Sosyal Kaygı Bozukluğunun Bilişsel Davranışçı Terapisi: Kapsamlı Bir Gözden Geçirme

Yıl 2024, Cilt: 14, 311 - 327, 30.06.2024

Koray Akkuş

https://doi.org/10.13114/mjh.1476738

Öz

Yaygın olarak görülen psikolojik sorunlardan olan Sosyal kaygı bozukluğu (SKB), bireylerin hayatlarının çeşitli alanlarında ciddi zorluklar yaratmakta ve başka psikolojik sorunlarla sıklıkla bir arada görülmektedir. SKB’yi açıklamak için çeşitli bilişsel davranışçı modeller önerilmiş ve bu modelleri temel alan tedavi protokolleri geliştirilmiştir. Bu çalışmada ilgili alanyazın gözden geçirilmiş ve yaygın olarak kullanılan bilişsel davranışçı terapi programları hakkında detaylı bilgiler sunulmuştur. Tedavi programları incelendiğinde bireylerin sosyal durumlara ilişkin uyumsuz inançlarına yönelik bilişsel müdahaleler ile korkulan duruma yönelik maruz bırakma uygulamalarının birçok tedavi programında temel bileşenler olduğu görülmektedir. SKB’nin tedavisine yönelik güncel araştırmaların sonuçları en etkili tedavi yöntemlerinden birinin BDT olduğunu ve elde edilen kazanımların uzun vadede de sürme eğiliminde olduğunu göstermektedir. Öte yandan önemli sayıda sosyal kaygılı bireyin bilişsel davranışçı terapiden yeterli faydayı göremediği anlaşılmıştır.

Anahtar Kelimeler

sosyal kaygı bozukluğu, bilişsel davranışçı kuram, bilişsel davranışçı terapi, derleme

