فهرست مطالب vajihe babaie

Social anxiety disorder often has a poorer recovery rate than other anxiety disorders. A review of previous studies shows that two variables, social anxiety disorder and the focused – attention (which is one of the predictors of social anxiety disorder), respond less well to conventional psychological treatments. Among the newest integrated alternative approaches are paradoxical time table therapy and virtual reality technology therapy, there is a research gap regarding the comparison of their effectiveness in improving the focused – attention and reducing the symptoms of social anxiety disorder.

The present study was conducted with the aim of comparing the effectiveness of paradoxical time table therapy and virtual reality technology therapy on the focused – attention and symptoms of social anxiety disorder.

The current research design was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all people who referred to counseling centers and psychotherapy clinics in Tehran in the fall and winter of 2022. The statistical sample included 45 people with social anxiety disorder who were selected as available samples and were divided into three groups of 15 people (two experimental groups and one control group). To collect data, the Focous of Attention Questionnaire (Woody et al., 1997) and the social anxiety scale (Connor et al., 2000) were used. Also, the treatment of the paradoxical time table therapy (Besharat, 2017) was implemented in six sessions on the first experimental group and and the virtual reality technology therapy was implemented in 8 sessions on the second experimental group. Data analysis was done using multivariate analysis, variance analysis with repeated measures, Bonferroni post hoc test and SPSS-25 software.

The results showed that both treatments of paradoxical time table therapy and virtual reality technology therapy had a significant effect on the focus of attention and symptoms of social anxiety disorder (P<0.001). There was no significant difference between the effectiveness of the virtual reality technology therapy and the paradoxical time table therapy in the focused – attention, However, there was a significant difference between the effectiveness of the virtual reality technology therapy and the paradoxical time table therapy on the symptoms of social anxiety disorder. In this way, the paradoxical time table therapy is more effective in reducing the symptoms of social anxiety disorder compared to the treatment based on virtual reality technology therapy (P<0.001).

According to the findings of the present research, it seems that the paradoxical time table therapy and virtual reality technology therapy can be used as a therapeutic approach that according to the needsof patients with social anxiety disorder.

Anxiety sensitivity and focused – attention are important components in creating and maintaining social anxiety disorder, and a defect in each of them can play a role as a potential risk factor in this disorder. Some studies have shown that paradoxical time table therapy can lead to a reduction in worry and social anxiety symptoms. In Iran, there is a research gap regarding the efficacy of this treatment method on anxiety sensitivity and focus of attention in people with social anxiety disorder.

The present study was conducted with the aim of investigating the efficacy of paradoxical time table therapy on anxiety sensitivity and focused–attention in people with social anxiety disorder.

The current research design was a semi-experimental pre-test-post-test type with a control group and a one-month follow-up. The statistical population of the research included all people who referred to counseling centers and psychotherapy clinics in Tehran in the fall and winter of 2022. The statistical sample included 30 people with social anxiety disorder who were selected as available samples and were divided into two groups of 15 people (experimental group and control group). Focous of Attention Questionnaire (Woody et al., 1997) and revised anxiety sensitivity index (Taylor & Cox 1998) were used to collect data. Also, the treatment of the paradoxical time table therapy (Besharat, 2017) was implemented in six sessionsof 45 minutes on the experimental group. In addition to descriptive statistics, data analysis was performed using multivariate analysis, variance analysis with repeated measures, Bonferroni post hoc and SPSS25 software.

The results of the research showed that the treatment of paradox time program on all components of anxiety sensitivity (fear of respiratory symptoms, Fear of anxiety reactions, fear of cardiovascular symptoms, cognitive dyscontrol and the total score) and focused – attention (self-focused attentio and attention to the outside) had a significant effect (P<0.001).

According to the findings of the current research, it seems that the paradoxical time table therapy can be used by psychologists and psychiatrists as an efficient treatment to reduce the symptoms of social anxiety disorder, especially anxiety sensitivity and focused–attention.

</span></span> Social anxiety disorder is the most common anxiety disorder whose main feature is fear or severe anxiety. Anxiety sensitivity as a cognitive and mediating variable plays an essential role in the occurrence of mental disorders, including social anxiety disorder. A growing body of research supports the role of anxiety sensitivity in social anxiety disorder. A high prevalence of social anxiety disorder has led to the development and expansion of new treatments for this disorder. Some previous studies have shown that paradoxical timetable therapy (rooted in psychodynamic and systemic theories) and virtual reality technology therapy (in which the basic techniques of psychotherapy are simulated with the help of modern technologies) can reduce the symptoms of social anxiety disorder. Considering the research gap in comparing these two types of treatments in reducing anxiety sensitivity, the present study was conducted to compare the effectiveness of paradoxical timetable therapy and virtual reality technology on the anxiety sensitivity of patients with social anxiety disorder.</span></span></span></span></span>

</span> This quasi–experimental research was conducted with a pretest–posttest and a one–month follow–up design with a control group. The statistical population included all people referred to counseling centers and psychotherapy clinics in Tehran City, Iran, from September 23, 2022, to March 20, 2023. The study sample consisted of 45 qualified volunteers diagnosed with social anxiety disorder based on the initial interview and social anxiety scale. They were selected by available sampling and randomly assigned to three groups of 15 people each (two experimental groups and one control group). The Anxiety Sensitive Questionnaire (Taylor & Cox, 1998) was used to collect data. The revised anxiety sensitivity index has a four–factor ordinal structure. These factors include fear of respiratory symptoms, fear of anxiety reactions, fear of cardiovascular symptoms, and cognitive dyscontrol. The reliability of this questionnaire in the present study was 0.92. The first experimental group undertook six 90–minute paradoxical timetable program therapy (Besharat, 2019), and the second group received eight 45–minute virtual reality technology therapy sessions (North, North & Coble, 2017). The control group did not receive any intervention. The obtained data were analyzed using repeated measure analysis of variance. The significance level of the tests was considered 0.05. The inclusion criteria were as follows: suffering from social anxiety disorder based on the diagnostic interview and the social anxiety scale questionnaire (with a score of at least 50), informed consent to participate in treatment and research sessions, aged 18 to 50 years, having minimum degree of diploma, no concomitant use of psychiatric drugs, and without other clinical or chronic physical disorders (such as cardiovascular diseases).</span> The exclusion criteria were not participating in more than two treatment sessions, the occurrence of severe stressful events in life (such as divorce or death of first–degree relatives) during the research process, and unwillingness to continue the treatment.</span></span>

</span> The results showed that both types of paradoxical timetable therapy and virtual reality technology reduced anxiety sensitivity in people with social anxiety disorder (p<0.001). The non–significance of the mean difference between the posttest and follow–up phase also shows the permanent effect of the two therapeutic methods of paradoxical timetable and virtual reality technology therapy on anxiety sensitivity and its components one month after the end of the implementation period.</span> Based on this, the results of the present study showed that the two methods of treatment have reduced the average anxiety sensitivity and its components in a stable manner; however, the effectiveness of the paradoxical timetable therapy was higher. </span></span>

</span> Based on the research findings, the treatment of paradoxical timetable was more effective in reducing anxiety sensitivity than the virtual reality technology intervention. Therefore, therapists can use the mentioned treatment to reduce anxiety sensitivity in patients with social anxiety disorder. </span></span></span></span>