Lobjoie C, Pélissolo A
Service de psychiatrie adultes, GH Pitié-Salpêtrière, Paris, France.
Encephale. 2012 Sep;38(4):345-50. doi: 10.1016/j.encep.2012.01.011. Epub 2012 Feb 28.
Cognitive behavioral therapy (CBT) has shown to be effective in the treatment of social anxiety disorders (SAD). However, fear of social blushing is almost never measured as a therapeutic outcome variable, even though some data suggest that this dimension constitutes a specific syndrome in social anxiety spectrum, justifying specific therapeutic strategies. For these reasons, we developed a group therapy program including a combination of task concentration training (TCT) and other CBT strategies targeting fear of blushing.
We aimed to investigate the efficacy of this program in an open trial conducted in 55 patients suffering from SAD (Diagnostic and statistical manual of mental disorders IV criteria) with fear of blushing.
Throughout a program including eleven weekly sessions, systematic measurements of fear of blushing and other anxiety and personality dimensions were performed at inclusion, at the end of the therapy and 3 months later, in order to explore the therapeutic effects of the program on fear of blushing, social anxiety, and other dimensions (Liebowitz social anxiety scale, blushing propensity questionnaire, Rathus assertiveness scale, Rosenberg self-esteem scale, Hospital anxiety and depression scale, Sheehan disability scale). The statistical analyses compared the scores of all measurements at inclusion, at the end of the therapy, and 6 months later. We also calculated the effect size obtained after treatment, and performed a logistic regression to determine the factors associated with a remission of fear of blushing after therapy.
The main outcome criterion - the Salpêtrière fear of blushing questionnaire (SFBQ) score - was significantly reduced after treatment (P<0.001) and remained stable at follow up. A satisfying effect size was obtained on this score after treatment (1.7), and 57.6% of subjects were considered in remission on the basis of a SFBQ score of 6 or less. Other measurements of blushing propensity, social anxiety, assertiveness, self-esteem, anxiety, depression and disability showed significant improvement after treatment and reductions remained stable at 3-month follow-up. To be a female and to have a low SFBQ score at inclusion appeared as two independent predictors of good improvement.
Despite the preliminary nature of this study, our results suggest the efficacy of this specific group therapy program for erythrophobia. Further controlled and comparative trials are now required to confirm the program efficacy including a comparison between group and individual therapies.
认知行为疗法（CBT）已被证明在治疗社交焦虑障碍（SAD）方面有效。然而，尽管一些数据表明社交脸红恐惧这一维度构成社交焦虑谱系中的一种特定综合征，从而证明了特定治疗策略的合理性，但社交脸红恐惧几乎从未被作为治疗结果变量进行测量。基于这些原因，我们制定了一个团体治疗方案，该方案结合了任务集中训练（TCT）和其他针对脸红恐惧的CBT策略。
我们旨在通过一项针对55名患有社交焦虑障碍（符合《精神疾病诊断与统计手册》第四版标准）且有脸红恐惧的患者进行的开放性试验，来研究该方案的疗效。
在一个为期十一周的方案中，于入组时、治疗结束时以及三个月后，对脸红恐惧以及其他焦虑和人格维度进行系统测量，以探究该方案对脸红恐惧、社交焦虑及其他维度（利博维茨社交焦虑量表、脸红倾向问卷、拉瑟斯自信量表、罗森伯格自尊量表、医院焦虑抑郁量表、希恩功能障碍量表）的治疗效果。统计分析比较了入组时、治疗结束时以及六个月后的所有测量得分。我们还计算了治疗后获得的效应量，并进行了逻辑回归分析，以确定与治疗后脸红恐惧缓解相关的因素。
主要结局指标——萨尔佩特里埃脸红恐惧问卷（SFBQ）得分——在治疗后显著降低（P<0.001），且在随访时保持稳定。治疗后该得分获得了令人满意的效应量（1.7），并且基于SFBQ得分6分及以下，57.6%的受试者被认为已缓解。脸红倾向、社交焦虑、自信、自尊、焦虑、抑郁和功能障碍的其他测量指标在治疗后均显示出显著改善，且在三个月随访时降低程度保持稳定。女性以及入组时SFBQ得分较低似乎是改善良好的两个独立预测因素。
尽管本研究具有初步性质，但我们的结果表明这种特定的团体治疗方案对恐红症有效。现在需要进一步的对照和比较试验来证实该方案的疗效，包括团体治疗与个体治疗之间的比较。
