Лечение социального тревожного расстройства: механизмы, методы и эмпирически подтвержденная терапия

Социальное тревожное расстройство (СТР) является распространенным заболеванием, негативно влияющим на самоощущение и межличностное функционирование человека. Опираясь на когнитивные, но интегрирующие межличностные и эволюционные модели СТР в качестве нашей теоретической базы, мы рассматриваем основные процессы, провоцирующие это расстройство (например, сосредоточенное на себе внимание, мысленные образы, избегание), а также методы лечения, направленные на изменение таких процессов (например, экспозиционная терапия, модификация внимания, рескриптинг). Мы рассматриваем когнитивно-поведенческую терапию (КПТ) как объединение нескольких методов лечения в «набор» вмешательств. Далее мы рассматриваем существующие эмпирические данные об эффективности КПТ. Несмотря на то, что КПТ получила наибольшую поддержку в сравнении с другими заслуживающими доверия вмешательствами, мы предполагаем, что многие проблемы с лечением остаются нерешенными. В статье также обсуждаются способы повышения эффективности КПТ при СТР. В частности, мы подчеркиваем необходимость (а) прояснения сложной взаимосвязи между базовыми процессами и методами, (б) продвижения персонализированных вмешательств и (в) включения более разнообразного и комплексного подхода к оценке результатов терапии.

1. Abbott M.J., Rapee R.M. Post-event rumination and negative self-appraisal in social phobia before and after treatment. Journal of Abnormal Psychology, 2004, vol. 113 (1), pp. 136–144. DOI: 10.1037/0021-843X.113.1.136
2. Aderka I.M. Factors affecting treatment efficacy in social phobia: the use of video feedback and individual vs. group formats. Journal of Anxiety Disorders, 2009, vol. 23, pp. 12–17. DOI: 10.1016/j.janxdis.2008.05.003
3. Aderka I.M., Hofmann S.G., Nickerson A. et al. Functional impairment in social anxiety disorder. Journal of Anxiety Disorders, 2012, vol. 26 (3), pp. 393–400. DOI: 10.1016/j.janxdis.2012.01.003
4. Alden L.E., Buhr K., Robichaud M. et al. Treatment of social approach processes in adults with social anxiety disorder. Journal of Consulting and Clinical Psychology, 2018, vol. 86 (6), pp. 505–517. DOI: 10.1037/ccp0000306
5. Alden L.E., Taylor C.T. Relational treatment strategies increase social approach behaviors in patients with Generalized Social Anxiety Disorder. Journal of Anxiety Disorders, 2011, vol. 25, pp. 309–318. DOI: 10.1016/j.janxdis.2010.10.003
6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing, 2013. 947 p.
7. Andersson G. Internet-delivered psychological treatments. Annual Review of Clinical Psychology, 2016, vol. 12, pp. 157–179. DOI: 10.1146/annurev-clinpsy-021815-093006
8. Andersson G., Titov N. Advantages and limitations of Internet-based interventions
   for common mental disorders. World Psychiatry, 2014, vol. 13 (1), pp. 4–11. DOI: 10.1002/wps.20083
9. Arntz A. Imagery rescripting as a therapeutic technique: Review of clinical trials, basic studies, and research agenda. Journal of Experimental Psychopathology, 2012, vol. 3 (2), pp. 189–208. DOI:10.5127/jep.024211
10. Auyeung K.W., Alden L.E. Accurate empathy, social rejection, and social anxiety disorder. Clinical Psychological Science, 2020, vol. 8 (2), pp. 1–14. DOI: 10.1177/ 2167702619885410
11. Azoulay R., Berger U., Keshet H. et al. Social anxiety and the interpretation of morphed facial expressions following exclusion and inclusion. Journal of Behavior Therapy and Experimental Psychiatry, 2020, vol. 66, 101511. DOI: 10.1016/j.jbtep.2019.101511
12. Azoulay R., Gilboa-Schechtman E. Social construction and evolutionary perspectives on gender differences in post-traumatic distress: The case of status loss events. Frontiers in Psychiatry, 2022. DOI: 10.3389/fpsyt.2022.858304
13. Badra M., Schulze L., Becker E.S. et al. The association between ruminative thinking and negative interpretation bias in social anxiety. Cognition and Emotion, 2017, vol. 31 (6), 1234–1242. DOI: 10.1080/02699931.2016.1193477
14. Bandelow B., Lichte T., Rudolf S. et al. The German guidelines for the treatment of anxiety disorders. European Archives of Psychiatry and Clinical Neuroscience, 2015, vol. 265 (5), pp. 363–373. DOI: 10.1080/02699931.2016.1193477
15. Beard C., Amir N. A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy, 2008, vol. 46 (10), pp. 1135–1141. DOI: 10.1016/j.brat.2008.05.012
