Journal of Anxiety Disorders最新文献_第9页

Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials 减少成人状态焦虑、牙科特质焦虑和牙科恐惧症的干预措施：随机对照试验的系统回顾和荟萃分析。

IF 4.8 2区医学

Journal of Anxiety Disorders Pub Date : 2024-07-01 DOI: 10.1016/j.janxdis.2024.102891

Serge A. Steenen , Fabiënne Linke , Roos van Westrhenen , Ad de Jongh

{"title":"Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials","authors":"Serge A. Steenen , Fabiënne Linke , Roos van Westrhenen , Ad de Jongh","doi":"10.1016/j.janxdis.2024.102891","DOIUrl":"10.1016/j.janxdis.2024.102891","url":null,"abstract":"<div><p>This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (<em>SMD</em>=–0.31, <em>95 %CI</em>[–0.56,–0.05]), and low-certainty evidence supports prescribing benzodiazepines (<em>SMD</em>=–0.43, [–0.74,–0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; <em>SMD</em>=–0.65, [–1.06, –0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (<em>SMD</em>=–0.48, [–0.72,–0.24]), and CBT specifically (<em>SMD</em>=–0.43, [–0.68,–0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose—managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102891"},"PeriodicalIF":4.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000677/pdfft?md5=21ea3f7200299bd8728d747dd47c1bf0&pid=1-s2.0-S0887618524000677-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and validation of the positive evaluation core beliefs scale for social anxiety 社交焦虑积极评价核心信念量表的开发与验证

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-06-13 DOI: 10.1016/j.janxdis.2024.102890

Sarina I. Cook, Christina Bryant, Lisa J. Phillips

引用次数: 0

A novel independence intervention to treat child anxiety: A nonconcurrent multiple baseline evaluation 治疗儿童焦虑症的新型独立干预措施：非同期多重基线评估

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-06-11 DOI: 10.1016/j.janxdis.2024.102893

Camilo Ortiz, Matthew Fastman

{"title":"A novel independence intervention to treat child anxiety: A nonconcurrent multiple baseline evaluation","authors":"Camilo Ortiz, Matthew Fastman","doi":"10.1016/j.janxdis.2024.102893","DOIUrl":"10.1016/j.janxdis.2024.102893","url":null,"abstract":"<div><p>Rates of child and adolescent anxiety have increased markedly over the past decade (Haidt & Twenge, 2023). Exposure-based cognitive-behavioral therapy is the gold standard in the treatment of anxious children (<span>Hofmann et al. (2012)</span>). However, many clinicians refrain from using exposure due to concerns about its safety, effectiveness, and ethics (Deacon et al., 2013; Whiteside et al., 2016). We propose a novel treatment approach for child anxiety composed of independence activities (IAs), which are child-directed, fun, unstructured, developmentally challenging tasks performed without parents’ help. These tasks are purposely topographically unrelated to the stimuli that cause anxiety, in direct contrast to exposure therapy. Despite this dissimilarity, IAs target putative mechanisms involved in the development and maintenance of child anxiety (e.g., parental accommodation and overinvolvement, child avoidance, unhelpful thinking styles). Using a nonconcurrent multiple baseline design, this five-session treatment provided preliminary evidence of high treatment acceptability from children and parents. Medium to large improvements were reported in child anxiety and avoidance, parent and child (behavioral and cognitive) mechanisms involved in the maintenance of child anxiety, and untargeted secondary outcomes such as child happiness. Results may suggest a new treatment paradigm, which is desperately needed, given unabated increases in child and adolescent anxiety despite vast resources being directed toward the problem.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102893"},"PeriodicalIF":10.3,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sleep deprivation increases the generalization of perceptual and concept-based fear: An fNIRS study 剥夺睡眠会增加知觉恐惧和概念恐惧的泛化：fNIRS 研究

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-06-11 DOI: 10.1016/j.janxdis.2024.102892

