Risk profiles for poor treatment response to internet-delivered CBT in people with social anxiety disorder |
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| Institution: | 1. Center for Health and Medical Psychology, JPS, Psychology, Örebro University, Sweden;2. Department of Psychology, Uppsala University, Sweden;3. Department of Psychology, Stockholm University, Sweden;4. Department of Behavioural Sciences and Learning, Linköping University, Sweden;5. Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden;1. Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA;2. Emory University, Department of Psychiatry and Behavioral Sciences, Grady Health System, 80 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA;3. University of Vermont, Department of Psychology, 2 Colchester Ave, Burlington, VT, 05405, USA;1. University of Michigan, USA;2. Michigan State University, USA;3. Jewish Vocational Services, Detroit, USA;4. Temple University, USA;1. Department of Psychology, Stanford University, Jordan Hall, 450 Serra Mall, Stanford, CA 94305, USA;2. Department of Psychology, Institute of Personality and Social Research, University of California, Berkeley, 4152 Tolman Hall, Berkeley, CA 95720, USA;3. Betty Irene Moore School of Nursing, University of California, Davis Health System, Education Building, 4610 X Street, Sacramento, CA 95817, USA;4. Department of Psychology, Temple University, Weiss Hall 420, 1701 North 13th Street, Philadelphia, PA 19122, USA |
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| Abstract: | In social anxiety disorder (SAD) co-morbid depressive symptoms as well as avoidance behaviors have been shown to predict insufficient treatment response. It is likely that subgroups of individuals with different profiles of risk factors for poor treatment response exist. This study aimed to identify subgroups of social avoidance and depressive symptoms in a clinical sample (N = 167) with SAD before and after guided internet-delivered CBT, and to compare these groups on diagnostic status and social anxiety. We further examined individual movement between subgroups over time. Using cluster analysis we identified four subgroups, including a high-problem cluster at both time-points. Individuals in this cluster showed less remission after treatment, exhibited higher levels of social anxiety at both assessments, and typically remained in the high-problem cluster after treatment. Thus, in individuals with SAD, high levels of social avoidance and depressive symptoms constitute a risk profile for poor treatment response. |
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| Keywords: | Social anxiety disorder Social avoidance Depressive symptoms Guided internet-based CBT Risk factors Cluster analysis |
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