Etik Beyan

Etik kurul izni gerektiren bir çalışma değildir

Destekleyen Kurum

Herhangi bir kurumdan destek alınmamıştır

Kaynakça

• Acarturk C., Cuijpers P., van Straten A. & de Graaf R. (2009). Psychological treatment of social anxiety disorder: a meta-analysis. Psychological Medicine, 39(2), 241-254. https://doi.org/10.1017/S003329170800 3590
• Akkuş K. (2021). Sosyal kaygı bozukluğunun üstesinden gelmek: danışanlar için bilişsel davranışçı bir el kitabı (2.baskı). Nobel Akademik Yayıncılık
• Akkuş K. (2022). Sosyal kaygı bozukluğunun bilişsel davranışçı modelinin bir konuşma performansı görevi ile incelenmesi. Yayınlanmamış doktora tezi. Ege Sosyal Bilimler Enstitüsü
• Akkuş K. & Peker M. (2022). Exploring the relationship between interpersonal emotion regulation and social anxiety symptoms: The mediating role of negative mood regulation expectancies. Cognitive Therapy and Research, 46(2), 287-301. https://doi.org/10.1007/s10608-021-10262-0
• Amerikan Psikiyatri Birliği. (2013). Diagnostic and statistical manual of mental disorders (5. baskı).
• Andrews G., Be ll C., Boyce P., Gale C., Lampe L., Marwat O. & Wilkins G. (2018). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry, 52(12), 1109-1172. https://doi.org/10.1177/0004867418799453
• Beesdo‐Baum K., Knappe S., Fehm L., Höfler M., Lieb R., Hofmann S. G. & Wittchen H. U. (2012). The natural course of social anxiety disorder among adolescents and young adults. Acta Psychiatrica Scandinavica, 126(6), 411-425. https://doi.org/10.1111/j.1600-0447.2012.01886.x
• Beesdo K., Bittner A., Pine D. S., Stein M. B., Höfler M., Lieb R. & Wittchen H. U. (2007). Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Archives of General Psychiatry, 64(8), 903-912. 10.1001/archpsyc.64.8.903
• Bruffaerts R., Harris M. G., Kazdin A. E., Vigo D. V., Sampson N. A., Chiu W. T. & Kessler R. C. (2022). Perceived helpfulness of treatment for social anxiety disorder: findings from the WHO World Mental Health Surveys. Social Psychiatry and Psychiatric Epidemiology, 1-17. https://doi.org/10.1007/s00127-022-02249-3
• Butler A. C., Chapman J. E., Forman E. M. & Beck A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17-31. 10.1016/j.cpr.2005.07.003
• Carpenter J. K., Andrews L. A., Witcraft S. M., Powers M. B., Smits J. A. & Hofmann S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety, 35(6), 502-514. https://doi.org/10.1002/da.22728
• Clark D. A. & Beck A. T. (2010). Cognitive therapy of anxiety disorders: science and practice. Guilford Press.
• Clark D. M. & Wells A. (1995). A cognitive model of social phobia. R. G. Heimberg ve M. R. Liebowitz (Eds), içinde Social phobia: Diagnosis, assessment, and treatment (69-93). New York, NY, US: Guilford Press.
• Cook S. I., Moore S., Bryant C. & Phillips L. J. (2022). The role of fear of positive evaluation in social anxiety: A systematic review and meta-analysis. Clinical Psychology: Science and Practice, 29(4), 352-369. https://doi.org/10.1037/cps0000082
• Crome E., Grove R., Baillie A. J., Sunderland M., Teesson M. & Slade T. (2015). DSM-IV and DSM-5 social anxiety disorder in the Australian community. Australian & New Zealand Journal of Psychiatry, 49(3), 227-235. https://doi.org/10.1177/0004867414546699
• Cuijpers, P., Cristea I. A., Karyotaki E., Reijnders M. & Huibers M. J. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence. World Psychiatry, 15(3), 245-258. 10.1002/wps.20346
• DeWit D. J., Ogborne A., Offord D. R. & MacDonald K. (1999). Antecedents of the risk of recovery from DSM-III-R social phobia. Psychological Medicine, 29(3), 569-582. https://doi.org/10.1017/S0033291 799008399
• Dindi R., & Karaaziz M. (2023). Sosyal Fobi ve Bilişsel Davranışçı Terapisi Üzerine Sistematik Derleme. Journal of Academic Social Science Studies, 16(95).
• Dryman M. T. & Heimberg R. G. (2018). Emotion regulation in social anxiety and depression: A systematic review of expressive suppression and cognitive reappraisal. Clinical Psychology Review, 65, 17-42. https://doi.org/10.1016/j.cpr.2018.07.004
• Fang A. & Hofmann S. G. (2010). Relationship between social anxiety disorder and body dysmorphic disorder. Clinical Psychology Review, 30(8), 1040-1048. https://doi.org/10.1016/j.cpr.2010.08.001
• Fergus, T. A., Valentiner, D. P., McGrath, P. B., Stephenson, K., Gier, S. & Jencius, S. (2009). The Fear of Positive Evaluation Scale: Psychometric properties in a clinical sample. Journal of Anxiety Disorders, 23(8), 1177–1183. https://doi.org/10.1016/j.janxdis.2009.07.024
• Feske U. & Chambless D. L. (1995). Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis. Behavior Therapy, 26(4), 695-720. https://doi.org/10.1016/S0005-7894(05)80040-1
