social anxiety disorder

The present study was conducted with the aim of predicting the social health and social anxiety of female students based on the emotional atmosphere of the family. The present research method was descriptive-correlation. The statistical population consisted of all undergraduate female students of the Faculty of Humanities of Azad University of Boroujerd, and the sample group was 205 female students who were selected by multi-stage cluster sampling and studied using Hill Affair Blind Questionnaire (1964) Social Anxiety Watson & Weber (1969), and Keystone Social Health (2004). The statistical test of Pearson correlation and regression with the help of spss21 software showed that there is a significant positive relationship between social health and all its components, except for social participation and the emotional atmosphere of the family, a significant negative relationship was obtained between social anxiety and the emotional atmosphere of the family. The regression results showed that social anxiety and social health can be predicted with the help of the emotional atmosphere of the family. Therefore, it can be concluded that improving the quality of the emotional atmosphere of the family is important and significant in improving the social health index and reduce social anxiety.

This research was conducted with the aim of comparing the effectiveness of existential therapy and cognitive therapy based on mindfulness in coping with distress in adolescents with social anxiety disorder. The research method was semi-experimental including two experimental groups and a control group with a pre-test-post-test design and a three-month follow-up period. The statistical population of this research included all female students of the second year of middle school in Torbat Jam city in the academic year of 2023. The sample of the research was 45 students with social anxiety disorder, who were divided into two experimental groups and one control group (15 people in each group). Existential therapy in 8 sessions and cognitive therapy based on mindfulness was also implemented in 8 sessions for the experimental groups and the control group did not receive any training.The research tools were Paklak's Social Anxiety Questionnaire (1997), Simmons and Gaher's Distress Tolerance Scale (2005) and Wells and Davis' Anxiety Scale (1994). The data were analyzed using repeated measures analysis in SPSS software version 25. The results showed that both interventions had a significant effect on reducing anxiety and increasing distress tolerance of adolescents with social anxiety disorder. The follow-up phase was stable (P<0.05). The results of Tukey's follow-up test showed that cognitive therapy based on mindfulness had a greater effect on reducing anxiety and increasing emotional distress tolerance (0.05). Based on the findings of the research, it can be concluded that counselors and clinical psychologists can use existential therapy and cognitive therapy based on mindfulness as effective therapeutic approaches in the field of reducing anxiety and increasing distress tolerance of adolescents with Use social anxiety disorder.

The purpose of this study was to investigate the effectiveness of cognitive behavioral psychodrama group therapy (CBPGT) on the fear of negative(FNE) and positive evaluation(FPE) and social anxiety in socially anxious Adolescents. The research method was semi-experimental with a pre-test-post-test design and one-month follow-up with the control group. The statistical include 250 females in ninth grade in Sirjan City in the academic year 2021-22 after screening and initial diagnosis, 24 persons were conveniently selected and randomly assigned to the experimental and the control groups. Before any intervention, a pre-test was taken from groups and then the experimental group received integrated CBPGT for 9 sessions (120 minutes per session) (Treadwell et al,2016) per week. The research tools included the Social Anxiety Scale for Adolescents(Puklek, 2008), fear of negative evaluation (Leary, 1983), and fear of positive evaluation (Weeks et al., 2008) and The data were analyzed using SPSS-24 software and the statistical method of MANCOVA and ANCOVA. The results of Multivariate analysis of covariance demonstrated that after the control of pre-test effects, there was significant difference in the linear combination of fear of negative and positive evaluation and social anxiety of the two groups (Wilks' lambda= 0.048, F= 71/45, P= 0.001). The results of ANCOVA showed a significant decrease in FNE and FPE and social anxiety in the experimental group participants compared to the control group(P≤0/01). The findings of this research provide useful information about the Integrated and counselors and psychologists can use this integrated intervention to improve SAD in adolescents.

This study aimed to examine the effectiveness of metacognitive therapy in improving mind reading, autobiographical memory, and cognitive emotion regulation in students with social anxiety disorder.
 
