Examining Long-Term Effects and Neural Mediators of Behavioral Treatments for Social Anxiety Disorder
Condition: Social Anxiety Disorder
MeSH terms: Anxiety Disorders; Phobia, Social
Study type: Interventional

Summary: 
      This study will compare the effects that two types of behavioral therapy have on brain
      function in people with social anxiety disorder.
    

Detailed description: 
      Social anxiety disorder (SAD) is characterized by intense and debilitating anxiety in common
      social situations. Cognitive behavioral therapy (CBT) is a talking treatment that aims to
      reduce immediate anxiety symptoms. However, some anxiety symptoms and comorbid disorders not
      directly addressed by CBT may only improve in the short term, while recurring in the long
      term. Behavioral therapy based on acceptance and mindfulness is thought to have longer
      lasting effects, because this approach emphasizes accepting anxiety instead of controlling
      anxiety. This study will compare standard CBT to acceptance and commitment therapy (ACT),
      which uses acceptance and mindfulness, to determine which is more effective on both a short-
      and long-term basis. Participants with SAD will undergo brain scans to determine how the two
      therapies affect brain functioning.

      Participation in this study will last 12 months. Participants with SAD will be randomly
      assigned to receive CBT, ACT, or a waitlist condition. Both CBT and ACT treatments will
      include 12 weekly sessions that will deal with objects and situations that provoke anxiety.
      All sessions will be audio- and videotaped. The waitlist group will complete weekly
      self-monitoring forms to track anxiety and panic and will receive a phone call from a
      research coordinator every 2 weeks to make sure symptoms have not worsened. After 12 weeks,
      participants on the waitlist will be offered treatment.

      All participants will attend study visits to undergo brain scanning at baseline, after 3
      months, and after 12 months. Each study visit will involve MRI scanning (to evaluate brain
      structure), functional MRI (fMRI) scanning (to evaluate brain function), questionnaires about
      a participant's experience in the scanner, and collection of saliva samples before, during,
      and after scanning. While undergoing the fMRI scan, participants will be asked to remain at
      rest for a certain period of time, and then to perform tasks that will engage certain parts
      of the brain. Assessments for all participants will occur at baseline and after 3, 6, and 12
      months. These assessments will include diagnostic evaluations by a therapist, self-report
      questionnaires, ongoing self-monitoring, physiological measurements, cognitive assessments,
      and behavioral observation.
    

Intervention name(s): Acceptance- and commitment-based behavioral therapy; Cognitive behavioral therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 12 weekly treatment sessions conducted individually with a therapist; strategies for dealing with anxiety will include mindfulness and acceptance of negative feelings; 12 weekly treatment sessions conducted individually with a therapist; methods for dealing with anxiety will include cognitive and breathing strategies
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Social Anxiety; Social Anxiety Treatment; Cognitive Therapy; Mindfulness; Social Phobia; Social Phobia Treatment