J. Appl. Environ. Biol. Sci.,8(7)20-25, 2018 | ISSN: 2090-4274 |
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ClinicalPsychologyUnit,GovernmentCollegeUniversity,Lahore,Pakistan.
Received:February 1, 2018 Accepted: April 1, 2018
Social Anxiety is evidently becoming an increasing problem in this socially modern era as a person’s self– acceptanceis gettingtiltedtowardsotherspointofview.Thisanxietyisbecomingquiteprevalent amonguniversity students where it inculcates negative thinking, emotion and behavior pattern. This study targeted effectiveness of RationalEmotiveBehaviorTherapyonthe featuresofsocialanxietyamonguniversitystudents. Method:Apre/posttestquasiexperimentaldesign wasused where asampleof10 referred clientswith manifesting featuresofsocialanxiety,whoscored abovethecut-offscoreof19 onSocialPhobiaInventory(SPIN) wasselected [20].Clientswere randomlyassignedtoExperimentaland controlgroups(5 clientsper group).Treatmentconsisted of8sessionscompromisingofRationalEmotiveBehaviorTherapy,withafollow-upof2sessions. Results:Post-testviaSocialPhobiaInventory(SPIN)suggested effectivedecreaseinthesymptomsofsocialanxiety forexperimentalgroupascomparedtothecontrolgroup. Conclusion: This studyprovides evidence that Rational Emotive Behavior Therapy can effectively alleviate social anxiety particularly the features of fear, avoidance and other physiological symptoms that causes hindrance for a person’swell-being. KEY WORDS: Socialanxiety;RationalEmotiveBehaviorTherapy,UniversityStudents
Social anxietyis described as a feeling of extreme anxiety and fear regarding social situations which may impair the daily functioning of individuals and may compel them where to avoid the scrutiny of others [1]. The prevalence of social anxietydisorder is different across the studies due to sampling, assessment strategies, applied diagnostic method, and cultural norms. In western culture, prevalence of the disorder is measured to be in higher rates than the eastern culture. One ofthe reasons could be the cultural aspects ofthe society and its associated self construct[2]. Distinctprevalence ofsocial anxietyin the eastern cultures ranging from0.5%isreported rather than in a western culture which is 16% in generalpopulation [3]. Studies suggested that the age of onset is typicallyin adolescence than in adulthood. Earlyonset atthe ageof11yearshas been reportedin about50% andbythe ageof 20 yearsinabout80%oftheindividuals[4].
Risk factors implicated for the development of the disorder include deficits in social skills and negative peer status, alongwith family-related factors includingparentalpsychopathology,heritabilityestimatesand temperament, anxiogenic parenting, and transmission ofinterpretation bias [5].Other studies have also reported aboutthe influence of genetic and biological dispositions, cognitive factors, parental and peer relations, deficits in performance, modes of learning, and cultural factors are responsible for the development of the disorder [6]. The factors which influence thesocial anxietyamong youngindividuals are social interactionsparticularlyin educationalinstitutions. These social interactions help the young individual in learning educational and life skills particularly throughpeers. Butifjudged negatively, it maydevelop anxiousness in the youngindividuals [7]. Their dailyfunctioning mightgetdisturbed as theycoulddevelop problems in classparticipation, making friends, attending classes ornoteventakingtheclasses’altogether [8].
Socialanxietyischaracterized as acomplicated andimpenetrablevicious cycleofnegativeexpectationsof social situations in which students befall. Effective interventions are needed to address avarietyof factors,notably negative thinking, poor social skills even including physical appearance features as well [9]. A plethora of studies conducted for finding out the effective treatments for social anxietydisorder in adolescents and young adults suggestedCognitiveBehaviorTherapy[10],Mindfulness[11],AttentionTraining[12]andSocialSkillsTraining(SST)
[13] to be efficient in dealing with Social AnxietyDisorder. Literature has suggested that social anxiety also possesses the emotionaldysregulation as well. These emotionaldysregulation led to significantlylower levels offixed
Corresponding author: Amna Aurooj, Institute of Clinical Psychology, University of Management and Technology, Lahore, Pakistan.E-mail:amna.aurooj@gmail.com
beliefs about anxiety and other kinds of maladaptive beliefs and discussing about families of emotion regulation processes including selection and modification of situation, attentional deployment, change in cognition, and re-sponsemodulation[14].
RationalEmotiveBehaviorTherapy(REBT)isconsideredtobeanewdimensioninthetreatmentofpsychological disorders as it underpins cognitive, emotional andbehavioralderegulation [15]. It regulates fromrecognizing, appraising and assessing one’s irrational self-deprecatingbeliefs and retaliates against thembydisputing thosebeliefs andformulatingpositivechangewithin oneself. REBT was found effective on theshynessamongNigerian university students,improvingtheir self-efficacybeforegraduation[16].REBTingroupformwasfoundtobeaneffectivestrategyin dealingwiththedistresscausedbyparanoia[15].AstudyconductedtostudytheimpactofREBTonIndianadolescentssufferingfromconductdisordershowedsignificantresultsaswell[17].EffectivenessofGroupRationalEmotiveBehaviorTherapy(REBT)inthetreatmentofshynessinPakistanifemalecollegestudentswasalsoobserved[18]. RationalEmotiveBehaviorTherapyalsoproved effectiveindisputingirrationalbeliefsofpersonswith substanceused disorders [19]. These studies proclaimed that Rational Emotive Behavior Therapyhas a potential to be effective for manypsychologicalproblemswhilehonoringthediversityamongindividuals.