The research employed a quasi-experimental pre-test, post-test, and follow-up design with a comparison group. The statistical population consisted of female high school students diagnosed with social anxiety disorder who were referred to educational counseling centers in Sanandaj during the 2022–2023 academic year. A total of 30 students were selected using purposive sampling and randomly assigned to either the experimental or comparison group. The experimental group received eight 90-minute sessions of metacognitive therapy, while the comparison group received no treatment. Participants completed assessments including a social anxiety questionnaire, an autobiographical memory test, the Cognitive Emotion Regulation Questionnaire, and the Reading the Mind in the Eyes Test at three time points: pre-test, post-test, and follow-up (four months after the post-test). Data were analyzed using repeated measures ANOVA.
 
The findings indicated that metacognitive therapy significantly reduced social anxiety (p < 0.01) and led to significant improvements in autobiographical memory, mind reading, and cognitive emotion regulation (p < 0.01) in the experimental group. These effects were sustained over time.
 
The results suggest that metacognitive therapy is an effective intervention for students with social anxiety disorder. It is recommended for implementation in schools and counseling centers to enhance cognitive and emotional functioning in affected students.

The present study was conducted with the aim of the effectiveness of psychodrama group therapy and cognitive behavioral play therapy on executive functions (working memory, response inhibition, cognitive flexibility and emotional self-regulation) in students with social anxiety disorder. The current research is semi-experimental with pre-test-post-test and control group. The statistical population of this research included all students with social anxiety disorder in Ardabil city in the academic year of 1401-1402. The sample of this research consists of 45 students with social anxiety disorder who were selected by available sampling method and were placed in 3 groups, each group consisting of 15 subjects (psychodrama 15 people, cognitive behavioral play therapy 15 people and control 15 people). Each subject was randomly assigned to two treatment groups (psychodrama, cognitive behavioral play therapy) and control. The instrument and questionnaire of this research included the Wisconsin card classification test and the emotional regulation questionnaire of Gross and John (2003). The results showed that psychodrama group therapy and cognitive play therapy are effective in improving executive functions and emotional regulation of male students with social anxiety at a significant level (0.05); No significant difference was found between the pre-test and post-test scores of the control group. The results of Bonferroni's post hoc test also showed that the effectiveness of psychodrama treatment is more effective in improving executive functions and emotional regulation. According to the sessions and results obtained, psychodrama group therapy and cognitive behavioral therapy had a positive effect on improving executive functions.

It seems that considering the role of emotions in distress tolerance and cognitive flexibility as two important dimensions of social anxiety disorder, which is one of the most debilitating anxiety disorders, using treatments that target emotions can be helpful.

The aim of the present study was to investigate the effectiveness of emotion-focused therapy on cognitive flexibility and distress tolerance married women with social anxiety disorder.

The research method was a semi-experimental pretest-posttest design with a 45-day follow-up strage by control group. The study population included all married women with social anxiety disorder referred to psychological counseling centers in the 18th district of Tehran in 2023 which among those 34 cases were selected through available sampling and according to the inclusion criteria and they were randomly divided into experimental and control groups. The Experimental group received emotion-focused therapy (Johnsano, 2008) sessions for nine 90-minutes sessions. All participants were assessed by the questionnaires of cognitive flexibility Inventory (Dennis & Vander Wal, 2010) and distress tolerance (Simons & Gaher, 2005). Data were analyzed by SPSS-24 software and MANOVA with repeated measure test.

The results indicated the effectiveness of emotion-focused therapy on improving cognitive flexibility and distress tolerance (p< 0.01) and maintaining its effectiveness in the follow-up stage (p< 0.01).

Considering to the effectiveness of emotion-focused therapy it is suggested to focus on this therapy as one of the auxiliary, supportive and rehabilitation therapy along with drug treatment in reducing the consequences of difficulties in distress tolerance and cognitive flexibility.

