False safety behaviour elimination therapy for social anxiety disorder in Japanese men

ABSTRACT

Background

Social anxiety disorder (SAD) is an excessive fear of social situations that can lead to serious functional impairment. The prevalence of SAD has increased over the past four decades, making it one of the most prevalent psychiatric disorders in Japan. Therefore, more effective interventions are needed to treat this disorder. False safety behavior elimination therapy (F-SET), which eliminates safety behavior (i.e., strategies that reduce anxiety), was administered in our study to six Japanese patients with SAD. This is the first adaptation of F-SET into Japanese. Patients were diagnosed using the Mini-International Neuropsychiatric Interview. The Liebowitz Social Anxiety Scale was used as the primary outcome measure to evaluate the change in symptoms. All patients received five weekly 60-minute F-SET sessions.

Results and Conclusions

Participants who completed the treatment exhibited a substantial decrease in SAD symptoms, providing preliminary support for the adapted treatment’s efficacy. We have discussed the cultural differences in SAD and the adaptation of F-SET.

KEY POINTS

What is already known about this topic:

• (1) Transdiagnostic group CBT is an effective treatment for anxiety disorders.

• (2) Few studies have examined the effectiveness of transdiagnostic group CBT in naturalistic settings.

• (3) Few studies have examined the effectiveness of treatments as implemented by clinicians in routine clinical practice.

What this paper adds:

• (1) Eight to ten sessions of transdiagnostic group CBT developed by practising clinicians seemed sufficient in improving anxiety and depressive symptoms, daily functioning, and quality of life in patients from an outpatient anxiety disorders clinic in a hospital setting.

• (2) Patients that completed treatment reported significantly more impairment in daily functioning before treatment than participants who dropped out.

• (3) High attrition rates suggest that organisational factors need to be considered while implementing evidence-based treatments into routine clinical practice.

KEYWORDS:

• Social anxiety disorder
• taijin kyofusho
• false safety behaviour elimination therapy
• case report
• transdiagnostic cbt
• treatment

Ethical considerations

All procedures performed in studies involving human participants were in accordance with the ethical standards and approved by the institutional review board of the first author (29,058) and it is registered in the national UMIN Clinical Trial Registry (reference number: UMIN000032064). All participants provided written informed consent before participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The data that support the findings of this study are available from the corresponding author, [HA], upon reasonable request.

Additional information

Funding

This research was supported by the Japan Society for the Promotion of Science (JSPS KAKENHI Grant Number JP18J12164).