- VChatter: Exploring Generative Conversational Agents for Simulating Exposure Therapy to Reduce Social Anxiety
Six-day qualitative study (N=10) of an LLM multi-agent exposure simulator reported reduced social anxiety and avoidance; uncontrolled.
- Virtual reality exposure therapy with biofeedback for high social anxiety: randomized trial
n=72 high social anxiety: VRET+heart-rate/EEG biofeedback reduced self-reported arousal more than VRET alone; both improved (title not confirmed).
- Why Woebot, a pioneering therapy chatbot, shut down
Scripted CBT chatbot used by about 1.5M people closed its app in mid-2025; founder cited cost of FDA authorization and no regulatory path for LLMs.
- Associations between adolescent social phobia, sickness absence and unemployment: a prospective study of twins in Sweden
2,845 Swedish twins: adolescent social phobia predicted unemployment (OR 1.58 at age 13-14, null after familial adjustment) and sickness absence (OR 1.73 at 19-20, robust).
- When r/socialanxiety Gets It
Clinician-style blog: Reddit offers validation but risks echo chambers and substituting for offline exposure; proposes a 'digital ladder' from lurking to in-person contact.
- Virtual reality exposure therapy for social anxiety disorder: a randomized controlled trial
n=97 SAD with public speaking as primary fear: 8 sessions of VRET and exposure group therapy both beat waitlist with no differences between them; gains maintained at 12 months.
- Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis
Guided internet CBT and face-to-face CBT were equivalent (pooled g about -0.01) across conditions; only 3 SAD trials were included.
- Combination of medication and alcohol on social anxiety
Poster drinks 'only to manage social anxiety', helping ~50% of the time; replies warn against mixing with stimulants, multi-day 'hangxiety'.
- about to start my first beta blocker - share your experiences with me
32 comments; consistent pattern: beta-blockers help heart rate/shaking but 'not the thoughts'; therapist said as-needed, GP said 3x daily; side effects tiredness, nausea.
- Hate the feeling of phone anxiety
Shame about phone fear in one's 20s; replies: script the opening, start with low-stakes calls, imagine the bored worker taking dozens of calls.
- What helped me with my anxiety
Seven-point recovery list after therapy: self-worth, dropping shame, self-compassion, facing fears ('usually turned out better than expected'), meditation, breathing.
- Is there an overlap between anxiety disorders and autism?
45 comments; users distinguish fear-driven avoidance from social confusion/sensory needs and describe late autism diagnoses after anxiety labels.
- I regret buying into all the negative SSRI talk online.
176 points, 47 comments; escitalopram user reports social anxiety 'nearly vanished'; replies split between life-saving and numbing/harm reports.
- What helped me overcome my social anxiety
Credits a self-worth reframe over exposure: 'People can judge something you do, but not tie it to your worth'; reply asks for concrete steps.
- Propranolol is life changing
Representative enthusiastic propranolol post; seen only in search results, not opened.
- Social Anxiety treatments
'I keep cancelling social events and I keep hating myself'; 'What would be the first step?'; replies: CBT, exposure, improv, Psychology Today filter by insurance, SSRIs.
- Gender differences in social anxiety disorder: A review
Women more likely to have SAD and report greater severity; men may seek treatment more; course similar across genders.
- Mental disorders among college students in the World Health Organization World Mental Health Surveys
20.3% of college students had a 12-month disorder; 83.1% of these began before matriculation; only 16.4% received treatment.
- Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology
Consensus BAP pharmacological guideline covering acute, long-term and non-responder treatment across anxiety disorders including SAD.
- World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part I: Anxiety disorders
33 experts from 22 countries reviewed 1,007 RCTs: SSRIs and SNRIs first-line medications, CBT first-line psychotherapy for anxiety disorders including SAD (abstract only; SAD-specific details not read).
- Efficacy of treatments for anxiety disorders: a meta-analysis
234 RCTs (37,333 patients, panic/GAD/social phobia): pre-post d 2.02 for medications vs 1.22 for psychotherapies - opposite ranking to Mayo-Wilson NMA, illustrating that metric choice (pre-post vs vs-control) drives 'pills vs therapy' conclusions.
- Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials
28 trials (n=5233) of responders: discontinuation vs continuation OR for relapse 3.11; relapse 36.4% on placebo vs 16.4% on antidepressant within up to 1 year (all anxiety disorders pooled).
- The natural course of social anxiety disorder among adolescents and young adults
Community sample aged 14-24 followed 10 years: 56.7% still at least symptomatic, 15.5% full SAD again, only 15.1% completely remitted; BI, early onset and parental SAD predicted persistence.
- A meta-analytic examination of attrition in virtual reality exposure therapy for anxiety disorders
Pooled VRET dropout 16% (46 studies, n=1,057); no difference in odds of dropout vs in vivo; homework associated with better retention.
- Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naive social phobia patients
Single 600 mg CBD dose (n=12) vs placebo (n=12) reduced anxiety during a simulated public speaking test.
- Anthropophobia (Taijin Kyofusho) beyond the Boundaries of a Culture-Bound Syndrome: A Case Series from India
Case series describing taijin kyofusho presentations in India, outside Japan (abstract not available; title/authors confirmed).
- Can playing Dungeons and Dragons be good for you? A registered exploratory pilot programme using offline tabletop role-playing games to mitigate social anxiety and reduce problematic involvement in multiplayer online video games
10-session tabletop RPG protocol as structured real-life exposure for socially anxious online gamers; pilot feasibility (effect sizes not read).
- A placebo-controlled trial of phenelzine, cognitive behavioral group therapy, and their combination for social anxiety disorder
N=128; week-24 remission 14.8% placebo, 23.5% CBGT, 25.7% phenelzine, 53.1% combined.
- Interactive roles of pubertal timing and peer relations in predicting social anxiety symptoms among youth
Among 167 adolescents aged 10-17, early-maturing youth with problematic peer relations had elevated social anxiety symptoms.
- Internet-based attention bias modification for social anxiety: a randomised controlled comparison of training towards negative and training towards positive cues
n=129: symptoms improved but attention bias did not change across conditions, undermining the proposed mechanism.
- Paroxetine reduces social anxiety in individuals with a co-occurring alcohol use disorder
42 people with social anxiety and an alcohol use disorder (US), 16 weeks: paroxetine beat placebo on LSAS total and subscales.
- The Liking Gap in Conversations: Do People Like Us More Than We Think?
After conversations, people systematically underestimated how much partners liked them; the gap persisted for months among new dorm mates.
- Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial
n=59 (VR 17, in vivo 22, WL 20), 14 sessions of CBT: VR exposure more effective than in vivo on LSAS at post, gains held at 6 months, VR more practical for therapists; scenarios not matched.
