Garke Maria Å, Hentati Isacsson Nils, Kolbeinsson Örn, Hesser Hugo, Månsson Kristoffer N T
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm 171 77, Sweden.
Department of Behavioural Sciences and Learning, Linköping University, Linkoping 581 83, Sweden.
Cogn Behav Ther. 2025 Jan;54(1):78-95. doi: 10.1080/16506073.2024.2373784. Epub 2024 Jul 10.
Individuals with social anxiety disorder (SAD) experience overall emotion regulation difficulties, but less is known about the long-term role of such difficulties in cognitive behavior therapy (CBT) for SAD. Forty-six patients with SAD receiving internet-delivered CBT, and matched healthy controls (HCs; = 39), self-reported the Difficulties in Emotion Regulation Scale (DERS), Liebowitz Social Anxiety Scale (LSAS-SR), and participated in anticipatory speech anxiety behavioral experiments. Patients were measured at seven time points before, during and after CBT over a total period of 28 months, and HCs at two timepoints. Disaggregated growth curve models with a total of 263 observations were used, as well as intra-class correlation coefficients and regression models. Patients' LSAS-SR and DERS ratings were reliable (ICC = .83 and .75 respectively), and patients, relative to controls, showed larger difficulties in emotion regulation at pre-treatment ( < .001). During CBT, within-individual improvements in emotion regulation significantly predicted later LSAS-SR reductions ( = .041, pseudo- = 43%). Changes in emotion regulation may thus be important to monitor on an individual level and may be used to improve outcomes in future developments of internet-delivered CBT.
社交焦虑障碍（SAD）患者存在整体情绪调节困难，但对于这些困难在SAD的认知行为疗法（CBT）中的长期作用，人们了解较少。46名接受互联网交付的CBT的SAD患者以及匹配的健康对照者（HCs；n = 39），自我报告了情绪调节困难量表（DERS）、利博维茨社交焦虑量表（LSAS-SR），并参与了预期性言语焦虑行为实验。患者在CBT治疗前、治疗期间和治疗后的7个时间点进行测量，为期28个月，HCs在2个时间点进行测量。使用了共有263个观察值的分解增长曲线模型，以及组内相关系数和回归模型。患者的LSAS-SR和DERS评分是可靠的（ICC分别为0.83和0.75），并且与对照组相比，患者在治疗前的情绪调节困难更大（p < 0.001）。在CBT治疗期间，个体情绪调节的改善显著预测了后期LSAS-SR的降低（p = 0.041，伪R² = 43%）。因此，情绪调节的变化可能在个体层面上进行监测很重要，并且可用于改善未来互联网交付的CBT的疗效。
