Cognitive Bias Modification versus CBT in Reducing Adolescent Social Anxiety: A Randomized Controlled Trial

Abstract

Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n = 86) was compared to a school-based cognitive behavioral group training (CBT; n = 84) and a control group (n = 70) in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13–15 years. Participants (n = 240) were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations.Trial RegistrationTrialRegister.nl NTR965

Systematic review and economic modelling of the clinical effectiveness and cost-effectiveness of art therapy among people with non-psychotic mental health disorders

“…., but equally they do not tend to deteriorate rapidly'. 93 More recent data provided in Sportel et al 94 (table 3) Test Anxiety Inventory 95 ), the effect had not entirely waned at 12-month follow-up. This may be generalisable to other forms of successful psychological therapy, and conservatively we elected to assume that all benefit had dissipated at 52 weeks post treatment, although a longer period of 104 weeks was used in sensitivity analyses.…”

Cognitive-Behavioral and Psychodynamic Therapy in Adolescents with Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

“…The same concerns the study by Spence et al [12], they reported that 29% dropped out in a generic CBT condition, 21% in CBT specifically tailored to SAD, and 10% in a WL condition. However, Sportel et al [13] found comparable or even higher dropout rates: 32% in the CBT group, who did not receive the allocated intervention, compared to 65% in the internet-based cognitive bias modification group, and 17% in the control group. Higher dropout rates were reported by Ingul et al [11].…”

“…Furthermore, 2 recently conducted RCT also demonstrated the efficacy of internet-delivered CBT interventions in these patients [12, 13]. …”

Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology

“…These initially disappointing results could be due to only single training sessions being administered. Interestingly, a recent study looking specifically at adolescents with high levels of social concerns showed that a combination of CBM-A and CBM-I was effective (Sportel et al, 2013), but these effects were less persistent than those of other frontline treatments such as CBT. One strategy to improve effectiveness may be to increase userengagement of these computerized training programs.…”