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Cognitive Therapy and Research

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01-08-2021 | Social Anxiety Disorder | Original Article

Interpersonal Patterns in Social Anxiety Disorder: Predictors and Outcomes of Cognitive-Behavioral Therapy

Authors: Michaela B. Swee, Rachel M. Butler, Brennah V. Ross, Arielle Horenstein, Emily B. O’Day, Richard G. Heimberg

Published in: Cognitive Therapy and Research | Issue 4/2021

Abstract

Background

Given the strong associations of social anxiety disorder (SAD) with interpersonal problems and insecure attachment, this study sought to examine specific interpersonal problem domains in relation to the outcome of cognitive-behavioral therapy (CBT) for SAD.

Method

Ninety-five adults with SAD received individual CBT and completed a measure of attachment style at pretreatment, as well as measures of interpersonal problems and social anxiety at pre- and posttreatment.

Results

At baseline, social anxiety was significantly associated with overall interpersonal problems, multiple specific interpersonal problems, as well as insecure attachment. Interpersonal problems decreased significantly over the course of treatment but did not predict a reduction in social anxiety. No specific interpersonal problem predicted changes in social anxiety. The greatest changes from pre- to posttreatment were observed across avoidance-related interpersonal problems. Higher levels of secure attachment predicted lower social anxiety, but individuals with less secure attachment experienced a greater reduction in social anxiety from pre- to posttreatment. However, this interaction was significant for only one of three measures of social anxiety.

Conclusions

Our findings suggest that although higher levels of interpersonal problems and lower levels of secure attachment predict greater social anxiety, interpersonal problems and insecure attachment do not predict poorer treatment outcome.

Available only for authorised users

It should be noted that the LSAS, SIAS-S and SPS were all used as social anxiety outcome measures in these analyses; as stated earlier, the LSAS was used as our primary outcome measure. With one exception (i.e., lower secure attachment scores predicted a greater decrease in social anxiety symptoms only according to the LSAS but not according to the SIAS-S or SPS), results were uniform across all three measures. Thus, we report the representative results using the LSAS. Means and standard deviations for the SIAS-S and SPS are included in Table 2 and results of the primary analyses for these measures are available in the supplementary file for this manuscript.

Alden, L. E., Buhr, K., Robichaud, M., Trew, J. L., & Plasencia, M. L. (2018). Treatment of social approach processes in adults with social anxiety disorder. Journal of Consulting and Clinical Psychology, 86, 505–517. https://doi.org/10.1037/ccp0000306.CrossRefPubMed

Alden, L. E., & Capreol, M. J. (1993). Interpersonal problem patterns in avoidant personality disordered outpatients: Prediction of treatment response. Behavior Therapy, 24, 356–376. https://doi.org/10.1016/S0005-7894(05)80211-4.CrossRef

Alden, L. E., & Phillips, N. (1990). An interpersonal analysis of social anxiety and depression. Cognitive Therapy and Research, 14, 499–513. https://doi.org/10.1007/BF01172970.CrossRef

Alden, L. E., Regambal, M. J., & Plasencia, L. (2014). Relational processes in social anxiety disorder. In J. W. Weeks (Ed.), The Wiley Blackwell handbook of social anxiety disorder (pp. 159–178). Chichester: Wiley. https://doi.org/10.1002/9781118653920.ch8.CrossRef

Alden, L. E., & Taylor, C. T. (2004). Interpersonal processes in social phobia. Clinical Psychology Review, 24, 857–882. https://doi.org/10.1016/j.cpr.2004.07.006.CrossRefPubMed

Alden, L. E., & Taylor, C. T. (2011). Relational treatment strategies increase social approach behaviors in patients with generalized social anxiety disorder. Journal of Anxiety Disorders, 25, 309–318. https://doi.org/10.1016/j.janxdis.2010.10.003.CrossRefPubMed

Alden, L. E., Wiggins, J. S., & Pincus, A. L. (1990). Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55, 521–536. https://doi.org/10.1207/s15327752jpa5503&4_10.CrossRefPubMed

Altmann, U., Gawlytta, R., Hoyer, J., Leichsenring, F., Leibing, E., Beutel, M., et al. (2020). Typical symptom change patterns and their predictors in patients with social anxiety disorder: A latent class analysis. Journal of Anxiety Disorders, 71, 102200. https://doi.org/10.1016/j.janxdis.2020.102200.CrossRefPubMed

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV). Washington, DC: American Psychiatric Publishing. https://doi.org/10.1007/springerreference_179660.CrossRef

