Longitudinal assessment of cognition in social phobia: An exploration of the process of cognitive change

The present study was an attempted to validate current theoretical understandings of the process of therapeutic change from a cognitive perspective. Ten subjects diagnosed with social phobia were treated with Cognitive-Behavioral Group Therapy, an intervention shown in numerous studies to be highly effective in the treatment of this disorder. Throughout the course of therapy, each subjects' functioning was repeatedly assessed across several cognitive domains, including anticipatory and in vivo cognitive products, cognitive propositions, and cognitive operations. Cognitive theory predicts an orderly sequence of therapeutic change across these domains. In vivo cognitive products are thought to be the first domain that will evidence positive change, followed by changes in cognitive propositions. Concomitant changes in cognitive operations and anticipatory cognitive products are thought to be the last portions of the cognitive system that will evidence improvement during therapy.; Results of the study only partially supported the hypotheses. Evidence was found which supported the hypotheses that in vivo cognitive products change first, while anticipatory cognitive products change last. However, measures of cognitive propositions evidenced changes earlier than predicted. Due to difficulties with a sequence effect, data relating to cognitive operations generally failed to follow a predictable pattern. The failure of the present study to fully support the cognitive model is attributable to at least three possible sources; (1) insufficient frequency of measurement, (2) insufficient sensitivity of measurement, and/or (3) shortcomings in the cognitive theory. Each of these possibilities is discussed and suggestions for future research are offered.