• Gallagher M., Prinstein M. J., Simon V. & Spirito A. (2014). Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: Examining loneliness and social support as longitudinal mediators. Journal of Abnormal Child Psychology, 42(6), 871-883. https://doi.org/10.1007/s10802-013-9844-7
• Garey L., Olofsson H., Garza T., Rogers A. H., Kauffman B. Y. & Zvolensky M. J. (2020). Directional effects of anxiety and depressive disorders with substance use: a review of recent prospective research. Current Addiction Reports, 7(3), 344-355. https://doi.org/10.1007/s40429-020
• Goetter E. M., Frumkin M. R., Palitz S. A., Swee M. B., Baker A. W., Bui E. & Simon, N. M. (2020). Barriers to mental health treatment among individuals with social anxiety disorder and generalized anxiety disorder. Psychological Services, 17(1), 5. http://dx.doi.org/10.1037/ser0000254
• Goldin P. R., Jazaieri H. & Gross J. J. (2014). Emotion regulation in social anxiety disorder. Hofmann, S. G. ve BiBartolo, P.M. (Eds.). Social Anxiety: Clinical, developmental, and social perspectives (3.Baskı) (s. 511-529). Academic Press.
• Gök B. G. & İnönü M. (2022). Sosyal Kaygı Bozukluğu: Mevcut yaygınlık, eştanı ve bozulma durumu. Klinik Psikoloji Dergisi,7(3) 448-467. https://doi.org/10.5455/kpd.26024438m000101
• Grant B. F., Hasin D. S., Blanco C., Stinson F. S., Chou S. P., Goldstein, R. B & Huang B. (2005). The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(11), 1351-1361. 10.4088/jcp.v66n1102
• Guo S., Deng W., Wang H., Liu J., Liu X., Yang X. & Li X. (2021). The efficacy of internet‐based cognitive behavioural therapy for social anxiety disorder: A systematic review and meta‐analysis. Clinical Psychology & Psychotherapy, 28(3), 656-668. https://doi.org/10.1002/cpp.2528
• Heimberg R. G. & Becker R. E. (2002). Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. Guilford Press.
• Heimberg R. G., Brozovich F. A. & Rapee R. M. (2014). A cognitive-behavioral model of social anxiety disorder. İçinde Hofmann, S. G. ve BiBartolo, P.M. (Eds.). Social Anxiety: Clinical, developmental, and social perspectives (3.Baskı) (s. 705-728). Academic Press.
• Hofmann S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36(4), 193-209. https://doi.org/10.1080/16506070701421313
• Hofmann S. G. & Bögels S. M. (2006). Recent advances in the treatment of social phobia: Introduction to the special issue. Journal of Cognitive Psychotherapy, 20(1), 3-5. https://doi.org/10.1891/jcop.20.1.3
• Hofmann S. G. & Otto M. W. (2018). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder-specific treatment techniques (2.baskı). Routledge.
• Hofmann S. G., Anu Asnaani M. A. & Hinton D. E. (2010). Cultural aspects in social anxiety and social anxiety disorder. Depression and Anxiety, 27(12), 1117-1127. https://doi.org/10.1002/da.20759 Jazaieri H., Morrison A. S., Goldin P. R. & Gross J. J. (2015). The role of emotion and emotion regulation in social anxiety disorder. Current Psychiatry Reports, 17, 1-9. 10.1007/s11920-014-0531-3 Jefferies P. & Ungar M. (2020). Social anxiety in young people: A prevalence study in seven countries. PLoS One, 15(9). https://doi.org/10.1371/journal.pone.0239133
• Katzman M. A., Bleau P., Blier P., Chokka P., Kjernisted K. & Van Ameringen M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, 14(1), 1-83. https://doi.org/10.1186/1471-244X-14-S1-S1
• Keller M. B. (2003). The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatrica Scandinavica, 108, 85-94. https://doi.org/10.1034/j.1600-0447.108.s417.6.x
• Keller M. B. (2006). Social anxiety disorder clinical course and outcome: review of Harvard/Brown Anxiety Research Project (HARP) findings. Journal of Clinical Psychiatry, 67, 14.
• Kerr-Gaffney J., Harrison A. & Tchanturia K. (2018). Social anxiety in the eating disorders: a systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S003 3291718000752
• Kessler R. C., Berglund P., Demler O., Jin R., Merikangas, K. R. & Walters E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. https://doi.org/10.1001/archpsyc.62.6.593
• Kobezak H. M. & Gibb B. E. (2020). Prospective associations between social anxiety and depression in youth: The moderating role of maternal major depressive disorder. Journal of Adolescence, 82, 19-22. https://doi.org/10.1016/j.adolescence.2020.05.003
• Koyuncu A., İnce E., Ertekin E. & Tükel R. (2019). Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs in Context, 8. 10.7573/dic.212573
