Portions of this paper were presented at the 2012 meeting of the Association for Behavioral and Cognitive Therapies.
CHILDHOOD MALTREATMENT AND RESPONSE TO COGNITIVE BEHAVIORAL THERAPY AMONG INDIVIDUALS WITH SOCIAL ANXIETY DISORDER
Version of Record online: 3 APR 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 7, pages 662–669, July 2013
How to Cite
Bruce, L. C., Heimberg, R. G., Goldin, P. R. and Gross, J. J. (2013), CHILDHOOD MALTREATMENT AND RESPONSE TO COGNITIVE BEHAVIORAL THERAPY AMONG INDIVIDUALS WITH SOCIAL ANXIETY DISORDER. Depress. Anxiety, 30: 662–669. doi: 10.1002/da.22112
Contract grant sponsor: NIMH; contract grant number R01 MH076074 (J. G.).
None of the other authors have any direct or indirect conflicts of interest, financial, or personal relationships or affiliations to disclose.
- Issue online: 1 JUL 2013
- Version of Record online: 3 APR 2013
- Manuscript Accepted: 9 MAR 2013
- Manuscript Revised: 3 FEB 2013
- Manuscript Received: 27 AUG 2012
- NIMH. Grant Number: R01 MH076074
- social anxiety disorder;
- social phobia;
- childhood maltreatment;
- cognitive-behavioral therapy;
- treatment outcome
The association between childhood maltreatment—particularly emotional maltreatment—and social anxiety disorder (SAD) has been established by research. Only recently have researchers begun to look at the impact of childhood maltreatment on treatment outcomes, and findings have been mixed. Because prior studies have focused on pharmacotherapy outcomes, or used global measures of childhood adversity or abuse, it is not clear how specific types of maltreatment impact outcomes in cognitive-behavioral therapy (CBT) for SAD. The current study reports on how specific types of childhood maltreatment such as physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect impact response to CBT in adults with SAD.
Sixty-eight individuals with a primary diagnosis of SAD completed the childhood trauma questionnaire, along with measures of social anxiety, disability, and life satisfaction.
Childhood maltreatment did not affect the rate of response to CBT, but there is evidence for its negative impact. Patients with histories of emotional abuse and emotional neglect reported greater social anxiety, less satisfaction, and greater disability over the course of treatment. Sexual abuse also predicted greater social anxiety.
Childhood abuse and/or neglect did not result in differential rates of improvement during CBT; however, those reporting histories of emotional and sexual forms of maltreatment evidenced greater symptoms and/or impairment at pre- and posttreatment. Additional attention to the role of traumatic experiences within CBT for SAD may be warranted.