Carlton Corinne N, Sullivan-Toole Holly, Strege Marlene V, Ollendick Thomas H, Richey John A
Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States.
Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States.
Front Psychol. 2020 Jul 22;11:1783. doi: 10.3389/fpsyg.2020.01783. eCollection 2020.
Social anxiety disorder (SAD) is a debilitating and often chronic psychiatric disorder that typically onsets during early adolescence. Cognitive behavior therapy (CBT), the current "gold-standard" treatment for SAD, tends to focus on threat- and fear-based systems hypothesized to maintain the disorder. Despite this targeted approach, SAD ranks among the least responsive anxiety disorders to CBT in adolescent samples, with a considerable proportion of individuals still reporting clinically significant symptoms following treatment, suggesting that the CBT-family of interventions may not fully target precipitating or maintaining factors of the disorder. This gap in efficacy highlights the need to consider new therapeutic modalities. Accordingly, this brief review critically evaluates the emergent literature supporting the use of mindfulness-based interventions (MBIs) for treating adolescent SAD. MBIs may be particularly relevant for addressing maintaining factors within this diagnosis, as they may target and interrupt cycles of avoidance and de-motivation. Despite limitations in the relative lack of randomized controlled trials (RCTs) on this topic, a unique convergence of factors emerge from the extant literature that support the notion that MBIs may hold particular promise for attenuating symptoms of SAD in adolescents. These factors include: (1) MBIs demonstrate the ability to directly engage symptoms of SAD; (2) MBIs also show consistent reduction of anxiety, including symptoms of social anxiety in adolescent populations; and (3) MBIs demonstrate high rates of feasibility and acceptability in anxious adolescent samples. We briefly review each topic and conclude that MBIs are an encouraging treatment approach for reducing symptoms of social anxiety in adolescents. However, given the lack of research within MBIs for adolescent SAD in particular, more research is needed to determine if MBIs are more advantageous than other current treatment approaches.
社交焦虑障碍(SAD)是一种使人衰弱且通常为慢性的精神障碍,通常在青春期早期发病。认知行为疗法(CBT)是目前治疗SAD的“金标准”,倾向于关注那些被认为维持该障碍的基于威胁和恐惧的系统。尽管采用了这种有针对性的方法,但在青少年样本中,SAD是对CBT反应最差的焦虑障碍之一,相当一部分个体在治疗后仍报告有临床显著症状,这表明CBT系列干预措施可能未完全针对该障碍的促发或维持因素。这种疗效差距凸显了考虑新治疗方式的必要性。因此,本简要综述批判性地评估了支持使用基于正念的干预措施(MBIs)治疗青少年SAD的新兴文献。MBIs可能与解决该诊断中的维持因素特别相关,因为它们可能针对并打断回避和动力不足的循环。尽管关于这一主题的随机对照试验(RCTs)相对缺乏存在局限性,但现有文献中出现了一系列独特的因素,支持MBIs可能对减轻青少年SAD症状特别有前景这一观点。这些因素包括:(1)MBIs显示出直接针对SAD症状的能力;(2)MBIs还显示出焦虑持续减少,包括青少年群体中的社交焦虑症状;(3)MBIs在焦虑青少年样本中显示出高可行性和可接受性。我们简要回顾了每个主题,并得出结论,MBIs是减轻青少年社交焦虑症状的一种令人鼓舞的治疗方法。然而,鉴于特别是在MBIs治疗青少年SAD方面缺乏研究,需要更多研究来确定MBIs是否比其他当前治疗方法更具优势。