Trials of cognitive behaviour therapy (CBT) for social anxiety disorder (SAD) have struggled to identify replicable moderators of treatment outcome. This could be due to a genuine lack of effects, or a spurious finding caused by methodological factors such as inadequate testing of theory-driven moderators, use of small homogenous samples, failure to model non-linear relationships, and over-reliance on significance testing. We probed explanations for the field's failure to detect moderators by testing whether 15 theory-driven and atheoretical variables moderated treatment outcome in a large heterogeneous sample treated with group CBT for SAD. Moderation was not assessed by only using p-values for linear models, but also by considering effect sizes, plots, and non-linear relationships. Despite using a comprehensive approach to assess moderation, only two variables - the baseline severity of SAD symptoms and fear of negative evaluation (FNE) - were found to moderate social anxiety symptom trajectories. FNE had a non-linear relationship with symptom change that would have been missed using common research methods. Our findings suggest both a genuine lack of effects and limitations of research methods have contributed to the field's inability to identify moderators. We provide suggestions that may increase the likelihood of future researchers detecting genuine effects.
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http://dx.doi.org/10.1016/j.janxdis.2023.102676 | DOI Listing |
Neurology
February 2025
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Objectives: To analyze sex differences in outcomes in Tourette syndrome (TS) and Persistent Motor or Vocal tic disorders (PMVT) in the Tourette Association of America International Consortium for Genetics (TAAICG) dataset.
Methods: The relationship between sex and clinical measures was explored in 2,403 participants (N = 2,109 with TS; N = 294 with PMVT) from the TAAICG dataset using generalized estimating equation regression models, and adjusted for age and family relationships.
Results: Female (vs male) participants with TS (25.
Cad Saude Publica
January 2025
Universidade Federal de Alagoas, Maceió, Brasil.
This study aimed to investigate the presence of mental illness in victims of soil instability in neighborhoods affected by rock salt extraction from a mining company located in the city of Maceió, Alagoas, Brazil. It is a quantitative, descriptive-analytical, and cross-sectional study. The sample was intentional and non-probabilistic and consisted of 158 participants, with a 0.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr
November 2024
Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA.
Background: HIV pre-exposure prophylaxis (PrEP) remains particularly underutilized among homeless-experienced people who use drugs (PWUD).
Setting: Boston Health Care for the Homeless Program, a Federally Qualified Health Center serving homeless-experienced individuals in Boston, Massachusetts.
Methods: To identify determinants of PrEP prescription initiation and continuation, we analyzed electronic medical records and pharmacy data between April 2018-March 2022.
PLoS One
January 2025
Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom.
Introduction: Undiagnosed chronic disease has serious health consequences, and variation in rates of underdiagnosis between populations can contribute to health inequalities. We aimed to estimate the level of undiagnosed disease of 11 common conditions and its variation across sociodemographic characteristics and regions in England.
Methods: We used linked primary care, hospital and mortality data on approximately 1.
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