Cognitive reappraisal self-efficacy mediates the effects of individual cognitive-behavioral therapy for social anxiety disorder.
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OBJECTIVE: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. METHOD: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57% Caucasian) with a principal diagnosis of generalized SAD were randomly assigned to 16 sessions of I-CBT (n = 38) or a wait-list control (WL) group (n = 37). All patients completed self-report inventories measuring CR-SE and social anxiety symptoms at baseline and post-I-CBT/post-WL, and I-CBT completers were also assessed at 1-year posttreatment. RESULTS: Compared with WL, I-CBT resulted in greater increases in CR-SE and greater decreases in social anxiety. Increases in CR-SE during I-CBT mediated the effect of I-CBT on social anxiety. Gains achieved by patients receiving I-CBT were maintained 1-year posttreatment, and I-CBT-related increases in CR-SE were also associated with reduction in social anxiety at the 1-year follow-up. CONCLUSIONS: Increasing CR-SE may be an important mechanism by which I-CBT for SAD produces both immediate and long-term reductions in social anxiety.
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Cognitive restructuring is considered a type of cognitive reappraisal, which involves modifying the meaning of a stimulus or context that gives rise to an emotion.
“Cognitive restructuring is considered as a type of cognitive reappraisal, which involves modifying the meaning of a stimulus or context that gives rise to an emotion [18].”
From Effects of five-minute internet-based cognitive behavioral therapy and simplified emotion-focused mindfulness on depressive symptoms: A randomized controlled trial (2017) · cites this paper as [18]
The “Cognitive Behavioral Therapy for SAD” section states the relationship in the opposite direction: cognitive reappraisal is thought to be a component of cognitive restructuring, not vice versa. The source does support the sentence’s definition of cognitive reappraisal as modifying the meaning of an emotion-eliciting stimulus or context. (LLM, conf=0.87)
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Experimental — accuracy not yet measuredIncreases in cognitive reappraisal self-efficacy mediated CBT treatment efficacy.
“Goldin et al. (2012) found that increases in cognitive reappraisal self-efficacy mediated CBT treatment efficacy.”
From United we stand: emphasizing commonalities across cognitive-behavioral therapies. (2013) · cites this paper as Goldin et al., 2012
Compared with SAD patients on a waitlist, those receiving CBT reported greater self-efficacy in using reappraisal.
“Goldin et al. (2012) have found that, relative to patients with SAD in a wait list control condition, those who underwent CBT showed increased self-efficacy in the use of reappraisal.”
From Adaptive and maladaptive emotion regulation strategies: Interactive effects during CBT for social anxiety disorder (2014) · cites this paper as Goldin et al. (2012)
All therapists reached CBT proficiency before treating participants and met adherence criteria.
“All treating therapists achieved proficiency in implementing CBT prior to treating study participants and met treatment adherence criteria (for details see Goldin et al., 2012)”
From Adaptive and maladaptive emotion regulation strategies: Interactive effects during CBT for social anxiety disorder (2014) · cites this paper as Goldin et al., 2012
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“MEASURES To measure CR-SE, we used a scale derived from the Emotion Regulation Questionnaire (ERQ; Goldin, Manber-Ball, et al., 2009; Gross & John, 2003), which has good reliability and construct validity (Gross & John, 2003).”
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Horenstein, A., Morrison, A. S., Goldin, P., ten Brink, M., Gross, J. J., & Heimberg, R. G. (2019) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2019.1617854 · Cited by 45 · see citing works
“It is sensitive to treatment change (e.g., Baker, Heinrichs, Kim, & Hofmann, 2002; Goldin et al., 2012, 2016) and has demonstrated strong convergent validity ( r = .62 – .71) with other measures of social anxiety among individuals with SAD (Fresco et al., 2001).”
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Butler, R. M., O’Day, E. B., Swee, M. B., Horenstein, A., & Heimberg, R. G. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.06.002 · Cited by 39 · see citing works
Self-citationThey are laughing at me: Cerebral mediation of cognitive biases in social anxiety
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“The six participants with the highest LSAS self-ratings fulfilled the clinical criteria of SAD.”
BackgroundInfluentialEmotion Regulation in Social Anxiety Disorder
Goldin, P. R., Jazaieri, H., & Gross, J. J. (2014) · Social Anxiety · doi:10.1016/b978-0-12-394427-6.00017-0 · Cited by 31 · see citing works
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“Cognitive restructuring is considered as a type of cognitive reappraisal, which involves modifying the meaning of a stimulus or context that gives rise to an emotion [18].”
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Low perceived self-efficacy impedes discriminative fear learning
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Common Mental Disorders and Work: Barriers and Opportunities
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Shame or What Makes Irrational Social Anxiety Rational.
Leonov, A., & Laplante, J. P. (2025) · Healthcare · doi:10.3390/healthcare13222891
“…for soothing the fear of feeling shame during and after a social interaction, e.g., by applied relaxation techniques that reduce somatic anxiety response [37], or by increasing the patients’ confidence in their abilities to assess their social performance more objectively, thus favorably [46].”
- Authors
- Goldin, P. R., Ziv, M., Jazaieri, H., Werner, K., Kraemer, H., Heimberg, R. G., & Gross, J. J.
- Affiliations
- Stanford University (US)
- Stanford Medicine (US)
- Temple University (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2012-12
- Volume
- 80
- Issue
- 6
- Pages
- 1034-1040
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3424305
- OpenAlex
- W1992944524
- Semantic Scholar
- 2624777dc36f135a8935c0ab99a288181cb859d5
- Cited by
- 332
- References
- 55
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 25 · 2023: 24 · 2022: 20 · 2021: 23 · 2020: 31 · 2019: 42 · 2018: 26 · 2017: 20 · 2016: 25 · 2015: 17 · 2014: 27 · 2013: 15 · 2012: 4
- FWCI
- 26.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (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 › Psychotherapy Techniques and Applications
- Keywords
- social anxiety disorder, mediation, social anxiety symptoms, long-term treatment outcomes, maintenance of treatment gains
- MeSH terms
- Adult, Anxiety, Female, Humans, Male, Middle Aged, Phobic Disorders, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Self Efficacy
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