16. Beck J.S., Beck A.T. Cognitive behavior therapy. New York, NY: Basics and beyond. Guilford Publication, 2011. 391 p.
17. Blalock D.V., Kashdan T.B., McKnight P.E. High risk, high reward: Daily perceptions of social challenge and performance in social anxiety disorder. Journal of Anxiety Disorders, 2018, vol. 54, pp. 57–64. DOI: 10.1016/j.janxdis.2018.01.006
18. Blay Y., Keshet H, Friedman L. et al. Interpersonal motivations in social anxiety: Weakened approach and intensified avoidance motivations for affiliation and social rank. Personality and Individual Differences, 2021, vol. 170, 110449. DOI: 10.1016/j.paid. 2020.110449
19. Bruijniks S.J., De Rubeis R.J., Hollon S.D. et al. The potential role of learning capacity in cognitive behavior therapy for depression: A systematic review of the evidence and future directions for improving therapeutic learning. Clinical Psychological Science, 2019, vol. 7 (4), pp. 668–692. DOI: 10.1177/2167702619830391
20. Carl E., Stein A.T., Levihn-Coon A. et al. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 2019, vol. 61, pp. 27–36. DOI: 10.1016/j.janxdis.2018.08.003
21. Carpenter J.K., Andrews L.A., Witcraft S.M. et al. Cognitive-behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials. Depression and Anxiety, 2018, vol. 35 (6), pp. 502–514. DOI: 10.1002/da.22728
22. Chesham R.K., Malouff J.M., Schutte N.S. Meta-analysis of the efficacy of virtual reality exposure therapy for social anxiety. Behaviour Change, 2018, vol. 35(3), pp. 152–166. DOI: 10.1017/bec.2018.15
23. Clark D.M., Wells A. A cognitive model of social phobia. In R.G. Heimberg(ed.), Social Phobia: Diagnosis, Assessment, and Treatment. New York, NY: Guilford Press, 1995, pp. 69–93.