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). Arlington, VA: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.744053.CrossRef

Asher, M., Asnaani, A., & Aderka, I. M. (2017). Gender differences in social anxiety disorder: A review. Clinical Psychology Review, 56, 1–12. https://doi.org/10.1002/jclp.22624.CrossRefPubMed

Azadeh, S. M., Kazemi-Zahrani, H., & Besharat, M. A. (2016). Effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder. Global Journal of Health Science, 8, 131–138. https://doi.org/10.5539/gjhs.v8n3p131.CrossRef

Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226–244. https://doi.org/10.1037/0022-3514.61.2.226.CrossRefPubMed

Berry, K., Wearden, A., Barrowclough, C., & Liversidge, T. (2006). Attachment styles, interpersonal relationships and psychotic phenomena in a non-clinical student sample. Personality and Individual Differences, 41, 707–718. https://doi.org/10.1016/j.paid.2006.03.009.CrossRef

Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., et al. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial. Depression and Anxiety, 28, 1034–1042. https://doi.org/10.1002/da.20877.CrossRefPubMed

Blanco, C., Heimberg, R. G., Schneier, F. R., Fresco, D. M., Chen, H., Turk, C. L., et al. (2010). A placebo-controlled trial of phenelzine, cognitive behavioral group therapy and their combination for social anxiety disorder. Archives of General Psychiatry, 67(286), 295. https://doi.org/10.1001/archgenpsychiatry.2010.11.CrossRef

Bögels, S. M., Wijts, P., Oort, F. J., & Sallaerts, S. J. M. (2014). Psychodynamic psychotherapy versus cognitive behavior therapy for social anxiety disorder: An efficacy and partial effectiveness trial. Depression and Anxiety, 31, 363–373. https://doi.org/10.1002/da.22246.CrossRefPubMed

Borge, F.-M., Hoffart, A., & Sexton, H. (2010). Predictors of outcome in residential cognitive and interpersonal treatment for social phobia: Do cognitive and social dysfunction moderate treatment outcome? Journal of Behavior Therapy and Experimental Psychiatry, 41, 212–219. https://doi.org/10.1016/j.jbtep.2010.01.005.CrossRefPubMed

Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting and Clinical Psychology, 70, 288–298. https://doi.org/10.1037//0022-006X.70.2.288.CrossRefPubMed

Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford.

Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5-L): Lifetime vs. client interview schedule. New York, NY: Oxford University Press. https://doi.org/10.4135/9781483365817.n81.CrossRef

Butler, R. M., O’Day, E. B., Swee, M. B., Horenstein, A., & Heimberg, R. G. (2020). Cognitive behavioral therapy for social anxiety disorder: Predictors of treatment outcome in a quasi-naturalistic setting. Behavior Therapy. https://doi.org/10.1016/j.beth.2020.06.002.CrossRefPubMed

Cain, N. M., Pincus, A. L., & Grosse Holtforth, M. (2010). Interpersonal subtypes in social phobia: Diagnostic and treatment implications. Journal of Personality Assessment, 92, 514–527. https://doi.org/10.1080/00223891.2010.513704.CrossRefPubMed

Cappe, R. F., & Alden, L. E. (1986). A comparison of treatment strategies for clients functionally impaired by extreme shyness and social avoidance. Journal of Consulting and Clinical Psychology, 54, 796–801. https://doi.org/10.1037/0022-006X.54.6.796.CrossRefPubMed

Carlbring, P., Gunnarsdóttir, M., Hedensjö, L., Andersson, G., Ekselius, L., & Furmark, T. (2007). Treatment of social phobia: Randomized trial of Internet-delivered cognitive-behavioural therapy with telephone support. British Journal of Psychiatry, 190, 123–128. https://doi.org/10.1192/bjp.bp.105.020107.CrossRef

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates Inc.

Cramer, V., Torgersen, S., & Kringlen, E. (2005). Quality of life and anxiety disorders: A population study. The Journal of Nervous and Mental Disease, 193, 196–202. https://doi.org/10.1097/01.nmd.0000154836.22687.13.CrossRefPubMed

Craske, M. G., Niles, A. N., Burklund, L. J., Wolitzky-Taylor, K. B., Vilardaga, J. C. P., Arch, J. J., et al. (2014). Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators. Journal of Consulting and Clinical Psychology, 82, 1034–1048. https://doi.org/10.1037/a0037212.CrossRefPubMedPubMedCentral

Darcy, K., Davila, J., & Beck, J. G. (2005). Is social anxiety associated with both interpersonal avoidance and interpersonal dependence? Cognitive Therapy and Research, 29, 171–186. https://doi.org/10.1007/s10608-005-3163-4.CrossRef

Davila, J., & Beck, J. G. (2002). Is social anxiety associated with impairment in close relationships? A preliminary investigation. Behavior Therapy, 33, 447–464. https://doi.org/10.1016/S0005-7894(02)80037-5.CrossRef

Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Lifetime version (ADIS-IV-L). New York, NY: Oxford University Press.

