Predictors of response to cognitive-behavioral group therapy for social phobia.

Response to cognitive-behavioral group therapy for social phobia was assessed at posttest and 6-month follow-up in a sample of 62 clients (41 generalized subtype, 21 nongeneralized). Predictors assessed were depression, expectancy, personality disorder traits, clinician-rated breadth and severity of impairment, and frequency of negative thoughts during social interactions. Outcome measures included self-report questionnaires and behavioral tests of dyadic interaction and a public speech. Although no predictor was related to outcome across all domains of measurement, higher depression, more avoidant personality traits, and lower treatment expectancy were each related to poorer treatment response on one or more outcome criteria. Cognitive change was consistently associated with change on self-report symptom measures, but, contrary to expectation, lower rates of negative thinking at posttest did not predict better maintenance of treatment gains at follow-up.

[1]  G. Steketee,et al.  Predicting behavioral treatment outcome for agoraphobia and obsessive compulsive disorder , 1995 .

[2]  R. Bootzin,et al.  Expectancy factors in the treatment of fear: methodological and theoretical issues. , 1975, Psychological bulletin.

[3]  P. Sweeney,et al.  Attributional style in depression: a meta-analytic review. , 1986, Journal of personality and social psychology.

[4]  A. Bergin,et al.  The effectiveness of psychotherapy. , 1994 .

[5]  Robert A. Taylor,et al.  Induced mood and accessibility of memories: An effect of mood state or of induction procedure? , 1981 .

[6]  C. R. Glass,et al.  Self-focused attention in the treatment of social phobia. , 1997, Behaviour research and therapy.

[7]  R. Heimberg,et al.  Social phobia subtype and avoidant personality disorder: Effect on severity of social phobia, impairment, and outcome of cognitive behavioral treatment , 1995 .

[8]  Cognitive approaches to the psychopathology and treatment of social phobia. , 1996 .

[9]  Philip H. Dubois,et al.  Correlational Methods in Research on Human Learning , 1962 .

[10]  B. Renneberg,et al.  Avoidant Personality Disorder as a Predictor for Treatment Outcome among Generalized Social Phobics , 1996 .

[11]  D. Chambless,et al.  Psychopathology of social phobia: Effects of subtype and of avoidant personality disorder , 1995 .

[12]  L. Horowitz,et al.  On averaging judges' ratings to increase their correlation with an external criterion. , 1979, Journal of consulting and clinical psychology.

[13]  Paul M. Salkovskis,et al.  Frontiers of Cognitive Therapy , 1997 .

[14]  P. Salkovskis,et al.  A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder , 1994, British Journal of Psychiatry.

[15]  B. Renneberg,et al.  MCMI-diagnosed personality disorders among agoraphobic outpatients: Prevalence and relationship to severity and treatment outcome , 1992 .

[16]  W. W. Muir,et al.  Regression Diagnostics: Identifying Influential Data and Sources of Collinearity , 1980 .

[17]  M. Drake.  Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) , 1988 .

[18]  I. Kirsch,et al.  Extinction versus credibility in the desensitization of speech anxiety. , 1977, Journal of consulting and clinical psychology.

[19]  U. Feske,et al.  Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis , 1995 .

[20]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[21]  Michel Hersen,et al.  Dictionary of behavioral assessment techniques , 1988 .

[22]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[23]  Gail Steketee,et al.  Methodological issues in prediction of treatment outcome. , 1992 .

[24]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[25]  B. Renneberg,et al.  The Structured Clinical Interview for DSM-III-R, Axis II and the Millon Clinical Multiaxial Inventory: A Concurrent Validity Study of Personality Disorders Among Anxious Outpatients , 1992 .

[26]  R. Heimberg,et al.  DSM-III-R Subtypes of Social Phobia: Comparison of Generalized Social Phobics and Public Speaking Phobics , 1990, The Journal of nervous and mental disease.

[27]  I. Kirsch,et al.  Self-desensitization and meditation in the reduction of public speaking anxiety. , 1979, Journal of consulting and clinical psychology.

[28]  P. Emmelkamp,et al.  Effects of historically portrayed modeling and group treatment on self-observation: a comparison with agoraphobics. , 1975, Behaviour research and therapy.

[29]  M. Franklin.  Social phobia : diagnosis, assessment, and treatment , 1996 .

[30]  A. J. Conger,et al.  It May Not Be Worth the Effort! , 1983, Behavior modification.

[31]  D. Clark,et al.  Cognitive processes in social phobia. , 1993, Behaviour research and therapy.

[32]  I. Marks,et al.  Physiological habituation to continuous phobic stimulation. , 1972, Behaviour research and therapy.

[33]  D. Chambless,et al.  Adherence during sessions and homework in cognitive-behavioral group treatment of social phobia. , 1995, Behaviour research and therapy.

[34]  G. Butler.  Predicting outcome after treatment for generalised anxiety disorder. , 1993, Behaviour research and therapy.

[35]  J. Mattia,et al.  The revised Stroop color-naming task in social phobics. , 1993, Behaviour research and therapy.

[36]  Theodore Millon,et al.  Millon Clinical Multiaxial Inventory manual , 1983 .

[37]  I. Gotlib,et al.  Psychological-aspects of depression-toward a cognitive-interpersonal integration (vol 7, pg 141, 1993) , 1992 .

[38]  A. Kazdin,et al.  The impact of variations in treatment rationales on expectancies for therapeutic change , 1983 .

[39]  Deborah C. Beidel,et al.  Assessment of social phobia: Reliability of an impromptu speech task , 1989 .

[40]  J. Frank.  Persuasion and healing , 1961 .

[41]  G. Styan,et al.  Relationship of social phobia with other psychiatric illness. , 1991, Journal of affective disorders.

[42]  T. Borkovec,et al.  Credibility of analogue therapy rationales , 1972 .

[43]  R. Friend,et al.  Measurement of social-evaluative anxiety. , 1969, Journal of consulting and clinical psychology.

[44]  M. Seligman,et al.  The effectiveness of psychotherapy. The Consumer Reports study. , 1995, The American psychologist.