Attention Disengagement Training for Social Phobia

描述(申请人提供)：广泛性社交恐惧症(GSP)的特征是严重的社交焦虑，导致功能障碍(Schneider等人，1992)。GSP的患病率为13.3%(Life，Kessler等人，1994年)，在所有精神障碍中排名第三。尽管社交焦虑症的发病率很高，但超过30%的需要治疗的社交焦虑症患者由于各种原因(例如，害怕别人可能会怎么想，Olfson等人，2000)而没有得到治疗。此外，40%的出席治疗的人没有反应(39%的Heimberg等人，1998年；42%的人，Liebowitz等人，2005年)。因此，显然有必要为社交恐惧症开发高效和高效的治疗程序。这项为期三年的提案旨在通过一项双盲、安慰剂对照的研究来测试社交焦虑的计算机化治疗。具体地说，研究表明，患有社交恐惧症的人会将他们的注意力转向与社会相关的负面信息。因此，治疗的重点将是改变这种注意力偏向，从而缓解社交焦虑症状。我们介绍了一项初步研究的结果(n=26)，在寻求社交恐惧症患者的治疗中，展示了治疗的有效性。一项更大规模的研究将允许我们测试这种治疗方法，或许还可以修改其成分以提高其疗效。试点的初步结果令人鼓舞。简而言之，我们的干预措施在以下方面是有效的：a)改变了社交焦虑个体的偏向注意力，b)将这种注意力脱离的变化从威胁推广到其他注意力脱离的措施，c)减少了由独立评价者评估的社交焦虑症状，d)保持了较高的遵从率(在试点研究中为0%)，以及e)在后续评估中保持其效果长达一年。这种改变社交恐惧症注意力偏向的有效技术可以提供一种基于基本认知科学的成本效益高和易于管理的治疗方法，可能有助于减少GSP患者的痛苦。我们将检验这一提案中的两个假设。1)与安慰剂组相比，完成注意力分离训练(ADT)的GSP患者在社交焦虑的面试者测量(利博维茨社交焦虑量表，LSAS)上表现出更大的症状减轻。2)与安慰剂组相比，完成ADT的GSP患者在社交焦虑症状的自我报告方面表现出更大的减少。

DESCRIPTION (provided by applicant): Generalized Social Phobia (GSP) is characterized by severe social anxiety that leads to functional impairment (Schneider, et al., 1992). The prevalence of GSP is 13.3% (lifetime, Kessler, et al., 1994), ranking third among all psychiatric disorders. Despite its high prevalence, over 30% of individuals with social anxiety who need treatment do not receive treatment for a variety of reasons (e.g., afraid of what others might think, Olfson, et al., 2000). Additionally, 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 treatment procedures for social phobia. This three-year proposal aims to test a computerized treatment for social anxiety in a double-blind, placebo-controlled study. Specifically, research suggests that individuals with social phobia direct their attention toward socially-relevant negative information. Therefore, the treatment will focus on changing this attention bias and thereby alleviate symptoms of social anxiety. We present the results of a pilot study (n=26) in treatment seeking socially phobic individuals demonstrating the effectiveness of the treatment. A larger study would allow us to test the treatment and perhaps modify its component to increase its efficacy. The preliminary results of the pilot are encouraging. In brief, our intervention was effective in: a) changing biased attention in socially anxious individuals, b) generalizing this change in disengagement of attention from threat to other measures of attention disengagement, c) reduce symptoms of social anxiety as assessed by an independent rater, d) maintain a high rate of compliance (0% drop out in the pilot study), and e) maintain its effects in follow-up assessment up to one year. This efficient and efficacious techniques for changing attention bias in social phobia can provide a cost-effective and easy to administer treatment that is grounded in basic cognitive science and may help reduce suffering in individuals with GSP. We will test two hypotheses in this proposal. 1) Individuals with GSP completing the Attention Disengagement Training (ADT) will show a larger reduction in their symptoms compared to the placebo group on an interviewer measure of social anxiety (Liebowitz Social Anxiety Scale, LSAS). 2) Individuals with GSP completing ADT will show a larger reduction in their self-report of social anxiety symptoms compared to the placebo group.