McCall Hugh Cameron, Helgadottir Fjola Dogg, Menzies Ross G, Hadjistavropoulos Heather D, Chen Frances S
Department of Psychology, University of Regina, Regina, SK, Canada.
AI-Therapy, North Vancouver, BC, Canada.
J Med Internet Res. 2019 Jan 10;21(1):e11566. doi: 10.2196/11566.
Social anxiety is both harmful and prevalent. It also currently remains among the most undertreated major mental disorders, due, in part, to socially anxious individuals' concerns about the stigma and expense of seeking help. The privacy and affordability of computer-aided psychotherapy interventions may render them particularly helpful in addressing these concerns, and they are also highly scalable, but most tend to be only somewhat effective without therapist support. However, a recent evaluation of a new self-guided, 7-module internet-delivered cognitive behavioral therapy intervention called Overcome Social Anxiety found that it was highly effective.
The initial evaluation of Overcome Social Anxiety revealed that it led to significant reductions in symptom severity among university undergraduates. The aim of this study was to extend the results of the initial study and investigate their generalizability by directly evaluating the intervention's effectiveness among a general community sample.
While signing up for Overcome Social Anxiety, users consented to the usage of their anonymized outcome data for research purposes. Before and after completing the intervention, users completed the Fear of Negative Evaluation Scale (FNE), which we employed as the primary outcome measure. Secondary outcome measures included the Depression Anxiety Stress Scales (DASS) and 2 bespoke questionnaires measuring socially anxious thoughts (Thoughts Questionnaire) and avoidance behaviors (Avoidance Questionnaire).
Participants who completed the intervention (102/369, 27.7%) experienced significant reductions in the severity of their symptoms on all measures employed, including FNE (P<.001; Cohen d=1.76), the depression subscale of DASS (P<.001; Cohen d=0.70), the anxiety subscale of DASS (P<.001; Cohen d=0.74), the stress subscale of DASS (P<.001; Cohen d=0.80), the Thoughts Questionnaire (P<.001; Cohen d=1.46), and the Avoidance Questionnaire (P<.001; Cohen d=1.42).
Our results provide further evidence that Overcome Social Anxiety reduces the severity of social anxiety symptoms among those who complete it and suggest that its effectiveness extends to the general community. The completion rate is the highest documented for a fully automated intervention for anxiety, depression, or low mood in a real community sample. In addition, our results indicate that Overcome Social Anxiety reduces the severity of symptoms of depression, physiological symptoms of anxiety, and stress in addition to symptoms of social anxiety.
社交焦虑既有害又普遍。目前，它仍是治疗最不足的主要精神障碍之一，部分原因是社交焦虑个体担心寻求帮助会带来污名化和费用问题。计算机辅助心理治疗干预的隐私性和可承受性可能使其在解决这些问题方面特别有帮助，而且它们还具有高度可扩展性，但大多数在没有治疗师支持的情况下往往效果有限。然而，最近对一种名为“克服社交焦虑”的新型自我引导式、7模块互联网认知行为疗法干预进行的评估发现，它非常有效。
对“克服社交焦虑”的初步评估表明，它能显著降低大学本科生的症状严重程度。本研究的目的是扩展初步研究的结果，并通过直接评估该干预在普通社区样本中的有效性来调查其普遍性。
在注册“克服社交焦虑”时，用户同意将其匿名化的结果数据用于研究目的。在完成干预前后，用户完成了消极评价恐惧量表（FNE），我们将其用作主要结果指标。次要结果指标包括抑郁焦虑压力量表（DASS）以及2份定制问卷，分别测量社交焦虑思维（思维问卷）和回避行为（回避问卷）。
完成干预的参与者（102/369，27.7%）在所有使用的测量指标上症状严重程度均显著降低，包括FNE（P<.001；Cohen d=1.76）、DASS抑郁分量表（P<.001；Cohen d=0.70）、DASS焦虑分量表（P<.001；Cohen d=0.74）、DASS压力分量表（P<.001；Cohen d=0.80）、思维问卷（P<.001；Cohen d=1.46）和回避问卷（P<.001；Cohen d=1.42）。
我们的结果进一步证明，“克服社交焦虑”能降低完成该干预者的社交焦虑症状严重程度，并表明其有效性扩展到了普通社区。在真实社区样本中，对于焦虑、抑郁或情绪低落的全自动干预，该完成率是有记录以来最高的。此外，我们的结果表明，“克服社交焦虑”除了能减轻社交焦虑症状外，还能减轻抑郁症状、焦虑的生理症状和压力。