Jie Zhang , Jinxia Wang , Yuanyuan Wang , Dandan Zhang , Hong Li , Yi Lei

{"title":"Sleep deprivation increases the generalization of perceptual and concept-based fear: An fNIRS study","authors":"Jie Zhang , Jinxia Wang , Yuanyuan Wang , Dandan Zhang , Hong Li , Yi Lei","doi":"10.1016/j.janxdis.2024.102892","DOIUrl":"10.1016/j.janxdis.2024.102892","url":null,"abstract":"<div><p>Insufficient sleep can initiate or exacerbate anxiety by triggering excessive fear generalization. In this study, a de novo paradigm was developed and used to examine the neural mechanisms governing the effects of sleep deprivation on processing perceptual and concept-based fear generalizations. A between-subject design was adopted, wherein a control group (who had a typical night's sleep) and a one-night sleep deprivation group completed a fear acquisition task at 9:00 PM on the first day and underwent a generalization test the following morning at 7:00 AM. In the fear acquisition task, navy blue and olive green were used as perceptual cues (P+ and P−, respectively), while animals and furniture items were used as conceptual cues (C+ and C−, respectively). Generalization was tested for four novel generalized categories (C+P+, C+P−, C−P+, and C−P−). Shock expectancy ratings, skin conductance responses, and functional near-infrared spectroscopy were recorded during the fear acquisition and generalization processes. Compared with the group who had a typical night's sleep, the sleep deprived group showed higher shock expectancy ratings (especially for P+ and C−), increased oxygenated hemoglobin in the dorsolateral prefrontal cortex, and increased activation in the triangular inferior frontal gyrus during the generalization test. These findings suggest that sleep deprivation increases the generalization of threat memories, thus providing insights into the overgeneralization characteristics of anxiety and fear-related disorders.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102892"},"PeriodicalIF":10.3,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis 心理疗法对社交焦虑症的疗效，系统回顾与荟萃分析。

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-06-01 DOI: 10.1016/j.janxdis.2024.102881

Nino de Ponti , Minoo Matbouriahi , Pamela Franco , Mathias Harrer , Clara Miguel , Davide Papola , Ayşesu Sicimoğlu , Pim Cuijpers , Eirini Karyotaki

{"title":"The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis","authors":"Nino de Ponti , Minoo Matbouriahi , Pamela Franco , Mathias Harrer , Clara Miguel , Davide Papola , Ayşesu Sicimoğlu , Pim Cuijpers , Eirini Karyotaki","doi":"10.1016/j.janxdis.2024.102881","DOIUrl":"10.1016/j.janxdis.2024.102881","url":null,"abstract":"<div><h3>Background</h3><p>Given the growth in research examining the effects of psychotherapy on social anxiety disorder (SAD), an up-to-date comprehensive meta-analysis in this field is needed.</p></div><div><h3>Methods</h3><p>We selected studies from a database of randomized trials (RCTs) on psychotherapies for anxiety disorders (last updated search of PubMed, PsycINFO, Embase, and Cochrane (CENTRAL): 1 January 2024) We included RCTs comparing psychotherapy to a control condition for adults with SAD and conducted random effects meta-analyses to examine the efficacy of psychotherapy compared to control conditions at post-treatment.</p></div><div><h3>Results</h3><p>Sixty-six RCTs were included with 5560 participants and 98 comparisons between psychotherapy and control groups. Psychotherapy was effective in reducing SAD symptoms, with a large effect size (<em>g</em> = 0.88; 95 % CI: 0.76 to 1.0; I<sup>2</sup> = 74 %; 95 % CI: 69 to 79, NNT = 3.8). Effects remained robust across sensitivity analyses. However, there was evidence for significant risk of bias in the included trials. The multivariable meta-regression indicated significant differences in treatment delivery formats, type of recruitment strategy, target group, and number of sessions.</p></div><div><h3>Conclusion</h3><p>Psychotherapy is an effective treatment for SAD, with moderate to large effect sizes across all treatment types and formats. Future research is needed to determine the long-term effects.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102881"},"PeriodicalIF":10.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000574/pdfft?md5=83c2a3296d69a6fb60c94c7009d46c1d&pid=1-s2.0-S0887618524000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Things You Do: A randomized controlled trial of an unguided ultra-brief intervention to reduce symptoms of depression and anxiety 你做的事情减少抑郁和焦虑症状的无指导超短期干预随机对照试验

