Attention Disengagement Training for Social Phobia

Generalized Social Phobia (GSP) is characterized by severe social anxiety that leads to
functional impairment (Schneider, et al., 1992). The prevalence of GSP is 13.3% (lifetime,
Kessler, et al., 1994), ranking third among all psychiatric disorders. Despite its high
prevalence, over 30% of individuals with social anxiety who need treatment do not receive
treatment for a variety of reasons (e.g., afraid of what others might think, Olfson, et al.,
2000). Additionally, 40% of individuals who present for treatment do not respond (39%
Heimberg, et al., 1998; 42%, Liebowitz et al., 2005). Thus, there is a clear need to
develop highly effective and efficient treatment procedures for social phobia. This
three-year proposal aims to test a computerized treatment for social anxiety in a
double-blind, placebo-controlled study. Specifically, research suggests that individuals
with social phobia direct their attention toward socially-relevant negative information.
Therefore, the treatment will focus on changing this attention bias and thereby alleviate
symptoms of social anxiety. We present the results of a pilot study (n=26) in treatment
seeking socially phobic individuals demonstrating the effectiveness of the treatment. A
larger study would allow us to test the treatment and perhaps modify its component to
increase its efficacy. The preliminary results of the pilot are encouraging. In brief, our
intervention was effective in: a) changing biased attention in socially anxious individuals,
b) generalizing this change in disengagement of attention from threat to other measures of
attention disengagement, c) reduce symptoms of social anxiety as assessed by an independent
rater, d) maintain a high rate of compliance (0% drop out in the pilot study), and e)
maintain its effects in follow-up assessment up to one year. This efficient and efficacious
techniques for changing attention bias in social phobia can provide a cost-effective and
easy to administer treatment that is grounded in basic cognitive science and may help reduce
suffering in individuals with GSP. We will test two hypotheses in this proposal. 1)
Individuals with GSP completing the Attention Disengagement Training (ADT) will show a
larger reduction in their symptoms compared to the placebo group on an interviewer measure
of social anxiety (Liebowitz Social Anxiety Scale, LSAS). 2) Individuals with GSP
completing ADT will show a larger reduction in their self-report of social anxiety symptoms
compared to the placebo group

Inclusion Criteria:

- Principle DSM-IV-TR (APA, 2000) Diagnosis of social phobia - Generalized Type (GSP)

Exclusion Criteria:

- No change in medication type or dosage twelve weeks prior to initiating treatment

- No current psychotherapy

- No evidence of suicidal intent

- No evidence of substance abuse in the last 6 months

- No evidence of current or past schizophrenia, bipolar disorder, or organic mental
disorder