Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychology, University of Milan-Bicocca, Milan, Italy.
J Affect Disord. 2022 Aug 1;310:174-182. doi: 10.1016/j.jad.2022.05.008. Epub 2022 May 7.
Social Anxiety Disorder (SAD) or Social Phobia is characterized by fear and anxiety of social circumstances that negatively impact an individual's occupational and relational life. There are several treatment options for this disorder ranging from pharmacological therapy to psychotherapies. In particular, the Acceptance and Commitment Therapy (ACT), a form of cognitive-behavioral therapy that practices acceptance and awareness strategies with behavior change strategies in order to increase an individual's mental flexibility, has been found to be effective. In this review, we aimed to provide an overview of recent studies that examined ACT's efficacy in SAD, also taking into consideration the comparison with traditional Cognitive-behavioral Therapy (CBT) interventions.
A bibliographic search on PubMed, EMBASE and Scopus was conducted from inception to the 3rd of February 2022 of all studies investigating the effect of ACT in SAD individuals without any comorbidity. Among the articles retrieved, 11 met the inclusion criteria.
From the reviewed studies, ACT may be considered a promising treatment of social phobia by improving attentional bias, awareness, emotion regulation, and safety/avoidance behaviors; however, the results have not yet demonstrated a valid alternative to the CBT.
Only four studies considered a follow-up evaluation, which is paramount to exploring the effectiveness of ACT and several studies have a very small sample size. Concerning the review itself we only considered original English articles and we did not measure the risk of publication bias and the risk of bias between studies.
The results of this study suggest that ACT can be a promising treatment for improving selective psychological problems often observed in SAD. However, larger longitudinal studies further exploring the effectiveness of the behavioral and cognitive "third-wave" psychotherapies, based mainly on acceptance of SAD, are necessary.
社交焦虑障碍（SAD）或社交恐惧症的特征是对社交环境的恐惧和焦虑，这会对个人的职业和人际关系生活产生负面影响。这种障碍有几种治疗选择，从药物治疗到心理治疗都有。特别是，接受与承诺疗法（ACT），一种认知行为疗法，它结合了接受和意识策略以及行为改变策略，以提高个体的心理灵活性，已被证明是有效的。在这篇综述中，我们旨在提供对最近研究的概述，这些研究检查了 ACT 在 SAD 中的疗效，同时也考虑了与传统认知行为疗法（CBT）干预的比较。
从开始到 2022 年 2 月 3 日，我们在 PubMed、EMBASE 和 Scopus 上进行了文献检索，检索所有研究 ACT 对无共病 SAD 个体影响的研究。在检索到的文章中，有 11 篇符合纳入标准。
从综述研究中可以看出，ACT 通过改善注意力偏向、意识、情绪调节和安全/回避行为，可能被认为是一种治疗社交恐惧症的有前途的方法；然而，结果尚未证明 ACT 是 CBT 的有效替代方法。
只有四项研究考虑了随访评估，这对于探索 ACT 的有效性至关重要，而且几项研究的样本量非常小。关于综述本身，我们只考虑了原始的英文文章，我们没有衡量发表偏倚的风险和研究之间的偏倚风险。
这项研究的结果表明，ACT 可能是改善 SAD 中经常观察到的选择性心理问题的一种有前途的治疗方法。然而，需要进一步探索以接受 SAD 为基础的行为和认知“第三波”心理治疗的有效性的更大的纵向研究。
