Ponniah K, Hollon S D
New York State Psychiatric Institute, New York and Department of Psychiatry, Columbia University, New York, NY, USA.
Psychol Med. 2008 Jan;38(1):3-14. doi: 10.1017/S0033291707000918. Epub 2007 Jul 20.
Social phobia is a chronic disorder that results in substantial impairment. We conducted a qualitative review of randomized controlled trials (RCTs) of psychological interventions for social phobia.
Articles were identified through searches of electronic databases and manual searches of reference lists. They were classified by psychological interventions evaluated. Data regarding treatment, participants and results were then extracted and tabulated. We identified which psychological interventions are empirically supported, using the scheme proposed by Chambless & Hollon (Journal of Consulting and Clinical Psychology 1998, 66, 7-18).
Thirty studies evaluating the efficacy of social skills training (SST), exposure therapy and/or cognitive treatments were identified. Cognitive behavior therapy (CBT), involving cognitive restructuring and exposure to feared and avoided social situations or behavioral experiments, was found to be an efficacious and specific treatment for social phobia. Exposure therapy was found to be an efficacious treatment since most of the evidence of its efficacy was from comparisons with no treatment. There were mixed findings regarding the relative efficacy of CBT and in vivo exposure. Some studies reported that the interventions were equivalent, while others found that patients treated with CBT had a better outcome. There was little evidence to support the use of SST.
CBT is the psychological intervention of choice for social phobia. The findings of this review are compared to those of other major reviews and limitations are discussed.
社交恐惧症是一种导致严重功能障碍的慢性疾病。我们对社交恐惧症心理干预的随机对照试验（RCT）进行了定性综述。
通过电子数据库检索和参考文献列表手动检索来识别文章。根据所评估的心理干预进行分类。然后提取并列表有关治疗、参与者和结果的数据。我们使用Chambless和Hollon（《咨询与临床心理学杂志》1998年，66卷，7 - 18页）提出的方案，确定哪些心理干预得到了实证支持。
共识别出30项评估社交技能训练（SST）、暴露疗法和/或认知治疗疗效的研究。认知行为疗法（CBT），包括认知重构以及暴露于恐惧和回避的社交情境或行为实验，被发现是社交恐惧症的一种有效且特定的治疗方法。暴露疗法被发现是一种有效的治疗方法，因为其疗效的大部分证据来自与无治疗的比较。关于CBT和现场暴露的相对疗效存在不同的研究结果。一些研究报告称这些干预措施等效，而另一些研究发现接受CBT治疗的患者有更好的结果。几乎没有证据支持使用SST。
CBT是社交恐惧症心理干预的首选方法。将本综述的结果与其他主要综述的结果进行了比较，并讨论了局限性。
