December 7, 2017

Dear Colleagues,

As part of the National Social Anxiety Center’s (NSAC) ongoing service of disseminating and promoting evidence-based treatment, I’d like to share and receive feedback regarding new research showing the importance of patient’s expectations on effectiveness of SSRI’s for Social Anxiety Disorder (SAD).

This published study supports other research on the role that expectancies play in influencing both neural reactivity and clinical outcome in SSRI treatments. This study demonstrates that individuals with SAD who received correct information regarding the medication (Lexapro) and treatment plan were three times more likely to show a positive treatment response, compared to those who were told they were given an “active placebo” (which was actually Lexapro).

In line with past research implicating the role of the amygdala (and its connection to other regions) in SAD, the treatment group also demonstrated attenuated amygdala activity that was more functionally coupled with other brain regions.

Beyond medication, the study also brings to mind the importance of expectancy and of a shared understanding of the problem and treatment plan between patient and provider in psychotherapy.

What have been the most effective ways you have worked with / activated this important element of treatment outcome for patients beginning both CBT and/or medication management? How have you collaborated with psychiatrists to enhance patient education and expectancy, especially those taking SSRI’s?

Robert Yeilding, Psy.D.
Clinical Psychologist

Representative of NSAC Newport Beach / Orange County (Anxiety and Depression Center)