Journal of Behavior Therapy and Experimental Psychiatry最新文献

{"title":"Measuring attentional bias using the dot-probe task in young women: Psychometric properties and feasibility of response-based computations, dwell time, and the N2pc component","authors":"Sandra Klonteig ,&nbsp;Elise S. Roalsø ,&nbsp;Brage Kraft ,&nbsp;Torgeir Moberget ,&nbsp;Eva Hilland ,&nbsp;Peyman Mirtaheri ,&nbsp;Rune Jonassen","doi":"10.1016/j.jbtep.2025.102036","DOIUrl":"10.1016/j.jbtep.2025.102036","url":null,"abstract":"<div><h3>Background</h3><div>Attentional bias (AB) is characterized by preferential cognitive and emotional processing of mood-congruent stimuli and considered a central mechanism in mood disorders. Considerable research has focused on improving AB measures to enhance mechanistic understanding and clinical utility. The present study examines psychometric properties of a range of AB measures with a multimodal setup.</div></div><div><h3>Methods</h3><div>A nonclinical sample of 62 women aged 20–30 years completed the facial dot-probe task while behavioral responses (reaction time), eye-gaze patterns (eye tracking), and electrical brain potentials (electroencephalography) were recorded. AB metrics from four types of AB measures – traditional, response-based, dwell time, and the N2pc component– were examined with internal consistency and short-term test-retest calculations. AB metrics with an internal consistency score over .4 were considered reliable, and their validity were explored by examining relations to depression and anxiety symptoms. In addition, the consistency between reliable metrics across trials were examined.</div></div><div><h3>Results</h3><div>Findings show that traditional AB metrics exhibited no degree of reliability, whereas response-based and dwell time metrics overall demonstrated better internal consistencies. Response-based metrics also had higher test-retest reliability in all but one metric. The previously reported reliability of the N2pc component was not observed. As for validity, no linear associations were found between the reliable measures, depression, and anxiety. There were no relations between metrics across trials.</div></div><div><h3>Conclusions</h3><div>This study provides insights for future AB research, emphasizing the potential of novel metrics over traditional ones and the use of multimodal setups to develop reliable and potentially hybrid measurements for clinical assessment.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102036"},"PeriodicalIF":1.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of exposure scenario in virtual reality for the treatment of acrophobia: A randomized controlled trial","authors":"Anna Francová ,&nbsp;Markéta Kolman Jablonská ,&nbsp;Lenka Lhotská ,&nbsp;Jan Husák ,&nbsp;Iveta Fajnerová","doi":"10.1016/j.jbtep.2025.102035","DOIUrl":"10.1016/j.jbtep.2025.102035","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Individuals with acrophobia (fear of heights) can experience severe anxiety or panic attacks when they are located at height. This randomized controlled study aimed to verify the effects of a novel scalable virtual reality-based exposure (VR exposure) tool in individuals with acrophobia, by exposing them to a predefined set of situations they usually tend to avoid.</div></div><div><h3>Methods</h3><div>Forty-three adults were randomly assigned to one of the two groups: the experimental group or the waitlist group. Both groups attended initial short online education. The experimental group consecutively attended three VR-based exposure therapy (VRET) intervention sessions over 3–5 weeks during which the therapist encouraged participants to enter the predefined feared situations, while the control group on the waitlist had no additional intervention.</div></div><div><h3>Results</h3><div>The findings show that a 3-session VR exposure intervention with a standardized set of tasks effectively reduces the level of experienced height intolerance and particularly avoidance behavior compared to the control waitlist group limited to psychoeducation only. Results were maintained at the 2 months follow-up. The higher the sense of presence after the VR exposure was, the lower the avoidance level rated in the follow-up.</div></div><div><h3>Limitations</h3><div>Our study has some limitations, such as potential sample selection bias and tracking of only medium-term effects in the 2-month follow-up.