(PS2-34) Quality of Life in Patients with Social Anxiety Disorder Undergoing Exposure Therapy

Background: Quality of life is often lower in individuals with social  anxiety disorder due to the impairment caused in areas such as interpersonal relationships and engagement in social activities. Historically, studies of the treatment of social anxiety disorder have focused on symptom reduction although some more recent research has begun to expand this to also include quality of life (e.g. physical health, ability to function in daily life, overall sense of well being etc.). This study aims to add to this growing literature by testing whether the symptom improvement seen in exposure therapy predicts subsequent improvements in quality of life. . 

Methods: Participants were adults with a primary diagnosis of social anxiety disorder (n=152) who participated in a clinical trial that aimed to test the efficacy of d-cycloserine augmentation of exposure-based therapy. They received 5 sessions of group exposure therapy. An independent evaluator assessed symptom severity (using the Liebowitz Social Anxiety Scale, LSAS)and participants completed measures of quality of life (using the Quality of Life Enjoyment and Satisfaction Questionnaire, QLESQ) at baseline, pre-treatment, post-treatment, 1-month follow up, and 3-month follow up. 

Results: To examine the causal impact of LSAS change on QLESQ scores, we performed a within-person cross lag analysis, where we examined whether change in LSAS from baseline to post, and from baseline to 1MFU, predicted QLESQ at the next assessment point (1MFU and 3MFU, respectively), while controlling for QLESQ at the previous assessment (post and 1MFU). Consistent with predictions, greater decreases in LSAS scores were related to higher QLESQ at the next assessment, b = -.05, p=.027. Similarly, lower baseline anxiety scores were related to higher QLESQ scores across assessments, b = -.08, p=.012. As expected, QLESQ scores at each assessment were related to QLESQ scores at the next assessment, b=.69, p< .001.

Conclusions: These results demonstrate that participants report significant improvements in quality of life when undergoing exposure therapy. Furthermore, these improvements in quality of life are guided by the symptom severity reduction. Despite promising results, this study is not without limitations such as a predominantly White (n=90) sample. Future research may focus on quality of life improvements in a more diverse population. Future research should also focus on  predictors of  the variability in changes in quality of life seen with exposure therapy and other interventions.