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-05-27 DOI: 10.1016/j.janxdis.2024.102882

Madelyne A. Bisby , Victoria Barrett , Lauren G. Staples , Olav Nielssen , Blake F. Dear , Nickolai Titov

{"title":"Things You Do: A randomized controlled trial of an unguided ultra-brief intervention to reduce symptoms of depression and anxiety","authors":"Madelyne A. Bisby , Victoria Barrett , Lauren G. Staples , Olav Nielssen , Blake F. Dear , Nickolai Titov","doi":"10.1016/j.janxdis.2024.102882","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102882","url":null,"abstract":"<div><p>The ‘Things You Do’ encompass five types of actions that are strongly associated with good mental health: Healthy Thinking, Meaningful Activities, Goals and Plans, Healthy Habits, and Social Connections. Ultra-brief interventions which increase how often people perform these actions may decrease depression and anxiety. A two-arm randomized controlled trial (N = 349) compared an unguided ultra-brief intervention based on the ‘Things You Do’ against a waitlist control. The intervention included one online module, two practice guides, and four weeks of daily text messages. The primary timepoint was 5-weeks post-baseline. The intervention resulted in moderate reductions in depression (<em>d</em> = 0.51) and anxiety (<em>d</em> = 0.55) alongside moderate increases in the frequency of Things You Do actions (<em>d</em> = 0.54), compared to controls. No significant change in number of days out of role or life satisfaction were observed. Treatment completion was high (92 %), most participants reported being satisfied with the treatment (66 %), and improvements were maintained at 3-month follow-up. This study demonstrated that an automated ultra-brief ‘Things You Do’ intervention resulted in clinically significant reductions in depression and anxiety. Ultra-brief interventions may provide a scalable solution to support individuals who are unlikely to engage in longer forms of psychological treatment.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102882"},"PeriodicalIF":10.3,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000586/pdfft?md5=3b3039af1d06393fde2a9265a79bb1e6&pid=1-s2.0-S0887618524000586-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anhedonia is associated with overgeneralization of conditioned fear during late adolescence and early adulthood 失乐症与青春晚期和成年早期条件反射性恐惧的过度泛化有关

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-05-23 DOI: 10.1016/j.janxdis.2024.102880

Benjamin M. Rosenberg , Katherine S. Young , Robin Nusslock , Richard E. Zinbarg , Michelle G. Craske

{"title":"Anhedonia is associated with overgeneralization of conditioned fear during late adolescence and early adulthood","authors":"Benjamin M. Rosenberg , Katherine S. Young , Robin Nusslock , Richard E. Zinbarg , Michelle G. Craske","doi":"10.1016/j.janxdis.2024.102880","DOIUrl":"10.1016/j.janxdis.2024.102880","url":null,"abstract":"<div><h3>Background</h3><p>Pavlovian fear paradigms involve learning to associate cues with threat or safety. Aberrances in Pavlovian fear learning correlate with psychopathology, especially anxiety disorders. This study evaluated symptom dimensions of anxiety and depression in relation to Pavlovian fear acquisition and generalization.</p></div><div><h3>Methods</h3><p>256 participants (70.31 % female) completed a Pavlovian fear acquisition and generalization paradigm at ages 18–19 and 21–22 years. Analyses focused on indices of learning (self-reported US expectancy, skin conductance). Multilevel models tested associations with orthogonal symptom dimensions (Anhedonia-Apprehension, Fears, General Distress) at each timepoint.</p></div><div><h3>Results</h3><p>All dimensions were associated with weaker acquisition of US expectancies at each timepoint. Fears was associated with overgeneralization only at age 21–22. General Distress was associated with overgeneralization only at age 18–19. Anhedonia-Apprehension was associated with overgeneralization at ages 18–19 and 21–22.</p></div><div><h3>Conclusions</h3><p>Anhedonia-Apprehension disrupts Pavlovian fear acquisition and increases overgeneralization of fear. These effects may emerge during adolescence and remain into young adulthood. General Distress and Fears also contribute to overgeneralization of fear, but these effects may vary as prefrontal mechanisms of fear inhibition continue to develop during late adolescence. Targeting specific symptom dimensions, particularly Anhedonia-Apprehension, may decrease fear generalization and augment interventions built on Pavlovian principles, such as exposure therapy.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102880"},"PeriodicalIF":10.3,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anxious youth and adults share threat-biased interpretations of linguistic and visual ambiguity: A proof of concept study 焦虑的青少年和成年人对语言和视觉模糊性的解释具有共同的威胁偏差：概念验证研究