</div></div><div><h3>Conclusions</h3><div>The findings show that three sessions of VR exposure intervention with a standardized set of VR-based scenarios are effective in reducing the level of height intolerance and associated avoidance behavior and led to improvement of the outcome measures two months after the procedure. The role of presence was implicated in the prolonged outcome of the VR exposure intervention.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102035"},"PeriodicalIF":1.7,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of internet-based emotion-focused cognitive behavior therapy (IECBT) in improving stress and anxiety of women with suspected fetal malformation: A randomized controlled trial","authors":"Sajede Aligoltabar ,&nbsp;Fatemeh Nasiri-Amiri ,&nbsp;Soraya Khafri ,&nbsp;Hajar Adib-Rad ,&nbsp;Shahnaz Barat ,&nbsp;Zeinab Pahlavan ,&nbsp;Seyedsina Taheriotaghsara ,&nbsp;Mostafa Rayati ,&nbsp;Mahbobeh Faramarzi","doi":"10.1016/j.jbtep.2025.102033","DOIUrl":"10.1016/j.jbtep.2025.102033","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Anxiety is prevalent among pregnant women with suspected fetal malformation. Hence, this study aimed to assess the effectiveness of IECBT in alleviating pregnancy-specific stress and anxiety in anxious women with suspected fetal malformation.</div></div><div><h3>Methods</h3><div>A randomized four-arm parallel-group controlled trial was conducted involving 140 pregnant women displaying anxiety symptoms before 20 weeks of gestation and suspected fetal malformation. Participants were randomly allocated into four groups, each consisting of 35 women: IECBT alone, IECBT with booster sessions, IECBT with spouse participation, and IECBT combined with spouse participation and booster sessions. The IECBT intervention comprised six 50-min therapist-led sessions for women, with an additional 20-min session for men in the IECBT with spouse participation group. Those in the IECBT with booster sessions groups received six monthly 50-min sessions post-intervention until delivery. Five questionnaires—Spielberger's State Anxiety, Pregnancy-Specific Stress, Uncertainty Intolerance, and Emotion Regulation—were administered before the trial, upon completion of the 6-week intervention, and at 3-month and 6-month post-trial follow-ups.</div></div><div><h3>Results</h3><div>The IECBT interventions led to significant improvements in anxiety symptoms, pregnancy-specific stress, uncertainty intolerance, and emotional regulation after therapy, with these improvements sustained at the 3-month and 6-month post-treatment assessments. However, no superiority was observed among the four IECBT models across the three measurement intervals—post-trial, 3-month, and 6-month follow-ups regarding outcome improvement. Additionally, participants expressed high satisfaction levels with all IECBT approaches, with no significant differences noted among the four groups.</div></div><div><h3>Limitation</h3><div>IECBT with spouse participation and IECBT with booster sessions were not therapist-guided, results might stem from the masculism culture of the population and their low responsibility and assistance in solving pregnant women's problems, especially during pregnancy, the lack of long-term follow-up of treatment effectiveness and postnatal psychological outcomes with or without fetal malformation.</div></div><div><h3>Conclusions</h3><div>The findings suggest that the four models of IECBT improved anxiety, stress, uncertainty, and dysregulated emotions in women with suspected fetal malformation, and such improvements remained stable up to six months after the intervention.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102033"},"PeriodicalIF":1.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A feasibility study of an add-on psychomotor body-image protocol during CBT-E in female patients with an eating disorder","authors":"Suzanne H.W. Mares ,&nbsp;Marjon Voskamp ,&nbsp;Elke Wezenberg ,&nbsp;Annemarie A. van Elburg","doi":"10.1016/j.jbtep.2025.102034","DOIUrl":"10.1016/j.jbtep.2025.102034","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Disturbed body image is a potential precursor and maintaining factor when it comes to eating disorders. One of the dominant treatment approaches for eating disorders, enhanced cognitive-behaviour therapy (CBT-E), includes the cognitive-affective body image dimension as a core treatment target. Adding a component that focuses on the lived body dimension, could improve body image. In the current study, the feasibility of a psychomotor body image treatment as an add-on to CBT-E was examined.