Attentional Control and Inhibitory Capacity in Social Anxiety and Controls and as Predictors of Treatment

Social Anxiety Disorder (SAD) is a prevalent disorder marked by distress and/or avoidance regarding situations that involve potential scrutiny by others. While psychotherapy (e.g., Cognitive Behavioral Therapy (CBT), supportive therapy (ST)) can reduce the burden of SAD, symptom improvement is unpredictably varied and a substantial portion experience excessive social anxiety following treatment. Research indicates poor attentional control (AC) and inhibitory abnormalities play a role in SAD and as such they may serve as predictors of treatment outcome. This secondary data analysis examined baseline differences in subjective attentional control, via the Attentional Control Scale (ACS), and task-based inhibitory capacity, measured via an affective go/no-go task, between SAD and a healthy control comparator group via linear multiple regressions with ACS score and false alarms as the dependent variables (DVs) and Diagnostic Group (SAD vs HC) and Age as independent variables (IVs). Additionally, the study evaluated whether pre-treatment subjective attentional control and inhibitory capacity predicted improvement in social anxiety symptoms via linear multiple regression where a percent change score of the Liebowitz Social Anxiety Scale (LSAS) from baseline and 12-week timepoint after completion of psychotherapy as the IV and ACS score, total false alarms, Age, Gender, and baseline LSAS score as the DVs. Linear multiple regression results revealed that diagnostic group (HC vs SAD) was associated with ACS score, β = -14.96, SE = 1.18, p < 0.001, suggesting that the SAD group had poorer self-reported AC. There were no significant associations at baseline between diagnosis and go/no-go false alarms. Additionally, neither baseline ACS score or false alarms acted as a significant predictor of treatment outcome. As hypothesized, there were differences between HC and individuals with SAD such that those with SAD had lower self-reported attentional control. Future research should further explore the relationship between AC and SAD. Additionally, there does not appear to be a deficiency in inhibitory capacity, which should be replicated with additional research. Regarding treatment outcome, neither self-reported AC or go/no-go false alarms emerged as predictors of psychotherapy symptom change. Thus, additional studies are warranted to understand the role of attentional control and inhibitory capacity as predictors of treatment.