24. Clark G.I., Egan S.J. Clarifying the role of the Socratic method in CBT: A survey of expert opinion. International Journal of Cognitive Therapy, 2018, vol. 11 (2), pp. 184–199. DOI: 10.1007/s41811-018-0016-y
25. Cohen L., Huppert J.D. Positive emotions and social anxiety: The unique role of pride. Cognitive Therapy and Research, 2018, vol. 42 (4), pp. 524–538. DOI: 10.1007/s10608-018-9900-2
26. Craske M.G., Niles A.N., Burklund L.J. et al. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. Journal of Consulting and Clinical Psychology, 2014, vol. 82 (6), 1034. DOI: 10.1037/a0037212
27. Crome E., Grove R., Baillie A.J. et al. DSM-IV and DSM-5 social anxiety disorder in the Australian community. Australian & New Zealand Journal of Psychiatry, 2015, vol. 49 (3), pp. 227–235.DOI: 10.1177/0004867414546699
28. Dagoo J., Asplund R.P., Bsenko H.A. et al. Cognitive behavior therapy versus interpersonal psychotherapy for social anxiety disorder delivered via smartphone and computer: A randomized controlled trial. Journal of Anxiety Disorders, 2014, vol. 28 (4), pp. 410–417. DOI: 10.1016/J.JANXDIS.2014.02.003
29. D'Argembeau A., Van der Linden M., d'Acremont M. Et al. Phenomenal characteristics of autobiographical memories for social and non-social events in social phobia. Memory, 2006, vol. 14 (5), pp. 637–647. DOI: 10.1080/09658210600747183
30. Dryman M.T., Heimberg R.G. Emotion regulation in social anxiety and depression: A systematic review of expressive suppression and cognitive reappraisal. Clinical Psychology Review, 2018, vol. 65, pp. 17–42. DOI: 10.1016/j.cpr.2018.07.004
31. Eng W., Heimberg R.G., Hart T.A. et al. Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles, social anxiety, and depression. Emotion, 2001, vol. 1 (4), pp. 365–380. DOI: 10.1037/1528-3542.1.4.365
32. Everaert J., Bronstein M.V., Cannon T.D. et al. Looking through tinted glasses: Depression and social anxiety are related to both interpretation biases and inflexible negative interpretations. Clinical Psychological Science, 2018, vol. 6 (4), pp. 517–528. DOI: 10.1177/2167702617747968
33. Fergus T.A., Wheless N.E. The attention training technique causally reduces self-focus following worry provocation and reduces cognitive anxiety among self-focused individuals. Journal of Behavior Therapy and Experimental Psychiatry, 2018, vol. 61, pp. 66–71. DOI: 10.1016/j.jbtep.2018.06.006
34. Fluckiger C., Del A.C., Wampold B.E. et al. The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 2018, vol. 55 (4), pp. 316–340. DOI: 10.1037/ pst0000172
35. Fung K., Alden L.E. Social anxiety compared to depression better accounts for enhanced acquisition of self-reported anxiety towards faces paired with negative evaluation in a conditioning task. Journal of Experimental Psychopathology, 2020, vol. 11 (1), article 2043808719888309. DOI: 10.1177/2043808719888309
36. Gilbert P. Evolutionary models: Practical and conceptual utility for the treatment and study of social anxiety disorder. In J.W. Weeks (ed.), Handbook of Social Anxiety Disorder. Hoboken, NJ: Wiley Blackwell, 2014, pp. 24–52. DOI: 10.1002/97811186 53920.ch2
37. Gilbert P., Trower P. Evolution and process in social anxiety. In W.R. Crozier,
    L.E. Alden (eds.), International Handbook of Social Anxiety: Concepts, Research and Interventions Relating to the Self and Shyness. Hoboken, NJ: John Wiley & Sons Ltd., 2001, pp. 259–279.
