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Moghbeli F, Bahrami M, Jafari D. Comparing the Effectiveness of Cognitive-Behavioral Therapy with Eye Movement Desensitization and Reprocessing Therapy on Anxiety Sensitivity and Fear of Negative Evaluation among Adolescents Aged 15 to 17 Years with Social Anxiety Disorder Living in Karaj City, Iran. MEJDS 2023; 13 :61-61
URL: http://jdisabilstud.org/article-1-3121-en.html
1- Ph.D. student, Department of Psychology, Borujerd Branch, Islamic Azad University, Borujerd, Iran
2- Assistant Professor, Department of Psychology, Malayer Branch, Islamic Azad University, Malayer, Iran
Abstract:   (1258 Views)

Abstract
Background & Objectives: Individuals with social anxiety disorder fear other people’s negative evaluations, which results in the continuation of social anxiety through a series of vicious cycles. In addition, anxiety sensitivity is another factor contributing to social anxiety disorder development. Considering the relationship between anxiety sensitivity and fear of negative evaluation with social anxiety disorder, it is necessary to investigate the effective treatment of these psychological structures in social anxiety disorder. The first line of treatment for social anxiety disorder is cognitive–behavioral therapy (CBT). This therapy seeks to change thought patterns and physical reactions to anxiety–inducing situations. Eye movement desensitization and reprocessing (EMDR) is another promising approach to treating social anxiety. EMDR targets the early experiences that made patients develop a sense of social threat in the first place. Therefore, the present study aimed to compare the effects of CBT and EMDR therapy on anxiety sensitivity and fear of negative evaluations in patients with social anxiety disorder.
Methods: The method of the present study was quasi–experimental with a pretest–posttest and 1 month follow–up design with a control group. The statistical population included all adolescents referred to the Farhangian Clinic in Karaj City, Iran. A total of 51 eligible adolescents were included in the study using a convenience sampling method and were randomly assigned into 2 intervention groups and 1 control group (17 people in each group). The inclusion criteria were as follows: age range of 15–17 years, a definite diagnosis of social anxiety disorder during at least the last 6 months based on DSM–5 diagnostic criteria using the Structured Clinical Interview (SCID–5), not suffering from other clinical disorders at the same time, not dependent on alcohol or drugs, not receiving any other concurrent treatment, and completing the informed consent form to participate in the research. The exclusion criteria were having thoughts and ideas of suicide and absenting more than two sessions in therapy sessions. Patients in the first intervention group received 12 sessions (two sessions per week, each session lasting 60 minutes) of CBT. Patients in the second intervention group had 8 sessions (two sessions per week, each lasting 90 minutes) of EMDR therapy. The control group did not receive any intervention. The data collection tools included the Anxiety Sensitivity Index revised form (ASI–R) (Taylor & Cox, 1998) and the Brief Fear of Negative Evaluation (BFNE) Scale (Leary, 1983). Data were analyzed using descriptive statistics (frequency indices, mean, and standard deviation) and inferential statistics (1–way analysis of variance, repeated measures analyses of variance, and Tukey post hoc test) in SPSS24 at a significance level of 0.05.
Results: The results showed that the effects of time (p<0.001), group (p<0.001), and time and group interaction (p<0.001) were significant on variables of anxiety sensitivity and fear of negative evaluations. Both treatments significantly decreased anxiety sensitivity and fear of negative evaluation of patients in the posttest and follow–up in the intervention groups compared with the control group (p<0.001). In the posttest, a significant difference was observed between the effectiveness of CBT and EMDR therapy in reducing anxiety sensitivity scores (p=0.029) and fear of negative evaluation (p=0.004). In the follow–up, CBT, compared to EMDR therapy, was more effective in reducing anxiety sensitivity scores (p=0.003). Still, In the follow–up, the treatments had no significant difference in reducing fear of negative evaluation (p=0.995).
Conclusion: Both CBT and EMDR therapy are effective in reducing anxiety sensitivity and fear of negative evaluations of patients with social anxiety disorder, but CBT is more effective than EMDR therapy. As a result, both approaches can be used to reduce anxiety sensitivity and fear of negative evaluations in patients with social anxiety disorder.

