Prediction of treatment outcome in social phobia: A cross-validation

Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Behaviour Research and Therapy (Impact Factor: 3.85). 08/1999; 37(7):659-70. DOI: 10.1016/S0005-7967(98)00175-2
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This study was a replication of a study on the prediction of treatment outcome in social phobic patients [Chambless, D. L., Tran, G. Q. Glass, C.R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11 221-240]. Results at the posttest and the 18-months follow-up were analyzed for DSM-III-R social phobic patients, with either a generalized social phobia (n = 50) or a nongeneralized fear, i.e. fear of blushing, trembling or sweating in social situations (n = 26). Predictors were pretreatment depression, personality disorder traits, clinician rated severity of impairment and frequency of negative self-statements during social interactions. The criterium variable was (the residual gain score of) self-reported avoidance of social situations. In line with Chambless et al., pretreatment depression showed some predictive value, but smaller and only at the posttest. Change in the frequency of negative self-statements paralleled, but did not predict, change in social phobia symptoms. In contrast with Chambless et al., clinician rated severity was (slightly) predictive for treatment outcome, whereas avoidant personality traits had reverse correlations with outcome in both subgroups. The results are discussed and directions for further research are given.

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    • "Moreover, the somewhat limited data presently available suggest that the combination of cognitive strategies with exposure may not be significantly superior to exposure alone (e.g. Rodebaugh, Holaway and Heimberg, 2008; Hope, Heimburg and Bruch, 1995; Chambless, Tran and Glass, 1997; Scholing, and Emmelkamp, 1999; Gould, Buckminster, Pollack, Otto and Yap, 2006). Accordingly, it is important to examine alternate theoretical mechanisms that may help us to more completely predict, explain, and treat social anxiety. "

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    • "Scholing and Emmelkamp, 1999) and certain personality dimensions or disorders (e.g. Scholing and Emmelkamp, 1999). Documented predictors of a less favorable outcome of drug treatment for anxiety in younger and mixed-age populations seem to be similar to some extent, including such factors as higher levels of symptom severity (Solvason et al., 2003), a longer duration of symptoms (e.g. "
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    • "Potential hypotheses may be found in related literature on predictors of response to CBT such as pretreatment symptom severity, comorbid depression, or age of onset (Cameron, Thyer, Feckner, Nesse, & Curtis, 1986; Scholing & Emmelkamp, 1999). Moreover, benzodiazepines used on an as-needed basis may exert particular influence on performance anxiety (Davidson, 2006; Stahl, 2002). "
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