Clinical presentation and pharmacotherapy response in social anxiety disorder: The effect of etiological beliefs.
Therapies for social anxiety disorder (SAD) leave many patients symptomatic at the end of treatment and little is known about predictors of treatment response. This study investigated the predictive relationship of patients' etiological attributions to initial clinical features and response to pharmacotherapy. One hundred thirty-seven individuals seeking treatment for SAD received 12 weeks of open treatment with paroxetine. Participants completed the Attributions for the Etiology of Social Anxiety Scale at baseline in addition to measures of social anxiety and depression at baseline and over the course of treatment. A latent class analysis suggested four profiles of etiological beliefs about one's SAD that may be characterized as: Familial Factors, Need to be Liked, Bad Social Experiences, and Diffuse Beliefs. Patients in the more psychosocially-driven classes, Need to be Liked and Bad Social Experiences, had the most severe social anxiety and depression at baseline. Patients in the Familial Factors class, who attributed their SAD to genetic, biological, and early life experiences, had the most rapid response to paroxetine.These results highlight the effect of biological and genetically-oriented etiological beliefs on pharmacological intervention, have implications for person-specific treatment selection, and identify potential points of intervention to augment treatment response.
Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA.
Jonah N
JN
Cohen
Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA.
Carrie M
CM
Potter
Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA.
Deborah A G
DA
Drabick
Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
Carlos
C
Blanco
Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
Franklin R
FR
Schneier
Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, NY 10032, USA.
Michael R
MR
Liebowitz
Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, PA 19122, USA. Electronic address: heimberg@temple.edu.
Richard G
RG
Heimberg
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D010698:Phobic Disorders / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors
Latent class analysis; Paroxetine; Personalized medicine; Social anxiety disorder; Social phobia; Treatment-matching