title: Reduction of depersonalization during social stress through cognitive therapy for social anxiety disorder: A randomized controlled trial.
abstract: Symptoms of depersonalization during feared social situations are commonly experienced by individuals with social anxiety disorder (SAD). Despite its clinical relevance, it is not addressed in standard treatment manuals and it remains unclear if depersonalization is reduced by well-established treatments. This study investigated whether cognitive therapy (CT) for SAD effectively reduces depersonalization and whether pre-treatment severity of depersonalization predicts or mediates treatment outcome. In a randomized controlled trial, patients underwent the standardized Trier Social Stress Test before and after CT (n=20) or a waitlist period (n=20) and were compared to healthy controls (n=21). Self-reported depersonalization was measured immediately after each stress test. Depersonalization significantly decreased following CT, especially in treatment responders (ηp2=0.32). Pre-treatment depersonalization did neither predict nor mediate post-treatment severity of social anxiety. Further prospective studies are needed for a better scientific understanding of this effect. It should be scrutinized whether SAD-patients suffering from depersonalization would benefit from a more specific therapy.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany. Electronic address: tabea.schweden@tu-dresden.de.
authors.forename: Tabea L K
authors.initials: TLK
authors.lastname: Schweden
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Pittig
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Bräuer
authors.affiliation: Department of Biological Psychology, Technische Universität Dresden, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Klumbies
authors.affiliation: Department of Biological Psychology, Technische Universität Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Hoyer
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003861:Depersonalization / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D000072861:Phobia, Social / Q000150:complications / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive therapy; Depersonalization; Derealization; Dissociation; Social anxiety disorder; Social phobia