Comparison of the effectiveness of cognitive-behavioral therapy and acceptance and commitment therapy on cognitive distortions and rumination in adolescents with social anxiety disorder
Open accessAbstract
Objective: Social anxiety disorder is a prevalent and persistent psychological disorder that is characterized by an intense fear of negative judgment from others, leading to avoidance of social interactions.This study compared the effectiveness of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) in reducing SAD symptoms, including cognitive distortions, rumination, and anxiety sensitivity, in adolescents diagnosed with social anxiety disorder (SAD). Methods:The study was semi-experimental, with a pre-test and post-test design featuring a control group.The research sample comprised 45 adolescents diagnosed with SAD, who were recruited from psychological service offices in Bukan City, Iran, between April 4 th , 2022, and September 6 th , 2022.Fifteen adolescents were assigned to the first experimental group, 15 to the second experimental group, and 15 to the control group.The subjects were selected using the purposive sampling method and were randomly assigned to the experimental and control groups.CBT (12 sessions) and ACT (8 sessions) were implemented in two sessions per week for the experimental groups.Each session lasted for an hour.The control group did not receive any intervention.The participants completed the Social Phobia Inventory (SPIN) (2000), the Ruminative Response Scale (RRS) (2003), and the Dysfunctional Attitude Scale (DAS) (1978).The data of the research were analyzed using the analysis of variance test using SPSS software, version 23 and a significance level of 0.05. Results:The results of the analysis of variance showed that CBT and ACT have a significant effect on cognitive distortions and rumination in adolescents (P<0.001).Also, there is no significant difference between the effectiveness of CBT and ACT on cognitive distortions and rumination in adolescents (P>0.05).The mean±standard deviation (SD) difference before (54.76±13.88)and after (49.51±13.42) the rumination in the CBT group was significant (P<0.001).The mean±SD difference before (98.32±7.44)and after (83.90±7.77) the cognitive distortions in the CBT group was significant (P<0.001).The mean±SD difference before (52.33±14.78)and after (47.73±14.23) the rumination in the ACT group was significant (P<0.001).Also, the mean±SD difference before (98.70±7.02)and after (85.13±6.83) the cognitive distortion in the ACT group was significant (P<0.001). Conclusion:Based on the results of the analysis, it can be concluded that CBT and ACT can be considered in cognitive distortions and rumination in adolescents with SAD.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
ACT was not significantly different from CBT in all outcomes.
“The results of the meta-analyses of studies comparing ACT to CBT (Adeyinka and Olusakin, 2020; Ebrahimi et al., 2024; Hancock et al., 2018; Hayes et al., 2011; Shabani et al., 2019; Swain et al., 2015; Talaeizadeh, 2020) revealed no significant differences in all outcomes.”
From Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. (2025) · cites this paper as Ebrahimi et al., 2024
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Yaşlı Kadınlarda Üreme Sağlığı
Kokanalı, D., & Engin Üstün, Y. (n.d.) · DergiPark (Istanbul University) · Cited by 170,090 · see citing works
Rumination reconsidered: a psychometric analysis.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003) · Cognitive Therapy and Research · doi:10.1023/a:1023910315561 · Cited by 3,808 · see citing works
Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale
Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Weisler, R. H., & Foa, E. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.4.379 · Cited by 1,624 · see citing works
Further evaluation of the Dutch supervision system for suicides of mental health care users
(2013) · EUR Research Repository (Erasmus University Rotterdam) · doi:10.1176/appi · Cited by 1,030 · see citing works
Cognitive therapy: Past, present, and future
Beck, A. T. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.2.194 · Cited by 513 · see citing works
Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028310 · Cited by 443 · see citing works
Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions
Heimberg, R. G. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01183-0 · Cited by 351 · see citing works
Social anxiety in young people: A prevalence study in seven countries
Jefferies, P., & Ungar, M. T. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239133 · Cited by 320 · see citing works
Cognitive behavioral therapy in anxiety disorders: current state of the evidence
Otte, C. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.4/cotte · Cited by 313 · see citing works
Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., Huesing, J., Joraschky, P., Nolting, B., Poehlmann, K., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12081125 · Cited by 300 · see citing works
(2012) · Re-Unir (International University of La Rioja) · Cited by 262 · see citing works
Leigh, E., & Clark, D. M. (2018) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-018-0258-5 · Cited by 260 · see citing works
Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.07.002 · Cited by 207 · see citing works
Cuijpers, P., Auerbach, R. P., Benjet, C., Bruffaerts, R., Ebert, D., Karyotaki, E., & Kessler, R. C. (2019) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1761 · Cited by 190 · see citing works
Niles, A. N., Burklund, L. J., Arch, J. J., Lieberman, M. D., Saxbe, D., & Craske, M. G. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.04.006 · Cited by 115 · see citing works
Mind-Body Interactions in Anxiety and Somatic Symptoms
Mallorquí-Bagué, N., Bulbena, A., Pailhez, G., Garfinkel, S. N., & Critchley, H. D. (2016) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000085 · Cited by 96 · see citing works
Wong, S. S. (2008) · Current Psychology · doi:10.1007/s12144-008-9033-y · Cited by 84 · see citing works
Mohammadi, M. R., Salehi, M., Khaleghi, A., Hooshyari, Z., Mostafavi, S. A., Ahmadi, N., Hojjat, S. K., Safavi, P., & Amanat, M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.12.015 · Cited by 79 · see citing works
Anxiety sensitivity and sleep-related problems in anxious youth
Weiner, C. L., Elkins, R. M., Pincus, D. B., & Comer, J. S. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.03.009 · Cited by 77 · see citing works
Anxiety sensitivity, its stability and longitudinal association with severity of anxiety symptoms
Hovenkamp-Hermelink, J. H. M., van der Veen, D. C., Oude Voshaar, R. C., Batelaan, N. M., Penninx, B. W. J. H., Jeronimus, B. F., Schoevers, R. A., & Riese, H. (2019) · Scientific Reports · doi:10.1038/s41598-019-39931-7 · Cited by 73 · see citing works
Khoramnia, S., Bavafa, A., Jaberghaderi, N., Parvizifard, A., Foroughi, A., Ahmadi, M., & Amiri, S. (2020) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2019-0003 · Cited by 65 · see citing works
Cognitive distortion and depression in chronic pain: association with diagnosed disorders.
