Efficacy of cognitive behavioral therapy for social anxiety ...
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Efficacy of cognitive behavioral therapy for social anxiety ...
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[post_date] => 2024-12-26 08:27:18
[post_date_gmt] => 2024-12-26 13:27:18
[post_content] => Practice Passage (Question 1-5)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
Social anxiety disorder is a mental illness characterized by excessive fear or anxiety about one or more social situations. Individuals with social Anxiety Disorder are irrationally afraid of exposure to negative evaluation or scrutiny from others in social situations, and often avoid social interaction all together. For those with social anxiety disorder, socializing with others is endured, not enjoyed. This causes significant disturbances in daily functioning, and impairments are typically chronic and pervasive.
Cognitive Behavioral Therapy (CBT) seeks to actively change irrational thoughts and behaviors. A top CBT researcher decides to evaluate the potential of a manual-based CBT intervention to treat symptoms of social anxiety disorder, and change irrational thoughts and behaviors related to social situations. To do this, he recruits 50 clinical psychologists with advanced training in CBT. Each therapist is given a manual to use as a guide for therapy sessions, with enough content for 22 individual sessions. The manual includes a variety of CBT exercises, including role-play based behavioral exercises, challenges designed to restructure irrational or dysfunctional thoughts, biofeedback exercises, and goal setting tasks.To participate, individuals must have a primary diagnosis of Social Anxiety Disorder, and must not have any severe medical conditions, history of self-harm, or current diagnosis of a substance-use disorder. Of the 500 individuals who respond to an internet-based advertisement, 420 meet the eligibility criteria. They are then randomized the active (CBT; n = 210) or control (waitlist; n = 210) condition. Each participant completes questionnaires related to social anxiety, social phobia or anxiety symptoms, and depression at baseline and after 22 weeks. There are no significant demographic differences between the groups; there are equal numbers of men and women enrolled in the study and all participants are between the ages of 18 and 60, with a mean age of 38.8 (SD = 12.09).
Table 1 contains means of the outcome variables. Scores on the social anxiety questionnaire range from 0 to 100, scores on the social phobia and anxiety questionnaire range from 0 to 100, and scores on the depression questionnaire range from 0 to 30. Higher scores on any of the measures indicate greater pathology.
[post_title] => Efficacy of cognitive behavioral therapy for social anxiety disorder
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[question] => Some experts believe that anxiety is a learned response acquired through classical conditioning. A patient in the study recalls that she used to be able to go out with friends without feeling anxious. One night, she was attacked while out at a bar with friends. She now avoids socializing with friends, going out to bars, and remains very anxious about social situations in general. What is the neutral stimulus (NS) and conditioned response (CR) in this scenario?
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[description] => Reason for the Correct Answer:
The neutral stimulus is a situation that evokes a neutral (unconditioned) response.
When the unconditioned stimulus is paired with another event, the automatic response that follows is the conditioned response.
The neutral stimulus in this instance is going out with friends – it was initially paired with a neutral response that was not characterized by anxiety.
The conditioned response is the automatic reaction the patient has when going out – feeling anxiety.
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[each_answer] => A. NS – going out with friends; CR- feeling anxious
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[each_answer] => B. NS – going out with friends; CR – not feeling anxious
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[each_answer] => C. NS – avoiding going out with friends; CR- not feeling anxious
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[each_answer] => D. NS – avoiding going out with friends; CR – feeling anxious
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[1] => Array
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[quiz_unique_key] => 3873426850
[question] => Individuals with social anxiety disorder may use medication along with therapy to treat their symptoms. After analyzing the data, the researcher finds out that the majority of participants in the CBT group were taking medication, and none of the participants in the control group were taking medication. Given the results of the study, the use of medication by the individuals in therapy poses the greatest threat to which type of validity?
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[answer] => 4
[description] => Reason for the Correct Answer:
The study produced decreases across all outcome variables for the CBT group.
Face validity refers to the extent to which the research subjectively appears to examine the relationship between CBT and social anxiety. The research still appears to address examine the relationship between CBT and social anxiety , thus face validity is not substantially affected.
Construct validity refers to whether or not the questionnaires used to assess social anxiety adequately measure social anxiety. This has no relationship to the mechanism used to increase or decrease social anxiety; thus construct validity is not substantially affected.
