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KMID : 0981220130130020211
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Congnitive Behavior Therapy in Korea
2013 Volume.13 No. 2 p.211 ~ p.234
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The Efficacy of Cognitive Behavior Therapy for Social Anxiety Disorder: Changes in the Attentional Bias and the Implicit Self-Esteem
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Yoon Hyae-Young
Kwon Jung-Hye
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Abstract
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The purpose of this study was to examine whether cognitive behavioral therapy (CBT) would result in correcting biases in both the implicit/automatic information processing level (bottom-up process) and the volitional/controlled information processing level (top-down process). The participants consisted of forty-nine patients diagnosed with Social Anixety Disorder according to their responses on the SCID-I. Thirty patients participated in twelve session CBT group and nineteen patients were assigned to the control group. The Implicit Association Test (IAT, Greenwald, McGhee, & Schwartz, 1998) assessing self schema, and Emotional Face Dot Probe Task (MacLoed, Mathews, & Tara, 1986) assessing selective attentional bias, were administered to both groups prior to and after treatment. Participants also completed the social anxiety measures (i.e., SDAS, B-FNE, SIAS, SPS and SISST), the other emotional measures (i.e. BDI, BAI) prior to and after treatment. In order to objectively assess the severity of the symptoms, an independent assessor interviewed the participants via a semi-structured interview scale, Brief Social Phobia Scale (BSPS; Davidson et al., 1991) prior to and after treatment. The patients were treated for twelve weeks in a group therapy with one booster week after three months of treatment completion. The treatment protocol was based on Heimberg’s CBGT for social anxiety disorder (1991). Results were as follows; (1) At the post-treatment assessment, patients who received CBT had improved significantly more than control group patients on self-report measures and independent assessor ratings. The effect sizes ranged from -.56 to 1.71 (mean=1.09). These positive gains after treatment were maintained for three month follow-up. (2) Selective attentional bias for angry facial expressions (subliminal threshold 80msec presenting) has not changed over the course of CBT. (3) In treatment group, response rates to associate the ’self and positive words’ were improved after CBT. It means that the deeper level of implicit self-knowledge changed over the course of CBT for social anxiety disorder through the cognitive-behavioral therapeutic interventions such as the repetitive reappraisal about the circumstances, the exposure to threatening situations, behavioral experiments.
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KEYWORD
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social anxiety disorder, cognitive vulnerability, attentional bias, implicit self-esteem, CBT efficacy
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