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A 5-year follow-up of internet-based cognitive behavior therapy for Social Anxiety Disorder
Department of Clinical Neuroscience, Karolinska institutet, Stockholm, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden.
Umeå University, Faculty of Social Sciences, Department of Psychology.
Department of Clinical Neuroscience, Karolinska institutet, Stockholm, Sweden.
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2011 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, Vol. 13, no 2Article in journal (Refereed) Published
Abstract [en]

Background: Internet-basedcognitive behavior therapy (CBT) has been shown to be a promising method todisseminate cognitive behavior therapy for social anxiety disorder (SAD).Several trials have demonstrated that Internet-based CBT can be effective forSAD in the shorter term. However, the long-term effects of Internet-based CBTfor SAD are less well known.

Objective: Our objectivewas to investigate the effect of Internet-based CBT for SAD 5 years aftercompleted treatment.

Method: We conducted a 5-yearfollow-up study of 80 persons with SAD who had undergone Internet-based CBT.The assessment comprised a diagnostic interview and self-report questionnaires.The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social InteractionAnxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates werelow: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires.

Results: Mixed-effect models analysisshowed a significant effect of time on the three social anxiety measures,LSAS-SR, SIAS, and SPS (F3,98-102 = 16.05 -29.20, P < .001)indicating improvement. From baseline to 5-year follow-up, participants’ meanscores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI]66.1-76.5) to 40.3 (95% CI 35.2 - 45.3).

The effect sizes of the LSAS-SR were large (Cohen’s d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvementsgained at the 1-year follow-up were sustained 5 years after completedtreatment.

Conclusions: Internet-basedCBT for SAD is a treatment that can result in large and enduring effects.

Trial registration: Clinicaltrials.govNCT01145690; (Archived byWebCite at

Place, publisher, year, edition, pages
2011. Vol. 13, no 2
Keyword [en]
Internet; cognitive behavior therapy, anxiety disorders, social anxiety disorder, 5-year follow-up
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Research subject
URN: urn:nbn:se:umu:diva-45078DOI: 10.2196/jmir.1776OAI: diva2:425387
Available from: 2011-06-21 Created: 2011-06-21 Last updated: 2011-08-22Bibliographically approved

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