The purpose of this study was to comparing effectiveness of emotion-focused therapy and mindfulness-based cognitive therapy on externalized and internalized shame in people with social anxiety disorder. This semi-experimental study was conducted with a pretest-posttest design with control group and follow-up 2 month. The statistical population of the present study was all patients with social anxiety disorder in Tehran city in winter year 2024. In the first stage, the number of 45 patients with a score of 19 and above on the social anxiety disorder scale was selected and then randomly divided into 2 experimental groups (each group 15 people) and one control group (15 people) were replaced and experimental groups underwent emotion-focused therapy and mindfulness-based cognitive therapy, but the control group received no training and remained in the waiting list. To collect data social anxiety inventory (SPIN) of Connor and et al (2000), the other as shamer scale (AOS) of Goss and et al (1994) and internalized shame scale (ISS) of Cook and et al (1988).  Data analysis was performed using SPSS-28 software with analysis of variance with repeated measures and Bonferroni. The results of the study showed that of both interventions had a significant effect on externalized and internalized shame in people with social anxiety disorder (P<0.05). In addition, the results of Bonferroni post hoc test showed that emotion-focused therapy is more effective (P<0.05). It can be concluded that that, in addition effectiveness of both treatments, the priority of use in the treatment of problems patients with social anxiety disorder is with emotion-focused therapy.

Individuals with social anxiety disorder widely perceive online social networks as a convenient platform for social interaction, influencing their preference for online interaction over in-person engagement.The present research aimed to examine the experiences of adolescents with social anxiety disorder on Instagram. The research method used was descriptive phenomenology, conducted through semi-structured interviews with 12 adolescents until data saturation was reached. Instagram was selected as the sole platform among social networks due to its high usage rate and relevance. The study population consisted of male adolescents aged 15 to 18 from Tehran who were users of the Instagram app and had social anxiety disorder. Sampling in this research was done through purposeful sampling using the LaGreca Social Anxiety Scale (1999). Data analysis was carried out using the seven-step Colaizzi method. The findings related to adolescents' experiences were categorized into two core themes: "Restorative Experiences" and "Harmful Experiences." Restorative experiences encompassed four main codes: "establishing connections and maintaining friendships," "emotional regulation," "receiving mental health-related information," and "assisting in social identity formation." The core code for Harmful Experiences included "negative comparisons and evaluations," "undermining social competencies," and "weakening of personality." Adolescents with social anxiety disorder have varied positive and negative experiences on social networks. Mental health professionals can utilize the findings of this research to develop strategies and interventions tailored to adolescents' experiences

The purpose of this research is to compare the effectiveness of metacognitive therapy, solution-oriented therapy, and endurance exercises on the problem-solving styles of female students with social anxiety disorder. The design of this research is a semi-experimental pre-test-post-test type with a heterogeneous control group and a one-month follow-up. The statistical population was female students of the second level of high school in the three educational districts of Kermanshah in the academic year 1401-1402. From this population, 60 students with social anxiety were selected by screening and according to the criteria for entering the study. They were randomly assigned to 4 groups of 15 people (three experimental and one control). The research tools included social anxiety questionnaires (Kanor, 2000) and problem-solving styles (Dzurila et al., 2002). The data were analyzed with SPSS23 software and analysis of variance and Benferoni's post hoc test. The findings showed that metacognitive therapy, solution-oriented therapy, and endurance exercises increased efficient problem-solving styles and decreased ineffective problem-solving styles in people with social anxiety (P≤0.05) and among the three treatments, metacognitive therapy in efficient problem-solving styles and metacognitive and solution-oriented treatment in ineffective problem-solving styles were more effective than endurance exercises (P≤0.05). Based on these findings, it can be said that all three treatment models can be used in the Iranian clinical sample.

This study aimed to evaluate the relationship between social anxiety disorder and childhood trauma through the mediating of repetitive negative thinking.1-

The design of the current research is descriptive and correlational. Therefore, using random multistage cluster method 300 female students in the 10th, 11th and 12th grades of Tabriz city were selected in the academic year 2022 -2023. They were assessed by Social Anxiety Disorder scale (Puklek,1997), Childhood Trauma Questionnaire (Bernstein at el,2003), Ehring preservative Thinking Questionnaire (Ehring et al,2010). Structural equation modeling was used to analyze the research model.

Results showed that there was a significant direct and positive relationship between childhood trauma with repetitive negative thinking and repetitive negative thinking with social anxiety. The most important finding indicated, the indirect effect of childhood trauma on social anxiety through repetitive negative thinking was positive and significant (p<0.05). Hence, the theoretical model fit the data and was approved.

