The Effect of Shame on Patients With Social Anxiety Disorder in Internet-Based Cognitive Behavioral Therapy: Comparison Clinical Trial in China

Prior research has demonstrated the efficacy of internet-based cognitive behavioral therapy (ICBT) for social anxiety disorder (SAD). However, it is unclear how shame influences this treatment effect. This study aimed to investigate the role shame played in the ICBT treatment process for participants with SAD. A total of 104 Chinese participants (73 females; age: mean 24.92 years, SD 4.59) were divided into self-help ICBT, guided ICBT, or wait list control groups. Participants were assessed before and immediately after the intervention using Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), and Experience of Shame Scale (ESS). Participants' social anxiety symptoms (self-help: differences between pre and post-treatment SIAS=-12.71; Cohen d=1.01; 95% CI 9.08 to 16.32; P