38. Gilboa-Schechtman E. A dual-system model of social anxiety disorder: The interplay of the social-rank and affiliation biopsychosocial systems. Clinical Psychology and Special Education, 2020, vol. 9 (3), pp. 15–33. DOI: 10.17759/cpse.2020090302
39. Gilboa-Schechtman E., Franklin M.E., Foa E.B. Anticipated reactions to social events: Differences among individuals with generalized social phobia, obsessive compulsive disorder, and non-anxious controls. Cognitive Therapy and Research, 2000, vol. 24 (6), pp. 731–746. DOI: 10.1023/A:1005595513315
40. Gilboa-Schechtman E., Galili L., Sahar Y. et al. Being “in” or “out” of the game: subjective and acoustic reactions to exclusion and popularity in social anxiety. Frontiers in Human Neuroscience, 2014, vol. 8, pp. 147–159. DOI: 10.3389/fnhum.2014.00147
41. Gilboa-Schechtman E., Keshet H., Livne T. et al. Explicit and implicit self-evaluations in social anxiety disorder. Journal of Abnormal Psychology, 2017, vol. 126 (3), pp. 285–290. DOI: 10.1037/abn0000261
42. Gilboa-Schechtman E., Keshet H., Peschard V. et al. Self and identity in social anxiety disorder. Journal of Personality,2020, vol. 88 (1), pp. 106–121. DOI: 10.1111/jopy.12455
43. Gilboa-Schechtman E., Shachar-Lavie I. More than a face: a unified theoretical perspective on nonverbal social cue processing in social anxiety. Frontiers in Human Neuroscience, 2013, vol. 7 (December), 904. DOI: 10.3389/fnhum.2013.00904
44. Gilboa-Schechtman E., Shachar I., Helpman L. Evolutionary Perspective on Social Anxiety. In Social Anxiety: Clinical, Developmental, and Social Perspectives: 3rd ed. Cambridge, MA: Academic Press, 2014, pp. 599–622. DOI: 10.1016/B978-0-12-394427-6.00021-2
45. Gilboa-Schechtman E., Shachar I., Sahar Y. Positivity impairment as a broad-based feature of social anxiety. In J.W. Weeks (ed.), Handbook on Social Anxiety Disorder. Hoboken, NJ: Wiley-Blackwell, 2014, pp. 409–432. DOI: 10.1002/9781118653920.ch19
46. Goldin P.R., Lee I., Ziv M. et al. Trajectories of change in emotion regulation and social anxiety during cognitive-behavioral therapy for social anxiety disorder. Behaviour Research and Therapy, 2014, vol. 56, pp. 7–15. DOI: 10.1016/j.brat.2014.02.005
47. Gross J.J. Emotion regulation: Сurrent status and future prospects. Psychological Inquiry, 2015, vol. 26(1), pp. 130–137. DOI: 10.1080/1047840X.2014.940781
48. Gross J.J. The emerging field of emotion regulation: An integrative review. Review of General Psychology, 1998, vol. 2 (3), pp. 271–299. DOI: 10.1037/1089-2680.2.3.271
49. Hackmann A., Clark D.M., McManus F. Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 2000, vol. 38 (6), pp. 601–610. DOI: 10.1016/S0005-7967(99)00161-8
50. Heimberg R.G., Brozovich F.A., Rapee R.M. A cognitive behavioral model of social anxiety disorder: Update and extension. In S.G. Hofmann, P.M. DiBartolo (eds.), Social Anxiety. Cambridge, MA: Academic Press, 2010, pp. 395–422. DOI: 10.1016/B978-0-12-375096-9.00015-8
51. Herbert J.D., Forman E.M., Kaye J.L. et al. Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes. Journal of Contextual Behavioral Science, 2018, vol. 9, pp. 88–96. DOI: 10.1016/j.jcbs.2018.07.008
52. Hirsch C.R., Clark D.M. Information-processing bias in social phobia. Clinical Psychology Review, 2004, vol. 24 (7), pp. 799–825. DOI: 10.1016/j.cpr.2004.07.005
53. Hirsch C.R., Clark D.M., Mathews A. et al. Self-images play a causal role in social phobia. Behaviour Research and Therapy, 2003, vol. 41 (8), pp. 909–921. DOI: 10.1016/S0005-7967(02)00103-1
54. Hofmann S.G. Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 2007, vol. 36 (4), pp. 193–209. DOI: 10.1080/16506070701421313