Smith, T. W., O'Keeffe, J. L., & Christensen, A. J. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.62.1.195 · Cited by 61 · see citing works
Kuru, E., Şafak, Y., Özdemir, İ., Tulacı, R. G., Özdel, K., Özkula, N. G., & Örsel, S. (2017) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2017.08.004 · Cited by 58 · see citing works
Aderka, I. M., McLean, C. P., Huppert, J. D., Davidson, J. R. T., & Foa, E. B. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.03.007 · Cited by 49 · see citing works
Cognitive distortion and depression in chronic pain: Association with diagnosed disorders.
Smith, T. W., O'Keeffe, J. L., & Christensen, A. J. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.62.1.195 · Cited by 42 · see citing works
Social anxiety disorder: looking back and moving forward
Hyett, M. P., & McEvoy, P. M. (2018) · Psychological Medicine · doi:10.1017/s0033291717003816 · Cited by 38 · see citing works
Herbert, J. D., Forman, E. M., Kaye, J. L., Gershkovich, M., Goetter, E., Yuen, E. K., Glassman, L., Goldstein, S., Hitchcock, P., Tronieri, J. S., et al. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.07.008 · Cited by 36 · see citing works
Self-consciousness and social anxiety in youth: The Revised Self-Consciousness Scales for Children.
Takishima-Lacasa, J. Y., Higa-McMillan, C. K., Ebesutani, C. K., Smith, R. L., & Chorpita, B. F. (2014) · Psychological Assessment · doi:10.1037/a0037386 · Cited by 36 · see citing works
Social anxiety disorder and the psychobiology of self-consciousness
Stein, D. J. (2015) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2015.00489 · Cited by 35 · see citing works
(2012) · Dialnet (Universidad de la Rioja) · Cited by 30 · see citing works
Behavioral Activation Therapy on Reward Seeking Behaviors in Depressed People: An Experimental study
Karimpourvazifehkhorani, A., Rudsari, A. B., Rezvanizadeh, A., Kehtary-Harzang, L., & Hasanzadeh, K. (2020) · Journal of Caring Sciences · doi:10.34172/jcs.2020.030 · Cited by 27 · see citing works
Cognitive Behavioral Therapy in K-12 School Settings: A Practitioner's Toolkit
Joyce‐Beaulieu, D., & Sulkowski, M. L. (2015) · Cited by 22 · see citing works
Zohdi, Y., Mohammadkhani, P., & Vazifehkhorani, A. K. (2022) · Practice in Clinical Psychology · doi:10.32598/jpcp.10.2.815.1 · Cited by 7 · see citing works
Ghasemi, F., Emadian, S. O., & Hasanzadeh, R. (2023) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.30476/intjsh.2023.97316.1267 · Cited by 4 · see citing works
رضایی, ف., امیری, م., & طاهری, ا. (2017) · DOAJ (DOAJ: Directory of Open Access Journals) · doi:10.22054/qccpc.2018.23065.1565 · Cited by 4 · see citing works
The effectiveness of cognitive-behavioral therapy on social anxiety in children with type 1 diabetes
(2020) · Scientific research journal of Health System Research · doi:10.32592/hsr.2020.15.3.102 · Cited by 2 · see citing works
Vazifehkhorani, A. K., Jafari, M. R., & Rahmati, F. (2022) · ranian Journal of Health Education and Health Promotion · doi:10.52547/ijhehp.10.4.350 · Cited by 1 · see citing works
(1978)
Flagged first, then by citations
Research works printed but not linked: 9
- karimiazar, F., Saken Azari, R., Abdoltajedini, P., & Azmoudeh, M. (2022). [The effect of acceptance and commitment based therapy on the symptoms of social anxiety in shy girls ado- lescents (Persian)]. Nursing Psychiatric of Journal Iranian, 10(1), 46-54
- Esmaeili, L., Amiri, S., Reza Abedi, M., & Molavi, H. (2018). [The effect of acceptance and commitment therapy focused on self- compassion on social anxiety of adolescent girls (Persian)]. Clinical Psychology Studies, 8(30), 117-137.
