Understanding why some people benefit from cognitive behavioral therapy

Contributions of Self-Focused Attention to Early Warning Indicators of Cognitive Behavioral Therapy Non-Response

This study is trying to find out why some people with social anxiety and body dysmorphic disorder get better from cognitive behavioral therapy while others don’t, by looking at their brain scans and other information during treatment.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 160 (estimated)
• Ages: 18 Years to 45 Years
• Sex: All
• Sponsor: University of Washington (Academic / other)
• Locations: 1 site (Seattle, Washington)
• Trial ID: NCT06678295 on ClinicalTrials.gov

What this trial studies

This research aims to explore the individual factors that contribute to the success of cognitive behavioral therapy (CBT) in treating social anxiety disorder and body dysmorphic disorder. By analyzing neural, neurocognitive, clinical, and self-report data, the study seeks to identify why some individuals respond positively to CBT while others do not. Participants will undergo 12 sessions of CBT along with neuroimaging scans before, during, and after treatment. The study will include both clinical participants with the target disorders and healthy control participants for comparison.

Who should consider this trial

Good fit: Ideal candidates are treatment-seeking adults aged 18-45 with a primary diagnosis of social anxiety disorder or body dysmorphic disorder.

Not a fit: Patients with a history of psychiatric disorders or those who do not meet the inclusion criteria may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to more personalized and effective treatment strategies for individuals with social anxiety disorder and body dysmorphic disorder.

How similar studies have performed: Other studies have shown promise in understanding individual responses to CBT, but this specific approach focusing on self-focused attention biomarkers is relatively novel.

Eligibility criteria

Inclusion Criteria:

Clinical sample (N=110):

1. Men and women, age 18-45
2. Treatment-seeking individuals who meet criteria for a primary DSM-5 diagnosis of primary social anxiety disorder (SAD) or body dysmorphic disorder (BDD) based on the SCID-5-RV
3. Fluent in English and willing to provide informed consent.

Control sample (N=50):

1. Men and women, age 18-45
2. No current or lifetime history of psychiatric disorders, as assessed using the SCID-5-RV
3. Meet criteria for low levels of anxiety (GAD-7 score of \<8) and depression (PHQ-9 score \<10)
4. Fluent in English and willing to provide informed consent

Exclusion Criteria:

All groups:

1. Score \< 80 based on WRAT5 Word Reading Subtest
2. fMRI contraindications (e.g., electronic medical devices such as pacemakers, implanted defibrillators, etc.; metal implants not approved for MRI; pregnancy; claustrophobia)

2\. Active suicidal or homicidal ideation, or any features requiring a higher level of care 3. Lifetime history of manic or hypomanic episode, psychotic symptoms, traumatic brain injury, neurological disorder, pervasive developmental disorder, or attention deficit-hyperactivity disorder; active alcohol or substance use disorder in the past 6 months 4. Current use of psychotropic medications, except antidepressants taken at a stable dose for 3 months prior to study baseline 5. Previous CBT non-responder or current CBT

Where this trial is running

Seattle, Washington

• University of Washington — Seattle, Washington, United States (Recruiting)

Study contacts

• Principal investigator: Angela Fang, PhD — University of Washington
• Study coordinator: Angela Fang, PhD

Conditions Social Anxiety Disorder; Body Dysmorphic Disorder; Social Phobia; Self focused attention; fMRI; CBT; Cognitive Behavior Therapy; BDD