Dunlap, W. P., Cortina, J. M., Vaslow, J. B., & Burke, M. J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1, 170–177. https://doi.org/10.1037/1082-989X.1.2.170.CrossRef

Eng, W., Heimberg, R. G., Hart, T. A., Schneier, F. R., & Liebowitz, M. R. (2001). Attachment in individuals with social anxiety disorder: The relationship among adult attachment styles, social anxiety, and depression. Emotion, 1, 365–380. https://doi.org/10.1037/1528-3542.1.4.365.CrossRefPubMed

Erozkan, A. (2009). The relationship between attachment styles and social anxiety: An investigation with Turkish university students. Social Behavior and Personality: An International Journal, 37, 835–844. https://doi.org/10.2224/sbp.2009.37.6.835.CrossRef

Erwin, B. A., Heimberg, R. G., Schneier, F. R., & Liebowitz, M. R. (2003). Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behavior Therapy, 34, 331–350. https://doi.org/10.1016/S0005-7894(03)80004-7.CrossRef

Falk Dahl, C. A., & Dahl, A. A. (2010). Lifestyle and social network in individuals with high levels of social phobia/anxiety symptoms: A community-based study. Social Psychiatry and Psychiatric Epidemiology, 45, 309–317. https://doi.org/10.1007/s00127-009-0069-6.CrossRefPubMed

Frandsen, F. W., Simonsen, S., Poulson, S., Sørensen, P., & Lau, M. E. (2020). Social anxiety disorder and avoidant personality disorder from an interpersonal perspective. Psychology and Psychotherapy: Theory, Research and Practice, 93, 88–104. https://doi.org/10.1111/papt.12214.CrossRef

Gajwani, R., Patterson, P., & Birchwood, M. (2013). Attachment: Developmental pathways to affective dysregulation in young people at ultra-high risk of developing psychosis. British Journal of Clinical Psychology, 52, 424–437. https://doi.org/10.1111/bjc.12027.CrossRef

Goldin, P. R., Morrison, A., Jazaieri, H., Brozovich, F., Heimberg, R. G., & Gross, J. J. (2016). Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 84, 427–437. https://doi.org/10.1037/ccp0000092.CrossRefPubMedPubMedCentral

Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., & Gross, J. J. (2012). Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder. Journal of Consulting and Clinical Psychology, 80, 1034–1040. https://doi.org/10.1037/a0028555.CrossRefPubMedPubMedCentral

Grant, D. M., Beck, J. G., Farrow, S. M., & Davila, J. (2007). Do interpersonal features of social anxiety influence the development of depressive symptoms? Cognition and Emotion, 21, 646–663. https://doi.org/10.1080/02699930600713036.CrossRef

Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511–524. https://doi.org/10.1037/0022-3514.52.3.511.CrossRefPubMed

Heimberg, R. G., Dodge, C. S., Hope, D. A., Kennedy, C. R., Zollo, L. J., & Becker, R. E. (1990). Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control. Cognitive Therapy and Research, 14, 1–23. https://doi.org/10.1007/BF01173521.CrossRef

Heimberg, R. G., Horner, K. J., Juster, H. R., Safren, S. A., Brown, E. J., Schneier, F. R., & Liebowitz, M. R. (1999). Psychometric properties of the Liebowitz social anxiety scale. Psychological Medicine, 29, 199–212. https://doi.org/10.1017/s003329179800787.CrossRefPubMed

Heimberg, R. G., Liebowitz, M. R., Hope, D. A., Schneier, F. R., Holt, C. S., Welkowitz, L. A., et al. (1998). Cognitive-behavioral group therapy versus phenelzine in social phobia: 12-week outcome. Archives of General Psychiatry, 55, 1133–1141. https://doi.org/10.1002/(SICI)1520-6394(1999)10:3%3c89::AID-DA1%3e3.0.CO;2-5.CrossRefPubMed

