Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder.

Abstract

Objective To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually-administered Cognitive-Behavioral Therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method A randomized controlled trial in which 75 adult patients (21–55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a waitlist control (WL) group (n = 37). All patients completed self-report inventories measuring cognitive reappraisal self-efficacy (CR-SE) and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year post-treatment. Results Compared to WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year post-treatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up. Conclusions Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.

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“…We felt that such an approach was justifiable because challenging dysfunctional thoughts might not be essential for therapeutic success 14 and because self-efficacy in cognitive reappraisal had been found to mediate treatment outcomes in cognitive-behavioral therapy. 15 …”

The Prediction of Clinically Relevant Anxiety Symptoms in Early Adulthood: Direct and Indirect Effects of Childhood and Parental Factors

“…Studies show that individuals with AD with a low level of self-efficacy, experience high levels of subjective distress and approach potentially aversive situations more reluctantly, conjuring up possible injurious consequences and doubting their capabilities to solve problems [19][20][21]. Associations of lower selfefficacy with anxiety symptoms and disorders have been shown in several studies [22,23].…”

The regulation of achievements emotions: Implications for research and practice.

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