CBT vs. ABM vs. for Social Anxiety

Study Overview
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Brief Summary
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Adults with Social Anxiety Disorder will be pseudo randomly assigned to either an individual cognitive behavior therapy, attention bias modification treatment (allocation ratio - 1.5:1). Outcome measures will be social anxiety symptoms and severity as measured by gold standard questionnaires as well as diagnosis of social anxiety disorder derived from structured clinical interviews based on Diagnostic and Statistical Manual (DSM) IV criteria. The investigators expect to find significant reduction in social anxiety symptoms in all of the groups, with the cognitive behavior therapy group showing greater reduction in symptoms than the other groups. Mechanisms of change in all of the groups will be examined via measures of cognitive biases, affect, and other common and specific factors.

Detailed Description
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120 Adults with Social Anxiety Disorder will be pseudo randomly assigned to either an individual cognitive behavior therapy (CBT), attention bias modification treatment (ABM)). Outcome measures will be social anxiety symptoms and severity as measured by gold standard questionnaires as well as diagnosis of social anxiety disorder derived from structured clinical interviews based on DSM-IV criteria. The investigators expect to find significant reduction in social anxiety symptoms in all of the groups, with the cognitive behavior therapy group showing greater reduction in symptoms than the other groups. Mechanisms of change in all of the groups will be examined via measures of cognitive biases, affect, and other common and specific factors.

Official Title
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Cognitive Behavior Therapy vs. Attention Bias Modification Treatment for Social Anxiety

Conditions
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Social Phobia

Intervention / Treatment
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* Behavioral: Attention Bias Modification (ABM)
* Behavioral: Cognitive Behavior Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Generalized Social Anxiety Disorder, LSAS>50 If on medication, patients must be on a stable dose Hebrew language fluency Exclusion Criteria: Primary Axis I or Axis II disorder other than SAD suicidal ideation Substance dependence within the past three months or current substance abuse Mental retardation or another pervasive developmental disability Current or past schizophrenia or psychosis, current bipolar disorder, or organic brain syndrome

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Attention Bias Modification (ABM)<br>Attention training via 8 weekly repeated trials of a dot-probe task intended to direct attention away from threat stimuli. | Behavioral: Attention Bias Modification (ABM)<br>* Attention training via 8 weekly repeated trials of a dot-probe task intended to direct attention away from threat stimuli.<br>|
| Experimental: Cognitive Behavior Therapy<br>CBT will consist of 16-20 weekly individual treatment sessions aimed to reduce symptoms via cognitive and behavioral interventions | Behavioral: Cognitive Behavior Therapy<br>* CBT will consist of 16-20 weekly individual treatment sessions aimed to reduce symptoms via cognitive and behavioral interventions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Liebovitz Social Anxiety Scale (LSAS) - diagnostic interview | LSAS is a 24-items clinician-administered scale developed for the assessment of fear and avoidance associated with social situations. The LSAS assesses a wide range of both social interaction and performance/observation situations, which are rated for degree of fear/anxiety and frequency of avoidance. | Expected time frame of up to 32 weeks per participant. Participants will be assessed before and after the administration of the treatment, every 4 weeks during treatment and at 3 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Social Phobia Inventory (SPIN) - self-report questionnaire | The SPIN is a widely used 17-item self-report questionnaire that assesses fear, avoidance and physiological symptoms of social anxiety. | Up to 32 weeks per participant. The SPIN will be administered before and after each treatment session and at 3 months follow-up |