Themainobjectiveofthecurrentstudywasto findtheeffectivenessofRationalEmotiveBehavioralTherapy(REBT)onthefeaturesofsocialanxietymanifestedbyuniversitystudents.
2.METHOD
Aquasi-experimentalABAdesign was applied. Asample of20participantsreferred from counseling centre was recruited with inclusion criteria of a) 18-25 years of age b) depicting at least 3 out of 10 symptoms from DSM-V criteria. From there, asample of10 participants scoring above 19 on Social Phobia Inventory[20] wasselectedfor thestudy.Sinceafocusedgrasp onbeliefsandthoughtsaboutoneself and correspondingsocialsituations was essential for and Rational Emotive Behavior Therapy practices therefore, comorbidity with other medical or psychologicalconditionincluding majordepression,psychosisor anysubstanceinduceddisorderswereexcluded.
A sample of 10 participants was selected by administering Social Phobia inventory for assessment. The participants were then randomly divided into two groups including experimental and control group. Intervention based on Ellis’ rational-emotive-behavioral therapeutic model was implemented on experimental group consisting of; a)Cognitive therapy, e.g. identification ofirrationalbeliefs andtheir disputingb)Emotional methods, e.g.sense ofhumor,modeling, androle playingc)Behavioral methods,involvingskilltraining,useofreinforcementd)Home assignment.Thetherapyinvolved8sessionsfor1hour.Itwasheldtwiceaweek andtherapeuticeffectsweretraced after applicationofintervention.Post-testwasapplied onthe participantsfrombothgroupsviaSocialPhobiaInventory(SPIN).Afollow-up of2sessionswasalso implemented.
2.3.1. SocialPhobia Inventory(SPIN). It is a17-itemself-rating scale which covers the symptoms of fear, avoidance and physical signs of social anxiety. These symptoms are basically the three important dimensions ofSocial Anxiety. The inclusion of four autonomic symptoms (trembling, blushing, and heart palpitations sweating) provides the practical enlightenment about the bothersome experience of symptoms in public. The measure is rated on a scale from0 to 4. The total score for the SPINrangesfrom0to68.Thisscaledepictedanacceptabletest-retestreliabilityfortheSPIN(r=0.78-0.89)[20].
A healthy endeavor regarding the ethical considerations was adopted. Permissions were sought from the counselor of the particular university. Permission to use the screening scale was also sought from the author. Informed consentfromtheparticipantswastaken beforeimplementingthetherapeuticprogram.Discriminationonthe basis of gender, race, religion etc was avoided. Precautions were adopted to minimize any possible harm and to maintain theelementofprivacy.Aconcise fromRationalEmotiveBehavior Therapywasusedon thecontrolgroup after theconductionofstudy. Beneficialstepstomaximizethepossiblebenefitswerealsotaken.
Meansand standarddeviationswerecomputed for PreandPosttestresults. Non-parametric Statisticswere applieddue to sample size. Wilcoxon Signed RanksTest wasused for pairedpre-posttest comparison for both ex-perimentalandcontrolgroups.Kolmogorov-SmirnovZtwo-sampletestwasusedforthebetweengroupanalysis.
3.1. DemographicCharacteristics. Table 3.1 DemographicCharacteristics of theParticipants (N=10)
Category | REBT (n=5) | Control (n=5) | ||
M(SD) f | % | M(SD) f | % | |
Age | 19.40(1.14) | 19.80(1.30) | ||
Gender | ||||
Male | 3 | 60.00 | 3 | 60.00 |
Female | 2 | 40.00 | 2 | 40.00 |
Education | ||||
Bachelors I year | 1 | 20.00 | 1 | 20.00 |
Bachelors II year | 2 | 40.00 | 1 | 20.00 |
Bachelors III year | 1 | 20.00 | 1 | 20.00 |
Bachelors IV year | 1 | 20.00 | 2 | 40.00 |
Note. f=Frequency, %=Percentage,M=Mean, SD=StandardDeviation,REBT=RationalEmotiveBehaviorTherapy
Table3.1illustratedthat numberofmaleweremorethan femalestudentsamonggroups.Moreover,participantsfromBachelorsIVyearweregreaterinnumberwithincontrolgroup,whereasBachelorsIIyearshowedmore numberofparticipantsacrossRationalEmotiveBehaviorTherapygroup.
