Interpretation Modification Program for Social Phobia

描述（由申请人提供）：社交恐惧症的特征是严重的社交焦虑导致功能障碍（Schneider et al., 1992）。尽管患病率很高（13%,Kessler et al., 1994），超过30%需要治疗的社交焦虑症患者没有接受治疗（Olfson, et al., 2000）， 40%接受治疗的患者没有反应（39%,Heimberg, et al., 1998; 42%, Liebowitz et al., 2005）。因此，显然需要为普惠制开发高效的治疗方法。减少对社会事件的消极解释是治疗SP的有效方法，因为：1)良性解释与治疗后社交焦虑的改善有关（例如，Franklin, Huppert, Langner, Leiberg, & Foa, 2005）， 2)消极解释与SP的发病机制有关（例如，Rapee & Heimberg, 1997）， 3)与非焦虑对照组和其他焦虑障碍个体相比，SP对社会事件有更多的消极解释（例如，Amir等，1998）。4)这种偏见在治疗成功后会得到改善（例如，Stopa & Clark, 2000）。因此，改变消极解读是治疗SP的有效方法，目前的认知行为疗法采用认知重构（cognitive restructuring， CR）来针对消极解读，并以更良性的解读取而代之（Heimberg, et al., 1998）。当前应用的目标是测试一种新的SP计算机处理方法，旨在改变负面解释。我们选择了一种计算机化的干预方法，以提高效率和方便分娩。我们选择在GSP中测试这一干预措施，因为解释偏倚与这一临床人群特别相关。该项目的长期目标是利用广泛可用和经济的普惠制干预措施改善服务提供。更具体地说，我们将在本申请中检验三个假设：1)GSP个体完成口译修改计划（IMP）后，其消极口译会减少；2)IMP参与者的社交焦虑症状会减少；3)社交焦虑症状的改变会通过口译分数的变化来调节，说明口译改变减轻了社交焦虑症状。试点数据（n=34）表明这种干预是有效的。因此，我们的目标是进一步发展和验证这种高效的治疗方法，以改变对社交恐惧症患者的解释，作为一种经济有效的治疗方法。社交恐惧症的患病率很高（13%,Kessler et al., 1994），并会导致功能障碍（Schneider et al., 1992）。然而，超过30%的社交恐惧症患者没有接受治疗（Olfson, et al., 2000）， 40%接受治疗的患者没有反应（39%,Heimberg, et al., 1998; 42%, Liebowitz et al., 2005）。这个项目的目标是开发和测试一种新的计算机治疗社交恐惧症的方法。

DESCRIPTION (provided by applicant): Social phobia is characterized by severe social anxiety leading to functional impairment (Schneider et al., 1992). Despite its high prevalence (13%, Kessler et al., 1994) over 30% of individuals with social anxiety who need treatment do not receive treatment (Olfson, et al., 2000) and 40% of individuals who present for treatment do not respond (39%, Heimberg, et al., 1998; 42%, Liebowitz et al., 2005). Thus, there is a clear need to develop highly effective and efficient treatments for GSP. Reducing negative interpretation of social events is an efficacious treatment for SP because:1) benign interpretations is associated with improvement in social anxiety after treatment (e.g., Franklin, Huppert, Langner, Leiberg, & Foa, 2005), 2) negative interpretations are implicated in the pathogenesis of SP (e.g., Rapee & Heimberg, 1997), 3) SPs have more negative interpretations of social events than non-anxious controls and individuals with other anxiety disorders (e.g., Amir et al, 1998), and 4) this bias ameliorates after successful treatment (e.g., Stopa & Clark, 2000). Therefore, changing negative interpretations is an efficacious treatment for SP, and current cognitive- behavioral therapies use cognitive restructuring (CR) to target negative interpretations and replace them with more benign interpretations (Heimberg, et al., 1998). The goal of the current application is to test a new computerized treatment for SP that is designed to change negative interpretations. We chose a computerized intervention to increase efficiency and ease of delivery. We chose to test this intervention in GSP because interpretation bias is especially relevant to this clinical population. The long-term goal of this project is to improve service delivery using a widely available and economical intervention for GSP. More specifically, we will test three hypotheses in this application: 1) Individuals with GSP completing the Interpretation Modification Program (IMP) will show a reduction in their negative interpretation, 2) Participants in the IMP will show a decrease in their social anxiety symptoms, 3) Change in social anxiety symptoms will be mediated by the change in interpretation scores, suggesting that interpretation change reduced social anxiety symptoms. Pilot data (n=34) suggest that this intervention is efficacious. Thus, we aim to develop further and validate this highly efficient treatment for changing interpretations as a cost-effective treatment for patients with social phobia. Social phobia has high prevalence (13%, Kessler et al., 1994) and leads to functional impairment (Schneider et al., 1992). However, over 30% of individuals with social phobia do not receive treatment (Olfson, et al., 2000) and 40% of individuals who present for treatment do not respond (39%, Heimberg, et al., 1998; 42%, Liebowitz et al., 2005). The goal of this project is develop and test a new computerized treatment for social phobia.