 103-109
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Tidskriftsartikel (refereegranskat)abstract
- In social anxiety disorder (SAD) co-morbid depressive symptoms as well as avoidance behaviors have been shown to predict insufficient treatment response. It is likely that subgroups of individuals with different profiles of risk factors for poor treatment response exist. This study aimed to identify subgroups of social avoidance and depressive symptoms in a clinical sample (N=167) with SAD before and after guided internet-delivered CBT, and to compare these groups on diagnostic status and social anxiety. We further examined individual movement between subgroups over time. Using cluster analysis we identified four subgroups, including a high-problem cluster at both time-points. Individuals in this cluster showed less remission after treatment, exhibited higher levels of social anxiety at both assessments, and typically remained in the high-problem cluster after treatment. Thus, in individuals with SAD, high levels of social avoidance and depressive symptoms constitute a risk profile for poor treatment response.
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| 3. |
- Carlbring, Per, et al.
(författare)
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Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia : a 30-month follow-up
- 2009
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Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 47:10, s. 848-850
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Tidskriftsartikel (refereegranskat)abstract
- Internet-delivered guided cognitive behaviour therapy for social anxiety disorder has been found to generate promising short-term results, up to one year posttreatment. No study has however documented longer follow-up periods. In this 30-month follow-up we contacted 57 participants from the original study of which 77.2% (44/57) responded to the Internet-administered outcome measures and 66.7% (38/57) completed a telephone interview. Results showed large pretreatment to follow-up within-group effect sizes for the primary outcome measures (Cohen's d 1.10-1.71), and a majority (68.4%; 26/38) reported improvements in the interview. The findings suggest that the long-term effects seen in previous live treatment CBT trials can occur in Internet-delivered treatment as well.
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| 4. |
- Laukka, Petri, et al.
(författare)
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Neurofunctional correlates of expressed vocal affect in social phobia
- 2011
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Ingår i: Cognitive, Affective, & Behavioral Neuroscience. - : Springer Science and Business Media LLC. - 1530-7026 .- 1531-135X. ; 11:3, s. 413-425
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the neural correlates of expressed vocal affect in patients with social phobia. A group of 36 patients performed an anxiogenic public-speaking task while regional cerebral blood flow (rCBF) was assessed using oxygen-15 positron emission tomography. The patients’ speech was recorded and content masked using low-pass filtering (which obscures linguistic content but preserves nonverbal affective cues). The content-masked speech samples were then evaluated with regard to their level of vocally expressed nervousness. We hypothesized that activity in prefrontal and subcortical brain areas previously implicated in emotion regulation would be associated with the degree of expressed vocal affect. Regression analyses accordingly revealed significant negative correlations between expressed vocal affect and rCBF in inferior frontal gyrus, putamen, and hippocampus. Further, functional connectivity was revealed between inferior frontal gyrus and (a) anterior cingulate cortex and (b) amygdala and basal ganglia. We suggest that brain areas important for emotion regulation may also form part of a network associated with the modulation of affective prosody in social phobia.
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| 5. |
- Ma, Lichen, et al.
(författare)
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Seeking neutral : A VR-based person-identity-matching task for attentional bias modification – A randomised controlled experiment
- 2020
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Attentional bias modification (ABM) aims to reduce anxiety by attenuating bias towards threatening information. The current study incorporated virtual reality (VR) technology and 3-dimensional stimuli with a person-identity-matching (PIM) task to evaluate the effects of a VR-based ABM training on attentional bias and anxiety symptoms.Methods: One hundred participants with elevated social anxiety were randomised to four training groups. Attentional bias was assessed at pre- and post-training, and anxiety symptoms were assessed at pre-training, post-training, 1-week follow-up, and 3-month follow-up.Results: Change in anxiety did not correlate with change in bias (r = −0.08). A repeated-measures ANOVA showed no significant difference in bias from pre- to post-ABM, or between groups. For anxiety symptoms, a linear mixed-effects model analysis revealed a significant effect of time. Participants showed reduction in anxiety score at each successive assessment (p < .001, Nagelkerke's pseudo r2 = 0.65). However, no other significant main effect or interactions were found. A clinically significant change analysis revealed that 4% of participants were classified as ‘recovered’ at 3-month follow-up.Conclusions: A single session of VR-based PIM task did not change attentional bias. The significant reduction in anxiety was not specific to active training, and the majority of participants remained clinically unchanged.
