Changes in implicit and explicit self-esteem following cognitive and psychodynamic therapy in social anxiety disorder
Abstract
The present investigation is the first to analyse changes in implicit and explicit self-esteem following cognitive therapy (CT) and psychodynamic therapy (PDT) in social anxiety disorder (SAD). We assessed a sub-sample of patients with SAD (n=27 per treatment group, n=12 waitlist condition) in the course of a randomized controlled trial prior to and following individual treatment or wait assessment with an Implicit Association Test and the Rosenberg Self-Esteem Scale. Both CT and PDT consisted of 25 sessions. Treatments were effective in enhancing implicit and explicit self-esteem. In CT and PDT, changes in explicit self-esteem were associated with SAD symptom change. No such relationships were found in implicit self-esteem. The results seem to indicate that both CT and PDT are effective in establishing a positive implicit and explicit self-esteem in SAD. The differential relationships of changes in implicit and explicit self-esteem to treatment effects on social phobic symptoms are discussed.
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Treatment of SAD enhanced self-esteem.
“Treatment of SAD enhanced SE (Ritter et al. 2013; Salaberria and Echeburua 1998; Taylor et al. 1997)”
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 Ritter et al. 2013
Cites
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“An Implicit Association Test (IAT; Greenwald et al., 1998; Greenwald & Farnham, 2000) was administered to measure the relative strengths of automatic positive and negative associations of a person towards the self and others.”
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“These findings are not consistent with those reported in panic disorder (Teachman et al., 2008), showing that changes in implicit associations were significantly correlated with symptom reduction and predicted changes in panic symptoms over the course of CBT.”
ResultChanges in self-perception during treatment of social phobia
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“Treatment of SAD enhanced SE (Ritter et al. 2013; Salaberria and Echeburua 1998; Taylor et al. 1997), but to our knowledge, there are no formal mediation studies examining to what extent treatment-induced changes in SE predict subsequent reductions in SA symptoms.”
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“In anxiety disorders, with studies by Leichsenring [27-30], CBT is associated with a large decrease in primary symptoms (ds ranging from 1.06 to 1.97; mean = 1.56) and with a moderate to large decrease in secondary symptoms (ds ranging from 0.52 to 1.12; mean = 0.85) from pretreatment to post treatment and from pretre…”
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“Consistent with more recent evidence (Ritter et al. 2013), Hofmann (2007) further points out that treatment progress in SAD patients is generally closely associated with improved self ‐ perception and at least one study reports a reduction of anxiety symptoms through improved SE in a mediating…”
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“For most mental disorders, the evidence from clinical research studies has shown that a variety of psychotherapies are effective with children, adults and older adults (Lindgren et al., 2010; March et al., 1994; Ritter et al., 2013; Weisz et al., 1987).”
Background
- Authors
- Ritter, V., Leichsenring, F., Strauss, B. M., & Stangier, U.
- Affiliations
- Goethe University Frankfurt (DE)
- Justus-Liebig-Universität Gießen (DE)
- Friedrich Schiller University Jena (DE)
- Corresponding author
- Ritter, Viktoria
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2013-09
- Volume
- 23
- Issue
- 5
- Pages
- 547-558
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W1980939097
- Cited by
- 27
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 1
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- 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
- implicit self-esteem, explicit self-esteem, social anxiety disorder, cognitive therapy, psychodynamic psychotherapy, Implicit Association Test, Rosenberg Self-Esteem Scale, treatment outcomes
- MeSH terms
- Adult, Female, Humans, Male, Phobic Disorders, Psychological Tests, Self Concept, Cognitive Behavioral Therapy, Psychotherapy, Psychodynamic
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