From the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Va. (Rappaport); the Department of Psychology, McGill University, Montréal, Que. (Rappaport, Russel, Moskowitz); the Department of Psychiatry, McGill University, Montréal, Que. (Russel, Pinard, Bleau); and the Department of Public Health Sciences, University of Chicago, Chicago, Il. (Hedeker).
J Psychiatry Neurosci. 2018 Nov 1;43(6):407-415. doi: 10.1503/jpn.170141.
Laboratory-based research with community samples has suggested changes in affective, behavioural and cognitive processes as possible explanations for the effects of serotonergic medications. Examining the effects of serotonergic medications using an ecological momentary measure (such as event-contingent recording) in the daily lives of people with social anxiety disorder would contribute to establishing the effects of these medications on affect, behaviour and one form of cognition: perception of others’ behaviour.
The present study assessed changes in affect, interpersonal behaviour and perception of others’ behaviour in adults with social anxiety disorder using ecological momentary assessment at baseline and over 4 months of a single-arm, uncontrolled, open-label trial of treatment with the selective serotonin reuptake inhibitor paroxetine.
Anxiety and concurrent depressive symptoms decreased. Participants also reported increased positive and decreased negative affect; increased agreeable and decreased quarrelsome behaviour; increased dominant and decreased submissive behaviour; and increased perception that others behaved agreeably toward them. Moreover, participants demonstrated reduced intraindividual variability in affect, interpersonal behaviour and perception of others’ behaviour.
Limitations included the lack of a placebo group, the inability to identify the temporal order of changes and the restricted assessment of extreme behaviour.
The results of the present study demonstrate changes during pharmacotherapy in the manifestation of affect, interpersonal behaviour and interpersonal perception in the daily lives of people with social anxiety disorder. Given the importance of interpersonal processes to social anxiety disorder, these results may guide future research seeking to clarify mechanisms of action for serotonergic medications.
基于社区样本的实验室研究表明，情感、行为和认知过程的变化可能是解释 5-羟色胺能药物作用的原因。在社交焦虑障碍患者的日常生活中使用生态瞬时测量（如事件相关记录）来检查 5-羟色胺能药物的作用，将有助于确定这些药物对情绪、行为和一种认知形式（对他人行为的感知）的影响。
本研究采用生态瞬时评估，在基线和未经对照、开放标签的单臂研究中，评估了选择性 5-羟色胺再摄取抑制剂帕罗西汀治疗 4 个月期间，社交焦虑障碍成人的情绪、人际行为和对他人行为的感知变化。
焦虑和并发抑郁症状减轻。参与者还报告说积极情绪增加，消极情绪减少；友善行为增加，争吵行为减少；支配行为增加，顺从行为减少；以及认为他人对他们的行为更友善的感知增加。此外，参与者在情绪、人际行为和对他人行为的感知方面表现出个体内变异性降低。
局限性包括缺乏安慰剂组、无法确定变化的时间顺序以及对极端行为的评估受限。
本研究的结果表明，在社交焦虑障碍患者的日常生活中，药物治疗期间情绪、人际行为和人际感知的表现发生了变化。鉴于人际过程对社交焦虑障碍的重要性，这些结果可能有助于指导未来寻求阐明 5-羟色胺能药物作用机制的研究。
