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Effect of Comorbid Depression on Cognitive Behavioural Group Therapy for Social Anxiety Disorder

Published online by Cambridge University Press:  27 February 2014

Joelle LeMoult ,
Karen Rowa ,
Martin M. Antony ,
Susan Chudzik  and
Randi E. McCabe
Joelle LeMoult*
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Karen Rowa
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Martin M. Antony
Affiliation:
Department of Psychology, Ryerson University, Toronto, Ontario, Canada
Susan Chudzik
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Randi E. McCabe
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
*
Address for correspondence: Joelle LeMoult, Anxiety Treatment and Research Centre, St. Joseph's Healthcare, 6th Floor, Fontbonne Building, 301 James Street South, Hamilton, ON, CanadaL8P 3B6. Email: [email protected]
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Abstract

Many individuals seeking treatment for social anxiety disorder (SAD) also meet criteria for a comorbid depressive disorder. Little is known, however, about how a comorbid depressive disorder affects social anxiety treatment. This study examined 61 participants with SAD and 72 with SAD and a comorbid depressive disorder (SAD+D) before and after 12 weeks of cognitive behavioural group therapy (CBGT) for social anxiety. Although patients with SAD+D reported more severe symptoms of social anxiety and depression at pretreatment, treatment was similarly effective for individuals with SAD and SAD+D. However, individuals with SAD+D continued to report higher symptom severity at post-treatment. Interestingly, CBGT for social anxiety also led to improvements in depressive symptoms despite the fact that depression was not targeted during treatment. Improvement in social anxiety symptoms predicted 26.8% of the variance in improvement in depressive symptoms. Results suggest that depressive symptoms need not be in remission for individuals to benefit from CBGT for social anxiety. However, more than 12 sessions of CBGT may be beneficial for individuals with comorbid depression.

Keywords

anxietydepressioncognitive behavioural therapygroup treatmentcomorbidity
Type
Standard Papers
Information
Behaviour Change , Volume 31 , Issue 1 , April 2014 , pp. 53 - 64
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2014 

