The effectiveness of acceptance and commitment therapy for social anxiety disorder: a randomized clinical trial

Abstract Objective Acceptance and commitment therapy has been used to treat anxiety disorders recently. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy for psychological symptoms in students with social anxiety disorder, including difficulty in emotion regulation, psychological flexibility based on experiential avoidance, self-compassion, and external shame. Methods This study was a semi-experimental clinical trial. Twenty four students with social anxiety disorder were randomly divided into two groups after initial evaluations: an experimental group (12 subjects) and a control group (12 subjects). The experimental group received 12 treatment sessions based on a protocol of acceptance and commitment therapy for anxiety disorders, and the control group was put on a waiting list. Self-Compassion (SCS), Difficulty in Emotion Regulation (DERS), External Shame (ESS), Social Anxiety (SPIN), and Acceptance and Action (AAQ-II) questionnaires were used to assess participants. Data were analyzed using SPSS. Results Acceptance and commitment therapy was shown to be effective at the post-test and follow up stages for reducing external shame, social anxiety, and difficulty in emotion regulation and its components, and for increasing psychological flexibility and self-compassion (p < 0.05). The largest effect size of treatment was for increase of psychological flexibility and the lowest efficacy was for the components "difficulty in impulse control" and "limited access to emotional strategies" at the post-test and follow-up stages, respectively. Conclusion Acceptance and commitment therapy may be an appropriate psychological intervention for reducing the symptoms of students with social anxiety disorder and helping them to improve psychological flexibility. Emotion and related problems can be identified as one of the main targets of this treatment. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT20180421039369N1.

Avaliação da Vergonha em Adolescentes: 'The Other as Shamer Scale' / Assessment of Shame in Adolescents: The 'Other as Shamer' Scale

RESUMO A vergonha, entendida como uma emoção autoconsciente, multifacetada e socialmente focada, desempenha um papel central na saúde mental dos indivíduos. Nos adolescentes, é também uma experiência frequente, sendo importante a sua avaliação para a investigação e prática clinica. Este estudo pretende validar uma medida breve de vergonha externa (Escala de Vergonha Externa - Versão breve para Adolescentes [OASB-A]). Participaram 834 adolescentes com uma média de 15 anos. O modelo final da OASB-A (8 itens), obtido por meio da Análise Fatorial Confirmatória, apresenta um bom ajustamento aos dados, invariância para o sexo, boa consistência interna e fidedignidade temporal adequada. As correlações com as experiências traumáticas de vergonha (IES-R) e sintomatologia psicopatológica (DASS-21) são significativas. A OASB-A é uma medida válida e econômica para avaliação da vergonha externa em adolescentes.

ABSTRACT Shame, as a self-conscious, multidimensional and socially focused emotion, plays a central role in the mental health of individuals. In adolescents, shame is also a frequent experience and its assessment is important for research and clinical practice. This study aims to validate a brief measure of external shame (Other as Shamer Scale - brief version for adolescents [OASB-A]). The participants were 834 adolescents with a mean age of 15 years. The final model of the OASB-A (8 items), obtained through CFA, presents a good fit to the data. The OASB-A shows a good internal consistency and an adequate temporal reliability. The OASB-A also reveals significant correlations with traumatic shame experiences (IES-R) and psychopathological symptoms (DASS-21). The OASB-A is an economic and reliable measure to assess external shame in adolescents.