- Falsafi, A., & DashtBozorgi, Z. (2019). The effect of mindfulness training on rumination, body image, and sexual satisfaction in women with recurrent pregnancy loss (Persian)]. Iranian Journal of Rehabilitation Research, 5(3), 48-54.
- Karimpour Vazifehkhorani, A., Bakhsipour Roodsari, A., Rey- hanimehr, Q., Kamali Ghasemabadi, H., Noroozi, H., & Sha- dara, Z., et al. (2017). [Comparing brain behavioral systems in couples engaged in infidelity and normal couples in Tabriz, Tehran, and Karaj (Persian)]. Depiction of Health, 8(2), 97-103.
- Pourfarahani, M., Barabadi, H. A., & Heydarnia, A. (2020). [The effectiveness of acceptance and commitment group therapy in the social anxiety of adolescent orphan girls (Persian)]. Quarterly Journal of Social Work, 8, 5-13.
- Rahmanian, Z., Mirzaian, B., & Hassanzadeh, R. (2020). [Effec- tiveness of cognitive-behavioral group therapy on social anxi- ety of female students (Persian)]. Daneshvar Medicine, 19(5), 47-56.
- Tavoli, A., Allahyari, A., Azadfallah, P., Fathi Ashtiani, A., Melyani, M., & Sahragard, M. (2012). [Validity and reliabil- ity of the Farsi version of the social interaction anxiety scale (SIAS) (Persian)]. Iranian Journal of Psychiatry & Clinical Psy- chology, 18(3):227-232.
- Toghyani, M. (2014). [The relationship of Islamic lifestyle with dysfunctional attitudes in university students (Persian)]. Knowledge & Research in Applied Psychology, 14(4), 35-43.
- Yabandeh, M. R., Bagholi, H., Sarvghad, S., & Kouroshnia, M. (2019). [Comparing the effectiveness of cognitive behavioral therapy with acceptance and commitment therapy on reduc- tion of social anxiety disorder symptoms (Persian)]. Psycho- logical Methods and Models, 10(36), 177-196.
Cited by
Sorted by citations
López-Pinar, C., Lara-Merín, L., & Macías, J. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.076 · Cited by 17 · see citing works
Çelik, O., & NAZLI, S. (2025) · Türk Psikolojik Danışma ve Rehberlik Dergisi · doi:10.17066/tpdrd.1539049 · Cited by 1 · see citing works
Thorneloe, G., & Barrows, P. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4976235
An Automatic Approach for Detecting Cognitive Distortion from Spontaneous Thinking
Rajput, V., Jain, A., & Jain, M. (2025) · Procedia Computer Science · doi:10.1016/j.procs.2025.03.257
Sabra, M. A. A., Abualruz, H., Zoromba, M. A., & El‐Gazar, H. E. (2025) · Journal of Health Psychology · doi:10.1177/13591053251375324
Law of the Sea in Africa: Political Myopia and Inquisitiveness of Landlocked States
Chirozva, L., & Dzinesa, G. A. (2025) · International Journal of African Renaissance Studies - Multi- Inter- and Transdisciplinarity · doi:10.1080/18186874.2025.2590441
The mediating role of emotional intelligence in ageism: A cross-sectional study
Karacan, Y., Budak, S., & Bayram, R. (2026) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2026.152082
- Authors
- Ebrahimi, S., Moheb, N., & Alivani Vafa, M.
- Affiliations
- Islamic Azad University of Tabriz (IR)
- Corresponding author
- Moheb, Naiemeh
- Venue
- Practice in Clinical Psychology
- Publisher
- Negah Scientific Publisher
- Published
- 2024-01-01
- Volume
- 12
- Issue
- 1
- Pages
- 81-94
- ISSN
- 2423-5822 (ISSN-L)
- OpenAlex
- W4391364480
- Cited by
- 7
- References
- 37
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Practice in Clinical Psychology (publishedVersion, cc-by-nc)
- Funders
- Islamic Azad University
- 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 › Mindfulness and Compassion Interventions
- Keywords
- social anxiety disorder, adolescents, cognitive behavioral therapy, acceptance and commitment therapy, cognitive distortions, rumination, anxiety sensitivity, psychotherapy comparison, treatment effectiveness, dysfunctional attitudes, avoidance behavior, social interaction avoidance, treatment discontinuation, treatment satisfaction, treatment acceptability
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 ›
Are you an author, or do you see a problem with this page? Request a review
