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Cognitive-Behavioral Group Therapy for Social Phobia in Female Adolescents: Results of a Pilot Study

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ABSTRACT

Objectives

To examine the efficacy of cognitive-behavioral group therapy for adolescents (CBGT-A) in females with social phobia and the effect of this treatment on the risk for major depression.

Method

Female adolescents with social phobia (N = 35) were randomly assigned to treatment (n = 12) or no treatment (n = 23) groups. Assessments were conducted at baseline, after treatment, and at a 1-year follow-up.

Results

Eleven subjects completed treatment. Sixteen weeks of treatment produced a significant improvement in interference and reduction in symptoms of social anxiety. There was a significant reduction in the number of subjects meeting DSM-IV criteria for social phobia in the CBGT-A versus the untreated group; however, at the 1-year follow-up there were no significant differences by treatment condition. There was also suggestive evidence that treatment of social phobia lowers the risk for relapse of major depression among those with a history of major depression. Combining social phobia and major depression as the outcome produced more robust treatment effects in the 1-year follow-up.

Conclusions

This pilot study provides evidence for a moderate short-term effect of CBGT-A for treating female adolescents suffering from social phobia and indicates that treatment of social phobia may result in a reduction of major depression.

Section snippets

Subjects

Subjects in this study were 35 socially phobic female adolescents (mean age = 15.8 ± 1.6 years) and 18 non-socially phobic comparison subjects (mean age = 15.2 ± 1.4 years). Both groups were recruited through local advertisements. The socially phobic subjects were required to meet diagnostic criteria for DSM-IV social phobia. Subjects were excluded if they currently had major depression; if they had a current or previous history of panic disorder, agoraphobia, substance abuse, or psychotic

RESULTS

Pretreatment differences across treatment conditions were examined with χ2 tests and t tests. Variables assessed included age, previous history of major depression, and scores on the interference from the ADIS and on the SPAI. There were no significant pretreatment differences across conditions. One subject assigned to CBGT-A did not complete treatment. Excluding this subject, attendance for the 16 weeks of group treatment was 81% averaged across both groups. One subject in the untreated group

DISCUSSION

The results provide support for a moderate short-term effect of CBGT-A for the treatment of social phobia in female adolescents. There were considerable residual social-phobic symptoms at posttreatment in spite of statistically significant improvement. Also, the follow-up evaluation suggests that differences between subjects receiving CBGT-A and those in the untreated condition were not present 1 year later, when social phobia was the primary outcome.

In the only other study reporting results

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    This research was made possible by grants from the Stanford Center on Adolescence, the W.T. Grant Foundation Faculty Scholars Award (Dr. Hayward), and the Pritzker Consortium (Dr. Schatzberg).

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