• Ledley D. R., Foa E. B. & Huppert J. D. (2006). Comprehensive cognitive behavior therapy for social phobia: A treatment manual. https://www.div12.org/wpcontent/uploads/2014/09/Comprehensive-CBT-for-Social-Phobia-manual.pdf
• Leichsenring F. & Leweke F. (2017). Social anxiety disorder. New England Journal of Medicine, 376(23), 2255-2264. https://doi.org/10.1056/NEJMcp1614701
• Leichsenring F., Salzer S., Beutel M. E., Herpertz S., Hiller W., Hoyer J. & Leibing E. (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial. American Journal of Psychiatry, 170(7), 759-767. https://doi.org/10.1176/appi.ajp.2013.12081125
• Levinson C. A. & Rodebaugh T. L. (2012). Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears. Eating Behaviors, 13(1), 27-35. https://doi.org/10.1016/j.eatbeh.2011. 11.006
• Lim M. H., Rodebaugh T. L., Zyphur M. J. & Gleeson J. F. (2016). Loneliness over time: The crucial role of social anxiety. Journal of Abnormal Psychology, 125(5), 620–630. https://doi.org/10.1037/ abn0000162
• Linardon J., Torous J., Firth J., Cuijpers P., Messer M. & Fuller‐Tyszkiewicz M. (2024). Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta‐analysis of 176 randomized controlled trials. World Psychiatry, 23(1), 139-149. 10.1002/wps.21183
• Lydiard R. B. (2001). Social anxiety disorder: comorbidity and its implications. Journal of Clinical Psychiatry, 62, 17-24.
• MacKenzie, M. B. & Fowler K. F. (2013). Social anxiety disorder in the Canadian population: Exploring gender differences in sociodemographic profile. Journal of Anxiety Disorders, 27(4), 427-434. https://doi.org/10.1016/j.janxdis.2013.05.006
• Maes M., Nelemans, S. A., Danneel S., Fernández-Castilla, B., van den Noortgate, W., Goossens L. & Vanhalst J. (2019). Loneliness and social anxiety across childhood and adolescence: Multilevel meta-analyses of cross-sectional and longitudinal associations. Developmental Psychology, 55(7), 1548-1565. https://doi.org/10.1037/dev0000719
• Mayo-Wilson, E., Dias, S., Mavranezouli, I., Kew, K., Clark, D. M., Ades, A. E. & Pilling, S. (2014). Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 1(5), 368-376. https://doi.org/10.1016/ S2215-0366(14)70329-3
• Miloyan B. & Van Doorn G. (2019). Longitudinal association between social anxiety disorder and incident alcohol use disorder: results from two national samples of US adults. Social Psychiatry and Psychiatric Epidemiology, 54(4), 469-475. https://doi.org/10.1007/s00127-018-1569-z
• Norton P. J. & Price E. C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195(6), 521-531. https://doi.org/10.1097/01.nmd.0000253843.70149.9a
• Olfson M., Guardino, M., Struening, E., Schneier, F. R., Hellman, F., & Klein, D. F. (2000). Barriers to the treatment of social anxiety. American Journal of Psychiatry, 157(4), 521–527.
• Park C., Majeed A., Gill H., Tamura J., Ho R. C., Mansur R. B. & McIntyre, R. S. (2020). The effect of loneliness on distinct health outcomes: a comprehensive review and meta-analysis. Psychiatry Research, 294, 113514. https://doi.org/10.1016/j.psychres.2020.113514
• Patel T. A., Schubert F. T., Hom M. A. & Cougle J. R. (2022). Correlates of treatment seeking in individuals with social anxiety disorder: Findings from a nationally representative sample. Journal of Anxiety Disorders, 91, https://doi.org/10.1016/j.janxdis.2022.102616
• Peker M., & Akkuş K. (2024). Fear of positive evaluation differentially predicts social anxiety: a six-month longitudinal panel study. Current Psychology, 43(4), 3621-3631. https://doi.org/10.1007/s12144-023-04597-y
• Pelissolo A., Abou Kassm S. & Delhay L. (2019). Therapeutic strategies for social anxiety disorder: where are we now?. Expert Review of Neurotherapeutics, 19(12), 1179-1189. https://doi.org/10.1080/ 14737175.2019.1666713
• Pilling S., Mayo-Wilson E., Mavranezouli I., Kew K., Taylor C. & Clark D. M. (2013). Recognition, assessment and treatment of social anxiety disorder: summary of NICE guidance. Bmj, 346. doi: 10.1136/bmj.f2541
• Powers M. B., Sigmarsson S. R. & Emmelkamp P. M. (2008). A meta-analytic review of psychological treatments for social anxiety disorder. International Journal of Cognitive Therapy, 1(2), 94-113. https://doi.org/10.1521/ijct.2008.1.2.94
• Ruscio A. M., Brown T. A., Chiu W. T., Sareen J., Stein M. B. & Kessler R. C. (2008). Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15-28. https://doi.org/10.1017/S0033291707001699
• Sareen, J., Cox, B. J., Afifi, T. O., De Graaf, R., Asmundson, G. J., Ten Have, M. & Stein, M. B. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: a population-based longitudinal study of adults. Archives of General Psychiatry, 62(11), 1249-1257. https://doi.org/10.1001/ archpsyc.62.11.1249