55. Hofmann S.G. Interpersonal emotion regulation model of mood and anxiety disorders. Cognitive Therapy and Research, 2014, vol. 38 (5), pp. 483–492. DOI: 10.1007/ s10608-014-9620-1
56. Hofmann S.G., Curtiss J.E., Hayes S.C. Beyond linear mediation: Toward a dynamic network approach to study treatment processes. Clinical Psychology Review, 2020, vol. 76, 101824. DOI: 10.1016/j.cpr.2020.101824
57. Hoyer J., Wiltink J., Hiller W. et al. Baseline patient characteristics predicting outcome and attrition in cognitive therapy for social phobia: Results from a large multicentre trial. Clinical Psychology &Psychotherapy, 2016, vol. 23 (1), pp. 35–46. DOI: 10.1002/cpp.1936
58. Huppert J.D., Pasupuleti R.V., Foa E. B. et al. Interpretation biases in social anxiety: Response generation, response selection, and self-appraisals. Behaviour Research and Therapy, 2007, vol. 45 (7), pp. 1505–1515. DOI: 10.1016/j.brat.2007.01.006
59. Jazaieri H., Morrison A.S., Goldin P.R. et al. The role of emotion and emotion regulation in social anxiety disorder. Current Psychiatry Reports, 2015, vol. 17 (1), article 531. DOI: 10.1007/s11920-014-0531-3
60. Kalokerinos E.K., Erbas Y., Ceulemans E. et al. Differentiate to regulate: Low negative emotion differentiation is associated with ineffective use but not selection of emotion-regulation strategies. Psychological Science,2019, vol. 30 (6), pp. 863–879. DOI: 10.1177/0956797619838763
61. Kampmann I.L., Emmelkamp P.M.G., Morina N. Meta-analysis of technology-assisted interventions for social anxiety disorder. Journal of Anxiety Disorders, 2016, vol. 42, pp. 71–84. DOI: 10.1016/j.janxdis.2016.06.007
62. Kashdan T.B., Barrett L.F., McKnight P.E. Unpacking emotion differentiation. Current Directions in Psychological Science, 2015, vol. 24 (1), pp. 10–16. DOI : 10.1177/0963721414550708
63. Kashdan T.B., Farmer A.S. Differentiating emotions across contexts: comparing adults with and without social anxiety disorder using random, social interaction, and daily experience sampling. Emotion, 2014, vol. 14 (3), pp. 629–638. DOI: 10.1037/a0035796
64. Kashdan T.B., Steger M.F. Expanding the topography of social anxiety: An experience-sampling assessment of positive emotions, positive events, and emotion suppression. Psychological Science, 2006, vol. 17 (2), pp. 120–128. DOI: 10.1111/j.1467-9280.2006.01674.x
65. Katzelnick D.J., Greist J.H. Social anxiety disorder: An unrecognized problem in primary care. Journal of Clinical Psychiatry, 2001, vol. 62 (suppl. 1), pp. 11–16.
66. Kessler R.C., Chiu W.T., Demler O. et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 2005, vol. 62 (6), pp. 617–627. DOI: 10.1001/archpsyc.62.6.617
67. Kivity Y., Huppert J.D. Does cognitive reappraisal reduce anxiety? A daily diary study of a micro-intervention with individuals with high social anxiety. Journal of Consulting and Clinical Psychology,2016, vol. 84 (3), pp. 269–283. DOI: 10.1037/ ccp0000075
68. Kivity Y., Huppert J.D. Emotion regulation in social anxiety: a systematic investigation and meta-analysis using self-report, subjective, and event-related potentials measures. Cognition and Emotion, 2019, vol. 33 (2), pp. 213–230. DOI: 10.1080/02699931.2018.1446414
69. Kok B.E., Fredrickson B.L. Upward spirals of the heart: Autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness. Biological Psychology, 2010, vol. 85 (3), pp. 432–436. DOI: 10.1016/ j.biopsycho.2010.09.005
70. Lazarov A., Abend R., Bar-Haim Y. Social anxiety is related to increased dwell time on socially threatening faces. Journal of Affective Disorders, 2016, vol. 193, pp. 282–288. DOI: 10.1016/j.jad.2016.01.007