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| 6. |
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| 7. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Social phobia in Swedish university students : prevalence, subgroups and avoidant behavior
- 2007
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 42:1, s. 79-86
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Public speaking is a common situation that university students have to endure. This situation is feared or avoided by most individuals with social phobia, which has been associated with low levels of educational attainment. However, epidemiological data on social phobia in university students are scarce. The present study examined the prevalence of social phobia and its subgroups in a university student population. Demographic characteristics and avoidant behavior in educational settings were also examined. METHODS: The Social Phobia Screening Questionnaire (SPSQ)--a validated and DSM-IV compatible instrument, was distributed as a postal survey to 753 randomly selected university students in Sweden. Interpretable questionnaires were obtained from 523 students (69.5%). To investigate subgroups, students who met the SPSQ diagnostic criteria of social phobia were analyzed by hierarchical cluster analysis. RESULTS: The point prevalence of social phobia among the Swedish university students was 16.1%, comparable with 15.6% previously reported for the general population. Two clusters were distinguished consisting of students scoring either low (discrete subgroup) or high (generalized subgroup) on all cluster variables. The discrete subgroup was more common representing 83% of the cases. Social phobia was associated with use of dysfunctional avoidant strategies in educational situations and in anticipation of public speaking. The disorder was less common among students following a pedagogic university program. CONCLUSIONS: Social phobia was highly prevalent among Swedish university students, most cases pertaining to a mild or discrete form of the disorder. The commonness and severity of social phobia in students did not deviate significantly from the general population suggesting that socially anxious individuals do apply for higher education. However, since avoidance and low educational attainment are commonly reported features, future studies should investigate whether sufferers of social phobia underachieve or abolish their studies prematurely.
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| 8. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Treating university students with social phobia and public speaking fears : Internet delivered self-help with or without live group exposure sessions
- 2008
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 25:8, s. 708-717
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. METHODS: Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). RESULTS: Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. CONCLUSIONS: The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly.
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| 9. |
- Andersson, Evelyn, et al.
(författare)
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Genetic Polymorphisms in Monoamine Systems and Outcome of Cognitive Behavior Therapy for Social Anxiety Disorder
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe role of genetics for predicting the response to cognitive behavior therapy (CBT) for social anxiety disorder (SAD) has only been studied in one previous investigation. The serotonin transporter (5-HTTLPR), the catechol-o-methyltransferase (COMT) val158met, and the tryptophan hydroxylase-2 (TPH2) G-703Tpolymorphisms are implicated in the regulation of amygdala reactivity and fear extinction and therefore might be of relevance for CBT outcome. The aim of the present study was to investigate if these three gene variants predicted response to CBT in a large sample of SAD patients.MethodParticipants were recruited from two separate randomized controlled CBT trials (trial 1: n = 112, trial 2: n = 202). Genotyping were performed on DNA extracted from blood or saliva samples. Effects were analyzed at follow-up (6 or 12 months after treatment) for both groups and for each group separately at post-treatment. The main outcome measure was the Liebowitz Social Anxiety Scale Self-Report.ResultsAt long-term follow-up, there was no effect of any genotype, or gene × gene interactions, on treatment response. In the subsamples, there was time by genotype interaction effects indicating an influence of the TPH2 G-703T-polymorphism on CBT short-term response, however the direction of the effect was not consistent across trials.ConclusionsNone of the three gene variants, 5-HTTLPR, COMTval158met and TPH2 G-703T, was associated with long-term response to CBT for SAD.
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| 10. |
- Hedman, Erik, et al.
(författare)
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A 5-year follow-up of internet-based cognitive behavior therapy for Social Anxiety Disorder
- 2011
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internet-basedcognitive behavior therapy (CBT) has been shown to be a promising method todisseminate cognitive behavior therapy for social anxiety disorder (SAD).Several trials have demonstrated that Internet-based CBT can be effective forSAD in the shorter term. However, the long-term effects of Internet-based CBTfor SAD are less well known. Objective: Our objectivewas to investigate the effect of Internet-based CBT for SAD 5 years aftercompleted treatment. Method: We conducted a 5-yearfollow-up study of 80 persons with SAD who had undergone Internet-based CBT.The assessment comprised a diagnostic interview and self-report questionnaires.The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social InteractionAnxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates werelow: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires. Results: Mixed-effect models analysisshowed a significant effect of time on the three social anxiety measures,LSAS-SR, SIAS, and SPS (F3,98-102 = 16.05 -29.20, P < .001)indicating improvement. From baseline to 5-year follow-up, participants’ meanscores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI]66.1-76.5) to 40.3 (95% CI 35.2 - 45.3). The effect sizes of the LSAS-SR were large (Cohen’s d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvementsgained at the 1-year follow-up were sustained 5 years after completedtreatment. Conclusions: Internet-basedCBT for SAD is a treatment that can result in large and enduring effects. Trial registration: Clinicaltrials.govNCT01145690; http://clinicaltrials.gov/ct2/show/NCT01145690 (Archived byWebCite athttp://www.webcitation.org/5ygRxDLfK)
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