A new clinical trial conducted at the Center for Traumatic Stress and Resilience at Tel Aviv University has demonstrated an effective technology-driven alternative to psychiatric medications for people with social anxiety.
The groundbreaking study found that GC-MART (Gaze-Contingent Music Reward Therapy) is as effective in treating social anxiety disorder as drugs from the SSRI family.
The study found that the innovative treatment, developed at TAU, relieved the symptoms of about 50 percent of the participating patients.
About four to twelve percent of the population develops social anxiety disorder at some stage of their lives, according to Prof. Yair Bar-Haim, director of the Adler Center for Child Development and Psychopathology, and of the Center for Traumatic Stress and Resilience.
“Quite often, people with this disorder avoid social situations – at a heavy interpersonal, professional, and economic price,” he said.
The study was led by Prof. Bar-Haim together with research students Gal Arad and Omer Azriel from the School of Psychological Sciences at Tel Aviv University. Other collaborators included the NIH, the Tel Aviv Sourasky (Ichilov) and Sheba Medical Centers, and Prof. Amit Lazarov of TAU.
At present, psychiatry and psychology offer sufferers two types of treatment: SSRI (Selective Serotonin Reuptake Inhibitor) drugs, such as Cipralex, and CBT (Cognitive-Behavioral Therapy).
“CBT requires 12-20 sessions with a qualified clinical psychologist, in which symptoms are relieved through gradual exposure to the cause of anxiety,” Bar-Haim pointed out. “Thus, while effective, CBT is a complex treatment necessitating the presence of a highly skilled therapist and requiring patients to face their deepest fears, a requirement that often leads to treatment dropout.”
Psychiatric medication, while effective, also has drawbacks for some people, he noted. “Some patients prefer not to use psychiatric drug and in other cases, entire populations, such as young children, pregnant women, and individuals with specific diseases, cannot take SSRI drugs.” In other cases, the drug has certain side effects, he added.
In the clinical trial, 105 Israeli adults with social anxiety disorder were assigned into three groups: one group was treated with SSRI drugs, in this case Cipralex; a second group was treated with GC-MART; and a control group.
After ten 30-minute training sessions, about 50 percent of the patients provided with the new therapy demonstrated significant improvement in their symptoms – a result similar to the outcome reported for patients who took Cipralex.
“The therapy we developed is based on eye-tracking combined with a musical reward. The patients choose the music they would like to hear – Israeli, classical, hip hop, etc., and is shown a simulation of a crowd on a computer screen,” Bar-Haim said.
“Usually, individuals with social anxiety disorder tend to dwell on scowling or threatening facial expressions, quickly picking them out and unable to look away. Consequently, they often interpret the crowd or social situations as hostile, negative, or critical. People without social anxiety disorder, on the other hand, prefer to focus on positive or neutral faces in a crowd.
“In the new therapy, the music chosen by the patient provides positive feedback for a normal focus of attention on facial expressions in the crowd presented on the screen. Gradually, through training, patients’ biased attention is normalized, and symptoms recede.
“All participants in our trial underwent a comprehensive clinical assessment both before and after the treatment and were also asked to report on the symptoms and their severity.
“Results indicated that the new treatment significantly reduced symptoms of social anxiety, with an efficacy that is similar to that of SSRI drugs,” he said.
The researchers said they hope the new therapy will soon be available as an alternative to psychiatric medications.
The paper was published in the prestigious American Journal of Psychiatry.
