Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Individuals with social anxiety disorder fear other people’s negative evaluations, which results in the continuation of social anxiety through a series of vicious cycles. In addition, anxiety sensitivity is another factor contributing to social anxiety disorder development. Considering the relationship between anxiety sensitivity and fear of negative evaluation with social anxiety disorder, it is necessary to investigate the effective treatment of these psychological structures in social anxiety disorder. The first line of treatment for social anxiety disorder is cognitive–behavioral therapy (CBT). This therapy seeks to change thought patterns and physical reactions to anxiety–inducing situations. Eye movement desensitization and reprocessing (EMDR) is another promising approach to treating social anxiety. EMDR targets the early experiences that made patients develop a sense of social threat in the first place. Therefore, the present study aimed to compare the effects of CBT and EMDR therapy on anxiety sensitivity and fear of negative evaluations in patients with social anxiety disorder.
Methods: The method of the present study was quasi–experimental with a pretest–posttest and 1 month follow–up design with a control group. The statistical population included all adolescents referred to the Farhangian Clinic in Karaj City, Iran. A total of 51 eligible adolescents were included in the study using a convenience sampling method and were randomly assigned into 2 intervention groups and 1 control group (17 people in each group). The inclusion criteria were as follows: age range of 15–17 years, a definite diagnosis of social anxiety disorder during at least the last 6 months based on DSM–5 diagnostic criteria using the Structured Clinical Interview (SCID–5), not suffering from other clinical disorders at the same time, not dependent on alcohol or drugs, not receiving any other concurrent treatment, and completing the informed consent form to participate in the research. The exclusion criteria were having thoughts and ideas of suicide and absenting more than two sessions in therapy sessions. Patients in the first intervention group received 12 sessions (two sessions per week, each session lasting 60 minutes) of CBT. Patients in the second intervention group had 8 sessions (two sessions per week, each lasting 90 minutes) of EMDR therapy. The control group did not receive any intervention. The data collection tools included the Anxiety Sensitivity Index revised form (ASI–R) (Taylor & Cox, 1998) and the Brief Fear of Negative Evaluation (BFNE) Scale (Leary, 1983). Data were analyzed using descriptive statistics (frequency indices, mean, and standard deviation) and inferential statistics (1–way analysis of variance, repeated measures analyses of variance, and Tukey post hoc test) in SPSS24 at a significance level of 0.05.
Results: The results showed that the effects of time (p<0.001), group (p<0.001), and time and group interaction (p<0.001) were significant on variables of anxiety sensitivity and fear of negative evaluations. Both treatments significantly decreased anxiety sensitivity and fear of negative evaluation of patients in the posttest and follow–up in the intervention groups compared with the control group (p<0.001). In the posttest, a significant difference was observed between the effectiveness of CBT and EMDR therapy in reducing anxiety sensitivity scores (p=0.029) and fear of negative evaluation (p=0.004). In the follow–up, CBT, compared to EMDR therapy, was more effective in reducing anxiety sensitivity scores (p=0.003). Still, In the follow–up, the treatments had no significant difference in reducing fear of negative evaluation (p=0.995).
Conclusion: Both CBT and EMDR therapy are effective in reducing anxiety sensitivity and fear of negative evaluations of patients with social anxiety disorder, but CBT is more effective than EMDR therapy. As a result, both approaches can be used to reduce anxiety sensitivity and fear of negative evaluations in patients with social anxiety disorder.