TY - JOUR
T1 - Impacts of imagery-enhanced versus verbally-based cognitive behavioral group therapy on psychophysiological parameters in social anxiety disorder
T2 - Results from a randomized-controlled trial
AU - McEvoy, Peter M.
AU - Hyett, Matthew P.
AU - Johnson, Andrew R.
AU - Erceg-Hurn, David M.
AU - Clarke, Patrick J.F.
AU - Kyron, Michael J.
AU - Bank, Samantha R.
AU - Haseler, Luke
AU - Saulsman, Lisa M.
AU - Moulds, Michelle L.
AU - Grisham, Jessica R.
AU - Holmes, Emily A.
AU - Moscovitch, David A.
AU - Lipp, Ottmar V.
AU - Rapee, Ronald M.
N1 - Funding Information:
This study was supported by a project grant (APP1104007) from the National Health and Medical Research Council of Australia (NHMRC) awarded to McEvoy, Saulsman, Moulds, Grisham, Holmes, Moscovitch, Lipp, and Rapee. The funding body had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/8
Y1 - 2022/8
N2 - Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differential impact of imagery-enhanced vs. verbal-based cognitive behavioral group therapy (IE-CBGT, n = 53; VB-CBGT, n = 54) on biomarkers of emotion regulation and arousal during social stress in people with SAD (pre- and post-treatment differences in heart rate variability (HRV) and skin conductance). We acquired psychophysiological data from randomized participants across four social stress test phases (baseline, speech preparation, speech, interaction) at pre-treatment, and 1- and 6-months post-treatment. Analyses revealed that IE-CBGT selectively attenuated heart rate as indexed by increases in median heart rate interval (median-RR) compared to VB-CBGT at post-treatment, whereas one HRV index showed a larger increase in the VB-CBGT condition before but not after controlling for median-RR. Other psychophysiological indices did not differ between conditions. Lower sympathetic arousal in the IE-CBGT condition may have obviated the need for parasympathetic downregulation, whereas the opposite was true for VB-CBGT. These findings provide preliminary insights into the impact of imagery-enhanced and verbally-based psychotherapy for SAD on emotion regulation biomarkers.
AB - Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differential impact of imagery-enhanced vs. verbal-based cognitive behavioral group therapy (IE-CBGT, n = 53; VB-CBGT, n = 54) on biomarkers of emotion regulation and arousal during social stress in people with SAD (pre- and post-treatment differences in heart rate variability (HRV) and skin conductance). We acquired psychophysiological data from randomized participants across four social stress test phases (baseline, speech preparation, speech, interaction) at pre-treatment, and 1- and 6-months post-treatment. Analyses revealed that IE-CBGT selectively attenuated heart rate as indexed by increases in median heart rate interval (median-RR) compared to VB-CBGT at post-treatment, whereas one HRV index showed a larger increase in the VB-CBGT condition before but not after controlling for median-RR. Other psychophysiological indices did not differ between conditions. Lower sympathetic arousal in the IE-CBGT condition may have obviated the need for parasympathetic downregulation, whereas the opposite was true for VB-CBGT. These findings provide preliminary insights into the impact of imagery-enhanced and verbally-based psychotherapy for SAD on emotion regulation biomarkers.
KW - Cognitive behavior therapy
KW - Heart rate variability
KW - Imagery
KW - Physiological stress
KW - Randomized controlled trials
KW - Social phobia
UR - http://www.scopus.com/inward/record.url?scp=85132274514&partnerID=8YFLogxK
U2 - 10.1016/j.brat.2022.104131
DO - 10.1016/j.brat.2022.104131
M3 - Article
C2 - 35696837
AN - SCOPUS:85132274514
VL - 155
JO - Behaviour Research & Thearpy
JF - Behaviour Research & Thearpy
SN - 0005-7967
M1 - 104131
ER -
