Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder
Open accessAbstract
Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety.Clinicaltrialsgov identifier NCT00380731; http://www.clinicaltrials.gov/ct2/show/NCT00380731?term=social+anxiety+cognitive+behavioral+therapy+Stanford&rank=1.
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In individual CBT for SAD, weekly increases in reappraisal success predicted subsequent decreases in weekly social anxiety.
“and weekly increases in reappraisal success that predicted subsequent decreases in weekly social anxiety during individual CBT (Goldin et al., 2014).”
From Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder (2017) · cites this paper as Goldin et al., 2014
Prior studies of SAD patients have observed CBT-related increases in cognitive reappraisal processes.
“CBT-related increases in cognitive reappraisal processes have been observed in prior studies of patients with SAD (Goldin et al., 2014; Goldin et al., 2012b).”
From Trajectories of social anxiety, cognitive reappraisal, and mindfulness during an RCT of CBGT versus MBSR for social anxiety disorder (2017) · cites this paper as Goldin et al., 2014
Change in emotion regulation processes has been proposed as one key mechanism of action in CBT for mood and anxiety disorders.
“Change in ER processes has been proposed as one key mechanism of action in CBT for mood and anxiety disorders (Campbell‐Sills et al. 2006; Goldin et al. 2014; Hofmann et al. 2012).”
From Exploring Moderators and Mediators of the Outcome of Group Cognitive Behavioural Therapy Compared With Group Schema Therapy for Social Anxiety Disorder and Comorbid Avoidant Personality Disorder. (2025) · cites this paper as Goldin et al. 2014
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Self-citation
- Authors
- Goldin, P. R., Lee, I., Ziv, M., Jazaieri, H., Heimberg, R. G., & Gross, J. J.
- Affiliations
- Stanford University (US)
- Temple University (US)
- Corresponding author
- Goldin, Philippe R.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 56
- Pages
- 7-15
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC4136443
- OpenAlex
- W2088640923
- Cited by
- 130
- References
- 69
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 13 · 2023: 6 · 2022: 15 · 2021: 8 · 2020: 10 · 2019: 26 · 2018: 13 · 2017: 8 · 2016: 10 · 2015: 8 · 2014: 3
- FWCI
- 13.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIMH (R01 MH076074)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- social anxiety disorder, cognitive behavioral therapy, emotion regulation, cognitive reappraisal, expressive suppression, social anxiety, treatment trajectories, Granger causality
- MeSH terms
- Anxiety Disorders, Cognition, Emotions, Humans, Repression, Psychology, Time Factors, Cognitive Behavioral Therapy, Symptom Assessment
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