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Diagnostic subtype, avoidant personality disorder, and efficacy of cognitive—behavioral group therapy for social phobia

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Abstract

Increasing recognition of the heterogeneity of social phobia has led to the development of various subtyping classification schemes and controversy over the boundary between social phobia and avoidant personality disorder (APD). This study investigated the utility of one subtyping system by comparing efficacy of cognitive-behavioral group therapy for generalized social phobia (fears in all major situational domains) and nongeneralized social phobia (fears in multiple domains but at least one unaffected domain). Overall, most subjects improved in treatment, with generalized and nongeneralized social phobics making similar gains. However, because generalized social phobics were more impaired prior to treatment, they continued to be more impaired after treatment on some measures. A second hypothesis that social phobics with APD would respond more poorly to treatment than social phobics without APD was not supported. This study adds to the growing evidence that social phobia and APD, as defined by DSM-III-R, may not be conceptually distinct. Clinical and conceptual implications and directions for future research are discussed.

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Authors and Affiliations

  1. Department of Psychology, University of Nebraska—Lincoln, 68588-0308, Lincoln, Nebraska

    Debra A. Hope Ph.D.

  2. Hahnemann University, USA

    James D. Herbert

  3. University of Nebraska, Lincoln

    Cameron White

Authors
  1. Debra A. Hope Ph.D.
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  2. James D. Herbert
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  3. Cameron White
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Additional information

Completion of this manuscript was supported in part by grant number MH 48751 from the National Institute of Mental Health to the first author. The authors wish to thank Alan S. Bellack for his support in the completion of this study and Jack Blanchard, Eileen Wade, and Abby Michalski for serving as cotherapists. Portions of this study were presented at the annual meeting of the Association for the Advancement of Behavior Therapy, San Francisco, 1990.

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Hope, D.A., Herbert, J.D. & White, C. Diagnostic subtype, avoidant personality disorder, and efficacy of cognitive—behavioral group therapy for social phobia. Cogn Ther Res 19, 399–417 (1995). https://doi.org/10.1007/BF02230408

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