External validity refers to whether or not results from the smaller sample of individuals can be expected from or applied to other populations or other situations. In this research example, the use of medication could be more in line with the general population, so including this information may make the results more generalizable.
However, because medication was not accounted for, the researcher cannot tell whether or not the CBT was actually effective – this is a huge issue for internal validity. There is no way to tell if the decreases were caused by medication or CBT.
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[each_answer] => A. Construct validity, because the research does not adequately measure social anxiety
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[1] => Array
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[each_answer] => B. Face validity, because the research no longer appears to address its central question
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[each_answer] => C. External validity, because the research is no longer generalizable
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[each_answer] => D. Internal validity, because the research has been exposed to a significant confound
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[quiz_unique_key] => 83407773
[question] => The Stages of Change Model assesses readiness for change. The participants in the study responded to an ad that offered free therapy for social anxiety disorder. Which stage of change are the participants most likely experiencing when they respond to the ad for free therapy?
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[description] => Reason for the Correct Answer:
Action refers to the stage of change where the plan is put into practice. Participants in “action” could be in therapy and actively using and practicing strategies that decrease their social anxiety.
Preparation refers to the stage of change where the individual begins to plan what it would take to make change happen. Participants in “preparation” could be in the initial stages of therapy, working collaboratively with their therapist to plan for behavioral change.
Precontemplation refers to the stage of change where the individual is unaware of any issues with their life of behavior and has no plans to change. Participants in “precontemplation” may not reach out for help, because they would not see their social anxiety as an issue.
Contemplation refers to the stage of change where an individual is aware that there is a problem and is actively thinking about ways to solve the problem (this can often include seeking help or talking about issues). Thus, participants are likely in contemplation – they are aware that their social anxiety is an issue and would like help in changing their life.
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[each_answer] => A. Contemplation, because they are thinking about changing their behavior.
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[each_answer] => B. Action, because they are taking steps to change their behavior.
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[each_answer] => C. Precontemplation, because they do not plan to change their behavior.
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[each_answer] => D. Preparation, because they are planning to change their behavior.
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[quiz_unique_key] => 2261298308
[question] => Given the data outlined in Table 1, which of the following could describe the relationship between the outcome variables?
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[answer] => 3
[description] => Reason for the Correct Answer:
A correlation between two variables suggests that the variables are related.
Correlation coefficients in this question measure the strength of the relationship between depression and social anxiety.
Correlation coefficients cannot be greater than 1; they range from -1 to 1.
A correlation coefficient of zero would suggest that there is no relationship between the variables.
In the case of a negative correlation between depression and social anxiety, variables move in opposite ways of one another – if one increased, the other would decrease.
In the case of a positive correlation between depression and social anxiety, both variables would move in the same direction – if one increased, the other would increase (and vice versa).
The data shows clear decreases in all symptoms from the CBT intervention. Thus, there could be a positive correlation between the outcome variables.
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[each_answer] => A. There could be a negative correlation between depression and social anxiety.
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[each_answer] => B. The correlation coefficient between depression and social anxiety could be greater than 1.0.
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[each_answer] => C. There could be a positive correlation between depression and social anxiety.
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[each_answer] => D. The correlation coefficient between depression and social anxiety could be 0.
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[quiz_unique_key] => 574431310
[question] => One of the key features of social anxiety disorder is excessive fear of socializing with others. Which of the following statements most accurately describes fear?
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[answer] => 3
[description] => Reason for the Correct Answer:
Fear is one of the basic emotions and is similar to anxiety, but has some slight differences. First, fear is a response to a known threat.
Secondly, fear is typically a response to a current, tangible threat- it is not something that is felt without the threat being definite and immediate.
Fear brings about specific physiological changes, specifically activation of the fight or flight response.
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[answers] => Array
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[0] => Array
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[each_answer] => A. Fear is a basic emotion that involves negative evaluation without physiological changes.
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[each_answer] => B. Fear is a basic emotion that involves significant concern about future events or situations.
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[each_answer] => C. Fear is a basic emotion that involves the activation of a fight or flight response.
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[each_answer] => D. Fear is a basic emotion that involves a response to an unknown threat.
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