Does prediction error during exposure relate to clinical outcomes in cognitive behavior therapy for social anxiety disorder? A study protocol

Dados Bibliográficos

ID15519291
AutoresChris Winkler (0000-0001-5899-0586, The University of Melbourne, autor correspondente), Christopher D Winkler, Peter Koval (0000-0002-5461-2278, The University of Melbourne), Lisa Phillips (0000-0003-1060-6068, The University of Melbourne), Lisa J Phillips, Kim L Felmingham (0000-0002-0749-538X, The University of Melbourne)
Ano2022
Volume13
Páginas1000686-1000686
Data de publicação2022-11-24
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoFrontiers in Psychiatry (JOURNAL)
Identificadores do periódicoISSN: 1664-0640 • E-ISSN: 1664-0640
EditoraFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2022.1000686
PMID37082515
OpenAlexW4309905526
IdiomaEN
Referências citadas88

Facing your fears, or exposure therapy, is an effective psychological intervention for anxiety disorders that is often thought to work through fear extinction learning. Fear extinction learning is a type of associative learning where fear reduces through repeated encounters with a feared situation or stimulus in the absence of aversive outcomes. Laboratory research suggests fear extinction learning is driven by threat prediction errors, defined as when fearful predictions do not eventuate. Threat prediction error and its relationship to exposure therapy outcomes haven't been studied enough in actual therapy settings. It remains unclear whether prediction error and extinction learning are central mechanisms of exposure therapy. We are conducting a longitudinal and observational study of how threat prediction error during exposure in social anxiety disorder (SAD) treatment relates to session-by-session symptom change and treatment outcome in addition to exposure surprise and learning outcome. We aim to recruit 65 adults with a primary diagnosis of SAD through an outpatient psychology clinic. Participants will receive 12 sessions of individual manualized cognitive behavioral therapy (CBT), adapted from an efficacious group protocol, that includes graded exposure. Exposure processes, including self-report measures of anxiety, threat prediction, threat outcomes, surprise, and learning outcome, will be measured with smartphone-based event-contingent ecological momentary assessments (EMAs) of all behavioral experiments completed during treatment. Clinical outcomes include self-reported social anxiety symptoms and social threat appraisals, at each session, post and 3-months after treatment. Prediction error will be operationalized as the mismatch between the threat prediction and threat outcome. The joint effect of threat prediction and threat outcome on session-by-session symptom change, treatment outcome, exposure surprise, and learning outcome will be explored using multilevel modeling. The present study will help determine whether threat prediction error during exposures in SAD treatment is related to theoretically implied clinical outcomes. This would contribute to the larger research aim of clarifying exposure therapy mechanisms

Anxiety · Cognitive behavioral therapy · Exposure therapy · Extinction (optical mineralogy · Observational study · Psychiatry · Psychotherapist · Social anxiety · Surprise · Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Medicine · Mental Health Research Topics · Psychology · Social Psychology