Salta al menu principale di navigazione Salta al contenuto principale Salta al piè di pagina del sito

Sez. generale - Studi e ricerche

N. 47 (2020)

Le nuove tecnologie e la psicoterapia: approfondimento del trattamento del disturbo d’ansia sociale

Inviata
5 febbraio 2021
Pubblicato
05-02-2021

Abstract

Il disturbo d’ansia sociale (DAS) è uno dei disturbi psicologici più comuni e disabilitanti che, se non trattato, tende a cronicizzarsi provocando danni signifi cativi alla qualità di vita di una persona nonché a comportare ingenti costi sociali.
Nonostante l’elevata prevalenza del disturbo, solo il 10% delle persone infatti riceve farmacoterapia e psicoterapia da personale qualifi cato. Esistono infatti diverse barriere per l’accesso al trattamento tra cui la paura della stigmatizzazione e del giudizio negativo e l’aspettativa che altri possano giudicare imbarazzante il proprio comportamento o i propri sintomi fi sici. La natura stessa del disturbo è una delle ragioni principali che impedisce alle persone di chiedere una consulenza professionale. Gli interventi basati sulle nuove tecnologie di comunicazione, che recentemente si stanno facendo strada nel mondo della salute mentale, hanno il vantaggio di poter ovviare a diverse di queste barriere. Infatti, sono stati identificati diversi strumenti che utilizzano le tecnologie informatiche e di telecomunicazione per migliorare
attività di prevenzione, diagnosi e terapia.
Negli ultimi anni diversi studi ne hanno dimostrato l’effi cacia su una varietà di disturbi tra cui il disturbo d’ansia sociale.
Scopo del presente articolo è quello di fornire una revisione narrativa delle risorse presenti ad oggi nel campo delle nuove tecnologie utilizzabili e sfruttabili nel campo della salute mentale e in particolare nel disturbo d’ansia sociale.