- An analysis of post-event processing in social anxiety disorder
Defines post-event processing as repeated review/reconstruction of one's social performance and reviews diary, self-report and experimental evidence linking it to maintained anxiety.
- Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study
Clinical cohort (HARP): social phobia had the lowest probability of recovery of the anxiety disorders over 12 years; comorbid depression and alcohol/substance use worsened course.
- Perceived helpfulness of treatment for social anxiety disorder: findings from the WHO World Mental Health Surveys
27 surveys/24 countries: 22.8% of lifetime SAD ever treated (24.8% high-income vs 15.8% LMIC); mean onset-to-treatment delay about 15.5 years; 65.1% of treated ever found treatment helpful.
- Shyness versus social phobia in US youth
NCS-A (n=10,123 adolescents): only 12% of self-identified shy youths met lifetime social phobia criteria; social phobia carried more impairment and comorbidity.
- Social phobia and subtypes in the national comorbidity survey-adolescent supplement: prevalence, correlates, and comorbidity
About 9% of US adolescents aged 13-18 (N=10,123) met lifetime criteria for social phobia; 55.8% generalized subtype, only 0.7% performance-only.
- Do Parents Enhance Cognitive Behavior Therapy for Youth Anxiety? An Overview of Systematic Reviews Over Time
Of 25 systematic reviews since 2005, 21 found no difference between parent-involvement formats; parent-only CBT tended to be least effective.
- Epidemiology of social phobia in later life
Canadian older adults (N=12,792): lifetime 4.94% and 12-month 1.32% prevalence; current SP declines with age; no gender or SES correlation.
- Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials
30 RCTs (n=1,057; 8 SAD/performance anxiety): VRET vs waitlist g=0.90, vs psychological placebo g=0.78, vs in vivo g=-0.07 (ns); larger samples associated with smaller effects (beta=-0.007).
- Internet-delivered attention bias modification training in individuals with social anxiety disorder--a double blind randomized controlled trial
n=79: no group x time interaction; 'infinitesimal' between-group effect at post and 4 months, despite prior lab trials reporting up to 72% remission.
- Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials
41 placebo-controlled trials (N=2,843) across anxiety disorders incl. SAD: CBT vs placebo Hedges g=0.56 on target symptoms; response OR 2.97.
- AI-Based CBT Chatbot for Adolescent Social Anxiety (NCT07897084)
Registry: not yet recruiting; estimated 120 participants; estimated completion end 2026.
- Prospective associations between peer functioning and social anxiety in adolescents: A systematic review and meta-analysis
23 prospective studies: peer victimization predicted later social anxiety (r=.23) and social anxiety predicted later victimization (r=.17); bidirectional.
- Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial
N=62; no longer meeting criteria at post: 84% CT, 42% exposure+applied relaxation, 0% waitlist; differences persisted at 1 year.
- Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial
N=60; CT superior to fluoxetine+self-exposure and placebo+self-exposure on social phobia measures at post (16 wk) and 12-month follow-up; fluoxetine+SE did not differ from placebo+SE.
- A cognitive model of social phobia
Foundational maintenance model: self-focused attention, self-as-observer imagery, safety behaviours and anticipatory/post-event processing prevent disconfirmation of feared outcomes. Chapter not opened; citation confirmed only via secondary reference lists.
- More than doubling the clinical benefit of each hour of therapist time: a randomised controlled trial of internet cognitive therapy for social anxiety disorder
N=102; internet CT-SAD not different from face-to-face CT-SAD on primary outcome, using 6.45 h vs 15.8 h therapist time; small advantage for face-to-face on behaviour test.
- Behavioral inhibition and risk for developing social anxiety disorder: a meta-analytic study
Across 7 studies BI associated with OR 7.59 for later SAD; ~15% of children show extreme BI and authors estimate almost half of these develop SAD.
- Interventional studies with condition 'social anxiety disorder': counts by status and results
As of 2026-11-09: 768 interventional registrations, 471 completed, 85 completed with posted results (about 18%); zero matched psilocybin as intervention.
- Psychometric properties of the Social Phobia Inventory (SPIN). New self-rating scale
17-item SPIN covering fear, avoidance, physiological symptoms; cut-off 19 distinguished social phobia from controls; sensitive to change.
- Discontinuation of clonazepam in the treatment of social phobia
Responders to 6 months clonazepam: relapse 0% if continued vs 21.1% with slow taper; withdrawal symptoms 12.5% vs 27.7%.
- Mini-SPIN: A brief screening assessment for generalized social anxiety disorder
3 items, cut-off >=6: sensitivity 88.7%, specificity 90.0%, PPV 52.5%, NPV 98.5% in managed care.
- Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators
N=87; 12 sessions CBT or ACT both beat waitlist with no differences between them on self-report, clinician or speech outcomes; comorbid depression predicted poorer outcome.
- Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study
n=12 (8 MDMA, 4 placebo): LSAS change -44.1 vs -19.3 (p=0.037, d=1.4), maintained at 6 months; no serious adverse events.
- Treatment of social phobia with clonazepam and placebo
75 outpatients, up to 10 weeks: response 78.3% clonazepam vs 20.0% placebo; unsteadiness and dizziness more severe and persistent on clonazepam.
- The remedial value of blushing in the context of transgressions and mishaps
In two vignette experiments (n=66 and n=62), people shown with a blush after a transgression or mishap were mostly rated more favourably (e.g. sympathy, trustworthiness) than the same people without a blush.
- Anxiety in Children with Selective Mutism: A Meta-analysis
22 studies (N=837): 80% of children with selective mutism had a comorbid anxiety disorder, 69% social phobia.
- Treatment options for fear of blushing
Review: established psychological treatments for fear of blushing include task concentration training, exposure, cognitive therapy and applied relaxation; no established medicines specifically for fear of blushing, though SSRIs/SNRIs treat social anxiety disorder and may help some.
- Virtual Reality Therapy in Social Anxiety Disorder
Most SAD RCTs combine VRET with cognitive interventions; stand-alone VRET tested in only one RCT where it was not superior to in vivo; more stand-alone and process research needed before routine dissemination.
- EmpowerPharm announces Phase 2 trial results for CBD in social anxiety disorder
239 enrolled, 178 completed; company claims efficacy in a moderate-severe subset without public LSAS numbers.
- Cannabidiol (CBD) for the Treatment of Social Anxiety Disorder (NCT05600114)
Registry: actual enrollment 239, completed 2023-12-13, no results posted as of 2026-11-09.
- The Internet: home to a severe population of individuals with social anxiety disorder?