Heimberg, R. G., Mueller, G. P., Holt, C. S., Hope, D. A., & Liebowitz, M. R. (1992). Assessment of anxiety in social interaction and being observed by others: The social interaction anxiety scale and the social phobia scale. Behavior Therapy, 23, 53–73. https://doi.org/10.1016/S0005-7894(05)80308-9.CrossRef

Hofmann, S. G. (2014). Interpersonal emotion regulation model of mood and anxiety disorders. Cognitive Therapy Research, 38, 483–492. https://doi.org/10.1007/s10608-014-9620-1.CrossRefPubMed

Hope, D. A., Heimberg, R. G., & Turk, C. L. (2010a). Managing social anxiety: A cognitive-behavioral therapy approach (Therapist Guide, 2nd ed.). New York: Oxford University Press. https://doi.org/10.1093/med:psych/9780195336689.001.0001.

Hope, D. A., Heimberg, R. G., & Turk, C. L. (2010b). Managing social anxiety: A cognitive-behavioral therapy approach (Client Workbook, 2nd ed.). New York: Oxford University Press. https://doi.org/10.1093/med:psych/9780195336696.001.0001

Horowitz, L. M. (1979). On the cognitive structure of interpersonal problems treated in psychotherapy. Journal of Consulting and Clinical Psychology, 47, 5–15. https://doi.org/10.1037/0022-006X.47.1.5.CrossRefPubMed

Horowitz, L. M., Alden, L. E., Wiggins, J. S., & Pincus, A. L. (2000). Manual for the inventory of interpersonal problems. San Antonio, TX: Psychological Corporation.

Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureño, G., & Villaseñor, V. S. (1988). Inventory of interpersonal problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology, 56, 885–892. https://doi.org/10.1037//0022-006x.56.6.885.CrossRefPubMed

Horowitz, L. M., Rosenberg, S. E., & Bartholomew, K. (1993). Interpersonal problems, attachment styles, and outcome in brief dynamic psychotherapy. Journal of Consulting and Clinical Psychology, 4, 549–560. https://doi.org/10.1037/0022-006X.61.4.549.CrossRef

Hoyer, J., Wiltink, J., Hiller, W., Miller, R., Salzer, S., Sarnowsky, S., et al. (2016). Baseline patient characteristics predicting outcome and attrition in cognitive therapy for social phobia: Results from a large multicentre trial. Clinical Psychology and Psychotherapy, 23(35), 46. https://doi.org/10.1002/cpp.1936.CrossRef

Jones, W. H., & Briggs, S. R. (1984). The self-other discrepancy in social shyness. In R. Schwarzer (Ed.), The self in anxiety, stress and depression (pp. 93–107). Amsterdam: North Holland.CrossRef

Kachin, K. E., Newman, M. G., & Pincus, A. L. (2001). An interpersonal problem approach to the division of social phobia subtypes. Behavior Therapy, 32, 479–501. https://doi.org/10.1016/S0005-7894(01)80032-0.CrossRef

Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21, 169–184. https://doi.org/10.1002/mpr.1359.CrossRefPubMedPubMedCentral

Ledley, D. R., Heimberg, R. G., Hope, D. A., Hayes, S. A., Zaider, T. I., Van Dyke, M., et al. (2009). Efficacy of a manualized and workbook-driven individual treatment for social anxiety disorder. Behavior Therapy, 40, 414–424. https://doi.org/10.1016/j.beth.2008.12.001.CrossRefPubMed

Leichsenring, F., Hoyer, J., Beutel, M., Herpertz, S., Hiller, W., Irle, E., & Leibing, E. (2009). The social phobia psychotherapy research network. The first multicenter randomized controlled trial of psychotherapy for social phobia: Rationale, methods and patient characteristics. Psychotherapy and Psychosomatics, 78, 35–41. https://doi.org/10.1159/000162299.CrossRefPubMed

Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., & HoyerHuesingJoraschkyNoltingPoehlmannRitterStangierStraussStuhldreherTefikowTeismannWillutzkiWiltinkLeibing, J. J. P. B. K. V. U. B. N. S. T. U. J. E. (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. American Journal of Psychiatry, 170, 759–767. https://doi.org/10.1176/appi.ajp.2013.12081125.CrossRef

Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., & HoyerHuesingJoraschkyNoltingPoehlmannRitterStangierStraussStuhldreherTefikowTeismannWillutzkiWiltinkLeibing, J. J. P. B. K. V. U. B. N. S. T. U. J. E. (2014). Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder. American Journal of Psychiatry, 171, 1074–1082. https://doi.org/10.1176/appi.ajp.2014.13111514.CrossRef

