title: Shifting the focus of one's attention mediates improvement in cognitive therapy for social anxiety disorder.
abstract: BACKGROUND
  Cognitive therapy is an effective treatment for social anxiety disorder but little is known about the mechanisms by which the treatment achieves its effects.
  
  
  OBJECTIVE
  This study investigated the potential role of self-focused attention and social phobia related negative automatic thoughts as mediators of clinical improvement.
  
  
  METHODS
  Twenty-nine patients with social phobia received individual cognitive therapy (ICT) in a randomized controlled trial. Weekly process and outcome measures were analysed using multilevel mediation models.
  
  
  RESULTS
  Change from self-focused to externally focused attention mediated improvements in social anxiety one week later. In contrast, change in frequency of, or belief in, negative social phobia related negative automatic thoughts did not predict social anxiety one week later.
  
  
  CONCLUSIONS
  Change in self-focused attention mediate therapeutic improvement in ICT. Therapists should therefore target self-focused attention.
authors: Stockholm University, andKarolinska Institute,Sweden.
authors: Ewa
authors: E
authors: Mörtberg
authors: Research Institute Modum Bad, andUniversity of Oslo,Norway.
authors: Asle
authors: A
authors: Hoffart
authors: NIHR Biomedical Research Centre for Mental Health,South London and Maudsley NHS Foundation Trust and Institute of Psychiatry,Kings College London,UK.
authors: Benjamin
authors: B
authors: Boecking
authors: University of Oxford,UK.
authors: David M
authors: DM
authors: Clark
mesh_terms: D000328:Adult; D001288:Attention; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000523:psychology* / Q000628:therapy*; D012649:Self Concept
keywords: Social phobia; attention; beliefs; cognitive therapy; individual CBT
references: J Consult Clin Psychol. 2006 Dec;74(6):1203-12
references: 17154749
references: Arch Gen Psychiatry. 2011 Jul;68(7):692-700
references: 21727253
references: Behav Ther. 2009 Mar;40(1):10-22
references: 19187813
references: J Consult Clin Psychol. 2006 Jun;74(3):568-78
references: 16822113
references: Behav Res Ther. 2002 Jun;40(6):701-15
references: 12051488
references: Arch Gen Psychiatry. 2005 Jun;62(6):593-602
references: 15939837
references: Behav Res Ther. 2002 Dec;40(12):1367-84
references: 12457633
references: Eval Rev. 1999 Aug;23(4):418-44
references: 10558394
references: J Consult Clin Psychol. 2004 Aug;72(4):588-96
references: 15301643
references: Am J Psychiatry. 2005 Jun;162(6):1179-87
references: 15930067
references: Psychol Methods. 2006 Jun;11(2):142-63
references: 16784335
references: J Consult Clin Psychol. 2003 Dec;71(6):1058-67
references: 14622081
references: Behav Res Ther. 2003 Sep;41(9):991-1007
references: 12914803
references: J Clin Psychopharmacol. 2001 Jun;21(3):311-24
references: 11386495
references: Acta Psychiatr Scand. 2007 Feb;115(2):142-54
references: 17244178
references: J Anxiety Disord. 2009 May;23(4):496-503
references: 19081225
references: Behav Res Ther. 1997 Aug;35(8):741-56
references: 9256517
references: Arch Gen Psychiatry. 2002 Oct;59(10):877-83
references: 12365874
references: Psychol Med. 2009 Feb;39(2):241-54
references: 18507874
references: Behav Ther. 2016 Sep;47(5):669-674
references: 27816079
references: Behav Res Ther. 2012 May;50(5):287-91
references: 22445947
references: J Behav Ther Exp Psychiatry. 2008 Jun;39(2):147-61
references: 17433252
references: Behav Res Ther. 1997 Feb;35(2):117-29
references: 9046675
references: J Behav Ther Exp Psychiatry. 1996 Mar;27(1):1-9
references: 8814516
references: J Consult Clin Psychol. 2009 Apr;77(2):317-27
references: 19309190