PSYCHOLOGICAL SUPPORT TO PERSONS WITH SOCIAL ANXIETY DISORDER WITH COMORBID DEPRESSIVE SYMPTOMS
Abstract
Purpose. The purpose of the article is to study a program of low-intensity interventions for emotionalstabilization and prevention of psychosocial functioning disorders in persons with social anxiety disorderand comorbid depressive syndrome. Methods. The study was conducted from 2020 to 2022, with 388 peoplestudied. Screening interviews were conducted using The MINI: International Neuropsychiatric Interviewand the Social Phobia Inventory. Evaluation of psychopathological changes and changes in psychosocial functioning was carried out one month after the end of the program and six months later. The psychosocialsupport intervention program was developed based on the recommendations of the low-intensity cognitivebehavioralmodel. It consisted of six online sessions: twice a week lasting up to 50 minutes for four weeksand one booster session to address the risks of relapse. Results. The results showed that the program helpsto reduce the tendency to exaggerate/underestimate symptomatic distress and emotional avoidance, increasesacceptance and awareness of change, and strengthens helpful beliefs and corresponding corrective strategies.The results of the 6-month follow-up indicate a statistically significant decrease in distress, due to socialanxiety and comorbid depressive symptoms, and a decrease in avoidance of emotional experience. It was notedthat acceptance, awareness, and responsibility as elements of acquired corrective skills reduce the burdenof dysfunctional negative beliefs about oneself, interpersonal sensitivity to incongruent values, and socialwithdrawal. Low-intensity techniques, based on a cognitive-behavioral model offered online, demonstratedeffectiveness and sustainability of effects when used regularly in everyday life. The results obtained in the studyare consistent with the effectiveness of low-intensity CBT programs in previous studies. Conclusion. A programof low-intensity interventions for emotional stabilization and prevention of psychosocial functioning disordersis promising and flexible; its recommendations and techniques can be implemented in everyday life as partof caring for one’s psychological well-being.
References
2. Patra B.N., Sarkar S. Adjustment disorder: current diagnostic status. Indian J Psychol Med. 2013. № 35 (1). P. 4–9. https://doi.org/10.4103/0253-7176.112193. PMID: 23833335; PMCID: PMC3701359.
3. Experiential avoidance and bordering psychological constructs as predictors of the onset, relapse, and maintenance of anxiety disorders: One or many? / P. Spinhoven et al. Cognitive Therapy and Research. 2017. № 41 (6). P. 867–880. https://doi.org/10.1007/s10608-017-9856-7.
4. What Characteristics of Primary Anxiety Disorders Predict Subsequent Major Depressive Disorder? / A. Bittner et al. The Journal of Clinical Psychiatry. 2004. № 65 (5). P. 618–626. https://doi.org/10.4088/JCP.v65n0505.
5. Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life / K. Beesdo et al. Archives of general psychiatry. 2017. № 64 (8). P. 903–912. https://doi.org/10.1001/archpsyc.64.8.903.
6. Relationship between social phobia and depression differs between boys and girls in mid-adolescence / J.M. Väänänen et al. Journal of affective disorders. 2011. № 133 (1–2). P. 97–104. https://doi.org/10.1016/j.jad.2011.03.036.
7. Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges / A. Koyuncu et al. Drugs in context. 2019. № 8. e212573. https://doi.org/10.7573/dic.212573.
8. Ohayon M.M., Schatzberg A.F. Social phobia and depression: Prevalence and comorbidity. Journal of Psychosomatic Research. 2010. № 68 (3). P. 235–243. https://doi.org/10.1016/j.jpsychores.2009.07.018.
9. The clinical impact of mood disorder comorbidity on social anxiety disorder / A. Koyuncu et al. Compr Psychiatry. 2014. № 55 (2). P. 363–369. https://doi.org/10.1016/j.comppsych.2013.08.016.
10. Low perceived social support predicts later depression but not social phobia in middle adolescence / J. Väänänen et al. Health Psychology and Behavioral Medicine. № 2 (1). P. 1023–1037. https://doi.org/10.1080/21642850.2014.966716.
11. Belzer K., Schneier F.R. Comorbidity of anxiety and depressive disorders: issues in conceptualization, assessment, and treatment. Journal of psychiatric practice. 2004. № 10 (5). P. 296–306. https://doi.org/10.1097/00131746-200409000-00003.
12. Functional impairment in social anxiety disorder / I.M. Aderka et al. Journal of anxiety disorders. 2012. № 26 (3). P. 393–400. https://doi.org/10.1016/j.janxdis.2012.01.003.
13. Ho J., Moscovitch D.A. The moderating effects of reported pre-pandemic social anxiety, symptom impairment, and current stressors on mental health and affiliative adjustment during the first wave of the COVID-19 pandemic. Anxiety, Stress & Coping. 2022. № 35 (1). P. 86–100. https://doi.org/10.1080/10615806.2021.1946518.
14. Social Distancing During A COVID-19 Lockdown Contributes to The Maintenance of Social Anxiety: A Natural Experiment / G. Arad et al. Cogn Ther Res. 2021. № 45. P. 708–714. https://doi.org/10.1007/s10608-021-10231-7.
15. A 5-Year Follow-up of Internet-Based Cognitive Behavior Therapy for Social Anxiety Disorder / E. Hedman et al. J Med Internet Res. 2011. № 13 (2). e39. https://doi.org/10.2196/jmir.1776.
16. Treating Social Anxiety in an Era of Social Distancing: Adapting Exposure Therapy for Youth During COVID-19 / A.N. Khan et al. Cogn Behav Pract. 2021. № 28 (4). P. 669–678. DOI: 10.1016/j.cbpra.2020.12.002.
17. Unguided low-intensity cognitive behaviour therapy for anxiety and depression during the COVID-19 pandemic: A randomised trial / S.J. Egan et al. Behaviour Research and Therapy. 2021. № 144. e103902. https://doi.org/10.1016/j.brat.2021.103902.
18. A pilot study of intensive 7-day internet-based cognitive behavioral therapy for social anxiety disorder / N. Jain et al. Journal of Anxiety Disorders. 2021. № 84. e102473. https://doi.org/10.1016/j.janxdis.2021.102473.
19. Guided and unguided self-help for social anxiety disorder: randomised controlled trial / T. Furmark et al. British Journal of Psychiatry. 2009. № 195 (5). P. 440–447. https://doi.org/10.1192/BJP.BP.108.060996.
20. Internet-delivered cognitive therapy for social anxiety disorder: a development pilot series / R. Stott et al. Behavioural and cognitive psychotherapy. 2013. № 41 (4). P. 383–397. https://doi.org/10.1017/S1352465813000404.
