Side effects in internet-based interventions for social anxiety disorder
Open accessAbstract
Internet-based interventions are effective in the treatment of various mental disorders and have already been integrated in routine health care in some countries. Empirical data on potential negative effects of these interventions is lacking. This study investigated side effects in an Internet-based treatment for Social Anxiety Disorder (SAD). A total of 133 individuals diagnosed with SAD took part in an 11-week guided treatment. Side effects were assessed as open formatted questions after week 2 and at post-treatment after week 11. Answers were independently rated by two coders. In addition, rates of deterioration and non-response were calculated for primary social anxiety and secondary outcome measures (depression and quality of life). In total, 19 participants (14%) described unwanted negative events that they related to treatment. The emergence of new symptoms was the most commonly experienced side effect, followed by the deterioration of social anxiety symptoms and negative well-being. The large majority of the described side effects had a temporary but no enduring negative effect on participants' well-being. At post-treatment, none of the participants reported deterioration on social anxiety measures and 0–7% deteriorated on secondary outcome measures. Non-response was frequent with 32–50% for social anxiety measures and 57–90% for secondary outcomes at post-assessment. Results suggest that a small proportion of participants in Internet-based interventions experiences negative effects during treatment. Information about potential side effects should be integrated in patient education in the practice of Internet-based treatments.
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In Boettcher et al. (2014), 5% of participants receiving an 11-week guided treatment for Social Anxiety Treatment reported emergence of new symptoms, and 4% noted deterioration of targeted symptoms.
“For example, on the study of Boettcher et al. (2014), it was identified that from 133 participants receiving a 11-week guided treatment for Social Anxiety Treatment, that out of 19 participants, in detail from the total of participants, 5% reported the emergence of new symptoms, 4% noted a deterioration of targeted symptoms.”
From A Self-Applied Multi-Component Psychological Online Intervention Based on UX, for the Prevention of Complicated Grief Disorder in the Mexican Population During the COVID-19 Outbreak: Protocol of a Randomized Clinical Trial (2021) · cites this paper as Boettcher et al. (2014)
The literature on side-effects of online psychological treatments is in its infancy.
“The literature on side-effects of online psychological treatments is in its infancy, and although studies are beginning to emerge documenting participants' difficulties during online CBT (Boettcher et al., 2014; Melville et al., 2010), it is not yet known whether online mindfulness interventions are associated with any adverse events or side effects, particularly when participants undergo”
From Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial (2018) · cites this paper as Boettcher et al., 2014
It is not yet known whether online mindfulness interventions are associated with any adverse events or side effects, particularly when participants undergo mindfulness training without explicit guidance from a teacher.
“The literature on side-effects of online psychological treatments is in its infancy, and although studies are beginning to emerge documenting participants' difficulties during online CBT (Boettcher et al., 2014; Melville et al., 2010), it is not yet known whether online mindfulness interventions are associated with any adverse events or side effects, particularly when participants undergo”
From Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial (2018) · cites this paper as Boettcher et al., 2014
Negative side effects of IMIs have been understudied so far.
“It has been shown that IMIs can have negative side effects [103–105], but those have been understudied so far [104].”
It has been shown that IMIs can have negative side effects.
“It has been shown that IMIs can have negative side effects [103–105], but those have been understudied so far [104].”
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- Authors
- Boettcher, J., Rozental, A., Andersson, G., & Carlbring, P.
- Affiliations
- Stockholm University (SE)
- Linköping University (SE)
- Corresponding author
- Boettcher, Johanna
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 1
- Issue
- 1
- Pages
- 3-11
- ISSN
- 2214-7829 (ISSN-L)
- OpenAlex
- W2132252993
- Cited by
- 88
- References
- 57
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 8 · 2020: 7 · 2019: 9 · 2018: 10 · 2017: 4 · 2016: 9 · 2015: 8 · 2014: 6
- FWCI
- 13.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- FORTE the Swedish Research Council for Health, Working Life and Welfare (2013-1107)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- social anxiety disorder, online intervention, adverse effects, adverse events, treatment discontinuation, nonresponse, depression, quality of life, guided self-help, patient education
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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