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-05-21 DOI: 10.1016/j.janxdis.2024.102878

Michelle Rozenman , Timothy D. Sweeny , Delaney C. McDonagh, Emily L. Jones, Anni Subar

{"title":"Anxious youth and adults share threat-biased interpretations of linguistic and visual ambiguity: A proof of concept study","authors":"Michelle Rozenman , Timothy D. Sweeny , Delaney C. McDonagh, Emily L. Jones, Anni Subar","doi":"10.1016/j.janxdis.2024.102878","DOIUrl":"10.1016/j.janxdis.2024.102878","url":null,"abstract":"<div><p>Interpretation bias, or the threatening appraisal of ambiguous information, has been linked to anxiety disorder. Interpretation bias has been demonstrated for linguistic (e.g., evaluation of ambiguous sentences) and visual judgments (e.g., categorizing emotionally ambiguous facial expressions). It is unclear how these separate components of bias might be associated. We examined linguistic and visual interpretation biases in youth and emerging adults with (<em>n</em> = 44) and without (<em>n</em> = 40) anxiety disorder, and in youth-parent dyads (<em>n</em> = 40). Linguistic and visual biases were correlated with each other, and with anxiety. Compared to non-anxious participants, those with anxiety demonstrated stronger biases, and linguistic bias was especially predictive of anxiety symptoms and diagnosis. Age did not moderate these relationships. Parent linguistic bias was correlated with youth anxiety but not linguistic bias; parent and youth visual biases were correlated. Linguistic and visual interpretation biases are linked in clinically-anxious youth and emerging adults.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102878"},"PeriodicalIF":10.3,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parent-coached exposure therapy versus cognitive behavior therapy for childhood anxiety disorders 家长指导暴露疗法与认知行为疗法治疗儿童焦虑症的比较

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-05-18 DOI: 10.1016/j.janxdis.2024.102877

Stephen P.H. Whiteside , Bridget K. Biggs , Jennifer R. Geske , Lilianne M. Gloe , Stephanie T. Reneson-Feeder , Megan Cunningham , Julie E. Dammann , Elle Brennan , Mian Li Ong , Mark W. Olsen , Deanna R. Hofschulte

