Date of Award

12-18-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Page Anderson, Ph.D.

Second Advisor

Dominic Parrott, Ph.D.

Third Advisor

Erin Tone, Ph.D.

Fourth Advisor

Erin Tully, Ph.D.

Abstract

Social phobia (SP) is a highly prevalent and chronic condition associated with a number of negative outcomes, including significant impairments in social, occupational, and educational functioning (Stein & Kean, 2000). Fortunately, there is substantial evidence to support the efficacy of cognitive behavioral and pharmacological interventions for SP immediately following treatment (McCabe & Antony, 2008). Less is known, however, about the extent to which treatment gains are maintained over the long-term. The current study examined long-term outcomes of two cognitive behavioral treatments for SP, Exposure Group Therapy (EGT) and Virtual Reality Exposure Therapy (VRE). Guided by theories of state dependent and extinction learning, we also sought to explore the extent to which concurrent use of psychotropic medication during treatment attenuated long-term responses to exposure therapy. Eligible participants (N = 75) were individuals had who previously completed either EGT or VRE as a part of two larger treatment studies. Thirty-four participants completed the long-term follow-up assessment which occurred several years (M = 5.7) after the completion of treatment and consisted of self-report measures, a structured clinical interview, and a behavioral avoidance test. We hypothesized that treatment completers would (1) exhibit fewer SP symptoms at long-term follow-up, relative to pre-treatment and would (2) maintain post-treatment gains over the long-term follow-up period. Lastly, we predicted that (3) concurrent medication use, during treatment, would be associated with diminished treatment gains at long term-follow-up for individuals who had discontinued medication during the follow-up period. Results revealed a significant effect of time on self-report and behavioral ratings of SP with clinically significant improvement observed from pre-treatment to long-term follow-up (p < .05). No significant difference differences were observed from post-treatment to long-term follow-up (p >.05) which suggests that that post-treatment gains were well maintained in the long-term. We were unable to test our hypothesis that psychotropic medication would attenuate long-term treatment gains due to the fact that only one participant had taken medication during treatment that was discontinued during follow-up. In sum, the current study suggests that EGT and VRE post-treatment gains are maintained in the long run up to seven years after the completion of treatment

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