Changes in self-perception during treatment of social phobia.

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.