</div></div><div><h3>Methods</h3><div>In this pilot study, 115 primarily female patients with different eating disorders in outpatient CBT-E treatment participated. They were asked to complete questionnaires examining body image before and after the psychomotor body image treatment.</div></div><div><h3>Results</h3><div>Results showed good satisfaction with the treatment, and a significant improvement in body attitude and body satisfaction after the psychomotor body image treatment, with large effect sizes and clinical relevance. Results also showed that, overall, pre-treatment levels and changes over the course of treatment in body attitude and body satisfaction did not differ between patients within anorexia nervosa, bulimia nervosa or binge eating disorder diagnostic subgroups.</div></div><div><h3>Limitations</h3><div>Limitations were lack of a control group, and the fact that the body image treatment was complementary to CBT-E. This means that it is unclear whether other factors contributed to the change in body image as shown in the current study.</div></div><div><h3>Conclusions</h3><div>These results indicate that an experiential psychomotor approach in addition to a more cognitive-behavioral approach is feasible, and warrants future research.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102034"},"PeriodicalIF":1.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental imagery abilities in different modalities moderate the efficacy of cognitive bias modification for interpretation bias in social anxiety","authors":"Charlene L.M. Lam ,&nbsp;Andy S. Hin ,&nbsp;Luciana N.S. Lau ,&nbsp;Zhiqi Zhang ,&nbsp;Chantel J. Leung","doi":"10.1016/j.jbtep.2025.102031","DOIUrl":"10.1016/j.jbtep.2025.102031","url":null,"abstract":"<div><h3>Objectives</h3><div>Cognitive bias modification for interpretation bias (CBM-I) is an effective low-intensity intervention that targets interpretation biases associated with the development and maintenance of social anxiety. Few studies to-date have examined the extent to which individual mental imagery ability affects the efficacy of CBM-I.</div></div><div><h3>Methods</h3><div>A total of 666 individuals were screened. Seventy-two participants with high levels of social anxiety and elevated baseline interpretation bias were randomly assigned to either CBM-I (n = 36) or control groups (n = 36). They completed 5-day internet-delivered training in modifying their interpretation bias associated with ambiguous social scenarios (CBM-I) or reading neutral text passages (control).</div></div><div><h3>Results</h3><div>Intent-to-treat analyses revealed that participants in the CBM-I group had a significant reduction in their interpretation bias compared to the controls. They had a reduction of 11 %–18 % on the social anxiety measures. Participants’ mental imagery ability was significantly associated with the reduction of interpretation bias and social anxiety symptoms in the CBM-I group. Specifically, participants with higher mental imagery ability in emotional feelings benefited the most from the intervention.</div></div><div><h3>Conclusions</h3><div>CBM-I is an efficacious intervention for modulating social anxiety-related biases and symptoms. Mental imagery ability facilitated the efficacy of CBM-I.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102031"},"PeriodicalIF":1.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inducing dissociative states: A (re)view from the laboratory","authors":"Fiona G. Sleight,&nbsp;Charlie W. McDonald,&nbsp;Richard Mattson,&nbsp;Steven Jay Lynn","doi":"10.1016/j.jbtep.2025.102032","DOIUrl":"10.1016/j.jbtep.2025.102032","url":null,"abstract":"<div><div>Laboratory-based inductions of dissociative states promise to facilitate understanding of the etiology, maintenance, and treatment of dissociation and dissociative disorders. In the present scoping review, we identified articles via a systematic search of PsycINFO, PsycARTICLES, PubMed, and Google Scholar, resulting in 59 articles that met <em>a priori</em> inclusion criteria. Of the 19 techniques described, numerous elicited changes in dissociative symptoms. However, studies were highly heterogeneous regarding their definition and measurement of dissociation. We call attention to relevant validity concerns presented by laboratory-based inductions and offer directions and recommendations for future research.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102032"},"PeriodicalIF":1.