Consequently, it can be concluded that childhood trauma and repetitive negative thinking play an effective role in the risk of social anxiety disorder. Negative thoughts originate from many negative experiences that create comorbidity with negative mental disorders. Paying attention to these results can be effective in formulating preventive and therapeutic interventions for social anxiety disorder.

Social anxiety disorder often has a poorer recovery rate than other anxiety disorders. A review of previous studies shows that two variables, social anxiety disorder and the focused – attention (which is one of the predictors of social anxiety disorder), respond less well to conventional psychological treatments. Among the newest integrated alternative approaches are paradoxical time table therapy and virtual reality technology therapy, there is a research gap regarding the comparison of their effectiveness in improving the focused – attention and reducing the symptoms of social anxiety disorder.

The present study was conducted with the aim of comparing the effectiveness of paradoxical time table therapy and virtual reality technology therapy on the focused – attention and symptoms of social anxiety disorder.

The current research design was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all people who referred to counseling centers and psychotherapy clinics in Tehran in the fall and winter of 2022. The statistical sample included 45 people with social anxiety disorder who were selected as available samples and were divided into three groups of 15 people (two experimental groups and one control group). To collect data, the Focous of Attention Questionnaire (Woody et al., 1997) and the social anxiety scale (Connor et al., 2000) were used. Also, the treatment of the paradoxical time table therapy (Besharat, 2017) was implemented in six sessions on the first experimental group and and the virtual reality technology therapy was implemented in 8 sessions on the second experimental group. Data analysis was done using multivariate analysis, variance analysis with repeated measures, Bonferroni post hoc test and SPSS-25 software.

The results showed that both treatments of paradoxical time table therapy and virtual reality technology therapy had a significant effect on the focus of attention and symptoms of social anxiety disorder (P<0.001). There was no significant difference between the effectiveness of the virtual reality technology therapy and the paradoxical time table therapy in the focused – attention, However, there was a significant difference between the effectiveness of the virtual reality technology therapy and the paradoxical time table therapy on the symptoms of social anxiety disorder. In this way, the paradoxical time table therapy is more effective in reducing the symptoms of social anxiety disorder compared to the treatment based on virtual reality technology therapy (P<0.001).

According to the findings of the present research, it seems that the paradoxical time table therapy and virtual reality technology therapy can be used as a therapeutic approach that according to the needsof patients with social anxiety disorder.

Previous research has shown that emotion-focused therapy is effective in reducing the symptoms of social anxiety disorder and improving the social efficiency of people suffering from it. On the other hand, the review of studies shows that many treatment approaches will be more effective if they are used in the form of group psychotherapy. But so far, the protocol of this type of treatment has not been developed in such a way that its intervention techniques are suitable and compatible for implementation in the group.

The present study was conducted with the aim of developing a group therapy protocol focused on emotion and trial on the symptoms of social anxiety disorder.

The design of the current research was a type of exploratory combined research that has a qualitative and quantitative nature. The first stage of the research was conducted with a qualitative approach and thematic analysis method. In order to identify themes and draw a network of themes, first 121 related sources were identified and among them, 11 Persian sources published between 1392 and 1401 and 23 English sources published between 2000-2022 were selected. In the quantitative part, the research method was a quasi-experimental design of pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all the clients who referred to the Sense of Presence clinic in Tehran in the second half of 2022. 20 people with social anxiety disorder were selected from among the clients using the available method and were randomly divided into two experimental and control groups. The members of the experimental group were exposed to 16 sessions of emotion-focused group therapy protocol (designed by the researchers). The instrument used in the quantitative part was the social anxiety scale (Connor et al., 2000). For data analysis, thematic analysis method was used in the qualitative part and Variance analysis with repeated measurements was used in the quantitative part.

The findings of the present study in the qualitative part led to the identification of two overarching themes, including emotion-focused therapy and social anxiety, and finally, a 16-session protocol of emotion-focused therapy group. The results in the quantitative part also showed that the effectiveness of the group therapy focused on emotion was significant in reducing all the symptoms of social anxiety disorder, fear, avoidance, Physiological symptoms and the total score of social anxiety (P<0.05).