• Schneier F. R. (2006). Social anxiety disorder. The New England Journal of Medicine. 55, 1029-36.
• Solmi M., Radua J., Olivola M., Croce E., Soardo L., Salazar de Pablo G. & Fusar-Poli P. (2022). Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27(1), 281-295. https://doi.org/10.1038/s41380-021-01161-7
• Spence S. H., & Rapee R. M. (2016). The etiology of social anxiety disorder: An evidence-based model. Behaviour Research and Therapy, 86, 50-67. https://doi.org/10.1016/j.brat.2016.06.007
• Stangier U. (2016). New developments in cognitive-behavioral therapy for social anxiety disorder. Current Psychiatry Reports, 18, 1-8. 10.1007/s11920-016-0667-4
• Stein D. J., Lim C. C., Roest A. M., de Jonge P., Aguilar-Gaxiola S., Al-Hamzawi A. & Scott K. M. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Medicine, 15(1), 1-21. https://doi.org/10.1186/s12916-017-0889-2
• Stein M. B. (2006). An epidemiologic perspective on social anxiety disorder. Journal of Clinical Psychiatry, 67, 38.
• Stein M. B. & Stein, D. J. (2008). Social anxiety disorder. The Lancet, 371(9618), 1115-1125. https://doi.org/10.1016/S0140-6736(08)60488-2
• Stein M. B., Fuetsch, M., Müller, N., Höfler, M., Lieb, R. & Wittchen, H. U. (2001). Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Archives of General Psychiatry, 58(3), 251-256. https://doi.org/10.1001/archpsyc.58.3.251
• Steinert, C., Hofmann, M., Leichsenring, F. & Kruse, J. (2013). What do we know today about the prospective long-term course of social anxiety disorder? A systematic literature review. Journal of Anxiety Disorders, 27(7), 692-702. https://doi.org/10.1016/j.janxdis.2013.08.002
• Sun J., Dong Q. X., Wang S. W., Zheng Y. B., Liu X. X., Lu T. S. & Han, Y. (2023). Artificial intelligence in psychiatry research, diagnosis, and therapy. Asian Journal of Psychiatry, 103705. https://doi.org/10.1016/j.ajp.2023.103705 Swinbourne J. M. ve Touyz, S. W. (2007). The co‐morbidity of eating disorders and anxiety disorders: A review. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 15(4), 253-274. https://doi.org/10.1002/erv.784
• Taylor S. (1996). Meta-analysis of cognitive-behavioral treatments for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 27(1), 1-9. https://doi.org/10.1016/0005-7916(95)00058-5
• Tolin D. F. (2010). Is cognitive–behavioral therapy more effective than other therapies?: A meta-analytic review. Clinical Psychology Review, 30(6), 710-720. 10.1016/j.cpr.2010.05.003
• Van Dis E. A., Van Veen S. C., Hagenaars M. A., Batelaan, N. M., Bockting C. L., van den Heuvel, R. M., & Engelhard I. M. (2020). Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: a systematic review and meta-analysis. JAMA Psychiatry, 77(3), 265-273. 10.1001/jamapsychiatry.2019.3986
• Wang F., Gao Y., Han Z., Yu Y., Long Z., Jiang X. & Zhao Y. (2023). A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nature Human Behaviour, 7(8), 1307-1319. https://doi.org/10.1038/s41562-023-01617-6
• Weeks J. W. & Howell A. N. (2014). Fear of positive evaluation: The neglected fear domain in social anxiety. içinde The Wiley Blackwell handbook of social anxiety disorder (433-453).
• Weeks J. W., Heimberg R. G., Rodebaugh T. L., Goldin P. R. & Gross J. J. (2012). Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder. Psychological Assessment, 24(2), 301-312. https://doi.org/10.1037/a0025723
• Werner K. H., Goldin P. R., Ball T. M., Heimberg R. G. & Gross J. J. (2011). Assessing emotion regulation in social anxiety disorder: The emotion regulation interview. Journal of Psychopathology and Behavioral Assessment, 33(3), 346-354. https://psycnet.apa.org/doi/10.1007/s10862-011-9225-x
• Wersebe H., Sijbrandij M. & Cuijpers P. (2013). Psychological group-treatments of social anxiety disorder: a meta-analysis. PloS one, 8(11), e79034. 10.1371/journal.pone.0079034
• Wong Q. J., & Rapee R. M. (2016). The aetiology and maintenance of social anxiety disorder: A synthesis of complementary theoretical models and formulation of a new integrated model. Journal of Affective Disorders, 203, 84-100. https://doi.org/10.1016/j.jad.2016.05.069
• Yalçın M. & Sütcü S. (2016). Yetişkinlerde sosyal fobinin tedavisinde bilişsel davranışçı grup terapisinin etkililiği: Sistematik Bir Gözden Geçirme. Psikiyatride Güncel Yaklaşımlar, 8(Ek 1), 61-78. doi:10.18863/pgy.28154
• Zimmerman M., McGlinchey J. B., Chelminski I. & Young D. (2008). Diagnostic co-morbidity in 2300 psychiatric out-patients presenting for treatment evaluated with a semi-structured diagnostic interview. Psychological Medicine, 38(2), 199-210. doi/10.1017/S0033291707001717