Efficacy of cognitive-behavioral group therapy for social anxiety disorder: a latent growth model analysis

Hee-Jung Kim; Jung-Ae Lee; Kang-Seob Oh; Se-Won Lim

서지반출

영문초록

The aim of this study was to investigate the effect of cognitive?behavioral group therapy (CBGT) on social anxiety disorder using latent growth model (LGM) to estimate average growth trajectories and individual differences in longitudinal treatment outcomes. LGM is able to deal with missing data using full-information maximum-likelihood (FIML) estimation. We analyzed piecewise latent growth for nonlinear growth functions to examine changes during treatment and post-treatment. Our CBGT involved Korean culture-specific variations in classical CBGT during weekly 2-hour sessions over the course of 8 weeks. We assessed 36 patients with social anxiety disorder using Liebowitz Social Anxiety Scale and a brief version of the Fear of Negative Evaluation Scale on five occasions (baseline, 4 weeks, 8 weeks, 4-week follow up, and 8-week follow up). As expected, social anxiety and avoidance decreased significantly during treatment periods. Fear of negative evaluation decreased significantly both during treatment and post-treatment. We could delicately explain individual differences in treatment effect with LGM. This study demonstrated the efficacy of CBGT for social anxiety disorder and the feasibility of using LGM to analyze repeated measures of data on clinical treatment, and longitudinal studies examining treatment effect could use LGM in the future.

국문초록

본 연구에서는 사회불안장애 환자들에게 인지 행동 집단 치료를 실시하여 효과가 있는지를 검증하고자 하였다. 치료 효과를 검증하기 위하여, 반복 측정된 사회 불안 증상의 변화 추이 를 살펴보기에 유용한 잠재 성장 모형을 활용하였다. 더욱이, 치료 효과의 비선형적인 변화 추이를 이해하기 위하여 분할 잠재 성장 모델 분석을 이용하였다. 분할 잠재 성장 모델 분석 은 치료 회기 동안의 사회 불안 증상 변화와 치료 종결 이후의 사회 불안 증상 변화에 대한 추이를 각각 볼 수 있다는 이점이 있다. 본 연구의 인지 행동 집단 치료는 한국형 문화에 특 성화된 사회 불안 증상을 고려한 심리교육, 인지재구조화, 노출 훈련이 포함되어 있으며, 1회 기에 2시간씩 8회기로 구성되어 있다. 본 연구에 참여한 사회 불안 장애 환자는 36명이었으 며, Liebowitz 사회 불안 척도(Liebowitz Social Anxiety Scale), 부정적 평가에 대한 두려움 척도-단 축형(Fear of Negative Evaluation Scale)를 5번에 걸쳐 반복 측정하였다(치료전, 치료 4주, 치료 8 주, 치료 후 4주, 치료 후 8주). 연구 결과, 치료 기간 동안 사회 불안 증상과 회피 양상은 유 의하게 감소하였다. 부정적 평가에 대한 두려움은 치료 회기 동안과 치료 후 8주까지도 유의 하게 감소하였다. 아울러 치료 효과에 영향을 미치는 개인차도 살펴볼 수 있었다. 본 연구는 사회불안장애에 대한 인지 행동 집단 치료의 효과를 검증하기 위해 반복 측정되는 자료를 분 석하기에 용이한 잠재 성장 모형을 활용할 수 있음을 보여주었다.

키워드

social anxiety disorder cognitive?behavioral group therapy latent growth model 사회불안장애 인지행동집단치료 잠재성장모형

참고문헌 (41건)

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