Emotion Regulation During RCT of CBT vs. MBSR for Social Anxiety Disorder

A. Aims

The overall goal of this research is to elucidate the neural bases of two specific forms of
emotion regulation - cognitive regulation (CR) and attention regulation (AR). CR and AR are
thought to be important mechanisms underlying therapeutic change associated with
Cognitive-Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR) for
generalized Social Anxiety Disorder (SAD). We seek to test whether changes in CR and AR
underlie the therapeutic effects of CBT and MBSR, which have been shown in the clinical
science literature to be effective treatments for SAD. We will examine CR and AR in healthy
controls (HCs) and in participants with generalized SAD at baseline, as well as in
participants with SAD after they have completed a randomized controlled trial (RCT) with
three treatment arms: CBT, MBSR, or Waitlist (WL). This work will address 3 aims: Aim 1 will
examine the efficacy of CR and AR in individuals with SAD versus HCs; Aim 2 will investigate
the immediate and longer-term impact of CBT versus MBSR for SAD; and Aim 3 will examine
treatment-related changes in CR and AR and test whether these changes mediate the effects of
CBT versus MBSR. The broad, long-term objective of this research is to contribute to advances
in clinical interventions targeting individuals suffering from SAD, as well as a wide range
of other anxiety and mood disorders.

Inclusion Criteria:

- Clinically diagnosable social anxiety disorder (generalized subtype per DSM-IV-TR
criteria)

- aged 21-55

- working fluency in English

- residence in the Bay Area.

- eligible for fMRI scans (right-handed, no metal in body, etc.)

Exclusion Criteria:

- left-handed

- Medication use in the last 3 months

- Pervasive developmental disability

- acute suicide potential

- inability to travel to the treatment site

- schizophrenia or other psychotic disorder

- history of bipolar disorder

- current primary Major Depression

- current substance dependence

- Comorbid diagnoses of Major Depressive or other mood or anxiety disorders are
acceptable ONLY if clearly secondary to the diagnosis of social anxiety disorder.