PSY JOURNAL due 12/04 7 AM est

1. What is the question the authors are asking?

They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.

2. Why do the authors believe this question is important?

According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.

3. How do they try to answer this question?

They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at the social settings. The OCQ (Outcome Cost Questionnaire) self-reporting questionnaire assessed individual’s assessment of the cost of negative social events. Considerably, the WAI-S (Working Alliance Inventory e Short form) instrument was used to assess therapeutic alliance.

4. What did they find?

Study 1 showed no variances in the variables on interest at pre-treatment (BFNE, OPQ, OCQ) across the EGT, VRE and WL conditions or demographic aspects. Independent Chi-square tests and sample t-tests were conducted to ascertain whether the participants from the uncontrolled trial were different regarding judgmental bias, symptom severity or demographics during pre-treatment evaluation from participants in the controlled trial. Based on the highlighted metrics, there were no significant differences between participants of the uncontrolled trial and those in a controlled trial.

5. How did the authors interpret what they found?

The authors concluded that treated participants have substantial reduction of judgmental bias compared to the non-treated participants. Pre and post changes in cost and probability biases were identified to mediate the treatment outcome whereby probability bias at mid-treatment was a predictor of the treatment outcome. Contrary to the highlighted hypothesis, cost bias at mid-treatment was not a predictor of the treatment outcome.

6. Briefly, discuss two original critiques of the study and relevant research questions

The CBT was compared to the waitlist control rather than active treatment control; thus it is not possible to conclude that social anxiety and appraisal found in the treated group was caused by elements of CBT.

Despite the fact that all participants identified public speaking as their most feared situation in the social setting, research is still needed to determine whether relations between social anxiety and threat reappraisal observed in the current study can be used to generalize participants with varying range of interaction fears and social performance.