Of 434 internet survey respondents, 92% met SAD cut-offs and were more impaired than a clinic sample, yet only about one-third had received psychotherapy; heavy online interaction linked to both positive and negative effects.
- Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia
SAD, phobia and PTSD patients show amygdala and insula hyperactivation to negative emotional stimuli; more frequent in SAD and phobia than PTSD.
- The Structure of Psychopathology on Reddit: Network Analysis of Mental Health Communities in Relation to the ICD Diagnostic System
Co-posting network of 114 mental-health subreddits (49 disorders) formed one interconnected giant component (density 0.135) spanning all 9 ICD F-categories, reflecting heavy cross-condition overlap (e.g., ADHD 85k users, GAD 44k).
- Efficacy of pregabalin in generalized social anxiety disorder: results of a double-blind, placebo-controlled, fixed-dose study
N=329; only 600 mg/day beat placebo on LSAS (-29.8 vs -19.7); 300 and 450 mg not significant.
- Understanding the relationship of social anxiety with alcohol use and alcohol-related problems in young people: A meta-analysis
70 studies (n=38,517, ages 13-29): social anxiety slightly negatively associated with alcohol use (r=-0.05) but positively with alcohol-related problems (r=0.13) and problematic use (r=0.06).
- Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses
n=346 across 9 NHS trusts: automated VR cognitive therapy added to usual care for agoraphobic avoidance in psychosis; largest VR mental health RCT, not a SAD trial.
- Virtual reality in the assessment, understanding, and treatment of mental health disorders
285 studies (192 anxiety); methodological quality generally low; 'VR' often misapplied to non-immersive technology; exposure for anxiety is the most established finding.
- The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats
Supports psychometric equivalence of LSAS self-report and clinician-administered versions.
- Comorbidity of personality disorders in anxiety disorders: a meta-analysis of 30 years of research
125 studies: any PD in 35-52% of anxiety patients; avoidant PD the most frequent cluster C PD, and social phobia highly comorbid with avoidant PD.
- Guided and unguided self-help for social anxiety disorder: randomised controlled trial
Pure bibliotherapy and guided internet CBT both beat waitlist, with gains maintained at 1 year; several authors receive royalties for the book.
- Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias
n=150 with specific phobia: 76% chose VR over in vivo; refusal 3% for VR vs 27% for in vivo (stated preference, not SAD).
- Safety and Efficacy of Modular Digital Psychotherapy for Social Anxiety: Randomized Controlled Trial
Two online RCTs by the app's developers (Alena), self-reported symptoms (SPIN >=30), vs waitlist: RCT1 102 women, 6 weeks, d=0.47; RCT2 248 adults, 8 weeks, d=0.42 on SPIN; adverse events similar to waitlist.
- The spotlight effect in social judgment: an egocentric bias in estimates of the salience of one's own actions and appearance
Across 5 experiments, people overestimated how many observers noticed an embarrassing T-shirt or their own utterances, anchoring on their own experience.
- The illusion of transparency: biased assessments of others' ability to read one's emotional states
Three sets of studies: people overestimate how far others can read their inner states (e.g. liars overestimated how detectable their lies were; people thought their disgust showed more than it did), anchoring on their own experience.
- Group CBT versus MBSR for social anxiety disorder: A randomized controlled trial
N=108; CBGT and MBSR both beat waitlist with similar symptom improvement; CBGT reduced subtle avoidance more.
- Self-Guided Virtual Reality Therapy for Anxiety: A Systematic Review
21 articles: self-guided VR effective for SAD, PSA and specific phobia with low attrition; no data beyond 12 months; no comparisons with iCBT or bibliotherapy.
- Efficacy of pregabalin in preventing relapse in patients with generalized social anxiety disorder: results of a double-blind, placebo-controlled 26-week study
153 responders to 10 weeks of open pregabalin randomized to continue or switch to placebo for 26 weeks: continuing delayed relapse (P=0.035); dizziness 11.3% vs 4.1%.
- Volume of subcortical brain regions in social anxiety disorder: mega-analytic results from 37 samples in the ENIGMA-Anxiety Working Group
1,115 SAD vs 2,775 controls: only small putamen (d about -0.08 to -0.16) and pallidum differences in adults; no volumetric differences in adolescents; amygdala not different.
- A randomized controlled trial of intranasal oxytocin as an adjunct to exposure therapy for social anxiety disorder
In 25 SAD patients, 24 IU oxytocin plus exposure improved self-evaluations of appearance/speech but did not improve overall treatment outcome vs placebo.
- The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness
Popular book arguing phone-based childhood since ~2012 caused rises in adolescent anxiety and depression; primary source for many claims to check.
- A major cause of school refusal, social anxiety disorder in children and adolescents is neglected
Opinion piece arguing SAD is a major, under-recognised cause of school refusal (no new data).
- Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology
Early adolescence is a sensitive juncture for SAD onset; normative rise in social worries; adolescent plasticity may also enhance intervention effects.
- Efficacy of three virtual reality interventions for social anxiety disorder: A meta-analysis
17 RCTs: VR overall SMD 0.48; VRET 0.52; VR-CBT 0.62; VR exposure + biofeedback 0.11 (ns); CIs not reported in abstract.
- Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: a randomized controlled non-inferiority trial
ICBT was non-inferior to group CBT for SAD (finding per abstract/secondary summaries; effect sizes not extracted here).
- A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder
80 ICBT-treated participants: LSAS-SR fell from 71.3 at baseline to 40.3 at 5 years (d 1.30-1.40); gains at 1 year sustained.
- Attention bias modification for social anxiety: A systematic review and meta-analysis
15 RCTs (n=1043): ABM g=0.27 on SAD symptoms post-training but g=0.09 (n.s.) at 4 months; study quality substandard; not ready for dissemination.
- The factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale
In 577 patients a two-correlated-factor model fit better than one factor: SIAS and SPS measure similar but not identical constructs.
- Social anxiety disorder in DSM-5
Explains DSM-5 changes: name, emphasis on fear of negative evaluation, sociocultural 'out of proportion' judgement, SAD with medical conditions, and replacing 'generalized' with 'performance only' specifier.
- Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome
N=133; phenelzine and CBGT both beat pill placebo and attention-placebo at 12 weeks; phenelzine faster and superior on some measures.
- Randomized Trial of a Generative AI Chatbot for Mental Health Treatment
N=210 adults with MDD, GAD or eating-disorder risk (no SAD stratum): Therabot beat waitlist at 4 and 8 weeks (depression d about 0.85-0.90); all outputs human-monitored.
- Fear not: Combining digital and virtual reality interventions for the treatment of social anxiety disorder - a randomized controlled trial
n=32 vs contact-matched active control: no difference in SAD severity, but higher remission rate on diagnostic interview in the app+VR arm.