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can attentional biases predict outcome of CBT in children with social anxiety disorder?","authors":"Steffen Schmidtendorf ,&nbsp;Julia Asbrand ,&nbsp;Brunna Tuschen-Caffier ,&nbsp;Nina Heinrichs","doi":"10.1016/j.jbtep.2025.102029","DOIUrl":"10.1016/j.jbtep.2025.102029","url":null,"abstract":"<div><h3>Background</h3><div>Many studies have investigated differences in attention allocation to threat between socially anxious individuals and healthy controls in adult and child samples. The extent to which differences exist within the group of socially anxious individuals and whether these have a predictive value for the extent of symptom reduction after cognitive-behavioral therapy (CBT) has been studied less until to date and yielded inconsistent findings, particularly in child samples.</div></div><div><h3>Methods</h3><div>The present study investigated whether three different indices of biased attention, measured at pretreatment by eye-tracking, were associated with differences in response to a 12-session exposure-based group CBT in a sample of 41 children with social anxiety disorder (SAD).</div></div><div><h3>Results</h3><div>In linear regression analyses neither initial vigilance nor initial maintenance nor attentional avoidance predicted symptom reductions after CBT. Children who no longer met diagnostic criteria after treatment did not differ from those who did not fully remit in terms of initial vigilance and attentional avoidance (<em>d</em> &lt; .36). With regard to initial maintenance of attention to threat, the analysis revealed a large but statistically non-significant effect between both groups (<em>d</em> = .81).</div></div><div><h3>Conclusion</h3><div>Initial maintenance of attention to threat may be beneficial for the treatment of social anxiety. However, the evidence in our study is only weak and further research is needed before clear implications can be drawn.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102029"},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A psycholinguistic investigation of biased semantic networks in contamination-related obsessive-compulsive disorder","authors":"Schauenburg Gesche,&nbsp;Moritz Steffen,&nbsp;Hottenrott Birgit,&nbsp;Miegel Franziska,&nbsp;Scheunemann Jakob,&nbsp;Jelinek Lena","doi":"10.1016/j.jbtep.2025.102028","DOIUrl":"10.1016/j.jbtep.2025.102028","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Increasing evidence confirms the significant involvement of disgust in contamination-related obsessive-compulsive disorder (C-OCD). More insights into the role of disgust within cognitive biases in OCD may illuminate the psychopathology and corresponding subdimensions or subtypes. The present study introduces a new approach adopted from psycholinguistic research to investigate biases in word association networks in C-OCD versus other OCD symptom dimensions (nC-OCD).</div></div><div><h3>Method</h3><div>Individuals with OCD (<em>N</em> = 70; <em>N</em> = 42 with C-OCD, <em>N</em> = 28 with nC- OCD) and healthy controls (HC; <em>N</em> = 36) were asked to produce up to five verbal associations with cue words. Written forms of the recorded associations were analyzed with word lexica providing rating norms for valence, arousal, potency, fear, and disgust. We examined bivariate correlations between OCI-R subscale “Washing” and affective variables across all participants. We investigated group differences in semantic biases in the association responses to these five variables given to standardized (three-group comparison: C-OCD vs. nC-OCD vs. HC) and individual (two-group comparison: C-OCD vs. nC-OCD) cue words.</div></div><div><h3>Results</h3><div>“Washing” and disgust showed the strongest correlation. The three-group comparison revealed more negative valence and disgust-related associations for C-OCD as compared to HC and nC-OCD. Associations generated by the C-OCD group were more pronounced in all emotion variables as compared to the nC-OCD group. <em>Limitations</em>: Rating norms did not cover all word associations, resulting in missing data. The OCD groups were unbalanced due to post-hoc allocation.</div></div><div><h3>Conclusions</h3><div>Results support the assumption of differentially biased semantic networks across the OCD spectrum, with greater negativity and disgust in C-OCD.