The Effectiveness of Cognitive Behavioral Therapy in Reducing Fear of Negative Evaluation and State–Trait Anxiety among Adolescents with Social Anxiety Disorder

Abstract

This study aimed to determine the effectiveness of cognitive behavioral therapy in reducing fear of negative evaluation and state–trait anxiety among adolescents diagnosed with social anxiety disorder. This applied study employed a quasi-experimental pretest–posttest design with a control group. The statistical population consisted of adolescents with social anxiety disorder studying in upper-secondary schools in Sari, Iran, during the first three months of 2023. Thirty eligible adolescents were selected through purposive sampling and randomly assigned to an experimental group and a control group, with 15 participants in each group. Data were collected using the Watson and Friend Fear of Negative Evaluation Scale, Spielberger’s State–Trait Anxiety Inventory, and Connor’s Social Phobia Inventory. The experimental group received cognitive behavioral therapy, whereas the control group received no intervention during the study period. Data were analyzed in SPSS version 26 using analysis of covariance after confirming the normality assumption. After controlling for pretest scores, cognitive behavioral therapy produced a statistically significant reduction in fear of negative evaluation in the experimental group compared with the control group (F=183.36, p<0.001, η²=0.88). A significant between-group difference was also observed in trait anxiety (F=133.88, p<0.001, η²=0.84). Furthermore, the intervention significantly reduced state anxiety among participants in the experimental group (F=54.25, p<0.001, η²=0.69). Bonferroni-adjusted pairwise comparisons confirmed that the adjusted posttest means of fear of negative evaluation, trait anxiety, and state anxiety were significantly lower in the experimental group than in the control group. Cognitive behavioral therapy appears to be an effective intervention for reducing fear of negative evaluation and state–trait anxiety in adolescents with social anxiety disorder. By identifying and modifying dysfunctional beliefs and cognitive distortions and strengthening adaptive cognitive and behavioral skills, this intervention may reduce adolescents’ vulnerability to anxiety-provoking social situations. Cognitive behavioral therapy can therefore be incorporated into school-based psychological services and adolescent counseling programs.