Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder

Abstract

Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety.

The Effectiveness of Emotion Regulation Skills Training on Anxiety and Emotional Regulation Strategies in Adolescent Students

“…This shows that training emotion regulation strategies are effective on reappraisal as a positive and adaptive emotion regulation strategy. The findings and conclusions of this research were in line with the results of previous studies (Ghaednia, 2013;Goldin et al, 2014). Goldin et al (2014) conducted a study among people suffering from social anxiety disorder.…”

“…The findings and conclusions of this research were in line with the results of previous studies (Ghaednia, 2013;Goldin et al, 2014). Goldin et al (2014) conducted a study among people suffering from social anxiety disorder. They found that training emotion regulation skills helped to decrease the signs and symptoms of social anxiety and shyness in people with anxiety disorder.…”

“…Goldin et al (2014) believe that training on emotion regulation skills by increasing the person's ability and diverting his or her attention from ineffective matters (such as concentrating on negative and inefficient thoughts in an anxious person who suffers from people's judgments), and focusing on what is more important and efficient can help to moderate the emotional experiences or in other words, notice flexibility and reappraisal.…”

“…Goldin et al (2014) in a study conducted among people with anxiety disorder found that training on emotion regulation skills could decrease their signs and symptoms of social anxiety. There is no considerable research conducted in the field of evaluating the effectiveness of training on emotion regulation skills and emotion regulation strategies to overcome the symptoms of anxiety in children and adolescents with anxiety disorders.…”

“…However, according to Goldin et al (2014), training on emotion regulation skills might decrease signs and symptoms of anxiety among anxious children and young people. Therefore, in this study, we aimed to answer the question that whether training on emotion regulation skills improves the level of emotional regulation strategies and decrease the signs and symptoms of anxiety in anxious students?…”