According to the obtained results, it seems that therapists can use the (researcher-made) emotion-focused group therapy package to treat people with social anxiety disorder.

The purpose of this study was to investigate the relationship between body dysmorphic concern, ideas of reference, and empathy with social anxiety disorder with the mediation of emotional awareness. The research method was descriptive correlational )structural equations(. The statistical population consisted of all female students, aged 16-17 years, studying in Jovein County. The instruments were the Social panic questionnaire, Dysmorphic concern, Paranoid thought, Interpersonal reactivity, and Emotional awareness. Path analysis were used to analyze the data. The findings showed an excellent fit of the model after modification. The results indicated that the body dysmorphic concerns, ideas of reference, and empathy directly associated with social anxiety disorder. Further analysis revealed a significant relationship only between ideas of reference and empathy and social anxiety disorder, mediated by emotional awareness. Although the value of its coefficient was weak. Based on these findings, it can be said that body dysmorphic concerns, ideas of reference, and empathy are effective on social anxiety of adolescent females and it is suggested to be considered in interventions related to the social anxiety of adolescents.

Social anxiety disorder is one of the most common anxiety disorders. Fear of negative evaluation by others is one of the most important features of social anxiety disorder. In various studies, the effectiveness of cognitive-behavioral treatments and virtual reality exposure therapy on the symptoms of anxiety disorders such as social anxiety disorder has been investigated and confirmed, But so far, no study has been conducted on the comparison of the effectiveness of these two types of treatment methods on the fear of negative evaluation of students with social anxiety disorder.

The present study was conducted with the aim of comparing the effectiveness of cognitive-behavioral therapy and virtual reality exposure therapy on the fear of negative evaluation of students with social anxiety disorder.

The current research method was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all second-year high school students studying in the schools of Qaem Shahr city in the academic year of 2022-2023. 51 students were included in the study with available sampling method and were randomly placed in two experimental groups and one control group (17 people in each group). The first and second experimental groups were subjected to cognitive-behavioral intervention and virtual reality exposure therapy during 12 and 8 60-minute sessions, respectively. The data collection tools in this research included the Social Phobia Inventory (Connor et al., 2000) and the short form of the Brief Fear of Negative Evaluation Scale (Leary, 1983). Data analysis was done by variance analysis method with repeated measurement and using SPSS-24 software.

The findings of this research showed that both cognitive-behavioral therapy interventions and virtual reality exposure therapy significantly reduced the fear of negative evaluation compared to the control group (P<0.01). And the effect of both intervention methods was maintained until the one-month follow-up phase. Also, the findings indicated that cognitive-behavioral therapy was more effective compared to virtual reality exposure therapy (P<0.01).

According to the obtained results, it is suggested that child and adolescent counselors and therapists as well as school counselors of the two interventional methods, cognitive-behavioral therapy and virtual reality exposure therapy, with the priority of cognitive-behavioral therapy in particular use to reduce the fear of negative evaluation and in general to reduce the symptoms of social anxiety of students.

The purpose of the present study was evaluation of the effectiveness of acceptance and commitment therapy on attention bias to threat and safety behaviors in students with social anxiety disorder (SAD) symptoms. The research design was quasi-experimental, pretest-posttest, follow-up with the control group. The statistical population of the research included all students aged 16-19 with SAD symptoms in Songhor city in 2022. By purposeful sampling method, 28 students were selected and assigned equally to experimental and control groups. Pictorial Dot Probe Task and Social Phobia Safety Behaviors Scale were used in three stages. The experimental group received eight 90-minute treatment sessions based on acceptance and commitment therapy protocol for social anxiety disorder in Adolescence (Alves et al.). Data were analyzed by mixed analysis of variance with repeated measure. The results showed that there was a significant difference in the average scores of the experimental group compared to the control group in the post-test stage. Also, therapeutic gains had maintained in the follow-up stage. Therefore, to reduce attention bias and safety behaviors in students with this disorder, acceptance and commitment therapy can be used by psychotherapists.

