Examining Long-Term Effects and Neural Mediators of Behavioral Treatments for Social Anxiety Disorder

NCT ID: NCT00872820

Last Updated: 2014-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2013-09-30

Brief Summary

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This study will compare the effects that two types of behavioral therapy have on brain function in people with social anxiety disorder.

Detailed Description

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Social anxiety disorder (SAD) is characterized by intense and debilitating anxiety in common social situations. Cognitive behavioral therapy (CBT) is a talking treatment that aims to reduce immediate anxiety symptoms. However, some anxiety symptoms and comorbid disorders not directly addressed by CBT may only improve in the short term, while recurring in the long term. Behavioral therapy based on acceptance and mindfulness is thought to have longer lasting effects, because this approach emphasizes accepting anxiety instead of controlling anxiety. This study will compare standard CBT to acceptance and commitment therapy (ACT), which uses acceptance and mindfulness, to determine which is more effective on both a short- and long-term basis. Participants with SAD will undergo brain scans to determine how the two therapies affect brain functioning.

Participation in this study will last 12 months. Participants with SAD will be randomly assigned to receive CBT, ACT, or a waitlist condition. Both CBT and ACT treatments will include 12 weekly sessions that will deal with objects and situations that provoke anxiety. All sessions will be audio- and videotaped. The waitlist group will complete weekly self-monitoring forms to track anxiety and panic and will receive a phone call from a research coordinator every 2 weeks to make sure symptoms have not worsened. After 12 weeks, participants on the waitlist will be offered treatment.

All participants will attend study visits to undergo brain scanning at baseline, after 3 months, and after 12 months. Each study visit will involve MRI scanning (to evaluate brain structure), functional MRI (fMRI) scanning (to evaluate brain function), questionnaires about a participant's experience in the scanner, and collection of saliva samples before, during, and after scanning. While undergoing the fMRI scan, participants will be asked to remain at rest for a certain period of time, and then to perform tasks that will engage certain parts of the brain. Assessments for all participants will occur at baseline and after 3, 6, and 12 months. These assessments will include diagnostic evaluations by a therapist, self-report questionnaires, ongoing self-monitoring, physiological measurements, cognitive assessments, and behavioral observation.

Conditions

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Social Anxiety Disorder

Keywords

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Social Anxiety Social Anxiety Treatment Cognitive Therapy Mindfulness Social Phobia Social Phobia Treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Participants will receive standard cognitive behavioral therapy.

Group Type ACTIVE_COMPARATOR

Cognitive behavioral therapy

Intervention Type BEHAVIORAL

12 weekly treatment sessions conducted individually with a therapist; methods for dealing with anxiety will include cognitive and breathing strategies

2

Participants will receive acceptance- and commitment-based behavioral therapy.

Group Type EXPERIMENTAL

Acceptance- and commitment-based behavioral therapy

Intervention Type BEHAVIORAL

12 weekly treatment sessions conducted individually with a therapist; strategies for dealing with anxiety will include mindfulness and acceptance of negative feelings

3

Participants will be placed on a waitlist for 3 months before being offered treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Acceptance- and commitment-based behavioral therapy

12 weekly treatment sessions conducted individually with a therapist; strategies for dealing with anxiety will include mindfulness and acceptance of negative feelings

Intervention Type BEHAVIORAL

Cognitive behavioral therapy

12 weekly treatment sessions conducted individually with a therapist; methods for dealing with anxiety will include cognitive and breathing strategies

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Meets diagnostic criteria for social anxiety disorder
* Right-handed
* If taking medications, stabilized on current dose for 3 months
* If undergoing psychotherapy, stabilized for 6 months
* Speaks English

Exclusion Criteria

* Currently undergoing cognitive behavioral therapy
* History of psychiatric hospitalization in the last 5 years
* Presence of serious medical condition, such as respiratory, cardiovascular, pulmonary, neurological, or muscular-skeletal disease or pregnancy
* Active suicidal ideation
* Current severe depression
* History of bipolar disorder, psychosis, mental retardation, or brain damage
* History of substance abuse or dependence in the last 6 months
* Presence of irremovable metal objects in the body that are not fMRI-safe
* Suffers from claustrophobia
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of California, Los Angeles

OTHER

Sponsor Role lead

Responsible Party

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Michelle Craske

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michelle G. Craske, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, Los Angeles

Locations

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UCLA Psychology Department - Franz Hall

Los Angeles, California, United States

Site Status

Countries

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United States

References

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Niles AN, Burklund LJ, Arch JJ, Lieberman MD, Saxbe D, Craske MG. Cognitive mediators of treatment for social anxiety disorder: comparing acceptance and commitment therapy and cognitive-behavioral therapy. Behav Ther. 2014 Sep;45(5):664-77. doi: 10.1016/j.beth.2014.04.006. Epub 2014 May 5.

Reference Type DERIVED
PMID: 25022777 (View on PubMed)

Other Identifiers

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R21MH081299

Identifier Type: NIH

Identifier Source: secondary_id

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DATR A3-NSS

Identifier Type: -

Identifier Source: secondary_id

R21MH081299

Identifier Type: NIH

Identifier Source: org_study_id

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