Levy, K. N., Kivity, Y., Johnson, B. N., & Gooch, C. V. (2018). Adult attachment as a predictor and moderator of psychotherapy outcome: A meta-analysis. Journal of Clinical Psychology, 74, 1996–2013. https://doi.org/10.1002/jclp.22685.CrossRefPubMed

Liebowitz, M. R. (1987). Social phobia. Modern Trends in Pharmacopsychiatry, 22, 141–173. https://doi.org/10.1159/000414022.CrossRef

Lincoln, T. M., Rief, W., Hahlweg, K., Frank, M., Witzleben, I. V., Schroeder, B., & Fiegenbaum, W. (2005). Who comes, who stays, who profits? Predicting refusal, dropout, success, and relapse in a short intervention for social phobia. Psychotherapy Research, 15, 210–225. https://doi.org/10.1080/10503300512331387834.CrossRef

Manning, R. P., Dickson, J. M., Palmier-Claus, J., Cunliffe, A., & Taylor, P. J. (2017). A systematic review of adult attachment and social anxiety. Journal of Affective Disorders, 211, 44–59. https://doi.org/10.1016/j.jad.2016.12.020.CrossRefPubMed

Mattick, R. P., & Clarke, J. C. (1998). Development and validation measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy., 36, 455–470. https://doi.org/10.1016/s0005-7967(97)10031-6.CrossRefPubMed

McEvoy, P. M., Burgess, M. M., & Nathan, P. (2014). The relationship between interpersonal problems, therapeutic alliance, and outcomes following group and individual cognitive behavior therapy. Journal of Affective Disorders, 157, 25–32. https://doi.org/10.1016/j.jad.2013.12.038.CrossRefPubMed

Mörtberg, E., Karlsson, A., Fyring, C., & Sundin, Ö. (2006). Intensive cognitive-behavioral group treatment (CBGT) of social phobia: A randomized controlled study. Journal of Anxiety Disorders, 20, 646–660. https://doi.org/10.1016/j.janxdis.2005.07.005.CrossRefPubMed

Piccirillo, M. L., Dryman, M. T., & Heimberg, R. G. (2016). Safety behaviors in adults with social anxiety: Review and future directions. Behavior Therapy, 47, 675–687. https://doi.org/10.1016/j.beth.2015.11.005.CrossRefPubMed

Plasencia, M. L., Alden, L. E., & Taylor, C. T. (2011). Functional implications of safety behaviour subtypes in social anxiety disorder. Behaviour Research and Therapy, 49, 665–675. https://doi.org/10.1016/j.brat.2011.07.005.CrossRefPubMed

Rodebaugh, T. L., Heimberg, R. G., Brown, P. J., Fernandez, K. C., Blanco, C., Schneier, F. R., & Liebowitz, M. R. (2011). More reasons to be straightforward: Findings and norms for two scales relevant to social anxiety. Journal of Anxiety Disorders., 25, 624–630. https://doi.org/10.1016/j.janxdis.2011.02.002.CrossRef

Rodebaugh, T. L., Lim, M. H., Fernandez, K. C., Langer, J. K., Weisman, J. S., Tonge, N., et al. (2014). Self and friend’s differing views of social anxiety disorder’s effects on friendships. Journal of Abnormal Psychology, 123, 715–724. https://doi.org/10.1037/abn0000015.CrossRefPubMedPubMedCentral

Rodebaugh, T. L., Woods, C. M., & Heimberg, R. G. (2007). The reverse of social anxiety is not always the opposite: The reverse scored items of the social interaction anxiety scale do not belong. Behavior Therapy, 38, 192–206. https://doi.org/10.1016/j.beth.2006.08.001.CrossRefPubMed

Scharfe, E., & Bartholomew, K. (1994). Reliability and stability of adult attachment patterns. Personal Relationships, 1, 23–43. https://doi.org/10.1111/j.1475-6811.1994.tb00053.x.CrossRef

Schmidt, N. B., Buckner, J. D., Pusser, A., Woolaway-Bickel, K., Preston, J. L., & Norr, A. (2012). Randomized controlled trial of false safety behavior elimination therapy: A unified cognitive behavioral treatment for anxiety psychopathology. Behavior Therapy, 43, 518–532. https://doi.org/10.1016/j.beth.2012.02.004.CrossRefPubMed

Schulz, A., Stolz, T., Vincent, A., Krieger, T., Andersson, G., & Berger, T. (2016). A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder. Behaviour Research and Therapy, 84, 14–26. https://doi.org/10.1016/j.brat.2016.07.001.CrossRefPubMed

