Interpretation Modification Program for Social Phobia

描述（由申请人提供）：社交恐怖症的特征在于导致功能障碍的严重社交焦虑（Schneider等人，1992年）。尽管其患病率很高（13%，Kessler等人，1994）超过30%的需要治疗的社交焦虑个体没有接受治疗（Olfson，et al.，2000）和40%的接受治疗的个体没有反应（39%，Heimberg等人，1998; 42%，Liebowitz等人，2005年）的报告。因此，显然需要为普惠制制定高效和高效率的处理办法。减少对社交事件的负面解读是对SP的有效治疗，因为：1）良性解读与治疗后社交焦虑的改善相关（例如，富兰克林，Huppert，Langner，Leiberg，& Foa，2005），2）阴性解释与SP的发病机制有关（例如，Rapee & Heimberg，1997），3）SP比非焦虑对照组和患有其他焦虑障碍的个体（例如，Amir等，1998），和4）这种偏差在成功治疗后改善（例如，Stopa & Clark，2000）。因此，改变负面解释是SP的有效治疗，并且当前的认知行为疗法使用认知重构（CR）来靶向负面解释并且用更良性的解释替换它们（Heimberg，et al.，1998年）。当前应用的目标是测试一种新的SP计算机化治疗方法，旨在改变阴性解释。我们选择了计算机化干预，以提高效率和方便交付。我们选择在GSP中测试这种干预，因为解释偏倚与该临床人群特别相关。该项目的长期目标是利用广泛提供的经济的普惠制干预措施改善服务的提供。更具体地说，我们将在本申请中测试三个假设：1）完成解释修改程序（IMP）的具有GSP的个体将显示其负面解释的减少，2）IMP中的参与者将显示其社交焦虑症状的减少，3）社交焦虑症状的变化将由解释分数的变化介导，这表明翻译的改变减少了社交焦虑症状。初步数据（n=34）表明，这种干预是有效的。因此，我们的目标是进一步开发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，作为一种具有成本效益的治疗。社交恐惧症的患病率很高（13%，Kessler等人，1994）并导致功能障碍（Schneider等，1992年）。然而，超过30%的社交恐惧症患者没有接受治疗（Olfson等人，2000）和40%的接受治疗的个体没有反应（39%，Heimberg等人，1998; 42%，Liebowitz等人，2005年）。这个项目的目标是开发和测试一种新的计算机化治疗社交恐惧症。

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.