Riferimenti bibliografici

  1. Aderka M.A., Haker A., Marom S., Hermesh H. (2012). Information-Seeking Bias in Social Anxiety Disorder. Journal of Abnormal Psychology, 122(1). DOI: 10.1037/a0029555.
  2. Alonso J., Angermeyer M.C., Bernert S., Bruffaerts R., Brugha T.S., Bryson H., De Girolamo G., De Graaf R., Demyttenaere K., Gasquet D., Haro J.M., Katz S.J., Kessler R.C., Kovess Y., Lépine J.P., Ormel J., Polidori G., Russo L.J., Vilagut G., Vollebergh W.A.M. (2004). Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, Supplement, 109(420): 21-27. DOI: 10.1111/j.1600-0047.2004.00327.x.
  3. Alonso J., Vilagut G., Adroher N.D., Chatterji S., He Y., Andrade L.H., Kessler R.C. (2018). Disability mediates the impact of common conditions on perceived health. PLoS One, 8(6): e65858. DOI: 10.1371/journal.pone.0065858.
  4. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: Author.
  5. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: Author.
  6. Andersson G., Carlbring P., Holmstrom A., Sparthan E., Furmark T., Nilsson-Ihrfelt E., Ekselius L. (2006). Internet-basedself-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 74: 677-686. DOI: 10.1037/0022-006X.74.4.677.
  7. Andersson G., Carlbring P., Furmark T. (2014). Internet-delivered treatments for socialanxiety disorder. In: Weeks J. (ed.), The Wiley Blackwell Handbook of Social Anxiety Disorder. Chichester, UK: John Wiley & Sons Inc. DOI: 10.1002/9781118653920.ch26.
  8. Andersson G., Carlbring P., Holmström A., Sparthan E., Furmark T., Nilsson-Ihrfelt E. et al. (2006). Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74: 677-686: DOI: 10.1037/0022-006X.74.4.677.
  9. Andersson G., Carlbring P., Ljotsson A., Hedman C. (2013). Guided Internet-Based CBT for Common Mental Disorders. Journal of Contemporary Psychotherapy, 43(4). DOI: 10.1007/s10879-013-9237-9.
  10. Andersson G., Cuijpers P. (2009). Internet-based and other computerized psychologicaltreatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy, 38: 196-205. DOI: 10.1080/16506070903318960.
  11. Andersson G., Estling F., Jakobsson E., Cuijpers P., Carlbring P. (2011a). Can the patient decide which modules to endorse? An open trial of tailored Internet treatment of anxiety disorders. Cognitive Behaviour Therapy, 40: 57-64. DOI: 10.1007/s10879-013-9237-9.
  12. Andersson G., Hedman E. (2013). Effectiveness of guided Internet-delivered cognitive
  13. behaviour therapy in regular clinical settings. Verhaltenstherapie, 23: 140-148. DOI: 10.1159/000354779.
  14. Andersson G., Hesser H., Hummerdal D., Bergman-Nordgren L., Carlbring P. (2013a). A 3.5-year follow-up of Internet-delivered cognitive behaviour therapy for major depression. Journal of Mental Health, 22: 155-164. DOI: 10.1007/978-3-319-06083-5_2.
  15. Berger T., Hohl E., Caspar F. (2009). Internet-based treatment for social phobia: A
  16. randomized controlled trial. Journal of Clinical Psychology, 65: 1021-1035. DOI: 10.1002/jclp.20603.
  17. Boettcher J., Carlbring P., Renneberg B., Berger T. (2013). Internet-based interventions
  18. for social anxiety disorder – an overview. Verhaltenstherapie, 23: 160-168. DOI: 10.1159/000354747.
  19. Botella C., Breton-Lopez J., Quero S., Banos R., Garcia-Palacios A. (2010). Treating
  20. cockroach phobia with augmented reality. Behavioural Therapy, 41(3): 401-13. DOI: 10.1016/j.beth.2009.07.002.
  21. Botella C., Perez-Ara M.A., Breton-Lopez J., Quero S., Garcia-Palacios A., Banos R.M. (2013). In vivo versus augmented reality exposure in the treatment of small animal phobia: a randomized controller trial. PLoS One, 11(2). DOI: 10.1371/journal.pone.0148237.
  22. Carlbring P., Andersson G., Kaldo V., Hesser H., Gustafsson T., Lundén C., Henrikson O., Fattahi K., Johnsson E., Westin V. Z., Mäki-Torkko E. (2012). A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. Journal of Consulting and Clinical Psychology, 80(4): 649-661. DOI: 10.1037/a0027021.
  23. Carlbring P., Nilsson-Ihrfelt E., Waara J., Kollenstam C., Buhrman M., Kaldo V., Soderberg M., Ekselius L., Andersson G. (2005). Treatment of panic disorder: Live therapy vs. self-help via Internet. Behaviour Research and Therapy, 43: 1321-1333. DOI: 10.1016/j.brat.2004.10.002.
  24. Coelho H.F, Cooper P.J., Murray L. (2007). A family study of co-morbidity between
  25. generalized social phobia and generalized anxiety disorder in a non-clinic sample. Journal of Affective Disorder, 100(1-3): 103-13. DOI: 10.1016/j.jad.2006.10.001.
  26. Cox B.J., Fleet C., Stein M.B. (2004). Self-criticism and social phobia in the US national comorbidity survey. Journal of Affective Disorder, 15, 82(2): 227-34. DOI: 10.1016/j.jad.2003.12.012.
  27. Cuijpers P., Donkers T., van Straten A., Li J., Andersson G. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychological Medicine, 40(12): 1943-57. DOI: 10.1017/S0033291710000772.
