Cognitive behavioural group treatment for social anxiety in individuals with and without adverse negative images: A single case study

Abstract

Social anxiety disorder (SAD) is a prevalent and debilitating disorder that usually does not remit without treatment. Cognitive behavioural therapy (CBT) has shown to have a large effect in treating SAD, but little is known what are the mechanisms of change. Cognitive and behavioural studies have indicated that adverse negative images are common for individuals with SAD and that has been considered to be of great influence in determining treatment’s efficacy. The aims of this study were to examine the outcome of CBT group treatment at the Icelandic Center for Treatment of Anxiety Disorders (Kvíðameðferðarstöðin) for SAD with a single-case methodology. Four individuals with and without adverse negative mental images and a primary DSM-5 diagnosis of SAD went through a standardized clinical interview (MINI) and an imagery interview. Questionnaires that measure the severity of SAD symptoms, depression, most destressing problems, and negative images were administered, pre-treatment, during treatment and at a one month follow up. The result suggests that the CBGT treatment for SAD is equally successful for individuals with and without negative images and the change during treatment is steady and there is a correlation between the reduction on SAD symptoms and negative images. This change does not seem to be traced to a specific mechanism in the treatment. Further studies are needed. Keywords: Social anxiety disorder, cognitive behavioural group treatment, mental images, mechanism of change, single-case study