- Work-Related Cognitive Behavioral Therapy for racially and economically diverse unemployed persons with social anxiety: A randomized clinical trial
N=250: WCBT+vocational services beat vocational services alone on LSAS at post (d=-0.25) but not at later time points or on hours worked.
- Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder
Job seekers with SAD perceived more barriers, reported fewer social-occupation skills, and were less likely to aspire to social jobs.
- A systematic review and meta-analysis of nonpharmacological interventions for children and adolescents with selective mutism
25 studies but only 5 RCTs; combined systems/behavioural approaches outperformed waitlist; outcomes heterogeneous.
- Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications
Integrative maintenance model: unrealistic social standards, self-focus, negative self-perception, cost estimation, low perceived emotional control, safety behaviours and post-event rumination.
- Cultural aspects in social anxiety and social anxiety disorder
Prevalence and expression of SAD vary by culture (Asian samples lowest, Russian and US highest); taijin kyofusho as possible culture-specific form, with mixed validity evidence.
- D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder
N=169; DCS sped improvement 24-33% but did not change post-treatment response (79.3% vs 73.3%) or remission (34.5% vs 24.4%, n.s.).
- Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis
Adults with ASD: current/lifetime any anxiety disorder 27%/42%; high heterogeneity, questionnaire measures inflate estimates.
- Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis
22 studies, n=703; within-VRET g=-0.86 [-1.04,-0.68] post and -0.74 [-1.05,-0.43] at 12 months; similar to in vivo at post but inferior at later follow-up; dropout not different from in vivo.
- Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study
In 1,519 children aged 5-18 treated with CBT, those with primary SAD had poorer response and lower remission than those with GAD.
- The Relationship of Family Accommodation with Pediatric Anxiety Severity: Meta-analytic Findings and Child, Family and Methodological Moderators
In under-19s, parent-reported family accommodation showed a moderate positive association with anxiety severity; the link was smaller when children reported; correlational (abstract read via Europe PMC).
- Pharmacotherapy for anxiety and comorbid alcohol use disorders
5 placebo-controlled RCTs (290 people), 2 in SAD: very low-quality evidence; paroxetine response 57.7% vs 25.8% placebo (2 trials, 57 people); no effect of any drug on drinking; 43.1% stopped medication.
- The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review
41 studies: ADHD in people with SAD ranged from 1.1% to 72.3%, SAD in people with ADHD from 0.04% to 49.5%; people with both had greater impairment; all but two studies rated weak quality; authors advise screening for each in the other.
- Cognitive behavioural therapy for anxiety disorders in children and adolescents
87 RCTs: CBT remission 49.4% vs 17.8% waitlist (OR 5.45, NNT 3); no clear superiority over treatment as usual; moderate-to-low quality.
- Social anxiety in young people: A prevalence study in seven countries
Online SIAS survey of 6,825 people aged 16-29 in 7 countries: 36% above SAD screening threshold - a self-report cut-off, not a diagnosis.
- School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008-2019), Norway
8,192 adolescents: screen-positive SAD had 14 percentage points lower probability of upper secondary completion at 21; 87% vs 92% progressed to higher education.
- Biological bases of childhood shyness
Most 2-year-olds extreme in behavioural restraint were quiet and socially avoidant with unfamiliar people at age 7.
- Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study
n=27 adolescents aged 13-16, one 90-minute session with low-cost headset: within-group d=1.53, maintained at 3 months; uncontrolled.
- 'Remember, You Are Not Alone': A Qualitative Internet-Mediated Study of Anxiety Among Adolescents on Reddit
Thematic analysis of 105 posts by 12-18-year-olds (2021-22): barriers to help-seeking, Reddit as a last resort for anonymous posting, and empathy through distance.
- Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial
n=60: stand-alone VRET with verbal virtual humans beat waitlist, but in vivo exposure was superior to VRET on social anxiety at post and follow-up.
- Meta-analysis of technology-assisted interventions for social anxiety disorder
37 RCTs (2,991 participants): ICBT g=0.84 and VRET g=0.82 vs passive controls; ICBT g=0.38 vs active controls; cognitive bias modification not better than passive control except in-lab (g=0.35).
- Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders
Graded pharmacotherapy lines for SAD; first-line escitalopram, fluvoxamine, paroxetine, pregabalin, sertraline, venlafaxine XR; benzodiazepines and gabapentin second-line; propranolol and atenolol listed as not recommended for generalized SAD (line assignments read via psychdb summary, not the PDF).
- Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States
US ages 13+: social phobia lifetime 10.7%, lifetime morbid risk 13.0%, 12-month 7.4%; median onset of phobias ages 15-17.
- Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences
Internalizing conditions, distress, self-harm and suicide are increasing among adolescents across many countries, most in females.
- Cultural factors in social anxiety: a comparison of social phobia symptoms and Taijin kyofusho
US (n=181) vs Japanese (n=161) students: social phobia and TKS (fear of offending others) loaded on separate factors and related differently to independent/interdependent self-construal.
- Therapist-guided online group forums in internet-based cognitive behavioral therapy for social anxiety disorder: A mixed-methods analysis
Content analysis of 511 forum posts from 60 iCBT participants found 18 categories; messages reflecting motivation (r=0.41), alliance (r=0.34) and observing positive consequences (r=0.32) correlated with greater SPS symptom reduction.
- oVRcome - Self Guided Virtual Reality for Social Anxiety Disorder
Registry entry for the Lacey 2024 trial; secondary reports list enrollment 100 (actual) vs 126 randomized in the paper; discrepancy unverified.
- A self-guided virtual reality solution for social anxiety: Results from a randomized controlled study
n=126, oVRcome app vs waitlist over 6 weeks: LSAS change -35.7 vs -2.2, effect size 1.8; retention 67.5% at week 6 (COI statement not checked).
- Avoidant personality disorder as a social anxiety phenotype: risk factors, associations and treatment
AvPD and SAD share genetic vulnerability but may differ in environmental risk; shame and negative self-concept characteristic of AvPD; most with AvPD do not also meet SAD criteria (per abstract).
- Parent-Based Treatment as Efficacious as Cognitive-Behavioral Therapy for Childhood Anxiety: A Randomized Noninferiority Study of Supportive Parenting for Anxious Childhood Emotions
124 children aged 7-14 with primary anxiety disorders: SPACE (parent-only, reducing family accommodation) was noninferior to child CBT on anxiety outcomes; accommodation fell more after SPACE (abstract read via Europe PMC).
- Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial
N=495; remission 36% CBT, 26% psychodynamic, 9% waitlist; response 60%, 52%, 15%; CBT superior for remission but not response; between-group effects small.
- Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder
Germany, CBT n=209 vs psychodynamic n=207 followed 24 months after therapy: response about 70% and remission nearly 40% in both; no significant differences after 6 months.
- Internet-delivered therapist-assisted cognitive therapy for adolescent social anxiety disorder (OSCA): a randomised controlled trial addressing preliminary efficacy and mechanisms of action
43 adolescents aged 14-18: 77% lost SAD diagnosis post-treatment vs 14% on waitlist, 91% at 6 months.
- Unraveling the Cross-Cultural Differences in Online Expression of Social Anxiety in Online Support Communities
Thematic + semantic analysis of 1,681 posts from Reddit and Douban SAD communities: Western users mainly sought advice/information and expressed more negative emotion; Chinese users sought networking and focused more on workplace anxiety.
- Social phobia
Original source of the Liebowitz Social Anxiety Scale (24 situations rated for fear and avoidance).
- Phenelzine vs atenolol in social phobia. A placebo-controlled comparison
74 people, 8 weeks: response 64% phenelzine, 30% atenolol (a beta-blocker), 23% placebo; atenolol did not differ significantly from placebo; 76% had the generalized form.
- Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety: A meta-analysis of 176 randomized controlled trials
Social anxiety apps g=0.52 (k=10, I2=75%, NNT 5.7), but most trials were high risk of bias and the only low-risk larger trial was non-significant.
- Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial
n=25+25: one-session therapist-led VRET vs waitlist, within-group d=1.67; waitlist then did self-led at-home version, d=1.35; maintained at 12 months (self-led arm not separately randomized).
- Effects of cognitive bias modification on social anxiety: A meta-analysis
36 RCTs (n=2550): CBM g=0.17 on primary symptoms; lab-delivered g=0.38 vs internet-delivered g=-0.03 (n.s.).
- The relationship between child maltreatment and social anxiety: A meta-analysis
29 studies: maltreatment-social anxiety r=0.20; emotional maltreatment r=0.25 stronger than physical (0.14) or sexual (0.15).
- Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis
11 RCTs: across all comparisons g=0.00; better than no treatment (g=0.89), equivalent to other active treatments, less effective than CBT (g=-0.29); effects at 12 months g=0.231.
- Temperament as a Risk Factor for Clinical Diagnosis During the Transition From Childhood Through Adolescence and Young Adulthood: A 16-Year Multimethod Longitudinal Study
In N=291 followed 16 years, observed BI at 24-36 months did not predict anxiety diagnoses at ages 12-18+; exuberance predicted ADHD.
- Natural Language Processing Reveals Vulnerable Mental Health Support Groups and Heightened Health Anxiety on Reddit During COVID-19: Observational Study
Released the Reddit Mental Health Dataset (826,961 users, 2018-2020, 15 support groups incl. r/socialanxiety); anxiety, ADHD and eating-disorder groups showed the most negative semantic change during early COVID.
- Social Anxiety MDMA-Assisted Therapy Investigation (SAMATI) (NCT05138068)
Registry: completed 2025-08-12, listed enrollment 90; no efficacy publication found.
- MDMA-assisted therapy for social anxiety disorder: A randomized, open-label, wait-list controlled trial
20 adults with SAD randomized to MDMA-assisted therapy or a 16-week waitlist (open-label): LSAS mean difference -43.3 favouring MDMA-AT (Hedges g = 2.8); no serious adverse events; authors call the data preliminary.
- Family accommodation mediates the impact of childhood anxiety on functional impairment
425 clinically anxious children aged 6-17 and their mothers: family accommodation partly explained the link between anxiety severity and impairment (up to 50%); cross-sectional, cannot show cause.
- Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders
37 Japanese teens: 300 mg/day CBD (n=17) vs placebo (n=20) for 4 weeks reduced FNE and LSAS scores; small, exploratory.
- Development and initial validation of the Visual Social Anxiety Scale (VSAS): Could a picture be worth a thousand words?
A picture-based self-report measure built on the 24 LSAS situations; high internal consistency and test-retest reliability, good convergent and discriminant validity.
- D-Cycloserine Augmentation of Exposure-Based Cognitive Behavior Therapy for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders: A Systematic Review and Meta-analysis of Individual Participant Data
IPD from 21 trials (n=1047): small DCS augmentation effect that declined over time across trials; no moderators identified.
- Development and validation of measures of social phobia scrutiny fear and social interaction anxiety
Companion scales: SPS (fear of scrutiny during routine activities) and SIAS (interaction anxiety), with high internal consistency and test-retest reliability.
- The Cost Effectiveness of Psychological and Pharmacological Interventions for Social Anxiety Disorder: A Model-Based Economic Analysis
Model of 28 interventions: individual cognitive therapy most cost-effective, then generic individual CBT, phenelzine and unsupported book-based self-help; drug side effects not modelled.
- Psychosocial Interventions for School Refusal with Primary and Secondary School Students: A Systematic Review
8 studies, 435 young people with school refusal: psychosocial interventions (mostly CBT) improved school attendance (moderate effect) but had no clear effect on anxiety compared with controls; few rigorous studies.
- Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis
101 trials (13,164 participants); vs waitlist individual CBT SMD -1.19, MAOIs -1.01, benzodiazepines -0.96, SSRIs/SNRIs -0.91, group CBT -0.92, psychodynamic -0.62; only individual CBT (vs psychological placebo, SMD -0.56) and SSRIs/SNRIs (vs pill placebo, -0.44) beat an appropriate placebo.
- Examining the association between parenting and childhood anxiety: a meta-analysis
Across 47 studies parenting explained only 4% of variance in child anxiety; autonomy-granting 18%, warmth <1%; control more strongly linked than rejection.
- Why social anxiety persists: an experimental investigation of the role of safety behaviours as a maintaining factor
High socially anxious participants used more safety behaviours and rated them helpful; experimentally, safety behaviours and self-focus were unhelpful.
- Guided and unguided internet-delivered psychodynamic therapy for social anxiety disorder: A randomized controlled trial
N=181: guided IPDT d=1.07 and unguided d=0.61 vs waitlist on LSAS-SR; guided beat unguided d=0.46.
- Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale
364 patients with SAD and 34 controls: on the clinician-administered LSAS, total cut-offs of 30 (SAD) and 60 (generalized subtype) gave the best balance of sensitivity and specificity.
- Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments
14 specific-phobia trials: behavioural gains g=1.23 uncontrolled, g=1.41 vs waitlist, no difference vs in vivo (g=-0.09 post); not tested in SAD.