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Type of Study: Original Research Article | Subject: Psychology

References
1. Lewis G, Rice F, Harold GT, Collishaw S, Thapar A. Investigating environmental links between parent depression and child depressive/anxiety symptoms using an assisted conception design. J Am Acad Child Adolesc Psychiatry. 2011;50(5):451–9. [DOI]
2. Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am. 2009;32(3):483–524. [DOI]
3. Rao PA, Beidel DC, Turner SM, Ammerman RT, Crosby LE, Sallee FR. Social anxiety disorder in childhood and adolescence: descriptive psychopathology. Behav Res Ther. 2007;45(6):1181–91. [DOI]
4. Spence SH, Rapee RM. The etiology of social anxiety disorder: an evidence-based model. Behav Res Ther. 2016;86:50–67. [DOI]
5. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edition. American Psychiatric Association; 2013.
6. Teale Sapach MJN, Carleton RN, Mulvogue MK, Weeks JW, Heimberg RG. Cognitive constructs and social anxiety disorder: beyond fearing negative evaluation. Cognitive Behaviour Therapy. 2015;44(1):63–73. [DOI]
7. Wong J, Gordon EA, Heimberg RG. Cognitive-behavioral models of social anxiety disorder. In: Weeks JW; editor. The Wiley Blackwell Handbook of social anxiety disorder. Chichester, UK: John Wiley & Sons, Ltd; 2014. [DOI]
8. Bahari S, Tozandehjani H, Taheri H. Effectiveness of modular cognitive behavioral therapy on the anxiety sensitivity, cognitive distortions of teen girls who has social anxiety disorder. Clinical Psychology. 2020;12(2):51–62. [Persian] [Article]
9. Zvolensky MJ, Schmidt NB, Bernstein A, Keough ME. Risk-factor research and prevention programs for anxiety disorders: a translational research framework. Behav Res Ther. 2006;44(9):1219–39. [DOI]
10. McNally RJ. Anxiety sensitivity and panic disorder. Biol Psychiatry. 2002;52(10):938–46. [DOI]
11. Deacon BJ, Abramowitz JS, Woods CM, Tolin DF. The anxiety sensitivity index-revised: psychometric properties and factor structure in two nonclinical samples. Behav Res Ther. 2003;41(12):1427–49. [DOI]
12. Bögels SM, Alden L, Beidel DC, Clark LA, Pine DS, Stein MB, et al. Social anxiety disorder: questions and answers for the DSM-V. Depress Anxiety. 2010;27(2):168–89. [DOI]
13. Asnaani A, Tyler J, McCann J, Brown L, Zang Y. Anxiety sensitivity and emotion regulation as mechanisms of successful CBT outcome for anxiety-related disorders in a naturalistic treatment setting. J Affect Disord. 2020;267:86–95. [DOI]
14. Mehta K, Hoadley A, Ray LA, Kiluk BD, Carroll KM, Magill M. Cognitive-behavioral interventions targeting alcohol or other drug use and co-occurring mental health disorders: a meta-analysis. Alcohol Alcohol. 2021;56(5):535–44. [DOI]
15. Warner CM, Reigada LC, Fisher PH, Saborsky AL, Benkov KJ. CBT for anxiety and associated somatic complain in pediatric medical settings: an open study. J Clin Psychol Med Setting. 2009;16:169-77. [DOI]
16. Walter HJ, Bukstein OG, Abright AR, Keable H, Ramtekkar U, Ripperger-Suhler J, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2020;59(10):1107–24. [DOI]
17. Butler RM, O’Day EB, Swee MB, Horenstein A, Heimberg RG. Cognitive behavioral therapy for social anxiety disorder: predictors of treatment outcome in a quasi-naturalistic setting. Behav Ther. 2021;52(2):465–77. [DOI]
18. Sagaltici E, Demirci OO. Eye movement desensitization and reprocessing (EMDR) treatment in social anxiety disorder: a case report. Psychiat Danub. 2019;3(31):358–9. [DOI]
19. Shapiro F. Eye movement desensitization and reprocessing: basic principles, protocols, and procedures. Second edition. New York: The Guilford Press; 2001.
20. Banerjee S, Argaez C. Eye movement desensitization and reprocessing for depression, anxiety, and post-traumatic stress disorder: a review of clinical effectiveness. Ottawa: CADTH; 2017.
21. Maghari H, Mohamadi Arya A. Tasire hassasiat zodaei az tarigh harakat cheshm va pardazesh mojadad bar ezterab ejtemaei koodakan azar dide hayajani [The effect of desensitization through eye movements and reprocessing on the social anxiety of emotionally abused children]. In: The 7th Congress of the Iranian Psychological Association [Internet]. Tehran: 2018. [Persian]
22. Andrews G, Bell C, Boyce P, Gale C, Lampe L, Marwat O, et al. Royal Australian and New Zealand college of psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Aust N Z J Psychiatry. 2018;52(12):1109–72. [DOI]
23. Edwards TM, Stern A, Clarke DD, Ivbijaro G, Kasney LM. The treatment of patients with medically unexplained symptoms in primary care: a review of the literature. Ment Health Fam Med. 2010;7(4):209–21.
