Typical symptom change patterns and their predictors in patients with social anxiety disorder: A latent class analysis.
OBJECTIVES
The use of trajectories and analysis of change patterns is a promising way toward better differentiation of subgroups in psychotherapy studies. Research on change patterns in social anxiety disorder (SAD) are still rare, although SAD is one of the most common mental disorders. In a secondary analysis of data from the SOPHO-NET-trial (ISRCTN53517394) this study aimed to investigate change patterns and their predictors in a sample of SAD patients.


METHODS
Patients with SAD (N = 357) were randomly assigned to cognitive-behavioral or psychodynamic therapy. The Liebowitz Social Anxiety Scale (LSAS) was assessed at 1st session (pre), 8th session, 15th session and at the end of treatment (post). We used latent state variables and latent class analysis for the classification of change patterns and logistic regression for the identification of different predictors.


RESULTS
Analyses revealed three typical patterns: (i.) responders with a high initial impairment (N = 57), (ii.) responders with a moderate initial impairment (N = 225), and (iii.) patients with a high initial impairment and no remission (N = 75). Among other significant predicators, patient´s attachment anxiety and therapeutic alliance at session eight contributed to the prediction of change patterns.


DISCUSSION
Psychotherapy of SAD should consider patient's attachment and focus on the establishment of a solid therapeutic alliance in an early therapy stage.
['Altmann|Uwe|U|', 'Gawlytta|Romina|R|', 'Hoyer|Jürgen|J|', 'Leichsenring|Falk|F|', 'Leibing|Eric|E|', 'Beutel|Manfred|M|', 'Willutzki|Ulrike|U|', 'Herpertz|Stephan|S|', 'Strauss|Bernhard|B|']
D001007:Anxiety D001008:Anxiety Disorders D006801:Humans D000077272:Latent Class Analysis D000072861:Phobia, Social D011613:Psychotherapy
Change patterns Social anxiety disorder Latent class analysis Attachment Helping alliance