71. Lazarus G., Shahar B. The role of shame and self-criticism in social anxiety: a daily-diary study in a nonclinical sample. Journal of Social and Clinical Psychology, 2018, vol. 37 (2), pp. 107–127. DOI: 10.1521/jscp.2018.37.2.107
72. Leary M.R. Social anxiety as an early warning system: A refinement and extension of the self-presentation theory of social anxiety. In S.G. Hofmann, P.M. DiBartolo (eds.), Social Anxiety: Clinical, developmental, and social perspectives. Cambridge, MA: Elsevier Academic Press, 2010, pp. 471–486. DOI: 10.1016/B978-0-12-375096-9.00018-3
73. Ledley D.R., Heimberg R.G., Hope D.A. et al. Efficacy of a manualized and workbook-driven individual treatment for social anxiety disorder. Behavior Therapy, 2009, vol. 40 (4), pp. 414–424. DOI: 10.1016/j.beth.2008.12.001
74. Leichsenring F., Salzer S., Beutel M.E. et al. Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. The American Journal of Psychiatry, 2013, vol. 170 (7), pp. 759–767. DOI: 10.1176/ appi.ajp.2013.12081125
75. Lloyd J., Marczak M. Imagery rescripting and negative self-imagery in social anxiety disorder: a systematic literature review. Behavioural and Cognitive Psychotherapy, 2022, vol. 50 (3), pp. 280–297. DOI: 10.1017/S135246582200008X
76. Maner J. K., Miller S.L., Schmidt N.B. Submitting to defeat: Social anxiety, dominance threat, and decrements in testosterone. Psychological Science, 2008, vol. 19, pp. 264–268. DOI: 10.1111/j.1467-9280.2008.02154.x
77. Månsson K.N.T., Lueken U., Frick A. Enriching CBT by Neuroscience: Novel Avenues to Achieve Personalized Treatments. Journal of Cognitive Therapy, 2021, vol. 14,  pp. 182–195. DOI: 10.1007/s41811-020-00089-0
78. Mayo-Wilson E., Dias S., Mavranezouli I. et al. Psychological and pharmacological interventions for social anxiety disorder in adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 2014, vol. 1 (5), pp. 368–376. DOI: 10.1016/S2215-0366(14)70329-3
79. McEvoy P.M., Grove R., Slade T. Epidemiology of anxiety disorders in the Australian general population: Findings of the 2007 Australian National Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 2011, vol. 45 (11), pp. 957–967. DOI: 10.3109/00048674.2011.624083
80. McEvoy P.M., Hyett M.P., Bank S.R. et al. Imagery-enhanced v. verbally-based group cognitive behavior therapy for social anxiety disorder: A randomized clinical trial.Psychological Medicine, 2020, pp. 1–10. DOI: 10.1017/S0033291720003001
81. Mogg K., Bradley B.P. Anxiety and threat-related attention: Cognitive-motivational framework and treatment. Trends in Cognitive Sciences, 2018, vol. 22 (3), pp. 225–240. DOI: 10.1016/j.tics.2018.01.001
82. Morrison A.S., Heimberg R.G. Social anxiety and social anxiety disorder. Annual Review of Clinical Psychology, 2013, vol. 9, pp. 249–274. DOI: 10.1146/annurev-clinpsy-050212-185631
83. Moscovitch D.A. What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 2009, vol. 16 (2), pp. 123–134. DOI: 10.1016/j.cbpra.2008.04.002
84. Moscovitch D.A., Gavric D.L., Merrifield C. et al. Retrieval properties of negative vs. Positive mental images and autobiographical memories in social anxiety: Outcomes with a new measure. Behaviour Research and Therapy, 2011, vol. 49 (8), pp. 505–517. DOI: 10.1016/j.brat.2011.05.009
85. Moscovitch D.A., Vidovic V., Lenton-Brym A.P. et al. Autobiographical memory retrieval and appraisal in social anxiety disorder. Behaviour Research and Therapy, 2018, vol. 107, pp. 106–116. DOI: 10.1016/j.brat.2018.06.008
86. National Institute for Health and Care Excellence. Social anxiety disorder: recognition, assessment and treatment of social anxiety disorder. NICE ClinicalGuideline, 2013, vol. 159. 19 p. URL: https://www.nice.org.uk/guidance/cg159/resources/social-anxiety-disorder-pdf-246100650181 (Accessed: 25.05.2022).