The present compared the effectiveness of cognitive-behavioral therapy and virtual reality exposure therapy on cognitive emotion regulation in students with social anxiety disorder. The study method was quasi-experimental with a pre-test and post-test design with a control group and a one-month follow-up. The statistical population of the study included all the second-year high school students of Ghaemshahr schools in the academic year 2022-2023. A total of 51 eligible students were included in the study using a convenience sampling method and were randomly divided into 2 intervention groups and 1 control group (17 people in each group). The first and second experimental groups, respectively, were cognitive-behavioral therapy and virtual reality exposure therapy during 12 and 8 sessions. The research tools were cognitive emotion regulation questionnaires (GERQ, Garnefski, & Kraaij, 2006). The data were analyzed by the method of analysis of variance with repeated measurements and Bonferroni’s post hoc test. The results revealed that both interventions of cognitive-behavioral therapy and virtual reality exposure therapy, compared to the control group, significantly increased adapted emotion regulation and decreased maladapted emotion regulation (P<0.01). Also, the effect of both intervention methods was maintained until the one-month follow-up stage. Also, cognitive-behavioral therapy was more effective compared to virtual reality exposure therapy (P> 0.01). The results of the study revealed the priority of using cognitive-behavioral therapy compared to virtual reality exposure therapy to improve cognitive emotion regulation by child and adolescent therapists.

Social anxiety Disorder is one of the most common anxiety disorders in the clinical sample. So far, many methods have been used to improve and treat this disorder, among which interventions based on acceptance and commitment are one of the most effective methods.
The present study was conducted with the aim of meta-analyzing the effect of interventions based on acceptance and commitment on social anxiety disorder and resolving possible contradictions in the results of different studies. The statistical population of this research included the researches conducted in the field of the effectiveness of interventions based on acceptance and commitment on social anxiety during the last 20 years in Iran (1380-1401) and international levels (2000-2022).
Based on the defined entry and exit criteria, 40 studies that had appropriate scientific and methodological conditions were selected to enter the meta-analysis. The results showed that the average size of the combined effects of the fixed model is -0.874 and that of the random model is -1.234, both of which are statistically significant. This shows the positive effect of interventions based on acceptance and commitment on social anxiety.
Therefore, it can be concluded that by using interventions based on acceptance and commitment, the amount of social anxiety in people can be reduced.

Anxiety sensitivity and focused – attention are important components in creating and maintaining social anxiety disorder, and a defect in each of them can play a role as a potential risk factor in this disorder. Some studies have shown that paradoxical time table therapy can lead to a reduction in worry and social anxiety symptoms. In Iran, there is a research gap regarding the efficacy of this treatment method on anxiety sensitivity and focus of attention in people with social anxiety disorder.

The present study was conducted with the aim of investigating the efficacy of paradoxical time table therapy on anxiety sensitivity and focused–attention in people with social anxiety disorder.

The current research design was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all people who referred to counseling centers and psychotherapy clinics in Tehran in the fall and winter of 2022. The statistical sample included 30 people with social anxiety disorder who were selected as available samples and were divided into two groups of 15 people (experimental group and control group). Focous of Attention Questionnaire (Woody et al., 1997) and revised anxiety sensitivity index (Taylor & Cox 1998) were used to collect data. Also, the treatment of the paradoxical time table therapy (Besharat, 2017) was implemented in six sessionsof 45 minutes on the experimental group. In addition to descriptive statistics, data analysis was performed using multivariate analysis, variance analysis with repeated measures, Bonferroni post hoc and SPSS25 software.

The results of the research showed that the treatment of paradox time program on all components of anxiety sensitivity (fear of respiratory symptoms, Fear of anxiety reactions, fear of cardiovascular symptoms, cognitive dyscontrol and the total score) and focused – attention (self-focused attentio and attention to the outside) had a significant effect (P<0.001).

According to the findings of the current research, it seems that the paradoxical time table therapy can be used by psychologists and psychiatrists as an efficient treatment to reduce the symptoms of social anxiety disorder, especially anxiety sensitivity and focused–attention.