Sparrevohn, R. M., & Rapee, R. M. (2009). Self-disclosure, emotional expression and intimacy within romantic relationships of people with social phobia. Behaviour Research and Therapy, 47, 1074–1078. https://doi.org/10.1016/j.brat.2009.07.016.CrossRefPubMed

Strauss, B., Altmann, U., Manes, S., Tholl, A., Koranyl, S., Nolte, T., et al. (2018). Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial. PLoS ONE, 13, e0192802. https://doi.org/10.1371/journal.pone.0192802.CrossRefPubMedPubMedCentral

Strauss, B., Koranyi, S., Altmann, U., Nolte, T., Beutel, M. E., Wiltink, J., & Kirchmann, H. (2017). Partner-related attachment as a moderator of outcome in patients with social anxiety disorder: A comparison between short-term cognitive-behavioral and psychodynamic therapy. Psychotherapy, 54, 339–350. https://doi.org/10.1080/10503307.2019.1630779.CrossRefPubMed

Taylor, C. T., & Alden, L. E. (2008). Self–related and interpersonal judgment biases in social anxiety disorder: Changes during treatment and relationship to outcome. International Journal of Cognitive Therapy, 1, 125–137. https://doi.org/10.1521/ijct.2008.1.2.125.CrossRef

Wei, M., Russell, D. W., Mallinckrodt, B., & Vogel, D. L. (2007). The Experiences in Close Relationship Scale (ECR)-short form: Reliability, validity, and factor structure. Journal of Personality Assessment, 88, 187–204. https://doi.org/10.1080/00223890701268041.CrossRefPubMed

Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M. (1995). Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. Behavior Therapy, 26, 153–161. https://doi.org/10.1016/s0005-7894(05)80088-7.CrossRef

Wenzel, A. (2002). Characteristics of close relationships in individuals with social phobia: A preliminary comparison with nonanxious individuals. In J. H. Harvey & A. Wenzel (Eds.), Maintaining and enhancing close relationships: A clinician’s guide (pp. 199–213). Mahwah, NJ: Lawrence Erlbaum Associates.

Wenzel, A., Graff-Dolezal, J., Macho, M., & Brendle, J. R. (2005). Communication and social skills in socially anxious and nonanxious individuals in the context of romantic relationships. Behaviour Research and Therapy, 43, 505–519. https://doi.org/10.1016/j.brat.2004.03.010.CrossRefPubMed

Wiggins, J. S. (1982). Circumplex models of interpersonal behavior in clinical psychology. In P. S. Kendall & J. N. Butcher (Eds.), Handbook of research methods in clinical psychology (pp. 183–221). New York: Wiley.

Zaki, J., & Williams, W. C. (2013). Interpersonal emotion regulation. Emotion, 13, 803–810. https://doi.org/10.1037/a0033839.CrossRefPubMed

Title: Interpersonal Patterns in Social Anxiety Disorder: Predictors and Outcomes of Cognitive-Behavioral Therapy
Authors: Michaela B. Swee
Rachel M. Butler
Brennah V. Ross
Arielle Horenstein
Emily B. O’Day
Richard G. Heimberg
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Social Anxiety Disorder
Anxiety
Published in: Cognitive Therapy and Research / Issue 4/2021
Print ISSN: 0147-5916
Electronic ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-020-10192-3

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Interpersonal Patterns in Social Anxiety Disorder: Predictors and Outcomes of Cognitive-Behavioral Therapy

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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Other articles of this Issue 4/2021

Are Changes in Beliefs About Rumination and in Emotion Regulation Skills Mediators of the Effects of Internet-Delivered Cognitive-Behavioral Therapy for Depression and Anxiety? Results from a Randomized Controlled Trial

To Approach or to Avoid: The Role of Ambivalent Motivation in Attentional Biases to Threat and Spider Fear

Regulating Emotionality to Manage Adversity: A Systematic Review of the Relation Between Emotion Regulation and Psychological Resilience

Inhibitory Control Moderates the Effect of Anxiety on Vagally Mediated Heart Rate Variability: Findings from a Community Sample of Young School-Aged Children

Social Anxiety Disorder and the Fear of Death: An Empirical Investigation of the Terror Management Approach towards Understanding Clinical Anxiety

Looming Cognitive Style More Consistently Predicts Anxiety than Depressive Symptoms: Evidence from a 3-Wave Yearlong Study