Modifying dysfunctional beliefs in social anxiety disorder with an emotion-focused approach-avoidance modification...

Dysfunctional beliefs play an important role in social anxiety disorder (SAD). Modifying the appraisal of such beliefs may be facilitated through emotion-based approach-avoidance modification trainings (eAAMTs). This study aimed to examine the feasibility and therapeutic potential of an eAAMT for SAD in a randomized-controlled pilot-study.

N = 30 participants with SAD were randomly allocated to an eAAMT-SAD, a non-active control condition, or a swipe-control condition (n = 28 analyzed). Participants in the eAAMT-SAD-condition received four 30-min-sessions of eAAMT-SAD within two weeks. They were instructed in using (a) swipe movements (day 1), (b) articulation of words with strong affective valence (day 2), and (c) deliberate expressions of emotion (days 3-4) to pull/push beliefs functional/dysfunctional towards/away from themself on a smartphone screen. The non-active control condition did not receive any training, participants in the swipe-control condition exclusively used swipe movements to pull/push functional/dysfunctional beliefs towards/away from themselves. Outcomes (symptom severity, agreement with (dys-)functional beliefs) were assessed immediately prior to training (T1), after the last training day (T2) and after a follow-up of 28 days (T3).

Results demonstrated the intervention's feasibility and indicated that participants in the eAAMT-SAD condition experienced a greater reduction in anxiety symptoms compared to both control conditions, with small to moderate effect sizes (pre-post: non-active control: g = 0.42, swipe-control: g = 0.39; pre-follow-up: non-active control: g = 0.56, swipe-control: g = 0.64).

Future studies should replicate these findings with larger samples and explore the feasibility and therapeutic potential of eAAMTs for other mental disorders.