  28. Cunningham A.E., Zibulsky J., Callahan M. (2009). Starting small: Building preschool
  29. teacher knowledge that supports early literacy development. Reading and Writing, 22: 487-510. DOI: 10.1007/s11145-009-9164-z.
  30. Dams J., König H.H., Bleibler F., Hoyer J., Wiltink J., Beutel M.E., Salzer S., Herpertz S., Willutzki U., Strauß B., Leibing E., Leichsenring F., Konnopka A. (2017). Excess costs of social anxiety disorder in Germany. Journal of Affective Disorder, 15: 213:23-29. DOI: 10.1016/j.jad.2017.01.041.
  31. Emmelkamp P.M. (2005). Technological innovations in clinical assessment and psychotherapy. Psychotherapy and Psychosomatic, 74: 336-43. DOI: 10.1159/000087780.
  32. Emmelkamp P., Meyerbröker K., Morina N. (2020). Virtual Reality Therapy in Social Anxiety Disorder. Current Psychiatry Reports, 22. DOI: 10.1007/s11920-020-01156-1.
  33. Farrand P., Bennet-Levy J., Richards D.A. (2010). Low intensity CBT interventions: a revolution in mental health care. In Bennett-Levy J., Richards D.A., Farrand P., Christensen H., Griffiths K.M., Kavanaugh D.J., Klein B., Lau M.A., Proudfoot J., Ritterband L., White J., Williams C. (eds.), Oxford guides in cognitive behavioural therapy. Oxford guide to low intensity CBT interventions. Oxford: Oxford University Press, pp. 3-18. DOI: 10.1093/med:psych/9780199590117.003.0001.
  34. Goetter E., Frumkin M., Palitz S., Swee M., Baker A., Bui E., Simon N. (2018). Barriers to Mental Health Treatment Among Individuals With Social Anxiety Disorder and Generalized Anxiety Disorder. Psychological Services, 17. DOI: 10.1037/ser0000254.
  35. Griffiths K., Christensen H., Jorm A. (2004). Predictors of Depression Stigma. BMC
  36. Psychiatry, 8: 25. DOI: 10.1186/1471-244X-8-25.
  37. Hedman E., Andersson G., Ljotsson B., Andersson E., Ruck C., Asmundson G. J.G. et al. (2011a). Internet-based cognitive behavioural therapy for severe health anxiety: Randomised controlled trial. British Journal of Psychiatry, 198: 230-236. DOI: 10.1192/bjp.bp.110.086843.
  38. Hedman E., Andersson E., Ljotsson B., Andersson G., Ruck C., Lindefors N. (2011b). Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: Results from a randomized controlled trial. Behaviour Research and Therapy, 49: 729-736. DOI: 10.1016/j.brat.2011.07.009.
  39. Hedman E., Andersson E., Lindefors N., Andersson G., Ruck C., Ljotsson B. (2014). Cost-effectiveness and long-term effectiveness of Internet-based cognitive behaviour therapy for severe health anxiety. Psychological Medicine, 43: 363-374. DOI: 10.1017/S0033291712001079.
  40. Hedman E., Ljotsson B., Rück C., Bergstrom J., Andersson G., Kaldo V., Jansson E., Andersson E., Andersson E., Blom K., El Alaoui S., Falk L., Ivarsson J., Nasri B., Rydh S., Lindefors N. (2013). Effectiveness of Internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care. Acta Psychiatrica Scandinavica, 128(6): 457-67. DOI: 10.1111/acps.12079.
  41. Heimberg R.G., Becker R.E., Goldfinger K., Vermilyea J.A. (1985). Treatment of social phobia by exposure, cognitive restructuring and homework assignments. Journal of Nervous and Mental Disease, 173(4): 236-245. DOI: 10.1097/00005053-198504000-00006.
  42. Hofmann S.G., Wu J.Q., Boettcher H. (2015). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: a meta-analysis. Journal of Consultant Clinical Psychology, 82(6): 1228. DOI: 10.1037/a0035491.
  43. Issakidis C., Andrews G. (2002). Service utilisation for anxiety in an Australian community sample. Social Psychiatry Psychiatric Epidemiology, 37: 153-163. DOI: 10.1007/s001270200009.
  44. Kashdan T.B., Roberts J.E. (2011). Comorbid social anxiety disorder in clients with
  45. depressive disorders: predicting changes in depressive symptoms, therapeutic
  46. relationships, and focus of attention in group treatment. Behaviour Research and Therapy, 49(12): 875-84. DOI: 10.1016/j.brat.2011.10.002.
  47. Kessler R.C., Berglund P., Demler O., Jin R.W.E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry, 62: 593-602. DOI: 10.1001/archpsyc.62.6.593.
  48. Kushner M.G., Abrams K., Borchardt C. (2000). The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clinical Psychology Review, 20(2): 149-71. DOI: 10.1016/s0272-7358(99)00027-
  49. PMID: 10721495.
  50. Levinson C., Rodebaugh T. (2012). Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears. Eating Behaviors, 13: 27-35. DOI: 10.1016/j.eatbeh.2011.11.006.
  51. Levinson C.A., Rodebaugh T.L., White E.K., Menatti A.R., Weeks J.W., Iacovino J.M., Warren C.S. (2013). Social appearance anxiety, perfectionism, and fear of negative evaluation: distinct or shared risk factors for social anxiety and eating disorders? Appetite, 67: 125-133. DOI: 10.1016/j.appet.
  52. Marsigli N. (a cura di) (2018). Stop all’ansia sociale. Strategie per affrontare e gestire la timidezza. Trento: Erickson.
