Behavioral Treatment of Heterosexual Social Anxiety: A Factorial Investigation

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This study was designed to sort out the factors producing inconsistent findings in the social anxiety treatment literature by (a) separating treatment-specific from non-treatmentspecific outcome effects and (b) investigating whether treatments had their major impact on anticipatory anxiety, actual social performance, or anxiety experienced following social interaction. Fifty-six male volunteers who complained of inhibition in heterosexual social situations were included in a treatments x therapists factorial design. Treatments suggested by prior literature to be most promising--systematic desensitization (SD), behavior rehearsal (BR), and a combination of the two---were compared to traditional insight therapy and a no-treatment assessment-only control. The insight group controlled for non-treatmentspecific factors and because of its clinical prevalence provided a baseline for evaluating behavioral treatments. Therapy was conducted in small groups during five weekly sessions. Two female therapists guided by detailed manuals conducted one group under each treatment. Verbal-cognitive, physiological, and behavioral outcome measures were taken preand post-treatment as part of an actual heterosexual social interaction with a female confederate. Results indicated that all four treatments were superior to no treatment. Nonspecific factors common to all treatments were as potent in reducing anxiety on most measures as behavioral treatment. BR was the most superior in reducing anticipatory anxiety and enhancing social skills. No advantage was offered by SD alone or in combination with BR. Therapist characteristics interacted with all treatments, including behavior therapies, in influencing the outcome. Intercorrelations between diverse anxiety measures were generally low so that, as in prior research, the convergent validity of a generalized anxiety construct was not established.

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Behavior Therapy, v. 9, issue 5, p. 971-972