Results for the main hypothesis regarding effectiveness of Rational Emotive Behavior Therapy among UniversitystudentsarementionedinTable2and3below.
Table3.2 Within Group AnalysisforRationalEmotiveBehaviorTherapy andControlgroups(N=10)
Category | Pre-Test (n=5) | Post-test (n=5) | Z-Score | p-value | ||
M | SD | M | SD | |||
REBT | 27.20 | 7.36 | 22.80 | 3.70 | -2.02 | .04⃰ |
Control | 27.60 | 4.82 | 31.20 | 2.16 | -1.84 | .06 |
Note. REBTgroup=RationalEmotiveBehaviorTherapygroup, M=Mean. SD=StandardDeviation, ⃰=p≤.05
Category | n | Kolmogorov-Smirnov Z | p-value |
---|---|---|---|
REBT | 5 | 1.58 | .01 |
Control | 5 |
Note. REBTgroup=RationalEmotiveBehaviorTherapygroup, ⃰=p≤.05
Theresults applied significantdifference for RationalEmotiveBehavior Therapy(M=22.80,SD=3.70,p= .04)post-testsuggesting adeclinein the social anxietysymptoms frommoderateto mild levelofseverity.Between groupsanalysisshowedasignificantpattern forRationalEmotiveBehaviorTherapy(Z=1.58,p=.01) effectiveness as comparedto Controlgroup. These finding suggestedthatRationalEmotive Behavior Therapy was not only a meagertreatmentforthesymptomsofsocialanxietybutaneffectivemanagementprocedureaswell.
Results from the current studyshowcased an effectiveness ofRationalEmotiveBehavior Therapy as adecreasein theintensityofnegativecognitive featuresofsocialanxietywasobserved.An alleviationofseverityrelat-ed to the features of avoidance, physical symptoms alongside the fear in social anxiety wasunderpinned. These results suggestthe effectivenessofRationalEmotivebehavior Therapyon universitystudents which wasin line with the results of [21] and [22] who supported with the current findings which highlighted the efficacy of Rational-Emotive Behavior Therapy on reducing the symptoms of depression among the adolescent girls and male college-menfacingproblemsinperformingregular exerciserespectively.
For effective application ofRational Emotive Behavior TherapyABC model of irrational beliefs was addressed based on the principle of the (A) adversity-occurrence of event and the reaction to that event (B) Belief-explanation ofthat event and its reaction (C)Consequences-emotions and behaviors after theoccurrence ofevents [23].Theresults fromcurrentstudyfollowthoseprinciples in fashionofportrayingthatthe individualsmanifesting the features of social anxietyface main challenge of negative cognitions related to the experience of anxiety in socialsituations.Thishypothesiswassupportedfromthestudyconductedby[24]whopresentedthatthesociallyanxious individuals manifest the core cognitive features of fear of negative evaluations by others, performance situations such asspeaking,eatinginpublic, engagingin conversations, or interactingwith authorityfiguresasobserved from the results of the current findings. Current finding also revealed a marked pattern of behavioral disturbance which wassupportedby[25] who explainedthatbehavioral problemsin particular includes feelings ofnervousness in thepresenceofpeoplewhich mayindulge individuals to behavein acertain wayor saysomething andthen feel embarrassed or after. Presence of physical symptoms while engaging in a social situation was also acknowledged from the current study. The findings were supported by[26] who highlighted the physical symptoms related to the anxietyexperiencedinsocialsettingsi.e.excessivesweating,blushing,palpitations,trembling,andnausea.
Findings obtained from the current studyalso reflect that social anxietyis most prevalent among the adolescents and young adults. These findings werecorrelated with the studyconducted to find the prevalenceof social anxiety among different populations. The study suggested that social anxiety often seemed to be experienced by adolescentsor youngadults,whoaremostofthetime,avoidssituationswhichmayrequireperformingtasksinfront ofpeopleduringtheirlife[27].
Selection of a small sample size can be addressed in further researches to generalize the effectiveness of Rational Emotive behavior Therapy. In order to fully understand the domains ofparticular therapyin relevance to social anxiety symptoms, the implication ofRational Emotive Behavior Therapyintervention could be generalized to other populations.For completelyunderstanding the impact ofthis approach on students’ sociallyanxioussymp-toms, long term effects ofthe treatment and the extent to which the treatment has the impact could be essential for future researches. Moreover, replication ofthese results on student population is could validate the effectivenessof RationalEmotiveBehaviorTherapy.
Despite the aforementioned concerns and limitations, the present study that Rational Emotive Behavior Therapywas effective to decrease the social anxietysymptoms in Universitystudents and also plays avital role in increasingtheir well-being.The three major domainsof fear,avoidance andphysical symptoms were all seemed to alleviatethroughthetherapy.
Theauthorsdeclarethattheyhavenoconflictsofinterestintheresearch. Theauthors would like to thank Ms.Ayesha, Government College University, Lahore, Pakistan for referrals ofthe participantsinthisproject.
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