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References

Aderka, I.M. (2009). Factors affecting treatment efficacy in social phobia: The use of video feedback and individual vs. group formats. Journal of Anxiety Disorders, 23, 12–17. doi:10.1016/j.janxdis.2008.05.003CrossRefGoogle ScholarPubMed
Allen, L.B., White, K.S., Barlow, D.H., Shear, M.K., Gorman, J.M., & Woods, S.W. (2010). Cognitive-behavior therapy (CBT) for panic disorder: Relationship of anxiety and depression comorbidity with treatment outcome. Journal of Psychopathology and Behavioral Assessment, 32, 185–192. doi:10.1007/s10862-009-9151-3CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
Antony, M.M., Bieling, P.J., Cox, B.J., Enns, M.W., & Swinson, R.P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample. Psychological Assessment, 10, 176–181. doi:10.1016/j.jad.2008.01.023CrossRefGoogle Scholar
Antony, M.M., Coons, M.J., McCabe, R.E., Ashbaugh, A.R., & Swinson, R.P. (2006). Psychometric properties of the Social Phobia Inventory: Further evaluation. Behaviour Research and Therapy, 44, 1177–1185. doi:10.1016/j.brat.2005.08.01CrossRefGoogle ScholarPubMed
Antony, M.M., & Swinson, R.P. (2008). Shyness and social anxiety workbook: Proven, step-by-step techniques for overcoming your fear (2nd ed.). Oakland, CA: New Harbinger Publications.Google Scholar
Chambless, D.L., Tran, G.Q., & Glass, C.R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11, 221–240.CrossRefGoogle ScholarPubMed
Chartier, M.J., Walker, J.R., & Stein, M.B. (2003). Considering comorbidity in social phobia. Social Psychiatry and Psychiatric Epidemiology, 38, 728–734. doi:10.1007/s00127-003-0720-6CrossRefGoogle ScholarPubMed
Connor, K.M., Davidson, J.R.T., Churchill, L E., Sherwood, A., Foa, E., & Wesler, R.H. (2000). Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry, 176, 379–386. doi:10.1192/bjp.176.4.379CrossRefGoogle ScholarPubMed
Dimidjian, S., Hollon, S.D., Dobson, K.S., Schmaling, K.B., Kohlenberg, R.J., Addis, M.E., . . . & Jacobson, N.S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670. doi:10.1037/0022-006X.74.4.658CrossRefGoogle ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1995). Structured Clinical Interview for DSM–IV Axis I Disorders—Clinician Version (SCID–CV). Washington, DC: American Psychiatric Press.Google Scholar
Erwin, B.A., Heimberg, R.G., Juster, H., & Mindlin, M. (2002). Comorbid anxiety and mood disorders among persons with social anxiety disorder. Behaviour Research and Therapy, 40, 19–35. doi:10.1016/S0005-7967(00)00114-5CrossRefGoogle ScholarPubMed
Herbert, J.D., Gaudiano, B.A., Rheingold, A.A., Myers, V.H., Dalrymple, K., & Nolan, E.M., (2005). Social skills training augments the effectiveness of cognitive behavioral group therapy for social anxiety disorder. Behavior Therapy, 36, 125–138. doi:10.1016/S0005-7894(05)80061-9CrossRefGoogle Scholar
Joormann, J., Kosfelder, J., & Schulte, D. (2005). The impact of comorbidity of depression on the course of anxiety treatments. Cognitive Therapy and Research, 29, 569–591. doi:10.1007/s10608-005-3340-5.CrossRefGoogle Scholar
Jones, S.H., Thornicroft, G., Coffey, M., & Dunn, G. (1995). A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). The British Journal of Psychiatry, 166, 654–659.CrossRefGoogle ScholarPubMed
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–602.CrossRefGoogle ScholarPubMed
Ledley, D.R., Huppert, J.D., Foa, E.B., Davidson, J.R.T., Keefe, F.J., & Potts, N.L.S. (2005). Impact of depressive symptoms on the treatment of generalized social anxiety disorder. Depression and Anxiety, 22, 161–167. doi:10.1002/da.20121CrossRefGoogle ScholarPubMed
Lovibond, S.H., & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney, Australia: Psychology Foundation.Google Scholar
Mannuzza, S., Aronowitz, B., Chapman, T., Klein, D.F., & Fyer, A.J. (1992). Panic disorder and suicide attempts. Journal of Anxiety Disorders, 6, 261–274. doi:10.1016/0887-6185(92)90038-9CrossRefGoogle Scholar
Mattick, R.P., & Clarke, J.C. (1989). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety Behaviour Research and Therapy, 36, 455–470. doi:10.1016/S0005-7967(97)10031-6CrossRefGoogle Scholar
Marom, S., Gilboa-Schechtman, E., Aderka, I.M., Weizman, A., & Hermesh, H. (2009). Impact of depression on treatment effectiveness and gains maintenance in social phobia: A naturalistic study of cognitive behavior group therapy. Depression and Anxiety, 26, 289–300. doi:10.1002/da.20390CrossRefGoogle ScholarPubMed
McEvoy, P.M. (2007). Effectiveness of cognitive behavioural group therapy for social phobia in a community clinic: A benchmarking study. Behaviour Research and Therapy, 45, 3030–3040. doi:10.1016/j.brat.2007.08.002CrossRefGoogle Scholar
Moscovitch, D.A., Hofmann, S.G., Suvak, M.K., & In-Albon, T. (2005). Mediation of changes in anxiety and depression during treatment of social phobia. Journal of Counseling and Clinical Psychology, 73, 945–952. doi:10.1037/0022-006X.73.5.945CrossRefGoogle ScholarPubMed
Newman, M.G., Przeworski, A., Fisher, A.J., & Borkovec, T.D. (2010). Diagnostic comorbidity in adults with generalized anxiety disorder: Impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses. Behavior Therapy, 41, 59–72.CrossRefGoogle ScholarPubMed
Osman, A., Gutierrez, P.M., Barrios, F.X., Kopper, B.A., & Chiros, C.E. (1998). The social phobia and social interaction anxiety scales: Evaluation of psychometric properties. Journal of Psychopathology and Behavioral Assessment, 20, 249–264.CrossRefGoogle Scholar
Paykel, E.S. (1994). Life events, social support and depression. Acta Psychiatrica Scandinavica, 89, 50–58. doi:10.1111/j.1600-0447.1994.tb05803.x.CrossRefGoogle Scholar
Rodebaugh, T.L., Holaway, R.M., & Heimberg, R.G. (2004). The treatment of social anxiety disorder. Clinical Psychology Review, 24, 883–908. doi:10.1016/j.cpr.2004.07.007.CrossRefGoogle ScholarPubMed
Rosenbaum, J.F., Pollack, M.H., & Pollack, R.A. (1996). Clinical issues in the long-term treatment of panic disorder. Journal of Clinical Psychiatry, 57, 44–48.Google ScholarPubMed
Steketee, G., & Chambless, D.L. (1992). Methodological issues in prediction of treatment outcome. Clinical Psychology Review, 12, 387–400.CrossRefGoogle Scholar
Stewart, R.E., & Chambless, D.L. (2009). Cognitive–behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77, 595–606. doi:10.1037/a0016032CrossRefGoogle ScholarPubMed