- Meta-analysis of virtual reality exposure therapy for social anxiety disorder
Reanalysis restricted to studies with >=10 VRET participants: VRET vs waitlist g=0.88 [0.43,1.34] (k=5, n=222, PI 0.03-1.79); vs in vivo at post g=0.07 [-0.32,0.17] (k=7, n=272); no significant difference vs in vivo at any follow-up (longest FU g=-0.24 [-0.83,0.35], I2=77%).
- Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: a randomized controlled trial
100 patients in Sweden: individual cognitive therapy (16 weekly sessions over 4 months) was superior to intensive group cognitive treatment (16 sessions over 3 weeks) and to usual care with an SSRI, which did not differ from each other.
- Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology
31 people with fear of blushing randomized to exposure or task concentration training (attention outward); both reduced fear of blushing, gains improved further at 1 year, while measured blushing did not change.
- Fear of blushing: fearful preoccupation irrespective of facial coloration
Women with high (n=29) and low (n=28) fear of blushing did not differ in measured facial colour or temperature under social stress, but the high-fear group rated their own blushing as much stronger.
- Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5
Supports classifying selective mutism as an anxiety disorder closely linked to social anxiety, while noting critical points against.
- Social anxiety disorder: recognition, assessment and treatment (CG159)
First-line for adults: individual CBT specifically for SAD (Clark & Wells: up to 14 x 90-min sessions over ~4 months, or Heimberg model); group CBT not to be routinely preferred; if drug wanted, SSRI escitalopram or sertraline, then fluvoxamine/paroxetine/venlafaxine, then phenelzine/moclobemide; Mini-SPIN >=6 triggers assessment. NICE site returned 403 in this session; details confirmed only via secondary quotes and search snippets.
- The social re-orientation of adolescence: a neuroscience perspective on the process and its relation to psychopathology
Pubertal gonadal steroid surge alters limbic emotional attributions to social stimuli while prefrontal maturation lags, linking adolescent social reorientation to onset of anxiety/mood disorders.
- Cannabidiol as a Treatment for Social Anxiety Disorder (R61) (NCT05571592)
Registry: enrollment 60, completed 2025-12-03, no results posted as of 2026-11-09.
- Reddit posts reveal how natural environments affect social anxiety in young people
Of >535,000 r/socialanxiety posts, 1,887 nature-related posts showed outdoors/physical activity often reduced anxiety, but outdoor spaces triggered fear of being watched/judged for others.
- The great rewiring: is social media really behind an epidemic of teenage mental illness?
Book review arguing The Anxious Generation's claim that digital technology is rewiring brains and causing a mental illness epidemic is not supported by science (seen via search snippets only).
- Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis
20 RCTs (n=1,308) comparing cognitive therapy with exposure: no difference for PTSD, OCD or panic; cognitive therapy significantly better than exposure for social phobia in short- and long-term outcomes.
- Treatment of social phobia with gabapentin: a placebo-controlled study
N=69, 14 weeks, 900-3600 mg/day: gabapentin reduced social phobia symptoms vs placebo (p<0.05); dizziness, dry mouth, somnolence more common.
- Examining Thematic Similarity, Difference, and Membership in Three Online Mental Health Communities from Reddit: A Text Mining and Visualization Approach
In r/Anxiety (3,677 posts), a 'social related' cluster (social anxiety; terms like friends, talk, phone) made up 10.31% of documents; medication 8.13%, school 7.81%, work 4.46%.
- Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6
Built from 456 patients in 5 treatment trials: two 6-item scales that correlated with related measures as well as the full SIAS and SPS, separated people with and without social phobia, and were as sensitive to treatment change.
- Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study
Interviews plus patient-website posts showed some SSRI users experience emotional blunting they strongly attribute to the drug, described in six themes.
- Social Anxiety Disorder
Lists DSM-5 criteria A-J (incl. 6-month duration, performance-only specifier), differentials (AvPD, ASD, shyness) and CANMAT 2014 medication lines.
- Fasedienol for social anxiety disorder does not demonstrate significant improvement in phase 3 study
PALISADE-3 (17 Dec 2025) missed primary endpoint: SUDS change 13.6 vs 14.0 placebo, difference 0.4, n.s.; no secondary differences.
- Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis
29 studies (80,879 youth): clinically elevated anxiety symptoms 20.5%, depression 25.2%, about double pre-pandemic estimates; higher in girls and later in pandemic.
- Concurrent alcoholism and social anxiety disorder: a first step toward developing effective treatments
93 people with alcohol dependence and SAD (US), 12 weeks CBT: treating both problems at once gave worse outcomes on 3 of 4 drinking measures than treating alcohol alone, and no difference in social anxiety.
- Social anxiety in Finnish adolescents from 2013 to 2021: change from pre-COVID-19 to COVID-19 era, and mid-pandemic correlates
In ~450,000 Finns aged 13-20, high social anxiety (Mini-SPIN>=6) increased markedly 2013/15-2021; 47% of females in 2021, a two-fold rise; no association with regional COVID incidence or distance-education time.
- Treatment of social phobia through pure self-help and therapist-augmented self-help
n=224 with severe generalized social phobia, four arms: pure self-help (written materials) led more people to lose the diagnosis than waitlist, but symptoms and life interference did not differ significantly; self-help plus five group sessions with a therapist beat waitlist on all measures and did not differ significantly from therapist-led group therapy.
- A cognitive-behavioral model of anxiety in social phobia
Model: mental representation of self as seen by audience, compared with perceived audience standard; biased processing of evaluative information maintains anxiety.
- Prevention and early intervention of anxiety disorders in inhibited preschool children
A 6-session parent education programme for inhibited preschoolers reduced anxiety diagnoses at 12 months vs no intervention, without changing inhibition.
- Altering the trajectory of anxiety in at-risk young children
146 inhibited preschoolers: parent intervention lowered frequency/severity of anxiety disorders at 3 years; inhibition levels not different by parent report.
- Parent-led CBT delivered via online and telephone support alongside usual school practice versus usual school practice only for young children identified as at risk for anxiety disorders through screening in schools: a cluster randomised controlled trial
95 English schools, 865 children aged 4-7: anxiety disorders at 12 months 6.8% vs 11.5% (aOR 0.67, n.s.); secondary outcomes improved (SMD 0.15-0.47).
- 360° Video virtual reality exposure therapy for public speaking anxiety: A randomized controlled trial
n=51: 360° audience and 360° empty-room VR both reduced PSA vs no-treatment (within-group partial eta2 .90 and .71), questioning whether the audience is the active ingredient.
- Prevalent Frequency of Emotional and Physical Symptoms in Social Anxiety using Zero Shot Classification: An Observational Study
BART zero-shot classification of r/socialanxiety posts (2018-2019) found trembling the most prominent physical symptom and fear of negative judgment the most frequent emotional symptom (reported avg. probabilities ~49% and 64-68%, figures from secondary summary).
