Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder
Mia Skytte O’Toolea b✉, Douglas S. Menninc d, Esben Hougaarda b, Robert Hugh Zachariaea b, Nicole Rosenberge f g h
- aDepartment of Psychology and Behavioral Sciences Aarhus University Aarhus Denmark
- bDepartment of Psychology and Behavioral Sciences, Aarhus University , Aarhus, Denmark
- cDepartment of Psychology, Hunter College City University of New York New York City NY USA
- dDepartment of Psychology, Hunter College, City University of New York, New York City, NY, USA
- eClinic for Anxiety Disorders Aarhus University Hospital Risskov Denmark
- fClinic for Anxiety Disorders
- gAarhus University Hospital
- hRisskov Denmark
- ✉Corresponding author
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Abstract
UNLABELLED: The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. KEY PRACTITIONER MESSAGE: Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies.
TL;DRInvestigating variables derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder as possible change processes in cognitive behaviour therapy (CBT) for SAD revealed only changes in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for S AD. (Semantic Scholar)