Brain Plasticity and Cellular Aging After Internet-delivered CBT for Social Anxiety Disorder (UMEII)

Linköping University (LiU)

Status: Unknown

Conditions: Social Anxiety Disorder; Anxiety Disorders

Treatments: Behavioral: Internet-delivered cognitive behavior therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT02592564

UMESTUDIEN-II

Details and patient eligibility

About

This study evaluates underlying psychological and biological mediators in Internet-delivered cognitive behavior therapy for adults with social anxiety disorder.

Full description

Internet-delivered cognitive behavior therapy for social anxiety disorder has previously demonstrated to target and affect the brain´s fear network, typically neural response in the amygdala ameliorate after effective psychological treatment. Commonly, neuroimaging studies have performed brain imaging at pre- and post-intervention, yet, longitudinal study designs including several repeated measures of neural response over the course of treatment are currently missing in anxiety disorder. In the current study the participants will undergo magnetic resonance imaging (MRI) at four occasion. a) Twice before treatment initiation (9 weeks apart), b) at week 4 (during treatment), c) and directly after treatment termination.

Biological aging can be quantified at the individual cell level by measuring telomere length in peripheral immune cells (leukocytes). Telomeres are located at the end of each chromosome and protect the genetic material during cell division. Telomerase is an enzyme that can lengthen telomeres, and have in this way a protective function against accelerated cellular aging. Variations in these bodily processes have been associated with psychiatric manifestations such as anxiety and depression. In the current study the participant´s telomere length and telomerase activity will be assessed at three occasion. a) Twice before treatment initiation (9 weeks apart), and b) directly after treatment termination.

Enrollment: 50 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Social Anxiety Disorder as primary diagnosis (DSM-5)
• Otherwise somatically healthy
• Willingness to participate in a symptom provocation brain imaging trial

Exclusion criteria

• Concurrent psychological treatment
• Treatment of social anxiety within the three months preceding the study
• Chronic use of prescribed medication that could influence the results (anxiolytic or antidepressant drugs, certain hypnotics or herbs like St Johns Wort)
• Contraindications for MRI investigation (implants or other metal objects in the body, brain and heart operations)
• Pregnancy or planned pregnancy during the first 6 months of the study period
• Postmenopausal women
• Any neurological disorders
• Depressive symptoms, as determined by scoring more than 20 on the MADRS questionnaire (self-report version)
• Suicidal ideation (scoring more than 2) on the self-report version of MADRS, item 9
• Suicide at moderate risk (MINI v7)
• Bipolar disorder (MINI v7)
• Psychotic syndromes (MINI v7)
• Substance abuse disorders (MINI v7)
• Alcohol abuse (MINI v7)
• Any eating disorder (MINI v7)
• Antisocial personality disorder (MINI v7)

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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50 participants in 1 patient group

Psychological treatment

Experimental group

Description:

Psychological treatment during 9 weeks.

Treatment:

Behavioral: Internet-delivered cognitive behavior therapy