TY - JOUR
T1 - Impact of depression on treatment effectiveness and gains maintenance in social phobia: A naturalistic study of cognitive behavioral group therapy: Efficacy and predictors of outcome
AU - Marom, S.
AU - Schechtman, E.
AU - Hermesh, H.
AU - Aderka, I.G.
AU - Weizman, A.
PY - 2009
Y1 - 2009
N2 - Background: The impact of depression on cognitive behavioral group therapy
(CBGT) for social phobia (SP) in a naturalistic outpatient setting was examined
after treatment termination and at 1-year follow-up. Methods: Consecutive SP
outpatients (N 5 219) were diagnosed using a structured interview. CBGT was
provided in 18 1.5-hr weekly sessions. At pretreatment and posttreatment
questionnaires and clinician ratings were administered. Self-report measures
were obtained at 1-year follow-up. The main outcome measure was the Liebowitz
Social Anxiety Scale. Results: CBGT was found to be effective in reducing both
social anxiety (effect size 5 1.23) as well as depression (effect size 5 0.94).
Individuals with generalized social phobia (GSP) and individuals with specific
social phobia (SSP) differed in their presenting psychopathology and in their
response to CBGT. Among treatment completers, 44% GSPs and 37% SSPs
achieved at least 50% improvement, and 44% GSPs and 87% SSPs reported
distress and functioning within the normal range at the end of treatment. Among
SPs diagnosed with major depressive disorder (MDD) at the onset of treatment,
SP symptoms aggravated during the follow-up period, whereas SPs not diagnosed
with MDD experienced a further alleviation of SP symptoms during follow-up.
CBGT provided in a public clinic to non-selected, mostly unmedicated and
comorbid patients, is an effective treatment for the majority of SP sufferers.
Conclusions: MDD at the onset of CBGT was not associated with poorer
treatment response, but predicted exacerbation of SP symptoms following
treatment termination. Depressed SPs may need additional intervention to
maintain CBGT gains. SSPs may benefit from less intensive CBGT than GSPs
AB - Background: The impact of depression on cognitive behavioral group therapy
(CBGT) for social phobia (SP) in a naturalistic outpatient setting was examined
after treatment termination and at 1-year follow-up. Methods: Consecutive SP
outpatients (N 5 219) were diagnosed using a structured interview. CBGT was
provided in 18 1.5-hr weekly sessions. At pretreatment and posttreatment
questionnaires and clinician ratings were administered. Self-report measures
were obtained at 1-year follow-up. The main outcome measure was the Liebowitz
Social Anxiety Scale. Results: CBGT was found to be effective in reducing both
social anxiety (effect size 5 1.23) as well as depression (effect size 5 0.94).
Individuals with generalized social phobia (GSP) and individuals with specific
social phobia (SSP) differed in their presenting psychopathology and in their
response to CBGT. Among treatment completers, 44% GSPs and 37% SSPs
achieved at least 50% improvement, and 44% GSPs and 87% SSPs reported
distress and functioning within the normal range at the end of treatment. Among
SPs diagnosed with major depressive disorder (MDD) at the onset of treatment,
SP symptoms aggravated during the follow-up period, whereas SPs not diagnosed
with MDD experienced a further alleviation of SP symptoms during follow-up.
CBGT provided in a public clinic to non-selected, mostly unmedicated and
comorbid patients, is an effective treatment for the majority of SP sufferers.
Conclusions: MDD at the onset of CBGT was not associated with poorer
treatment response, but predicted exacerbation of SP symptoms following
treatment termination. Depressed SPs may need additional intervention to
maintain CBGT gains. SSPs may benefit from less intensive CBGT than GSPs
UR - http://www.ruppin.ac.il/download/files/%20on%20treatment%20effectiveness%20and%20gains%20maintenance%20in%20social%20phobia-%20a%20naturalistic%20study%20of%20cognitive%20behavior%20group%20therapy.pdf
M3 - Article
SN - 1091-4269
VL - 26
SP - 289
EP - 300
JO - Depression and Anxiety
JF - Depression and Anxiety
ER -