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102028"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attend to the positive while feeling anxious: The effect of state anxiety on the effectiveness of Attentional Bias Modification","authors":"M.D. Nuijs ,&nbsp;H. Larsen ,&nbsp;B. Grafton ,&nbsp;C. MacLeod ,&nbsp;S.M. Bögels ,&nbsp;R.W. Wiers ,&nbsp;E. Salemink","doi":"10.1016/j.jbtep.2025.102030","DOIUrl":"10.1016/j.jbtep.2025.102030","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Elevating state anxiety during Attentional Bias Modification (ABM) may improve its effectiveness by matching the emotional state experienced during the training with the emotional state under which it is intended that the learned pattern of attentional bias will subsequently operate. This study examined whether inducing elevated levels of state anxiety during ABM enhanced the effectiveness in modifying an attentional bias to socially threatening information.</div></div><div><h3>Methods</h3><div>Participants (<em>n</em> = 160) were randomized to a single session of attend-negative or attend-positive dot-probe training which was interspersed with either a state anxiety induction or control condition. Attentional bias was assessed post-training by means of a dot-probe task and a visual search task.</div></div><div><h3>Results</h3><div>ABM was effective in modifying attentional bias in the direction of the allocated training condition as assessed with a dot-probe task, but did not generalize to a visual search task. Importantly, state anxiety did not moderate ABM's training effects.</div></div><div><h3>Limitations</h3><div>Although the state anxiety manipulation successfully induced state anxiety, state anxiety levels were modest which potentially limited the chance to detect a moderating effect of state anxiety.</div></div><div><h3>Conclusions</h3><div>Although these findings suggest that inducing state anxiety during ABM does not improve its effectiveness, more studies are needed to confirm this preliminary conclusion. Future studies should examine whether larger state anxiety elevations and state anxiety manipulations that are more integrated into the ABM procedure do enhance training effects.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102030"},"PeriodicalIF":1.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining two of the ingredients of Cognitive therapy for adolescent social anxiety disorder: Back-translation from a treatment trial","authors":"Eleanor Leigh ,&nbsp;David Clark ,&nbsp;Kenny Chiu","doi":"10.1016/j.jbtep.2025.102020","DOIUrl":"10.1016/j.jbtep.2025.102020","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive Therapy for Social Anxiety Disorder (CT-SAD) based on the Clark &amp; Wells model is a complex intervention comprised of a series of therapeutic elements. Two of the key ingredients are the <em>self-focused attention and safety behaviour experiment</em> and <em>video feedback</em>. The present study examined the effects of these two therapeutic procedures in adolescents with SAD, as well as common themes of the young people's social fears and negative self-images.</div></div><div><h3>Method</h3><div>35 participants with a diagnosis of SAD completed internet-delivered CT-SAD as part of a randomised controlled trial. We conducted a series of paired samples t-tests to evaluate the effects of the <em>self-focused attention and safety behaviour experiment</em> and <em>video feedback</em>. We applied Latent Dirichlet Allocation to identify latent topics based on participants' description of their social fears and negative self-images that were elicited during the course of these therapy procedures.</div></div><div><h3>Results</h3><div>Participants reported lower anxiety and more positive self-appraisals when focusing externally and dropping safety behaviours, compared to when focusing internally and using safety behaviours (<em>ps</em> &lt; 0.0025). After they watched the videos compared to before, they reported more positive appraisals of their appearance and performance (<em>ps</em> &lt; 0.0025). The differences in these outcomes were significantly larger when they focused internally and used safety behaviours, compared to focusing externally and dropping safety behaviours (<em>ps</em> &lt; 0.0025). Topic modelling identified six social fear topics and five negative self-image topics.</div></div><div><h3>Conclusions</h3><div>Self-focused attention, safety behaviours, and negative self-imagery are modifiable with the ‘self-focused attention and safety behaviour experiment’ and ‘video feedback’ as part of internet delivered CT-SAD.</div></div>","PeriodicalId":48198,"journal":{"name":"Journal of Behavior Therapy and Experimental Psychiatry","volume":"88 ","pages":"Article 102020"},"PeriodicalIF":1.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}