24. Taylor S, Cox BJ. An Expanded Anxiety Sensitivity Index: Evidence for a hierarchic structure in a clinical sample. J Anxiety Disord. 1998;12(5):463–83. [DOI]
25. Leary MR. A Brief Version of the Fear of Negative Evaluation Scale. Pers Soc Psychol Bull. 1983;9(3):371–5. [DOI]
26. Moradi Menesh F, Mirjafari A, Goodarzi M, Mohammadi N. Barrasi vizhegi haye ravan sanji shakhes tajdid nazar shode hasasiat ezterabi (ASIR) [Examining the psychometric properties of the revised anxiety sensitivity index (ASIR)]. Journal of Psychology. 2007;11(4):426–46. [Persian]
27. Amrai M, Khodaei A, Shokri A, Garavand F, Toulabi S. Standardization, validity and reliability of the Brief Fear of Negative Evaluation Scale for 12–18 years old adolescents in Tehran. Psychological Studies. 2011;7(1):65–96. [Persian] [Article]
28. Clark DM, Wells A. A cognitive model of social phobia. In: Heimberg RG, Liebowitz MR, Hope DA, Schneier FR; editors. Social phobia: diagnosis, assessment, and treatment. The Guilford Press; 1995.
29. Shapiro F, Wesselmann D, Mevissen L. Eye movement desensitization and reprocessing therapy (EMDR). In: Landolt MA, Cloitre M, Schnyder U; editors. Evidence-based treatments for trauma related disorders in children and adolescents. Cham: Springer International Publishing; 2017. [DOI]
30. Hekmatiyan Fard S, Rajabi S, Hoseini FS. The effectiveness of eye movement desensitization and reprocessing therapy on the anxiety speech and educational self-efficacy in students with social anxiety. Counseling Culture and Psychotherapy. 2021;12(45):269–94. [Persian] [Article]
31. Hashemi-Nosratabad T, Mahmoud-Alilou M, Gholizadeh A. The effectiveness of cognitive behavioral therapy based on hofmann’s model on fear of negative evaluation and self- focused attention in social anxiety disorder. Clinical Psychology. 2017;9(1):101–10. [Persian] [Article]
32. Nowakowski ME, Rowa K, Antony MM, McCabe R. Changes in anxiety sensitivity following group cognitive-behavior therapy for social anxiety disorder and panic disorder. Cogn Ther Res. 2016;40(4):468–78. [DOI]
33. Hunt C, Campbell-Sills L, Chavira D, Craske M, Sherbourne C, Sullivan G, et al. Prospective relations between anxiety sensitivity and transdiagnostic anxiety following cognitive-behavioral therapy: evidence from the coordinated anxiety learning management trial. Behav Res Ther. 2022;155:104119. [DOI]
34. Stein DJ. Social anxiety disorder and the psychobiology of self-consciousness. Front Hum Neurosci. 2015;9. [DOI]
35. Leigh E, Clark DM. Understanding social anxiety disorder in adolescents and improving treatment outcomes: applying the cognitive model of Clark and Wells (1995). Clin Child Fam Psychol Rev. 2018;21(3):388–414. [DOI]
36. Ledley DR, Huppert JD, Foa EB, Davidson JRT, Keefe FJ, Potts NLS. Impact of depressive symptoms on the treatment of generalized social anxiety disorder. Depress Anxiety. 2005;22(4):161–7. [DOI]
37. Azimisefat P, De Jongh A, Rajabi S, Kanske P, Jamshidi F. Efficacy of virtual reality exposure therapy and eye movement desensitization and reprocessing therapy on symptoms of acrophobia and anxiety sensitivity in adolescent girls: a randomized controlled trial. Front Psychol. 2022;13:919148. [DOI]
38. Shapiro F, Laliotis D. EMDR and the adaptive information processing model: integrative treatment and case conceptualization. Clin Soc Work J. 2011;39(2):191–200. [DOI]
39. Laliotis D, Luber M, Oren U, Shapiro E, Ichii M, Hase M, et al. What is EMDR therapy? past, present, and future directions. J EMDR Prac Res. 2021;15(4):186–201. [DOI]

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