An Internet-Based Self-Help Program for the Treatment of Fear of Public Speaking: A Case Study

Behaviour Research and Therapy

2011

Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment. KeywordsPost Event Processing; Treatment Outcome; Cognitive Behavioral Therapy; Social Anxiety Post Event Processing (PEP) is a negatively valenced review of social situations in which inadequacies, mistakes, imperfections, and negative perceptions of the interaction are exaggerated and integrated into a larger history of poor social performance (Rachman, Grater-Andrew, & Shafran, 2000). PEP is included as a maintaining factor for social anxiety disorder in theoretical models of social anxiety (Clark & Wells, 1995;Rapee & Heimberg, 1997), and empirical research has shown that PEP is associated with increased cognitive intrusions about social interactions, increased recall of past negative experiences, poorer concentration, and lowered anticipation for success in future social situations (Field, Psychol, & Morgan, 2004;Rachman, et al., 2000). There has been relatively little work examining PEP in a treatment context, and no controlled studies have examined whether PEP is impacted by treatment or impacts treatment response. The purpose of the current study is to determine whether or not PEP decreased as a result of cognitive behavioral therapy as compared to a waitlist comparison condition, and to examine the relation between PEP and treatment response for individual-and group-based therapies for social anxiety disorder. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The majority of research on PEP has examined its association with social anxiety (for a review see Brozovich & Heimberg, 2008 A second aim of the current study is to examine the impact of PEP on response to treat...

Section: Discussionsupporting

confidence: 84%

The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder

Price

Behaviour Research and Therapy

2011

“…Future investigations should recruit both healthy and patient control groups of larger samples sizes to determine whether changes in attention bias are merely an effect of the passage of time and/or statistical regression to the mean. The rate of comorbidity in the current sample (12%) is lower than what is typically found for individuals with SAD, although it is comparable to recent studies utilizing Internet-based or virtual reality-based exposure therapy (7%-12.5%; Andersson et al, 2006;Botella et al, 2008).…”

Section: Discussionsupporting

confidence: 71%

A Pilot Study of Attention Bias Subtypes: Examining Their Relation to Cognitive Bias and Their Change following Cognitive Behavioral Therapy

Calamaras¹,

Tone²,

2012

J Clin Psychol

“…The inclusion criteria specified that fear of public speaking must be the primary social fear, and others have argued that public speaking anxiety may be a specific subtype of social anxiety disorder (Blöte, Kint, Miers, & Westenberg, 2009). Also, the comorbidity in the current sample (12%) is lower than what is typically found for individuals with social anxiety disorder, although it is comparable to other research utilizing Internet-based or virtual reality for public speaking fears (7%−12.5%; Andersson et al, 2006; Botella et al, 2008). Finally, although the ethnic/racial diversity in the current sample represents the diverse community in which the study was conducted, such populations are underrepresented in treatment efficacy research (Whaley & Davis, 2007), including virtual reality exposure therapy.…”

Section: Discussionsupporting

confidence: 70%

Virtual reality exposure therapy for social anxiety disorder: A randomized controlled trial.

Journal of Consulting and Clinical Psychology

Price

Edwards

et al. 2013

294

247