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dc.contributor.authorLervik, Linn Vathne
dc.contributor.authorHoffart, Asle
dc.contributor.authorKnapstad, Marit
dc.contributor.authorSmith, Otto Robert Frans
dc.date.accessioned2022-04-21T11:11:59Z
dc.date.available2022-04-21T11:11:59Z
dc.date.created2021-07-21T14:35:09Z
dc.date.issued2022
dc.identifier.issn1050-3307
dc.identifier.urihttps://hdl.handle.net/11250/2991955
dc.description.abstractObjectives In cognitive behavioral therapy (CBT) for social anxiety disorder (SAD), avoidance behavior (AB) and cognitions (COG) are two important targets of intervention, but so far no studies have directly examined their relative importance. By means of cross-lagged panel models (CLPM), we examined their temporal associations and impacts on outcome in clients with symptoms of SAD while addressing typical methodological challenges. Method We used data from the first six therapy sessions in a sample of 428 primary care clients (mean [SD] age = 34.6 [12.2], 34.3% men), participating in the Prompt Mental Health Care trial. Session-by-session data was collected on AB, COG, depression and general anxiety. Competing multiple indicator CLPMs were tested. Results The Random Intercept-CLPM provided best fit, and indicated that AB predicted COG at subsequent time points (.39 ≤ β  ≤ .42 for T2–T5, p  < .05), but not vice versa. In addition, AB, but not COG, predicted clients’ general anxiety score at subsequent time points. Results were both robust to the inclusion of depressive symptoms as a within-level covariate, and sensitivity tests for stationarity and missing data assumptions. Conclusion Targeting avoidance behavior for primary care clients with symptoms of SAD may be more vital for the optimal effect of CBT than targeting cognitions. Methodological considerations and limitations of the study are discussed.en_US
dc.language.isoengen_US
dc.publisherTaylor & Francisen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/deed.no*
dc.titleExploring the temporal associations between avoidance behavior and cognitions during the course of cognitive behavioral therapy for clients with symptoms of social anxiety disorderen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2
dc.identifier.doi10.1080/10503307.2021.1930243
dc.identifier.cristin1922355
dc.source.journalPsychotherapy Researchen_US
dc.source.pagenumber195-208en_US
dc.relation.projectNorges forskningsråd: 260659en_US
dc.identifier.citationPsychotherapy Research. 2022, 32 (2), 195-208.en_US
dc.source.volume32en_US
dc.source.issue2en_US


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Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
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