- Cognitive-Behavior Therapy for Social Anxiety Does Not Increase Reports of Camouflaging Behavior in Autistic Adults: Results From an Exploratory Study
71 autistic adults in Australia, uncontrolled: an 8-week modified group CBT for social anxiety reduced social anxiety with moderate pre-post effects and did not increase camouflaging.
- Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication
Lifetime 12.1%, 12-month 7.1%; performance and interaction fears load on one latent factor (little evidence for subtypes); social phobia is the focus of treatment in only about half of treated cases.
- Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale
291 patients with SAD and 53 controls: LSAS-SR cut-offs of 30 (SAD) and 60 (generalized SAD) gave the best balance of sensitivity and specificity, matching the clinician version.
- Mapping Peer Support in Antidepressant Discussions on Reddit: Pilot Network Analysis
Analysis of 10 high-engagement r/depression threads: emotional flattening, sleep and cognitive issues were discussed more; withdrawal 'brain zaps' co-occurred with peer teaching and empathy.
- Genetic and environmental contributions to social anxiety across different ages: a meta-analytic approach to twin data
13 cohorts (42,585 subjects): genes and non-shared environment explain most variance; genetic contribution in adults about half that in younger people; shared environment minor.
- Studying social anxiety without triggering it: Establishing an age-controlled cohort of social media users for observational studies
From 535k r/SocialAnxiety posts, a validated cohort of 1,102 self-reported 13-25-year-olds with SAD diagnosis/therapy (37,073 posts); 61% reported >=1 comorbidity and 13% concerning drug or alcohol use.
- The lived experience of social anxiety disorder: A conceptual model focused on adolescents and young adults based on published literature and social media listening
NLP social media listening of 535,544 r/socialanxiety posts from 118,040 users plus 11 qualitative papers yielded a conceptual model with 3 symptom domains (physical, negative automatic thoughts, emotions) and 2 impact domains (social, occupational/educational); Roche-funded.
- Social anxiety disorder and alcohol use disorder co-morbidity in the National Epidemiologic Survey on Alcohol and Related Conditions
NESARC (n=43,093): SAD associated with alcohol dependence OR 2.8, abuse OR 1.2; lifetime co-occurrence 2.4% of population.
- Brief imaginal exposure exercises for social anxiety disorder: a randomized controlled trial
n=82, one-week smartphone imaginal exposure vs self-monitoring (results not extracted; title from search listing only).
- Effectiveness and User Experience of Virtual Reality for Social Anxiety Disorder: Systematic Review
18 studies: VRET generally effective, safe, usable; mean attrition 11.36%; gaps in children/adolescents and standardized user-experience measures; simulator sickness reported.
- D-cycloserine enhancement of exposure therapy for social anxiety disorder depends on the success of exposure sessions
N=145 adults with generalized SAD got 50 mg DCS or placebo 1 h before each of 5 exposure sessions in 12-session group CBT. After sessions ending with low fear, DCS led to more improvement at the next session; after high-fear sessions, DCS led to less improvement than placebo.
- Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies
For social anxiety disorder (k=42) median onset 13 years (IQR 9-17), peak 14.5; 50.9% onset before 14, 79.1% before 18, 87.5% before 25 (verified in full-text PDF; published online 2021, issue 2022).
- Conceptualizing and Treating Social Anxiety in Autism Spectrum Disorder: A Focus Group Study with Multidisciplinary Professionals
Professionals report difficulty disentangling social anxiety from core autism features (diagnostic overshadowing, alexithymia); calls for adapted services.
- Self-focused attention in social phobia and social anxiety
Reviews evidence that self-focused attention increases access to negative self-information, impairs performance and blocks disconfirmation, as in Clark & Wells.
- Cognitive therapy vs interpersonal psychotherapy in social anxiety disorder: a randomized controlled trial
117 patients in Germany, 16 sessions plus a booster: response 65.8% CT, 42.1% IPT, 7.3% waitlist; at 1 year 68.4% vs 31.6% for CT vs IPT. D.M. Clark is a co-author.
- Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis
Only 8 eligible RCTs across all anxiety disorders, of which a single social phobia trial (n=16); evidence insufficient to support routine propranolol use.
- The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative
28 surveys, 142,405 respondents: 30-day 1.3%, 12-month 2.4%, lifetime 4.0%; lowest in low/lower-middle income countries, Africa and Eastern Mediterranean; treatment lowest in low-income countries.
- Genetic risk variants for social anxiety
SNP-based heritability 0.12 (European ancestry); one genome-wide significant locus each in EUR and AFR; genetic correlation with extraversion -0.52, none with neuroticism.
- Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults
Munich EDSP (n=2,548, ages 14-24): baseline SAD 7.2%; SAD predicted later depression (OR 3.5) and, if comorbid, persistence (OR 2.3) and suicide attempt (OR 6.1).
- Social anxiety disorder
Onset by age 11 in ~50% and by 20 in ~80%; risk factor for later depression and substance misuse.
- What do we know today about the prospective long-term course of social anxiety disorder? A systematic literature review
Naturalistic 5-year recovery 27% in clinical vs 40% in non-clinical samples; remission in CBT trials 36-100% depending on design.
- Childhood behavioral inhibition and overcontrol: Risk for psychiatric and peer outcomes
In 123 children aged 5-6, overcontrol but not BI predicted worsening anxiety and peer relations 2 years later; overcontrol mediated BI effects.
- Social media behaviors and symptoms of anxiety and depression. A four-wave cohort study from age 10-16 years
Norwegian birth cohort (n=810), interview-assessed symptoms incl. social anxiety: within-person changes in posting/liking/commenting unrelated to later symptoms, and vice versa (RI-CLPM).
- AI-Assisted 4-Week Psychodynamic Therapy and CBT Via Smartphone for Social Anxiety: A Randomized Pilot Study (STePS-Ai) (NCT07533812)
Registry: active, not recruiting; estimated enrollment 90; estimated completion 2026-07-01.
- Internet-delivered cognitive therapy for social anxiety disorder: a development pilot series
Face-to-face CT-SAD normally involves up to 14 weekly sessions; internet version includes video feedback, attention training, behavioural experiments; pilot of 11 patients: 9 (82%) responders, 7 (64%) remission, therapist time about 20% of face-to-face.
- Beat the Fear of Public Speaking: Mobile 360° Video Virtual Reality Exposure Training in Home Environment Reduces Public Speaking Anxiety
n=35 students, uncontrolled 4-week home smartphone 360° training: speaking anxiety decreased, most in high-baseline participants (regression-to-mean not excluded).