  53. Mewton L., Wong N., Andrews G. (2012). The effectiveness of Internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice. Depress Anxiety, 29(10): 843-9. DOI: 10.1002/da.21995.
  54. Newby J.M., Mewton L., Williams A.D., Andrews G. (2014). Effectiveness of transdiagnostic Internet cognitive behavioural treatment for mixed anxiety and depression in primary care. Journal of Affective Disorder, 165: 45-52. DOI:
  55. 1016/j.jad.2014.04.037.
  56. Olfson M., Guardino M., Struening E., Schneier F.R., Hellman F., Klein D.F. (2000). Barriers to the treatment of social anxiety. Am. J. Psychiatry, 157(4): 521-7. DOI: 10.1176/appi.ajp.157.4.521.
  57. Organizzazione Mondiale della Sanità (2019). The WHO special initiative for mental health (2019-2023): Universal health coverage for mental health. Retrieved from https://apps.who.int/iris/handle/10665/310981.
  58. Pertaub D.P., Slater M., Barker C. (2002). An Experiment on Public Speaking Anxiety in Response to Three Different Types of Virtual Audience. Presence, 11: 68-78. DOI: 10.1162/105474602317343668.
  59. Ponniah K., Hollon S.D. (2008). Empirically supported psychological interventions for social phobia in adults: A qualitative review of randomized controlled trials. Psychological Medicine, 38(1): 3-14. DOI: 10.1017/S0033291707000918.
  60. Procacci M., Popolo R., Marsigli N. (a cura di) (2011). Ansia e ritiro sociale. Valutazione
  61. e trattamento. Milano: Raffaello Cortina.
  62. Procacci M., Semerari A. (a cura di) (2019). Ritiro sociale. Psicologia e clinica. Trento: Erickson.
  63. Reese R.J., Mecham M.R., Vasilj I., Lengerich A.J., Brown H.M., Simpson N.B., Newsome B.D. (2016). The effects of telepsychology format on empathic accuracy and the therapeutic alliance: An analogue counselling session. Counselling and Psychotherapy Research, 16(4): 256-265. DOI: 10.1002/capr.12092.
  64. Repetto C., Riva G. (2011). From virtual reality to interreality in the treatment of anxiety disorders. Neuropsychiatry, 1: 31-43. DOI: 10.2217/npy.11.5.
  65. Riva G. (2009) Virtual reality: an experiential tool for clinical psychology. British Journal of Guidance and Counselling, 37(3): 337-345.
  66. Riva G. (2011). Virtual reality: An experiential tool for clinical psychology. British Journal of Guidance and Counselling, 37(3): 337-345. DOI: 10.1080/03069880902957056.
  67. Robillard G., Bouchard S., Dumoulin S., Guitard T., Klinger E. (2010). Using virtual humans to alleviate social anxiety: Preliminary report from a comparative outcome study. Studies in Health Technology and Informatics, 154: 57-60. DOI: 10.3233/978-1-60750-561-7-57.
  68. Ruscio A.M., Brown T.A., Chiu W.T., Sareen J., Stein M.B., Kessler R.C. (2008). Social fears and social phobia in the USA: results from the National Comorbidity Survey Replica-tion. Psychological Meicine, 38: 15-28. DOI: 10.1017/S0033291707001699.
  69. Simpson S., Reid C. (2014). Therapeutic alliance in videoconferencing psychotherapy:
  70. A review. Australian Journal of Rural Health, 22(6): 280-299. DOI: 10.1111/ajr.12149.
  71. Spek V., Cuijpers P., Nyklíček I., Riper H., Keyzer J., Pop V. (2007). Internet-based
  72. cognitive behavior therapy for symptoms of depression and anxiety: A metaanalysis.
  73. Psychological Medicine, 37: 319-28. DOI: 10.1017/S0033291706008944.
  74. Stuhldreher N., Leibing E., Leichsenring F., Beutel M.E., Herpertz S., Hoyer J., Konnopka A., Salzer S., Strauss B., Wiltink J., König H.H. (2014). The costs of social anxiety disorder: the role of symptom severity and comorbidities. Journal of Affective Disorder, 165: 87-94. DOI: 10.1016/j.jad.2014.04.039. Epub 2014 Apr 24. PMID: 24882183.
  75. Thomas K., Ellis A., Konrad T., Holzer C., Morrissey J. (2009). County-level-estimates of mental health professional short age in the United States. Psychiatric Services, 60(10): 1323-1328. DOI: 10.1176/ps.2009.60.10.1323.
  76. Titov N., Andrews G., Schwencke G., Drobny J., Einstein D. (2008). Shyness 1: distance treatment of social phobia over the Internet. Aust. N. Z. J. Psychiatry, 42: 585-594. DOI: 10.1080/00048670802119762.
  77. United Nations (2020). Policy Brief: Covid-19 and the Need for Action on Mental Health. Retrieved from https://www.un.org/sites/un2.un.org/files/un_policy_brief-covid_and_mental_health_final.pdf.
  78. Wang P.S., Berglund P., Olfson M., Pincus H.A., Wells K.B., Kessler R.C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry, 62: 603-613. DOI: 10.1001/archpsyc.62.6.603.
  79. Williams A.D., Andrews G. (2013). The effectiveness of Internet Cognitive Behavioural Therapy (iCBT) for depression in primary care: a quality assurance study. PLoSONE, 8: e57447. DOI: 10.1371/journal.pone.0057447.
  80. Yuen E.K., Goetter E.M., Herbert J.D., Forman E.M. (2012). Challenges and opportunities in Internet-mediated telemental health. Professional Psychology: Research and Practice, 43(1): 1-8. DOI: 10.1037/a0025524.

Metriche

Caricamento metriche ...