Content area
Full Text
Abstract
Many individuals seeking treatment for social anxiety disorder (SAD) also meet criteria for a comorbid depressive disorder. Little is known, however, about how a comorbid depressive disorder affects social anxiety treatment. This study examined 61 participants with SAD and 72 with SAD and a comorbid depressive disorder (SAD+D) before and after 12 weeks of cognitive behavioural group therapy (CBGT) for social anxiety. Although patients with SAD+D reported more severe-symptoms of social anxiety and depression at pretreatment, treatment was similarly effective for individuals with SAD and SAD+D. However, individuals with SAD+D continued to report higher symptom severity at post-treatment. Interestingly, CBGT for social anxiety also led to improvements in depressive symptoms despite the fact that depression was not targeted during treatment. Improvement in social anxiety symptoms predicted 26.8% of the variance in improvement in depressive symptoms. Results suggest that depressive symptoms need not be in remission for individuals to benefit from CBGT for social anxiety. However, more than 12 sessions of CBGT may be beneficial for individuals with comorbid depression.
Keywords: anxiety, depression, cognitive behavioural therapy, group treatment, comorbidity
Social anxiety disorder (SAD) is one of the most common psychiatric disorders, with lifetime prevalence rates estimated at 12.1% (Kessler et al., 2005). Among those who present for treatment, the presence of a comorbid psychiatric diagnosis is increasingly recognised as the norm. For example, 31% of individuals with generalised SAD also experience major depressive disorder at some point in their lives (Chartier, Walker, & Stein, 2003). Compared to individuals without comorbidity, those with comor- bid depression report higher levels of distress, greater impairment, and higher risk of suicide (e.g., Mannuzza, Aronowitz, Chapman, Klein, & Fyer, 1992; Rosenbaum, Pollack, & Pollack, 1996). Randomised controlled trials demonstrate that SAD can be successfully treated via several approaches; however, cognitive behavioural therapy (CBT) has received especially strong empirical support (see Stewart & Chambless, 2009, for a recent meta-analysis). Cognitive behavioural group therapy (CBGT) is a commonly administered format of CBT, and robust evidence demonstrates its effec- tiveness (e.g., Herbert et al., 2005; Marom, Gilboa-Schechtman, Aderka, Weizman, & Hermesh, 2009; McEvoy, 2007). In fact, a recent meta-analysis reported average effect sizes for CBGT of .92 (Aderka, 2009). Although the efficacy of CBGT is well established for SAD (see Rodebaugh,...