Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety: Two-year follow-up of a randomized controlled trial

Eva de Hullu, B. Esther Sportel, Maaike H. Nauta*, Peter J. de Jong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND AND OBJECTIVESThis two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODSIn this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design. RESULTSPrimary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONSThere was a substantial (50%) though seemingly non-selective attrition at follow-up. CONCLUSIONSThis RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.
Original languageEnglish
Pages (from-to)81-89
Number of pages9
JournalJournal of Behavior Therapy and Experimental Psychiatry
Volume55
DOIs
Publication statusPublished - 2017

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Anxiety
Randomized Controlled Trials
Self Concept
Internet
Fear
Outcome Assessment (Health Care)
Early Intervention
Randomized Controlled Trial
Cognitive Bias
Therapeutics
Social Phobia
Anxiety Disorders

Cite this

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title = "Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety: Two-year follow-up of a randomized controlled trial",
abstract = "BACKGROUND AND OBJECTIVESThis two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODSIn this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design. RESULTSPrimary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6{\%}) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONSThere was a substantial (50{\%}) though seemingly non-selective attrition at follow-up. CONCLUSIONSThis RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.",
author = "{de Hullu}, Eva and Sportel, {B. Esther} and Nauta, {Maaike H.} and {de Jong}, {Peter J.}",
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Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety : Two-year follow-up of a randomized controlled trial. / de Hullu, Eva; Sportel, B. Esther; Nauta, Maaike H.; de Jong, Peter J.

In: Journal of Behavior Therapy and Experimental Psychiatry, Vol. 55, 2017, p. 81-89.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cognitive bias modification and CBT as early interventions for adolescent social and test anxiety

T2 - Two-year follow-up of a randomized controlled trial

AU - de Hullu, Eva

AU - Sportel, B. Esther

AU - Nauta, Maaike H.

AU - de Jong, Peter J.

N1 - exported from refbase (http://publicaties.ou.nl/show.php?record=1936), last updated on Tue, 05 Dec 2017 14:38:17 +0100

PY - 2017

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N2 - BACKGROUND AND OBJECTIVESThis two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODSIn this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design. RESULTSPrimary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONSThere was a substantial (50%) though seemingly non-selective attrition at follow-up. CONCLUSIONSThis RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.

AB - BACKGROUND AND OBJECTIVESThis two-year follow-up study evaluated the long-term outcomes of two early interventions that aimed at reducing social and test anxiety in young adolescents at risk for developing social anxiety disorder. METHODSIn this RCT, moderately socially anxious adolescents (N=240, mean age 13.6 years) were randomly assigned to a 10-week internet-based multifaceted cognitive bias modification training (CBM), a 10-week school-based cognitive behavioral group training (CBT), or a no-intervention control condition. Using multiple imputation, this study examined the changes in primary and secondary outcome measures from pretest to follow-up in a repeated measures design. RESULTSPrimary outcome: Self-reported social and test anxiety generally decreased from pre-test to two-year follow-up, regardless of treatment condition. The percentage of adolescents who developed a social anxiety disorder was very low (6%) and similar across conditions. Secondary outcome: There were beneficial changes in self-esteem, self-reported prosocial behaviors, and fear of negative evaluation, but none of these were related to treatment condition. Automatic social-threat associations did not significantly change. The CBM intervention was effective in changing interpretative bias as indexed by the Recognition Task but this long-term effect did not transfer to the Adolescent Interpretation and Belief Questionnaire. LIMITATIONSThere was a substantial (50%) though seemingly non-selective attrition at follow-up. CONCLUSIONSThis RCT does not support the longer-term efficacy of school-based CBT or CBM as an early intervention for social and test anxiety. Rather, it emphasizes the positive 'natural' course of highly socially anxious adolescents over two years.

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DO - 10.1016/j.jbtep.2016.11.011

M3 - Article

VL - 55

SP - 81

EP - 89

JO - Journal of Behavior Therapy and Experimental Psychiatry

JF - Journal of Behavior Therapy and Experimental Psychiatry

SN - 0005-7916

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