Cargando…

Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder

A considerable number of children and adolescents with social anxiety disorder (SAD) do not benefit from treatment as much as expected. However, treatment success should not be measured with social anxiety reports alone; the cognitive, behavioral, and physiological components of social stress should...

Descripción completa

Detalles Bibliográficos
Autores principales: Asbrand, Julia, Heinrichs, Nina, Schmidtendorf, Steffen, Nitschke, Kai, Tuschen-Caffier, Brunna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235054/
https://www.ncbi.nlm.nih.gov/pubmed/31960175
http://dx.doi.org/10.1007/s10578-019-00954-w
_version_ 1783535893745762304
author Asbrand, Julia
Heinrichs, Nina
Schmidtendorf, Steffen
Nitschke, Kai
Tuschen-Caffier, Brunna
author_facet Asbrand, Julia
Heinrichs, Nina
Schmidtendorf, Steffen
Nitschke, Kai
Tuschen-Caffier, Brunna
author_sort Asbrand, Julia
collection PubMed
description A considerable number of children and adolescents with social anxiety disorder (SAD) do not benefit from treatment as much as expected. However, treatment success should not be measured with social anxiety reports alone; the cognitive, behavioral, and physiological components of social stress should also be assessed. The authors examined an exposure-based SAD-specific group cognitive behavioral therapy (CBT) in a randomized controlled trial (N = 67, age 9–13 years, blind randomized allocation to treatment [CBT; n = 31] and waitlist control [WLC; n = 36] groups). Success was operationalized as a clinically significant reduction of symptoms measured with SAD-specific questionnaires, structured interviews, and changes in response to the Trier Social Stress Test (TSST). In the CBT group, there was a trend toward a significant increase in positive cognitions in the TSST after treatment (d = 0.37), whereas these positive cognitions decreased in the WLC group (d = 0.40). No significant results involving group appeared for negative cognitions, behavior and physiology. Children in the CBT group, but not parents, further reported less social anxiety in one questionnaire from pre- to post-treatment (d = 0.89). A structured interview confirmed a decrease in severity of SAD in the CBT group. While the gold standard of a blind interview showed efficacy of treatment, not all trait and state measures demonstrated similar success patterns. Trial registration Eligibility criteria and some of the dependent variables (cognitions, physiology) for treatment success were registered with the German Research Foundation (TU 78/5-2, HE 3342/4-2) prior to recruitment. Clinical assessment of diagnosis and behavioral data were not a priori planned as outcome measures for this trial and therefore analyzed in a post-hoc approach. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10578-019-00954-w) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-7235054
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-72350542020-05-20 Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder Asbrand, Julia Heinrichs, Nina Schmidtendorf, Steffen Nitschke, Kai Tuschen-Caffier, Brunna Child Psychiatry Hum Dev Original Article A considerable number of children and adolescents with social anxiety disorder (SAD) do not benefit from treatment as much as expected. However, treatment success should not be measured with social anxiety reports alone; the cognitive, behavioral, and physiological components of social stress should also be assessed. The authors examined an exposure-based SAD-specific group cognitive behavioral therapy (CBT) in a randomized controlled trial (N = 67, age 9–13 years, blind randomized allocation to treatment [CBT; n = 31] and waitlist control [WLC; n = 36] groups). Success was operationalized as a clinically significant reduction of symptoms measured with SAD-specific questionnaires, structured interviews, and changes in response to the Trier Social Stress Test (TSST). In the CBT group, there was a trend toward a significant increase in positive cognitions in the TSST after treatment (d = 0.37), whereas these positive cognitions decreased in the WLC group (d = 0.40). No significant results involving group appeared for negative cognitions, behavior and physiology. Children in the CBT group, but not parents, further reported less social anxiety in one questionnaire from pre- to post-treatment (d = 0.89). A structured interview confirmed a decrease in severity of SAD in the CBT group. While the gold standard of a blind interview showed efficacy of treatment, not all trait and state measures demonstrated similar success patterns. Trial registration Eligibility criteria and some of the dependent variables (cognitions, physiology) for treatment success were registered with the German Research Foundation (TU 78/5-2, HE 3342/4-2) prior to recruitment. Clinical assessment of diagnosis and behavioral data were not a priori planned as outcome measures for this trial and therefore analyzed in a post-hoc approach. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10578-019-00954-w) contains supplementary material, which is available to authorized users. Springer US 2020-01-20 2020 /pmc/articles/PMC7235054/ /pubmed/31960175 http://dx.doi.org/10.1007/s10578-019-00954-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Asbrand, Julia
Heinrichs, Nina
Schmidtendorf, Steffen
Nitschke, Kai
Tuschen-Caffier, Brunna
Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title_full Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title_fullStr Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title_full_unstemmed Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title_short Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder
title_sort experience versus report: where are changes seen after exposure-based cognitive-behavioral therapy? a randomized controlled group treatment of childhood social anxiety disorder
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235054/
https://www.ncbi.nlm.nih.gov/pubmed/31960175
http://dx.doi.org/10.1007/s10578-019-00954-w
work_keys_str_mv AT asbrandjulia experienceversusreportwherearechangesseenafterexposurebasedcognitivebehavioraltherapyarandomizedcontrolledgrouptreatmentofchildhoodsocialanxietydisorder
AT heinrichsnina experienceversusreportwherearechangesseenafterexposurebasedcognitivebehavioraltherapyarandomizedcontrolledgrouptreatmentofchildhoodsocialanxietydisorder
AT schmidtendorfsteffen experienceversusreportwherearechangesseenafterexposurebasedcognitivebehavioraltherapyarandomizedcontrolledgrouptreatmentofchildhoodsocialanxietydisorder
AT nitschkekai experienceversusreportwherearechangesseenafterexposurebasedcognitivebehavioraltherapyarandomizedcontrolledgrouptreatmentofchildhoodsocialanxietydisorder
AT tuschencaffierbrunna experienceversusreportwherearechangesseenafterexposurebasedcognitivebehavioraltherapyarandomizedcontrolledgrouptreatmentofchildhoodsocialanxietydisorder