Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Frankfurt, Varrentrappstr. 40-42, 60486, Frankfurt, Germany.
Curr Psychiatry Rep. 2016 Mar;18(3):25. doi: 10.1007/s11920-016-0667-4.
Social anxiety disorder (SAD) is a highly prevalent and chronic disorder that causes considerable psychosocial impairment. This article reviews recent changes in the definition of SAD in DSM-5 and summarizes the current evidence for effective cognitive-behavioral treatments in adults, children, and adolescents. Current data suggests that cognitive-behavioral therapy (CBT) is efficacious in the treatment of this condition. Among different CBT approaches, individual cognitive therapy may be associated with the largest effect sizes. In this review, interventions targeting dysfunctional cognitive processes that contribute to the effective treatment of SAD are discussed. Some recent findings from neuroimaging research and studies on the augmentation of CBT using neuroenhancers indicate that changes in emotion regulation as well as fear extinction are important psychological mediators of positive outcome. Furthermore, internet-delivered CBT is a promising field of technological innovation that may improve access to effective treatments. Despite the availability of effective treatments, treatment-resistant SAD remains a common problem in clinical practice that requires more research efforts. Finally, potential areas for further development of CBT as well as its dissemination in health care are summarized.
社交焦虑障碍（SAD）是一种高发且慢性的障碍，会导致相当大的社会心理损伤。本文综述了 DSM-5 中 SAD 定义的最新变化，并总结了目前针对成人、儿童和青少年的有效认知行为治疗的证据。目前的数据表明，认知行为疗法（CBT）对这种疾病的治疗是有效的。在不同的 CBT 方法中，个体认知疗法可能与最大的效应量相关。在这篇综述中，讨论了针对导致 SAD 有效治疗的功能失调认知过程的干预措施。神经影像学研究的一些最新发现以及使用神经增强剂增强 CBT 的研究表明，情绪调节和恐惧消退的变化是积极结果的重要心理中介。此外，基于互联网的 CBT 是技术创新的一个很有前途的领域，它可能会改善获得有效治疗的机会。尽管有有效的治疗方法，但在临床实践中，治疗抵抗性 SAD 仍然是一个常见的问题，需要更多的研究努力。最后，总结了 CBT 进一步发展的潜在领域及其在医疗保健中的传播。
