The study confirms and extends previously reported findings that ICT is more effective than group cognitive treatment and treatment with SSRIs. IGCT lasts only 3 weeks, and is as effective as more protracted TAU.
Background and AimsCognitive behavioral group therapy (CBGT) is an effective, well-established,
but not widely available treatment for social anxiety disorder (SAD).
Internet-based cognitive behavior therapy (ICBT) has the potential to
increase availability and facilitate dissemination of therapeutic services
for SAD. However, ICBT for SAD has not been directly compared with in-person
treatments such as CBGT and few studies investigating ICBT have been
conducted in clinical settings. Our aim was to investigate if ICBT is at
least as effective as CBGT for SAD when treatments are delivered in a
psychiatric setting.MethodsWe conducted a randomized controlled non-inferiority trial with allocation to
ICBT (n = 64) or CBGT (n = 62)
with blinded assessment immediately following treatment and six months
post-treatment. Participants were 126 individuals with SAD who received CBGT
or ICBT for a duration of 15 weeks. The Liebowitz Social Anxiety Scale
(LSAS) was the main outcome measure. The following non-inferiority margin
was set: following treatment, the lower bound of the 95 % confidence
interval (CI) of the mean difference between groups should be less than 10
LSAS-points.ResultsBoth groups made large improvements. At follow-up, 41 (64%)
participants in the ICBT group were classified as responders (95% CI,
52%–76%). In the CBGT group, 28 participants
(45%) responded to the treatment (95% CI,
33%–58%). At post-treatment and follow-up respectively,
the 95 % CI of the LSAS mean difference was 0.68–17.66
(Cohen’s d between group = 0.41)
and −2.51–15.69 (Cohen’s d between
group = 0.36) favoring ICBT, which was well within the
non-inferiority margin. Mixed effects models analyses showed no significant
interaction effect for LSAS, indicating similar improvement across
treatments (F = 1.58;
df = 2, 219;
p = .21).ConclusionsICBT delivered in a psychiatric setting can be as effective as CBGT in the
treatment of SAD and could be used to increase availability to CBT.Trial RegistrationClinicalTrials.gov NCT00564967
A link has been suggested between Autism Spectrum Disorder (ASD) and anxiety disorders. The aim of the study was to examine the severity of social anxiety measured by the Liebowitz Social Anxiety Scale Self-Report and prevalence of Social Anxiety Disorder (SAD) in adults with ASD, with SAD and a non-ASD comparison group. Individuals with ASD showed significantly higher scores of social anxiety and social avoidance relative to the comparison group, but significantly lower scores relative to the SAD sample.
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