Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.

Only about half of patients with social anxiety disorder (SAD) respond substantially to cognitive behavioral therapy (CBT). However, there has been little evidence available to clinicians or patients about whether any individual patient is more or less likely to have a positive response to CBT. Here...

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Main Authors: Qasim Bukhari, David Rosenfield, Stefan G Hofmann, John D E Gabrieli, Satrajit S Ghosh
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0313351
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author Qasim Bukhari
David Rosenfield
Stefan G Hofmann
John D E Gabrieli
Satrajit S Ghosh
author_facet Qasim Bukhari
David Rosenfield
Stefan G Hofmann
John D E Gabrieli
Satrajit S Ghosh
author_sort Qasim Bukhari
collection DOAJ
description Only about half of patients with social anxiety disorder (SAD) respond substantially to cognitive behavioral therapy (CBT). However, there has been little evidence available to clinicians or patients about whether any individual patient is more or less likely to have a positive response to CBT. Here, we used machine learning on data from 157 patients to examine whether individual patient responses to CBT can be predicted based on demographic information, psychiatric history, and self-reported or clinician-reported scales, subscales and questionnaires acquired prior to treatment. Machine learning models were able to explain about 26% of the variance in final treatment improvements. To assess generalizability, we evaluated multiple machine learning models using cross-validation and determined which input features were essential for prediction. While prediction accuracy was similar across models, the importance of specific features varied across models. In general, the combination of total scale score, subscale scores and responses to individual questions on a severity measure, the Liebowitz Social Anxiety Scale (LSAS), was the most informative in achieving the highest predictions that alone accounted for about 26% of the variance in treatment outcome. Demographic information, psychiatric history, personality measures, other self-reported or clinician-reported questionnaires, and clinical scales related to anxiety, depression, and quality of life provided no additional predictive power. These findings indicate that combining scaled and individual responses to LSAS questions are informative for predicting individual response to CBT in patients with SAD.
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spelling doaj-art-e086f182eec2479583d85e678654eece2025-08-20T01:55:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01203e031335110.1371/journal.pone.0313351Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.Qasim BukhariDavid RosenfieldStefan G HofmannJohn D E GabrieliSatrajit S GhoshOnly about half of patients with social anxiety disorder (SAD) respond substantially to cognitive behavioral therapy (CBT). However, there has been little evidence available to clinicians or patients about whether any individual patient is more or less likely to have a positive response to CBT. Here, we used machine learning on data from 157 patients to examine whether individual patient responses to CBT can be predicted based on demographic information, psychiatric history, and self-reported or clinician-reported scales, subscales and questionnaires acquired prior to treatment. Machine learning models were able to explain about 26% of the variance in final treatment improvements. To assess generalizability, we evaluated multiple machine learning models using cross-validation and determined which input features were essential for prediction. While prediction accuracy was similar across models, the importance of specific features varied across models. In general, the combination of total scale score, subscale scores and responses to individual questions on a severity measure, the Liebowitz Social Anxiety Scale (LSAS), was the most informative in achieving the highest predictions that alone accounted for about 26% of the variance in treatment outcome. Demographic information, psychiatric history, personality measures, other self-reported or clinician-reported questionnaires, and clinical scales related to anxiety, depression, and quality of life provided no additional predictive power. These findings indicate that combining scaled and individual responses to LSAS questions are informative for predicting individual response to CBT in patients with SAD.https://doi.org/10.1371/journal.pone.0313351
spellingShingle Qasim Bukhari
David Rosenfield
Stefan G Hofmann
John D E Gabrieli
Satrajit S Ghosh
Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
PLoS ONE
title Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
title_full Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
title_fullStr Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
title_full_unstemmed Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
title_short Predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics, psychiatric history, and scales: A machine learning approach.
title_sort predicting treatment response to cognitive behavior therapy in social anxiety disorder on the basis of demographics psychiatric history and scales a machine learning approach
url https://doi.org/10.1371/journal.pone.0313351
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