Do Social Threat Cognitions Decrease With School-Based CBT and Predict Treatment Outcome in Adolescents With Social Anxiety Disorder?

Julie L Ryan; Jeremy K Fox; Sarah R Lowe; Carrie Masia Warner

doi:10.1891/0889-8391.33.4.331

Do Social Threat Cognitions Decrease With School-Based CBT and Predict Treatment Outcome in Adolescents With Social Anxiety Disorder?

J Cogn Psychother. 2019 Nov 1;33(4):331-342. doi: 10.1891/0889-8391.33.4.331.

Authors

Julie L Ryan¹, Jeremy K Fox², Sarah R Lowe², Carrie Masia Warner^{2

3

4}

Affiliations

¹ William James College, Clinical Psychology Department.
² Montclair State University, Psychology Department.
³ Nathan Kline Institute for Psychiatric Research.
⁴ NYU Langone Medical Center, Department of Child and Adolescent Psychiatry.

PMID: 32746395
DOI: 10.1891/0889-8391.33.4.331

Abstract

Evidence suggests that Social Anxiety Disorder (SAD) is less responsive to cognitive behavioral treatment (CBT) compared to other anxiety disorders. Therefore, exploring what might facilitate clinical benefit is essential. Social threat cognitions, characterized by exaggerated perceptions of negative evaluation by others, may be one important avenue to examine. The current study investigated whether youths' social threat cognitions decreased with Skills for Academic and Social Success (SASS), a group, school-based CBT designed for SAD, and whether decreases predicted SAD severity and treatment response. Participants included 138 high school students with SAD randomly assigned to SASS, or a nonspecific school counseling intervention. SASS participants showed significantly decreased social threat cognitions at 5-month follow-up. Treatment responders had significantly greater reductions in social threat cognitions compared to nonresponders at post-intervention and follow-up. These findings suggest that social threat cognitions may be important to assess and monitor when treating youth with SAD.

Keywords: adolescents; cognitions; school-based CBT; social anxiety; social threat.