Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

Zaider, Talia; Heimberg, Richard G.; Fresco, David M.; Schneier, Franklin R.; Liebowitz, Michael R.

doi:10.1017/s0033291703007414

Cited by 234 publications

(203 citation statements)

References 27 publications

(34 reference statements)

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“…It has been used in large and rigorous randomized controlled trials of psychosocial and pharmacologic treatments for adolescent depression (e.g., Keller et al 2000;March et al 2004). Psychometrically, the CGI-S provides comparable information to other measures in studies of response to pharmacologic treatments (Leucht and Engel 2006) and is correlated with self-reported and clinician-rated affective symptoms (Zaider et al 2003). Clinicians administering the CGI-S compared and discussed their ratings during training.…”

Section: Methodsmentioning

confidence: 99%

Real-World Affect and Social Context as Predictors of Treatment Response in Child and Adolescent Depression and Anxiety: An Ecological Momentary Assessment Study

Forbes

Stepp

Dahl

et al. 2012

Journal of Child and Adolescent Psychopharmacology

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Objective: Response to treatment in child and adolescent affective disorders is variable, with limited ability of any one treatment to improve outcome across patients. Unfortunately, we know little about the factors that explain this variability in treatment response. Individual differences in the social and affective dynamics of daily life could help to elucidate the characteristics of youth who respond to treatment. Methods: We used ecological momentary assessment of negative affect, positive affect, and companions in natural settings over 4 days in a sample of young people with depressive and anxiety disorders who participated in an 8-week open trial of cognitive behavioral therapy (CBT), selective serotonin reuptake inhibitors (SSRIs), or a combination of the two. Clinicians rated participants' clinical severity at five time points, and participants reported their symptoms before and after treatment. Latent growth curve models were used to predict rate of change in clinical severity from pretreatment affect in natural settings. Results: Participants with high positive affect (PA), low negative affect (NA), and a high PA:NA ratio at baseline had lower severity, depressive symptoms, and anxiety symptoms at the end of treatment. Lower posttreatment symptoms were associated with spending more time with fathers and less time with peers before treatment. Although baseline affect was not associated with initial symptom severity, high NA and low PA:NA at baseline were related to slower rate of decline of severity during treatment. When baseline symptoms were included in models, NA and PA:NA predicted rate of decline in severity during treatment, whereas self-reported depressive and anxiety symptoms at baseline did not. Conclusion: A more typical profile of baseline affective functioning in natural settings-that is, lower NA and higher PAand time with fathers, could provide a foundation for treatment response in children and adolescents. Affective and social dynamics in natural settings could ultimately help investigate which young people might benefit from current treatments.

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Section: Methodsmentioning

confidence: 99%

Real-World Affect and Social Context as Predictors of Treatment Response in Child and Adolescent Depression and Anxiety: An Ecological Momentary Assessment Study

Forbes

Stepp

Dahl

et al. 2012

Journal of Child and Adolescent Psychopharmacology

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“…It has acceptable psychometric properties (Zaider, Heimberg, Fresco, Schneier & Liebowitz, 2003). The clinician rates on a 1-7 scale the severity of social anxiety (CGI-S).…”

Section: Outcome Measuresmentioning

confidence: 99%

Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

Book¹,

Thomas²,

Randall³

et al. 2008

Journal of Anxiety Disorders

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Patients with social anxiety disorder who are seen in clinical practice commonly have additional psychiatric comorbidity, including alcohol use disorders. The first line treatment for social anxiety disorder is selective-serotonin-reuptake-inhibitors (SSRIs), such as paroxetine. However, the efficacy of SSRIs has been determined with studies that excluded alcoholics. Forty two subjects with social anxiety and a co-occurring alcohol use disorder participated in a 16-week, double-blind, placebo-controlled clinical trial to determine the efficacy of paroxetine for social anxiety in patients with co-occurring alcohol problems. Paroxetine was superior to placebo in reducing social anxiety, as measured by the Liebowitz Social Anxiety Scale total and subscale scores and additional measures of social anxiety. This study provides the first evidence-based recommendation for the use of an SSRI to treat social anxiety in this patient population.

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Section: Brief Fear Of Negative Evaluation Scale (Bfne;mentioning

confidence: 99%

“…Improvement is measured on a 7-point Likert-type scale ranging from a score of 1 (markedly improved) to 7 (markedly worse). The CGI has been shown to be positively related to both self-report and clinician-administered measures of social anxiety, depression, impairment, and quality of life among clients with social anxiety disorder (Zaider, Heimberg, Fresco, Schneier, & Liebowitz, 2003).Liebowitz Social Anxiety Scale (LSAS; Liebowitz, 1987)-The LSAS is a 24-item interviewer-rated measure designed to assess fear and avoidance of specific social situations. Respondents rate their level of fear on a 4-point scale ranging from 0 (none) to 3 (severe) and degree of avoidance on a 4-point scale ranging from 0 (never or 0%) to 3 (usually or 67% to 100%) over the previous week.…”

mentioning

confidence: 99%

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

Hayes

Miller

Hope

et al. 2008

Cognitive and Behavioral Practice

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Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective improvement that asks clients with social anxiety disorder how much they have changed since the beginning of therapy. Change on the SASCI was related to change in fear of negative evaluation, a core aspect of social anxiety, and to clinician-rated improvement, but not to ratings of anxiety sensitivity or depression. Because it is brief and easily interpretable, the SASCI can be used in a variety of clinical settings to monitor change across therapy. The SASCI is presented along with examples of how the information gathered from frequent administration can inform clinical practice. Barlow, Hayes, and Nelson (1984) highlight three key reasons why clinicians should measure their clients' change across therapy: to improve treatment, to enhance clinical science, and to provide accountability. In short, these authors posit that assessing change during treatment allows modifications in the treatment procedure to enhance results; gives scientist-practitioners a better understanding of effective treatment techniques; and provides evidence of treatment effectiveness to insurance companies and other third-party payers. Research has shown that tracking clients' progress can improve outcome (see Lambert et al., 2003). A brief weekly progress update would allow for an efficient and sensitive method to NIH Public Access Author ManuscriptCogn Behav Pract. Author manuscript; available in PMC 2014 July 27. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript assess client improvement or relapse from week to week. Changes from the previous week could be used as a tool in session to either investigate what worked well over the week, or to make adjustments if needed. Further, researchers could utilize a session-by-session measure as a way to understand the elements and processes of treatment that lead to change. In addition, therapists have reported that they are interested in using such data to improve their services (e.g., Bickman et al., 2000). However, one of the primary difficulties in utilizing regular assessments in clinical settings is the time required to administer, score, and interpret frequent assessments. In our own work with social anxiety disorder, we found the need for an efficient instrument for ongoing assessment of change, but nothing was available. In response, we developed a brief measure of subjective change that can be administered, interpreted, and utilized in busy clinical practices and research settings.Traditionally, treatment research has focused on changes in symptoms from pretreatment to posttreatment (Kazdin, 2003). Whereas this approach provides a global account of the efficacy of the treatment, it neglects important intermediate steps ...

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Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

Cited by 234 publications

References 27 publications

Real-World Affect and Social Context as Predictors of Treatment Response in Child and Adolescent Depression and Anxiety: An Ecological Momentary Assessment Study

Real-World Affect and Social Context as Predictors of Treatment Response in Child and Adolescent Depression and Anxiety: An Ecological Momentary Assessment Study

Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder

Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

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