Network changes in psychopathological symptoms following cognitive behavioral therapy for social anxiety disorder: evidence from 29 university outpatient clinics
Year: 2026
Type: article
Abstract: While network theory posits that interactions between social anxiety symptoms perpetuate social anxiety disorder (SAD), findings on how these networks change following treatment remain inconsistent. This study used data from 29 university outpatient clinics in Germany to estimate psychopathological symptom networks for patients with SAD at pre-treatment, explore critical symptoms and connections in pre- and post-treatment networks, and identify network changes in remitted vs. non-remitted patients. By using the Brief Symptom Inventory to measure transdiagnostic symptoms in 2,392 patients with SAD, 59.8% female, M ( SD ) age = 30.46 (10.71), we estimated six networks using Gaussian Graphical Models. Further, network comparisons were performed between patients who achieved remission ( n = 277) and those who did not achieve remission of SAD at post-treatment ( n = 266). In baseline networks, four themes emerged: negative self-evaluation, loneliness, problems with cognitive functioning, and fear-related experiences. The network structure and global connectivity of remitted networks were significantly changed after treatment ( M = 0.30, p = .012; S = 20.46, p < .001). The global strength of non-remitted networks increased, whereas the overall network structure remained largely unchanged after treatment ( M = 0.30, p = .203; S = 21.93, p = .011). This study identified four core symptom themes in networks of patients with SAD. Structural changes in these themes were associated with remission after treatment, whereas the themes remained present in patients who continued to meet the criteria for SAD. These results highlight the importance of targeting core symptom clusters and their interconnections in effective SAD treatment.
Source: BMC Psychology
Authors: Xu Wen, Julia Velten, Hanna Christiansen, Jürgen Hoyer, Tina In-Albon, Tania M. Lincoln, Wolfgang Lutz, Julian A. Rubel, Brian Schwartz, Rudolf Stark, Katja Werheid, Ulrike Willutzki, Stephan Bartholdy, Elisa-Maria Berger, Anne-Kathrin Bräscher, Thomas Forkmann, Julia A. Glombiewski, Miriam Hehlmann, Sylvia Helbig-Lang, Andrea Hermann, Christiane Hermann, Anke Kirsch, Tim Klucken, Ulrike Lueken, Tanja Michael, Patrizia Odyniec, Anya Pedersen, Andre Pittig, Babette Renneberg, Anne Katrin Risch, Almut Rudolph, Saskia Scholten, Tabea Schweden, Tobias Teismann, Antonia Vehlen, Gabriele Wilz, Jürgen Margraf
Institutions: Ruhr University Bochum, Witten/Herdecke University, Philipps University of Marburg, Technische Universität Dresden, University of Mannheim, Universität Hamburg, Universität Trier, Osnabrück University, Johannes Gutenberg University Mainz, Justus-Liebig-Universität Gießen, Bielefeld University, Universität Greifswald, University of Duisburg-Essen, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Saarland University, University of Siegen, Humboldt-Universität zu Berlin, Christian-Albrechts-Universität zu Kiel, University of Göttingen, Freie Universität Berlin, Friedrich Schiller University Jena, Leipzig University
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,990
OpenAlex ID: W7225730528