Talk Therapy May Help Treat Social Anxiety
Study Shows Changes in Brain Activity in People With Social Phobia Treated With Psychotherapy
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD
woman in therapy session

Feb. 22, 2011 -- A 12-week course of talk therapy, when used to treat social anxiety disorder, produces changes in the electrical activity of the brain, according to new research. The findings appear in Psychological Science.

Symptoms of social phobia or social anxiety disorder include anxiety and self-consciousness in everyday social situations. This anxiety may also have associated physical symptoms such as sweating, nausea, and difficulty speaking. In some, the anxiety is limited to a specific situation, such as public speaking. In other people, it becomes so overwhelming and debilitating they can no longer leave the house.

The researchers say that there has been a substantial amount of research on how medications used to treat social anxiety disorder affect the brain but far less research on how psychotherapy produces changes in the brain.
The Study

In the new study, 25 people with social anxiety disorder completed a 12-week course of cognitive behavior therapy (CBT), a time-limited type of psychotherapy that aims to alter behavior by changing the way people think about their anxiety and its triggers. Researchers used electroencephalograms (EEGs) to measure brain electrical interactions before treatment, halfway through treatment, and after the final CBT session. These readings took place at rest and during an impromptu videotaped speech they were asked to give before two people -- an anxiety-producing task for many with social phobias.

EEG results were compared with those of two control groups consisting of people who had not been diagnosed with social anxiety disorder -- one group with high social anxiety levels and another group of people with low levels of social anxiety.

Talk therapy produced meaningful changes in the amount of "delta-beta coupling" seen on the EEGs. Delta-beta coupling, a particular pattern of brain waves, increases with rising anxiety. After the 12-week course of therapy, EEG readings of the people who received CBT resembled those of the control group who had low levels of social anxiety. By contrast, the earlier delta-beta coupling patterns seen before the talk therapy more closely resembled those with high anxiety levels, say the researchers, who were led by Vladimir Miskovic, a PhD candidate at McMaster University in Hamilton, Ontario, Canada.

“The main purpose of our study was not to set out to establish whether cognitive behavioral therapy is effective for the treatment of social anxiety, but rather, to determine whether there is some neural correlate that changes alongside symptomatic improvement,” the study authors tell WebMD in an email.

Whether these findings are generalizable to other anxiety or psychological disorders is not known but does seem likely based on what is already known about the effects of CBT, the researchers say. “Future studies need to specifically test individuals diagnosed with other mood and anxiety disorders,” they say.