Brettschneider Mona, Neumann Pauline, Berger Thomas, Renneberg Babette, Boettcher Johanna
Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstr. 8, 3012, Bern, Switzerland.
J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt A):21-9. doi: 10.1016/j.jbtep.2015.04.008. Epub 2015 May 12.
The biased interpretation of ambiguous social situations is considered a maintaining factor of Social Anxiety Disorder (SAD). Studies on the modification of interpretation bias have shown promising results in laboratory settings. The present study aims at pilot-testing an Internet-based training that targets interpretation and judgmental bias.
Thirty-nine individuals meeting diagnostic criteria for SAD participated in an 8-week, unguided program. Participants were presented with ambiguous social situations, were asked to choose between neutral, positive, and negative interpretations, and were required to evaluate costs of potential negative outcomes. Participants received elaborate automated feedback on their interpretations and judgments.
There was a pre-to-post-reduction of the targeted cognitive processing biases (d = 0.57-0.77) and of social anxiety symptoms (d = 0.87). Furthermore, results showed changes in depression and general psychopathology (d = 0.47-0.75). Decreases in cognitive biases and symptom changes did not correlate. The results held stable accounting for drop-outs (26%) and over a 6-week follow-up period. Forty-five percent of the completer sample showed clinical significant change and almost half of the participants (48%) no longer met diagnostic criteria for SAD.
As the study lacks a control group, results lend only preliminary support to the efficacy of the intervention. Furthermore, the mechanism of change remained unclear.
First results promise a beneficial effect of the program for SAD patients. The treatment proved to be feasible and acceptable. Future research should evaluate the intervention in a randomized-controlled setting.
对模糊社会情境的偏差解读被认为是社交焦虑障碍（SAD）的一个维持因素。关于解读偏差修正的研究在实验室环境中已显示出有前景的结果。本研究旨在对一项针对解读和判断偏差的基于互联网的训练进行初步测试。
39名符合SAD诊断标准的个体参加了一个为期8周的无指导项目。向参与者呈现模糊的社会情境，要求他们在中性、积极和消极解读之间进行选择，并评估潜在负面结果的代价。参与者会收到关于他们的解读和判断的详细自动反馈。
目标认知加工偏差（d = 0.57 - 0.77）和社交焦虑症状（d = 0.87）从训练前到训练后有所减少。此外，结果显示抑郁和一般精神病理学方面有变化（d = 0.47 - 0.75）。认知偏差的减少与症状变化不相关。考虑到退出者（26%）以及在6周的随访期内，结果保持稳定。45%的完成样本显示出临床显著变化，几乎一半的参与者（48%）不再符合SAD的诊断标准。
由于该研究缺乏对照组，结果仅为干预效果提供了初步支持。此外，变化机制仍不清楚。
初步结果表明该项目对SAD患者有有益效果。该治疗被证明是可行且可接受的。未来研究应在随机对照环境中评估该干预措施。