87. Nikitin J., Schoch S. Social approach and avoidance motivations. In R.J. Coplan, J.C. Bowker, L.J. Nelson (eds.), The Handbook of Solitude: Psychological Perspectives on Social Isolation, Social Withdrawal, and Being Alone, 2nd ed. New York, NY: Wiley Blackwell, 2021, pp. 191–208. DOI: 10.1002/9781119576457.ch14
88. Niles A.N., Axelsson E., Andersson E. et al. Internet-based cognitive behavior therapy for depression, social anxiety disorder, and panic disorder: Effectiveness and predictors of response in a teaching clinic. Behaviour Research and Therapy, 2021, vol. 136, 103767. DOI: 10.1016/j.brat.2020.103767
89. Norton A.R., Abbott M.J. The role of environmental factors in the aetiology of social anxiety disorder: A review of the theoretical and empirical literature. Behaviour Change, 2017, vol. 34 (2), pp. 76–97. DOI: 10.1017/bec.2017.7
90. Pearlstein S.L., Taylor C.T., Stein M.B. Facial affect and interpersonal affiliation: displays of emotion during relationship formation in social anxiety disorder. Clinical Psychological Science, 2019, vol. 7 (4), pp. 826–839. DOI: 10.1177/2167702619825857
91. Peschard V., Ben-Moshe S., Keshet H. et al. Social anxiety and sensitivity to social-rank features in male faces. Journal of Behavior Therapy and Experimental Psychiatry, 2019, vol. 63, pp. 79–84. DOI: 10.1016/j.jbtep.2018.10.005
92. Peschard V., Gilboa-Schechtman E., Philippot P. Selective attention to emotional prosody in social anxiety: A dichotic listening study. Cognition and Emotion, 2017, vol. 31 (8), pp. 1749–1756. DOI: 10.1080/02699931.2016.1261012
93. Piccirillo M.L., Rodebaugh T.L. Personalized networks of social anxiety disorder and depression and implications for treatment. Journal of Affective Disorders, 2022, vol. 298, pp. 262–276. DOI: 10.1016/j.jad.2021.10.034
94. Plasencia M.L., Taylor C.T., Alden L.E. Unmasking one’s true self facilitates positive relational outcomes. Clinical Psychological Science, 2016, 4 (6), pp. 1002–1014. DOI: 10.1177/2167702615622204
95. Rapee R.M., Fardouly J., Forbes M.K. et al. Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behaviour Research & Therapy,2019, vol. 123, 103501. DOI: 10.1016/j.brat.2019.103501
96. Rapee R.M., Heimberg R.G. A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 1997, vol. 35 (8), pp. 741–756. DOI:10.1016/s0005-7967(97)00022-3
97. Rapee R.M., Spence S.H. The etiology of social phobia: Empirical evidence and an initial model. Clinical Psychology Review, 2004, vol. 24 (7), pp. 737–767. DOI: 10.1016/j.cpr.2004.06.004
98. Romano M., Moscovitch D.A., Saini P. et al. The effects of positive interpretation bias on cognitive reappraisal and social performance: Implications for social anxiety disorder. Behaviour Research and Therapy, 2020, vol. 131, 103651. DOI: 10.1016/ j.brat.2020.103651
99. Rowa K., Paulitzki J.R., Ierullo M.D. et al. A false sense of security: Safety behaviors erode objective speech performance in individuals with social anxiety disorder. Behavior Therapy, 2014, vol. 46 (3), pp. 304–314. DOI: 10.1016/j.beth.2014.11.004
100. Sapach M.J.T., Carleton R.N. Can words be worse than stones? Understanding distressing social events and their relationship with social anxiety. Journal of Anxiety Disorders, 2020, vol. 72, 102225. DOI: 10.1016/j.janxdis.2020.102225
