title: Childhood maltreatment and response to cognitive behavioral therapy among individuals with social anxiety disorder.
abstract: BACKGROUND
  The association between childhood maltreatment-particularly emotional maltreatment-and social anxiety disorder (SAD) has been established by research. Only recently have researchers begun to look at the impact of childhood maltreatment on treatment outcomes, and findings have been mixed. Because prior studies have focused on pharmacotherapy outcomes, or used global measures of childhood adversity or abuse, it is not clear how specific types of maltreatment impact outcomes in cognitive-behavioral therapy (CBT) for SAD. The current study reports on how specific types of childhood maltreatment such as physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect impact response to CBT in adults with SAD.
  
  
  METHODS
  Sixty-eight individuals with a primary diagnosis of SAD completed the childhood trauma questionnaire, along with measures of social anxiety, disability, and life satisfaction.
  
  
  RESULTS
  Childhood maltreatment did not affect the rate of response to CBT, but there is evidence for its negative impact. Patients with histories of emotional abuse and emotional neglect reported greater social anxiety, less satisfaction, and greater disability over the course of treatment. Sexual abuse also predicted greater social anxiety.
  
  
  CONCLUSIONS
  Childhood abuse and/or neglect did not result in differential rates of improvement during CBT; however, those reporting histories of emotional and sexual forms of maltreatment evidenced greater symptoms and/or impairment at pre- and posttreatment. Additional attention to the role of traumatic experiences within CBT for SAD may be warranted.
authors.affiliation: Adult Anxiety Clinic, Department of Psychology, Temple University, Philadelphia, Pennsylvania 19122, USA.
authors.forename: Laura C
authors.initials: LC
authors.lastname: Bruce
authors.forename: Richard G
authors.initials: RG
authors.lastname: Heimberg
authors.forename: Philippe R
authors.initials: PR
authors.lastname: Goldin
authors.forename: James J
authors.initials: JJ
authors.lastname: Gross
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000145:classification / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: childhood maltreatment; cognitive-behavioral therapy; social anxiety disorder; social phobia; treatment outcome