Self-criticism in generalized social phobia and response to cognitive-behavioral treatment

Excessive self-criticism is a putative psychological vulnerability for depression, and recent findings suggest it may be important in social phobia as well. The present study investigated the role of self-criticism in predicting outcome to cognitive-behavior therapy for generalized social phobia. Eighty-four patients were assessed before and after treatment using a latent social phobia factor based on six different symptom measures. A hierarchical regression analysis was used to sequentially enter baseline severity of social phobia symptoms, interpersonal dependency (another depressogenic vulnerability), depressed mood state, and changes in the latter two variables in response to treatment. In the final model, change in level of self-criticism over the course of treatment was significantly associated with social phobia outcome. Implications of these findings for understanding psychological processes in social phobia are briefly discussed. Further research is needed to determine whether some social phobia patients with excessive self-criticism might benefit from treatment augmentation to more intensively target their core beliefs about self-worth.