{"title":"Parent-coached exposure therapy versus cognitive behavior therapy for childhood anxiety disorders","authors":"Stephen P.H. Whiteside , Bridget K. Biggs , Jennifer R. Geske , Lilianne M. Gloe , Stephanie T. Reneson-Feeder , Megan Cunningham , Julie E. Dammann , Elle Brennan , Mian Li Ong , Mark W. Olsen , Deanna R. Hofschulte","doi":"10.1016/j.janxdis.2024.102877","DOIUrl":"https://doi.org/10.1016/j.janxdis.2024.102877","url":null,"abstract":"<div><p>Cognitive-behavioral therapy (CBT) is the strongest evidenced-based therapy for childhood anxiety disorders (CADs). However, CBT’s impact is limited by its lack of clear superiority over treatment as usual, excessive length, and greater than 50% of patients remaining symptomatic. Parent-coached exposure therapy (PCET) is designed to treat CADs more effectively and efficiently through a focus on exposure and working with parents and youth together. In a randomized controlled trial, 78 patients (78% female) aged 7 to 17 with CADs were assigned to PCET or the gold-standard CBT. The primary outcome was independent evaluator ratings of anxiety severity at mid- and post-treatment. Secondary outcomes were parent- and child-reported symptoms. Patients receiving PCET had significantly lower mean scores than those receiving CBT on the primary outcome measure at mid-treatment (3.03 ± 0.14, 95% CI, 2.75–3.32 vs. 3.77 ± 0.16 95% CI, 3.45–4.08, p = 0.0010) and post-treatment (2.79 ± 0.14, 95% CI, 2.50–3.07 vs. 3.33 ± 0.16, 95% CI, 2.02–3.64, p = 0.0153). Similar significant results were found with the secondary parent- and child-reported outcomes. These superior results were achieved in PCET with fewer sessions (6.62, SD = 2.8) than those in CBT (8.00, SD = 3.1), <em>p</em> = 0.041. The superior effectiveness and efficiency of PCET likely results from the greater focus on implementing exposure exercises compared to traditional CBT.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102877"},"PeriodicalIF":10.3,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141084228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 10.3 2区医学

Journal of Anxiety Disorders Pub Date : 2024-05-16 DOI: 10.1016/j.janxdis.2024.102875

Joseph A. Himle , Richard T. LeBeau , Jennifer M. Jester , Amy M. Kilbourne , Addie Weaver , Daphne M. Brydon , Katherine M. Tucker , Nicole Hamameh , Natalie Castriotta , Michelle G. Craske

{"title":"Work-Related Cognitive Behavioral Therapy for racially and economically diverse unemployed persons with social anxiety: A randomized clinical trial","authors":"Joseph A. Himle , Richard T. LeBeau , Jennifer M. Jester , Amy M. Kilbourne , Addie Weaver , Daphne M. Brydon , Katherine M. Tucker , Nicole Hamameh , Natalie Castriotta , Michelle G. Craske","doi":"10.1016/j.janxdis.2024.102875","DOIUrl":"10.1016/j.janxdis.2024.102875","url":null,"abstract":"<div><p>Individuals with Social Anxiety Disorder (SAD) are at risk for employment problems. This multi-site trial examined the efficacy of <u>W</u>ork-Related <u>C</u>ognitive <u>B</u>ehavioral <u>T</u>herapy provided alongside <u>v</u>ocational <u>s</u>ervices <u>a</u>s <u>u</u>sual (WCBT+VSAU), a group-based treatment designed to improve mental health and employment outcomes for individuals with SAD. Vocational service-seeking participants with SAD (N = 250) were randomized to either WCBT+VSAU or VSAU-alone. Hypotheses were that participants randomized to WCBT+VSAU would report less social anxiety, less depression, and more hours worked than participants randomized to VSAU-alone. WCBT+VSAU participants had significantly greater improvements on the Liebowitz Social Anxiety Scale (LSAS; <em>d</em>=−.25, CI=−0.49 to −0.02, p = .03) at post-assessment compared to VSAU-alone. The conditions did not differ on any variable at later time points or on secondary outcomes. Unexpectedly, participants randomized to VSAU-alone experienced LSAS improvements, similar to WCBT+VASU at later timepoints. Baseline psychological flexibility (beta=−.098 [−0.19–0.008]) and depression (beta=−0.18 [−0.34–0.009]) moderated change in social anxiety. Participants with lower psychological flexibility and higher depression responded more strongly to WCBT+VSAU than VSAU-alone over the duration of the study, suggesting that WCBT+VSAU may particularly benefit those with greater psychopathology. Results indicate that vocational centers are promising settings for treating SAD and employment-focused refinements are likely needed to improve work outcomes.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"104 ","pages":"Article 102875"},"PeriodicalIF":10.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0