Forty-nine patients participated in a study comparing cognitive-behavioral group treatment (CBGT) for social phobia with a credible placebo control. CBGT consisted of exposure to simulated phobic events, cognitive restructuring of maladaptive thoughts, and homework for self-directed exposure and cognitive restructuring between sessions. Control patients received a treatment package consisting of lecture-discussion and group support that was comparable to CBGT on measures of treatment credibility and outcome expectations. At pretest, posttest, and 3-and 6-month follow-ups, patients completed assessments that included clinician ratings, self-report measures, and behavioral physiological and cognitive-subjective measures derived from a behavioral simulation of a personally relevant phobic event. Both groups improved on most measures, but, at both posttest and follow-up, CBGT patients were rated as more improved than controls and reported less anxiety before and during the behavioral test. At follow-up, CBGT patients also reported significantly fewer negative and more positive self-statements than controls on a thought-listing task following the behavioral test. Regardless of treatment condition, follow-up changes in clinician-rated phobic severity were significantly related to changes on the thought-listing measure.

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The convergent and discriminant validity of the Social Interaction Self-Statement Test (SISST) were evaluated in a sample of men and women awaiting treatment for fear and avoidance of social interactions. Partial correlations revealed that negative, but not positive, self-statement scores were generally related to self-report measures of anxiety and depression. Heart rate and subjective anxiety ratings derived from a behavioral simulation of a personally relevant anxiety-provoking situation were unrelated to SISST scores. However, subjects' reports of negative thoughts obtained via the thought-listing procedure were related to the SISST negative self-statement scores, suggesting that the negative subscale of the SISST and the thought-listing procedure tap similar dimensions. Finally, the negative subscale of the SISST discriminated between social phobics whose primary fear involved social interactions and social phobics whose anxiety was confined to public-speaking situations. The findings support the use of the SISST with clinically socially anxious patients.

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