Therapeutic strategies for social anxiety disorder: where are we now?

Pélissolo, Antoine; Kassm, Sandra Abou; Delhay, Lauriane

doi:10.1080/14737175.2019.1666713

Cited by 32 publications

(21 citation statements)

References 122 publications

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“…Lack of therapy for convicts with mental disorders may lead to deterioration of the quality of life of prisoners and suicide attempts, also described in general populations of different countries (20,33,34). In psychiatric disorders, including anxiety disorders, effective and integrated therapy is required, which includes both pharmacotherapy, psychotherapy and behavioural therapy (35)(36)(37). For obvious reasons, in prison conditions, it is extremely difficult to achieve sufficient conditions to achieve satisfactory results, for example, due to restrictions on the freedom of changing persons' place of stay and uninhibited undertaking physical activity that can have a positive effect on treatment (38).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

Stawińska-Witoszyńska

Czechowska

Moryson

et al. 2021

Front. Psychiatry

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Introduction: Generalised anxiety disorder (GAD) is one of the most common mental disorders. The psychosocial factors that may lead to generalised anxiety disorders include stress, traumatic events, conscious and unconscious internal conflicts, and low social and economic status. Imprisonment and forced isolation may favour the development of depression or anxiety disorders in inmates. Thus, this study aimed to analyse the prevalence of generalised anxiety disorder (GAD) in the population of inmates detained in one of the largest penitentiary units in north-eastern Poland.Materials and Methods: The data comes from 2017 and includes information on 635 male inmates incarcerated at the Czerwony Bór Prison. The information comes from the health records of individual inmates, kept by the prison outpatient clinician, and documented consultations with doctors of units outside the prison. The classification of generalised anxiety disorders (F41.1) was made in accordance with the 10th Revision of the International Statistical Classification of Diseases and Health Problems and the clinical diagnosis made by a psychiatrist. The Mann-Whitney test was used to compare quantitative data without normal distribution, chi-squared test or Fisher exact test for comparing qualitative data. A one-dimensional and multi-dimensional logistic regression model was used to examine the impact of the prison type on the prevalence of generalised anxiety disorder.Results: Generalised anxiety disorder was observed among 44 prisoners (6.9%), most often in the age range 30–39 years and among men younger than 30 years, respectively 40.9 and 31.8% of all diagnosed. The average age of patients was 34.6 years. The least number of prisoners with GAD was in the age group 50–59 (2.3%). Nearly 66% of patients were prisoners detained in a closed type prison; the chance of generalised anxiety disorder was three times higher than among the prisoners in a half-open and open type facility. Generalised anxiety disorder was diagnosed significantly more often with those currently serving a prison sentence than those before incarceration.Conclusions: In Polish conditions, the importance of the problem associated with GAD is evidenced by a significant increase in its prevalence in the prison environment and a three times higher chance of developing generalised anxiety disorder among prisoners in a closed type institution, which calls for highly organised psychiatric care and increased availability of psychological assistance for prisoners.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

Stawińska-Witoszyńska

Czechowska

Moryson

et al. 2021

Front. Psychiatry

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“…Attention bias modification has been criticized [53] and recent metaanalyses of studies into the effects of attention bias modification in SAD found indeed disappointing results [5,54]. As noted by Pelissolo et al [55], the effect size for attention bias modification reported is smaller than standard placebo effect sizes in RCTs examining the treatment of SAD. A recent study of Ma et al [56] employed virtual reality 3-D facial expression as stimuli in a dot-probe attentional bias modification task, but virtual reality-based attentional bias modification did not change the attentional bias and most participants did not clinically improve.…”

Section: Attention Biasmentioning

confidence: 99%

Virtual Reality Therapy in Social Anxiety Disorder

Emmelkamp

Meyerbröker

Morina

2020

Curr Psychiatry Rep

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Purpose of Review This review provides an overview of current methods and important aspects to consider when applying virtual worlds in the treatment of social anxiety disorder (SAD). Recent Findings Different aspects such as dialogs between avatars and patients have been investigated as well as virtual audiences, emotional facial expression, and verbal interaction with avatars. Results of these studies are promising. Few randomized controlled trials (RCTs) have investigated the efficacy of virtual reality exposure therapy (VRET) in SAD. Unfortunately, most RCTs into the efficacy of VRET in comparison with exposure in vivo in SAD have been conducted with a combination of cognitive interventions and VRET. No differences between these conditions were found, but the pure effect of VRET as a standalone treatment has only been investigated in one RCT, wherein VRET was not superior to exposure in vivo. Summary Current research into different facets of SAD and VRET has produced promising results with respect to technological aspects. No differences in efficacy between cognitive behavior therapy and VRET were found, but there is a clear need for studies investigating the efficacy of VRET as a stand-alone treatment and the therapeutic processes involved before this therapy can be disseminated in routine clinical practice.

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“…Another, at this stage even more promising new potential clinical strategy for SAD is virtual reality exposure therapy (VRET; e.g., Pelissolo et al, 2019). In a recent meta-analysis, Carl et al (2019) found VRET to be more effective than waitlist and placebo groups.…”

Section: Discussionmentioning

confidence: 99%

“…With the incorporation of current technological developments into VRET, sufficient technical conditions could be created to combine exposure therapy and attention training techniques in one strategy. Considering the promising nature of ABM (see Pelissolo et al, 2019), the combination of both therapeutic strategies may be suitable to increase efficacy of treatment in patients with SAD.…”

Section: Discussionmentioning

confidence: 99%

Initial Maintenance of Attention to Threat in Children with Social Anxiety Disorder? Findings from an Eye-Tracking Experiment

et al. 2021

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Background Attentional biases are assumed to be a core feature in the etiology and maintenance of clinical anxiety. The present study focuses on initial maintenance of attention to threat, one of three attentional components investigated the least, particularly in child anxiety. Methods Angry and neutral facial expressions were presented in a free-viewing task, while eye-movements were recorded. Participants were N = 96 school-aged children, with n = 50 children with a clinical social anxiety disorder (SAD) and n = 46 healthy control children (HC). Prior to the task, social stress was induced in half of participating children to investigate the impact of increased levels of distress on initial attention allocation. Results The length of first fixation to angry faces in children with SAD neither differed from the length of first fixation to neutral faces nor the length of first fixation to angry faces in HC children. Furthermore, this variable was not affected by a stress induction procedure. However, children with SAD initially fixated longer on faces than HC children. Conclusion Our findings provide evidence for difficulties disengaging attention from faces. This may indicate that attention allocation is determined by the social nature of the stimuli rather than by the specific emotional valence.

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Therapeutic strategies for social anxiety disorder: where are we now?

Cited by 32 publications

References 122 publications

The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

The Prevalence of Generalised Anxiety Disorder Among Prisoners of the Penitentiary Institution in North-Eastern Poland

Virtual Reality Therapy in Social Anxiety Disorder

Initial Maintenance of Attention to Threat in Children with Social Anxiety Disorder? Findings from an Eye-Tracking Experiment

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