Interpretation training in individuals with generalized social anxiety disorder: a randomized controlled trial.

Abstract

To examine the efficacy of a multisession computerized interpretation modification program (IMP) in the treatment of generalized social anxiety disorder (GSAD). The sample comprised 49 individuals meeting diagnostic criteria for GSAD who were enrolled in a randomized, double-blind placebo-controlled trial comparing IMP (n = 23) with an interpretation control condition (ICC; n = 26). The interpretation training procedures comprised a word-sentence association task in which participants decided whether a word implying a threatening or benign meaning was related to an ambiguous social scenario. In the IMP group, participants were reinforced for interpreting ambiguous social information in a nonthreatening and more benign manner. In the ICC group, participants were reinforced with equal frequency for interpreting ambiguous social information in either a threatening or benign manner. Intent-to-treat and completer analyses revealed that IMP significantly decreased threat interpretations and increased benign interpretations from pre- to post-assessment relative to the ICC group. Moreover, IMP participants displayed significantly larger reductions in clinician-rated social anxiety symptoms and functional impairment as well as self-reported trait anxiety and depression relative to ICC participants. Groups did not differ on change in self-rated social anxiety symptoms. Participants no longer meeting DSM-IV criteria for GSAD at post-assessment were 65% in IMP and 13% in ICC. These results suggest that computerized interpretation training procedures may be beneficial for treating social anxiety disorder.