Improvements in emotion regulation during cognitive behavior therapy predict subsequent social anxiety reductions

• Published in: Cognitive behaviour therapy pp. 1 - 18
• Main Authors: Garke, Maria Å, Hentati Isacsson, Nils, Kolbeinsson, Örn, Hesser, Hugo, Månsson, Kristoffer N T
• Format: Journal Article
• Language: English
• Published: England 10.07.2024
• Subjects: cognitive behavior therapy; Emotion regulation; Medicin och hälsovetenskap; social anxiety disorder; therapeutic processes; Emotion regulation; cognitive behavior therapy; social anxiety disorder; therapeutic processes
• ISSN: 1650-6073; 1651-2316; 1651-2316
• DOI: 10.1080/16506073.2024.2373784

Individuals with social anxiety disorder (SAD) experience overall emotion regulation difficulties, but less is known about the long-term role of such difficulties in cognitive behavior therapy (CBT) for SAD. Forty-six patients with SAD receiving internet-delivered CBT, and matched healthy controls (HCs;  = 39), self-reported the Difficulties in Emotion Regulation Scale (DERS), Liebowitz Social Anxiety Scale (LSAS-SR), and participated in anticipatory speech anxiety behavioral experiments. Patients were measured at seven time points before, during and after CBT over a total period of 28 months, and HCs at two timepoints. Disaggregated growth curve models with a total of 263 observations were used, as well as intra-class correlation coefficients and regression models. Patients' LSAS-SR and DERS ratings were reliable (ICC = .83 and .75 respectively), and patients, relative to controls, showed larger difficulties in emotion regulation at pre-treatment (  < .001). During CBT, within-individual improvements in emotion regulation significantly predicted later LSAS-SR reductions (  = .041, pseudo-  = 43%). Changes in emotion regulation may thus be important to monitor on an individual level and may be used to improve outcomes in future developments of internet-delivered CBT.