Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial

Background: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of...

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Autores principales:	Rodrigo C.T. Lopes, Dajana Šipka, Tobias Krieger, Jan Philipp Klein, Thomas Berger
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Internet-based cognitive-behavioral therapy Social anxiety Factorial design Mechanisms of change Information technology T58.5-58.64 Psychology BF1-990
Acceso en línea:	https://doaj.org/article/5c1ee12f377f440ab64d0a3f927d2fcf
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spelling	oai:doaj.org-article:5c1ee12f377f440ab64d0a3f927d2fcf2021-11-18T04:49:06ZOptimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial2214-782910.1016/j.invent.2021.100480https://doaj.org/article/5c1ee12f377f440ab64d0a3f927d2fcf2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214782921001202https://doaj.org/toc/2214-7829Background: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of evidence-based explanation of how treatments work and what their active ingredients might be. An approach to unpack the active ingredients and mechanisms of treatment is the factorial design. Objectives: The study is a factorial trial aiming (1) to examine the main effects and interactions for the four main treatment components of internet-based cognitive-behavioral therapy (ICBT) for SAD (i.e., psychoeducation, cognitive restructuring, attentional training, and exposure) and (2) to examine whether and which change mechanisms mediate the relationship between treatment components and symptom reduction. Methods: A total of 464 adults diagnosed with SAD will be randomized to one of 16 conditions containing combinations of the treatment components. The primary endpoint is SAD symptomatology at eight weeks. Secondary endpoints include symptoms of depression and anxiety, quality of life, and negative effects. Hypothesized change mechanisms are the increase of knowledge about SAD, the decrease of dysfunctional cognitions, the decrease of self-focused attention, and the decrease of avoidance and safety behaviors. Discussion: A better understanding of the differential efficacy of treatment components and mechanisms of treatment underlying ICBT for SAD might inform clinicians and researchers to plan more potent and scalable treatments. Trial registration: clinicaltrials.gov (NCT04879641) on June, 11th 2021. https://clinicaltrials.gov/ct2/show/NCT04879641.Rodrigo C.T. LopesDajana ŠipkaTobias KriegerJan Philipp KleinThomas BergerElsevierarticleInternet-based cognitive-behavioral therapySocial anxietyFactorial designMechanisms of changeInformation technologyT58.5-58.64PsychologyBF1-990ENInternet Interventions, Vol 26, Iss , Pp 100480- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Internet-based cognitive-behavioral therapy Social anxiety Factorial design Mechanisms of change Information technology T58.5-58.64 Psychology BF1-990
spellingShingle	Internet-based cognitive-behavioral therapy Social anxiety Factorial design Mechanisms of change Information technology T58.5-58.64 Psychology BF1-990 Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
description	Background: Social anxiety disorder (SAD) is characterized by a marked fear of negative evaluation in social situations and significant impairments. Even with the most effective treatments, remission rates are around 50%. An important reason for the limited effectiveness of treatments is the lack of evidence-based explanation of how treatments work and what their active ingredients might be. An approach to unpack the active ingredients and mechanisms of treatment is the factorial design. Objectives: The study is a factorial trial aiming (1) to examine the main effects and interactions for the four main treatment components of internet-based cognitive-behavioral therapy (ICBT) for SAD (i.e., psychoeducation, cognitive restructuring, attentional training, and exposure) and (2) to examine whether and which change mechanisms mediate the relationship between treatment components and symptom reduction. Methods: A total of 464 adults diagnosed with SAD will be randomized to one of 16 conditions containing combinations of the treatment components. The primary endpoint is SAD symptomatology at eight weeks. Secondary endpoints include symptoms of depression and anxiety, quality of life, and negative effects. Hypothesized change mechanisms are the increase of knowledge about SAD, the decrease of dysfunctional cognitions, the decrease of self-focused attention, and the decrease of avoidance and safety behaviors. Discussion: A better understanding of the differential efficacy of treatment components and mechanisms of treatment underlying ICBT for SAD might inform clinicians and researchers to plan more potent and scalable treatments. Trial registration: clinicaltrials.gov (NCT04879641) on June, 11th 2021. https://clinicaltrials.gov/ct2/show/NCT04879641.
format	article
author	Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger
author_facet	Rodrigo C.T. Lopes Dajana Šipka Tobias Krieger Jan Philipp Klein Thomas Berger
author_sort	Rodrigo C.T. Lopes
title	Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
title_short	Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
title_full	Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
title_fullStr	Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
title_full_unstemmed	Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial
title_sort	optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: study protocol for a randomized factorial trial
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/5c1ee12f377f440ab64d0a3f927d2fcf
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Optimizing cognitive-behavioral therapy for social anxiety disorder and understanding the mechanisms of change: Study protocol for a randomized factorial trial

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