Cognitive predictors of treatment outcome for exposure therapy: do changes in self-efficacy, self-focused attention, and estimated social costs predict symptom improvement in social anxiety disorder?

Isabel L Kampmann, Paul M G Emmelkamp, Nexhmedin Morina, Isabel L Kampmann, Paul M G Emmelkamp, Nexhmedin Morina

Abstract

Background: Cognitions play an important role in the development and maintenance of social anxiety disorder (SAD).

Methods: To investigate whether changes in cognitions during the first six sessions of exposure therapy are associated with treatment outcome, we assessed reported self-focused attention, self-efficacy in social situations, and estimated social costs in 60 participants (Mage = 36.9 years) diagnosed with SAD who received in vivo or virtual reality exposure therapy.

Results: Patients demonstrating a greater decrease in estimated social costs during treatment reported greater improvement of their social anxiety symptoms following both forms of exposure therapy. While changes in self-focused attention and social self-efficacy during treatment were significantly associated with treatment outcome when examined individually, these changes did not significantly predict symptom improvement beyond social costs.

Conclusions: Changes in estimated social costs during treatment are associated with improvement of social anxiety symptoms after exposure therapy. Future research needs to further investigate estimated social costs as a predictor in relation to other cognitive variables.

Trial registration: NCT01746667 ; www.clinicaltrials.gov, November 2012, retrospectively registered.

Keywords: Cognitive predictors; Exposure therapy; Virtual reality.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by an institutional review board (University of Amsterdam) and all participants provided written informed consent before their enrolment.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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