101. Springer K.S., Levy H.C., Tolin D.F. Remission in CBT for adult anxiety disorders:
     A meta-analysis. Clinical Psychology Review, 2018, vol. 61, pp. 1–8. DOI: 10.1016/ j.cpr.2018.03.002
102. Stangier U., Schramm E., Heidenreich T., Berger M. et al. Cognitive therapy versus interpersonal psychotherapy in social phobia: A randomized controlled trial. Archives of General Psychiatry, 2011, vol. 68, pp. 692–700. DOI: 10.1001/archgenpsychiatry.2011.67
103. Stein D.J., Lim C.C., Roest A.M. et al. The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine, 2017, vol. 15(1), article 143. DOI: 10.1186/s12916-017-0889-2
104. Stewart R.E., Chambless D.L. Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 2009, vol. 77 (4), pp. 595–606. DOI: 10.1037/a0016032
105. Stopa L., Clark D.M., Social phobia and interpretation of social events. Behaviour Research and Therapy, 2000, vol. 38 (3), pp. 273–283. DOI: 10.1016/S0005-7967(99) 00043-1
106. Taylor C.T., Alden L.E. Safety behaviors and judgmental biases in social anxiety disorder. Behaviour Research and Therapy, 2010, vol. 48 (3), pp. 226–237. DOI: 10.1016/ j.brat.2009.11.005
107. Taylor C.T., Cross K., Amir N. Attentional control moderates the relationship between social anxiety symptoms and attentional disengagement from threatening information. Journal of Behavior Therapy and Experimental Psychiatry, 2016, vol. 50, pp. 68–76. DOI: 10.1016/j.jbtep.2015.05.008
108. Trower P., Gilbert P. New theoretical conceptions of social anxiety and social phobia. Clinical Psychology Review, 1989, vol. 9 (1), pp. 19–35. DOI: 10.1016/0272-7358(89)90044-5
109. Weeks J.W., Heimberg R.G. Editorial — special issue positivity impairments: Pervasive and impairing (yet non-prominent?) features of social anxiety disorder. Cognitive Behaviour Therapy, 2012, vol. 41 (2), pp. 79–82. DOI: 10.1080/16506073.2012.680782
110. Weeks J.W., Heimberg R.G., Heuer R. Exploring the role of behavioral submissiveness in social anxiety. Journal of Social and Clinical Psychology, 2011, vol. 30 (3), pp. 217–249. DOI: 10.1521/jscp.2011.30.3.217
111. Wenzel A. Cognitive reappraisal. In S.C. Hayes, S.G. Hofmann (eds.), Process-based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy, 1st ed. Oakland, CA: New Harbinger Publications, 2018, pp. 325–338.
112. Werner A.M., Tibubos A.N., Rohrmann S. et al. The clinical trait self-criticism and its relation to psychopathology: A systematic review — Update. Journal of Affective Disorders, 2019, vol. 246, pp. 530–547. DOI: 10.1016/j.jad.2018.12.069
113. Wersebe H., Sijbrandij M., Cuijpers P. Psychological group-treatments of social anxiety disorder: a meta-analysis. PloS One, 2013, vol. 8 (11), e79034. DOI: 10.1371/ journal.pone.0079034
114. Wieser M.J., Keil A. Attentional threat biases and their role in anxiety: A neurophysiological perspective. International Journal of Psychophysiology. 2020. DOI: 10.31234/osf.io/3zerk
115. Wong Q.J. Anticipatory processing and post‐event processing in social anxiety disorder: An update on the literature. Australian Psychologist, 2016, vol. 51 (2), pp. 105–113. DOI: 10.1111/ap.12189
116. Wunderlich U., Bronisch T., Wittchen H.U. Comorbidity patterns in adolescents and young adults with suicide attempts. European Archives of Psychiatry and Clinical Neuroscience, 1998, vol. 248 (2), pp. 87–95. DOI: 10.1007/s004060050023