Information Processing Training for Social Phobia in Primary Care

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DESCRIPTION (provided by applicant): Social Phobia (SP) ranks second in prevalence among all psychiatric disorders and is associated with significant impairment. Anxiety disorder patients are more likely to seek treatment from general medical physicians than mental health specialists. However, less than one third of primary care patients with anxiety disorders receive appropriate care. Of those who do receive treatment, many patients do not respond. Computerized information processing training is a promising intervention for anxiety disorders that is firmly based in cognitive theory and empirical findings. Computerized information processing training procedures directly target attention and interpretation biases associated with SP. These procedures may improve the cost-effectiveness and accessibility of psychological treatments for anxiety disorders. The long-term goal of this line of research is to translate findings from basic psychopathology research into innovative treatments that are acceptable and easily disseminated in real world settings. The second long-term objective is to develop empirically based treatments for primary care populations with anxiety disorders. The specific aims of the study are to determine the acceptability, feasibility, and preliminary efficacy of information processing training in a primary care setting by comparing an innovative intervention, Attention and Interpretation Modification (AIM), to a placebo condition. Acceptability will be determined primarily from qualitative interviews. Feasibility will be determined by completer status and other qualitative data. Preliminary efficacy will be estimated with effect sizes. Specifically, it is hypothesized that participants completing AIM will experience a reduction in social anxiety symptoms, as assessed by interview, self-report, and behavioral measures, compared to placebo. Relevance to Public Health Recent prevalence estimates of Social Phobia are high, ranking second among all psychiatric disorders. Social Phobia results in significant impairment to~ the individual and in economic burden to society. Because most individuals with anxiety disorders seek treatment in primary care, research evaluating innovative treatments for Social Phobia in primary care will potentially reduce health care costs and utilization.