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Trial-Based Cognitive Therapy: Efficacy of a New CBT Approach for Treating Social Anxiety Disorder with Comorbid Depression

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Abstract

The present study aims to evaluate the efficacy of Trial-Based Cognitive Therapy (TBCT), a new cognitive-behavioral therapy approach, for generalized social anxiety disorder (GSAD) in a population with high rates of comorbid disorders, especially depression. This two-arm randomized clinical trial included 39 adults (TBCT = 18; waitlist group = 21) diagnosed with GSAD. The TBCT group received 16 weekly sessions of individual TBCT. Symptom severity was assessed at pre- and post-treatment. Participants in the TBCT group showed reduction in social anxiety, social avoidance, and depression, all associated with a large effect size. No differences between pre- and post-treatment scores were observed in the waitlist condition. Results also showed that comorbidity significantly moderated treatment efficacy. Patients with comorbid conditions showed greater reductions in social anxiety symptoms across treatment than those with SAD only. In summary, TBCT was effective in reducing social anxiety and depressive symptoms, particularly for patients with comorbidity.

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Notes

  1. These analyses were re-conducted controlling for baseline differences. The effects of treatment condition on changes in symptoms of social anxiety and depression remained significant (γ = − 20.70, P < .01; γ = − 10.90, P < .01, respectively).

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Funding

This research was supported by the São Paulo Research Foundation/FAPESP, a Brazilian public funding agency. The principal investigator (Kátia Alessandra de Souza Caetano) received a scholarship as a Ph.D. student during the execution of this study (FAPESP process number: 2013/19263-1; 2015/18937-4). Additionally, FAPESP approved a grant to developing this randomized clinical trial (FAPESP process number 2013/19981-1).

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Authors and Affiliations

  1. Department of Psychology, Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil

    Kátia A. S. Caetano & Carmem B. Neufeld

  2. Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA

    Kátia A. S. Caetano, Barbara Depreeuw, Inka Papenfuss, Joshua Curtiss, Robbert J. Langwerden & Stefan G. Hofmann

  3. Center for the Psychology of Learning and Experimental Psychopathology, University of Leuven, Leuven, Belgium

    Barbara Depreeuw

  4. Department of Psychology, University of Groningen, Groningen, The Netherlands

    Inka Papenfuss

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  1. Kátia A. S. Caetano
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Correspondence to Kátia A. S. Caetano.

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Disclosure

Dr. Hofmann receives support from NIH/NCCIH (R01AT007257), NIH/NIMH (R01MH099021, R34MH099311, R34MH086668, R21MH102646, R21MH101567, K23MH100259), the James S. McDonnell Foundation 21st Century Science Initiative in Understanding Human Cognition—Special Initiative, and the Department of the Army for work unrelated to the studies reported in this article. He receives compensation for his work as an advisor from the Palo Alto Health Sciences and Otsuka Digital Health, Inc., and for his work as a Subject Matter Expert from John Wiley & Sons, Inc. and SilverCloud Health, Inc. He also receives royalties and payments for his editorial work from various publishers.

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Caetano, K.A.S., Depreeuw, B., Papenfuss, I. et al. Trial-Based Cognitive Therapy: Efficacy of a New CBT Approach for Treating Social Anxiety Disorder with Comorbid Depression. J Cogn Ther 11, 325–342 (2018). https://doi.org/10.1007/s41811-018-0028-7

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