Comparison of the Effectiveness of Cognitive-behavioral Therapy and Acceptance and Commitment Therapy on Cognitive Distortions and Rumination in Adolescents With Social Anxiety Disorder

Objective: Social anxiety disorder is a prevalent and persistent psychological disorder that is characterized by an intense fear of negative judgment from others, leading to avoidance of social interactions. This study compared the effectiveness of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) in reducing SAD symptoms, including cognitive distortions, rumination, and anxiety sensitivity, in adolescents diagnosed with social anxiety disorder (SAD). Methods: The study was semi-experimental, with a pre-test and post-test design featuring a control group. The research sample comprised ۴۵ adolescents diagnosed with SAD, who were recruited from psychological service offices in Bukan City, Iran, between April ۴th, ۲۰۲۲, and September ۶th, ۲۰۲۲. Fifteen adolescents were assigned to the first experimental group, ۱۵ to the second experimental group, and ۱۵ to the control group. The subjects were selected using the purposive sampling method and were randomly assigned to the experimental and control groups. CBT (۱۲ sessions) and ACT (۸ sessions) were implemented in two sessions per week for the experimental groups. Each session lasted for an hour. The control group did not receive any intervention. The participants completed the Social Phobia Inventory (SPIN) (۲۰۰۰), the Ruminative Response Scale (RRS) (۲۰۰۳), and the Dysfunctional Attitude Scale (DAS) (۱۹۷۸). The data of the research were analyzed using the analysis of variance test using SPSS software, version ۲۳ and a significance level of ۰.۰۵.  Results: The results of the analysis of variance showed that CBT and ACT have a significant effect on cognitive distortions and rumination in adolescents (P<۰.۰۰۱). Also, there is no significant difference between the effectiveness of CBT and ACT on cognitive distortions and rumination in adolescents (P>۰.۰۵). The mean±standard deviation (SD) difference before (۵۴.۷۶±۱۳.۸۸) and after (۴۹.۵۱±۱۳.۴۲) the rumination in the CBT group was significant (P<۰.۰۰۱). The mean±SD difference before (۹۸.۳۲±۷.۴۴) and after (۸۳.۹۰±۷.۷۷) the cognitive distortions in the CBT group was significant (P<۰.۰۰۱). The mean±SD difference before (۵۲.۳۳±۱۴.۷۸) and after (۴۷.۷۳±۱۴.۲۳) the rumination in the ACT group was significant (P<۰.۰۰۱). Also, the mean±SD difference before (۹۸.۷۰±۷.۰۲) and after (۸۵.۱۳±۶.۸۳) the cognitive distortion in the ACT group was significant (P<۰.۰۰۱).  Conclusion: Based on the results of the analysis, it can be concluded that CBT and ACT can be considered in cognitive distortions and rumination in adolescents with SAD.