사회불안장애의 인지행동집단치료에서의 급성호전 연구 = Sudden Gains in Cognitive Behavioral Group Therapy for Individuals with Social Anxiety Disorder

다국어 초록 (Multilingual Abstract)

Sudden gains (SG) are the phenomena of sudden symptom improvements from one session to the next (Tang & DeRubeis, 1999). SG are known to be related to greater symptom reductions at post-treatment and follow-up session. It is also suggested that SG represent abrupt but sustainable symptom improvements which affect treatment outcome. SG are referred to as phenomena that support the cognitive modification hypothesis; cognitive changes function as a precedent factor that leads to symptom reductions in Cognitive Behavior Therapy (CBT). However, there is lack of consensus on the mechanism underlying SG or its effect on prognosis. Furthermore, in contrast to the growing number of SG studies on various different psychopathologies and interventions within Western culture, SG studies have been relatively scarce in Asian culture. The aim of this study was to investigate SG in Cognitive Behavioral Group Therapy (CBGT) for individuals with Social Anxiety Disorder (SAD) in Korea. Data were collected from 32 individuals with SAD who visited the Social Anxiety Counseling Center at Korea University. According to the results, Korean SAD participants showed comparable frequency and magnitude of SG to those reported in previous studies with Western populations. Sudden gainers, compared to non-sudden gainers, showed greater reductions in symptoms associated with social interaction anxiety from pre- to post-assessment. They also demonstrated greater symptom abbreviations in performance anxiety from post- to follow-up assessment. Moreover, the decrease in social anxiety was preceded by reduction of dysfunctional belief and catastrophic anticipation on social interactions. This study was the first to explore SG in Asian culture. In results of this study, patterns of SG in the Korean SAD sample were similar to those reported in Western culture. In addition, sudden gainers showed significantly greater symptom reductions compared to non-sudden gainers. These results support the conceptual importance of SG as both a predictor of positive treatment outcome and evidence to support the cognitive modification hypothesis. In addition, we found temporal difference in the occurrence of SG in social interaction anxiety and performance anxiety, suggesting that individually tailored assessment and intervention based on varying subtypes of social anxiety symptoms may be helpful in promoting better treatment outcome.

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