- BVR-100 and BES-100 Validation Trial: A Randomized, Double-Blind, Parallel-Group, Controlled Study of Two At-Home Self-Guided Virtual Reality Interventions for Adults With Social Anxiety Disorder
n=56; primary outcomes were treatment credibility/expectancy (CEQ), not symptoms; credibility at week 6 18.9 vs 12.3 (p=0.003); no symptom outcome posted; 24/28 vs 27/28 completed.
- Evidence-Based Alignment of Reddit Peer Advice for Depression and Anxiety: Qualitative Content Analysis
Top-ranked r/mentalhealth replies to 1,065 posts (327 anxiety-related with action-based advice) substantially aligned with NICE/WHO guidance, most often 'seek professional help'; weaker alignment on crises and complex interpersonal issues.
- Infant behavioral inhibition predicts personality and social outcomes three decades later
BI at 14 months predicted adult (age 26) reserved/introverted personality (beta=0.34), lower social functioning (beta=-0.23) and internalizing psychopathology (beta=0.20); n=165.
- Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial
n=18 crossover: clinician LSAS improved (33% vs 0% responders) but self-rated VAS anxiety did not differ; 17/18 identified ketamine, so blinding failed.
- Internet-delivered cognitive therapy for social anxiety disorder in Hong Kong: A randomized controlled trial
iCT-SAD (n=22 per arm) vs waitlist: Cohen's d about 2.41 on LSAS, with minimal cultural adaptation (numbers from search summary of abstract).
- Shyness 1: distance treatment of social phobia over the Internet
Australia, n=105: six-lesson clinician-assisted online CBT vs waitlist; 78% completed all lessons; between-group d 0.95 on primary social phobia measures.
- VIRTUS: virtual reality exposure training for adolescents with social anxiety - a randomized controlled trial
Protocol: 120 adolescents aged 12-16 randomized to VR exposure, in vivo exposure or waitlist (7 sessions); no results yet.
- PALISADE-2 Phase 3 topline results: fasedienol nasal spray in social anxiety disorder
Met primary endpoint: SUDS LS mean change -13.8 vs -8.0 placebo in a public-speaking challenge; PALISADE-1 had previously failed.
- Vistagen announces topline and post-hoc data from PALISADE-4 Phase 3 public speaking challenge study
PALISADE-4 (n=238) missed primary and secondary endpoints; company cited variable placebo response and a post-hoc signal in very severe SAD (not opened; via search summaries).
- Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication
Median delay to first treatment contact 9-23 years for anxiety disorders; the social-phobia-specific median (often quoted as ~16 years) is in tables and was not verified in this session; early onset predicts delay.
- Inferiority or Even Superiority of Virtual Reality Exposure Therapy in Phobias? A Systematic Review and Quantitative Meta-Analysis on Randomized Controlled Trials Specifically Comparing the Efficacy of Virtual Reality Exposure to Gold Standard in vivo Exposure in Agoraphobia, Specific Phobia, and Social Phobia
9 dose-matched RCTs (n=371): VR vs in vivo overall g=-0.20 (ns); social phobia (3 RCTs) g=-0.50 significantly favouring in vivo.
- Social Phobia: The Role of In-Situation Safety Behaviors in Maintaining Anxiety and Negative Beliefs - Republished Article
Single-case series (n=8): exposure plus dropping safety behaviours reduced anxiety and belief in feared catastrophe more than exposure alone. Originally published 1995 in Behavior Therapy 26; republished 2016 (this record).
- Pharmacotherapy for social anxiety disorder (SAnD)
66 RCTs (11,597 participants); SSRIs vs placebo response RR 1.65 (k=24, very low-quality evidence); MAOIs RR 2.36, benzodiazepines RR 4.03 (k=2), GABA-analogue anticonvulsants RR 1.60; SSRIs the only class with moderate-quality evidence of reducing relapse.
- Systematic review and meta-analysis of randomised controlled trials for evaluating the effectiveness of virtual reality therapy for social anxiety disorder
15 RCTs (n=720): no difference vs CBT on any outcome; vs waitlist g=-1.17 [-2.06,-0.28] on fear/avoidance; VR superiority confined to trials with n<50 and <=5 sessions.
- Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder: A Randomized Clinical Trial
167 autistic children aged 7-13 with interfering anxiety (US): CBT adapted for autism (BIACA) beat standard CBT and usual care; response 92.4% adapted CBT, 81.0% standard CBT, 11.1% usual care. Anxiety in general, not SAD only.
- Social anxiety and problematic social media use: A systematic review and meta-analysis
53 studies (59,928 participants): social anxiety highly positively correlated with problematic social media use; moderated by instrument, sex, year, platform.
- Sudden gains in internet cognitive therapy for social anxiety disorder in routine clinical practice
Examines sudden gains in therapist-guided iCT-SAD delivered in NHS Talking Therapies (routine care) - evidence that iCT-SAD has moved into practice.
- Efficacy and acceptability of parent-only group cognitive behavioral intervention for treatment of anxiety disorder in children and adolescents: a meta-analysis of randomized controlled trials
6 RCTs (407 participants): parent-only CBT beat waitlist, no significant difference vs CBT with parents (SMD 0.21, per search summary).
- Cognitive Behavioral Therapy for Patients with Social Anxiety Disorder Who Remain Symptomatic following Antidepressant Treatment: A Randomized, Assessor-Blinded, Controlled Trial
42 patients in Japan still symptomatic after antidepressants: adding 16 weeks of CBT to usual care cut LSAS by 41.55 points more than usual care alone; response 85.7% vs 10.0%, remission 47.6% vs 0.0%.
- Preliminary Evaluation of Translated and Culturally Adapted Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: Multicenter, Single-Arm Trial in Japan
15 participants in Japan, single-arm: translated and culturally adapted iCT-SAD; 80% reliable improvement and 60% remission at post-treatment; 1 of 15 dropped out; taijin kyofusho measured as a secondary outcome.
- Pilot randomized trial of self-guided virtual reality exposure therapy for social anxiety disorder
n=44 (26 VRE, 18 WL): self-guided VRE reduced SAD severity, job-interview fear and worry vs waitlist (g=-0.54 to -1.11), maintained at 6 months; cybersickness decreased (g=-0.43).
- Effectiveness of virtual reality therapy in the treatment of anxiety disorders in adolescents and adults: a systematic review and meta-analysis of randomized controlled trials
33 RCTs (n=3,182) across anxiety disorders: VR vs 'conventional interventions' SMD -0.95 [-1.22,-0.69]; figure conflicts with head-to-head vs in vivo, likely comparator dilution.