Effectiveness of eye communication training device for social anxiety disorder treatment: A single-arm pilot trial

Abstract

Background: Social anxiety disorder (SAD) is a common mental disorder that is characterized by severe anxiety in social situations. Individual cognitive-behavioral therapy (CBT) for SAD is the recommended first treatment, but there is a critical shortage of CBT-trained therapists. People with SAD often fear and avoid making eye contact, which can lead to social anxiety and difficulty functioning in daily life. If they become able to make eye contact more comfortably, their social life should improve. We developed a gaze training system (Eye Communication Trainer: ECOM) to treat SAD. This study aimed to investigate the efficacy and feasibility of ECOM in the single-arm, uncontrolled trial. Methods: The ECOM gaze training program consists of 8 weekly sessions. In each session for 20 min, subjects watched forty 30-second videos to practice visual control. The effectiveness of the training was evaluated at baseline, week 4 (mid-point), week 8 (completion), and week 12 (follow-up). The primary outcome was the Liebowitz Social Anxiety Scale (LSAS). The secondary outcomes were Social Phobia Inventory (SPIN), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and EuroQol 5 dimensions (EQ-5D). Results: Twenty-three subjects participated in the study. One subject did not complete the follow-up. The LSAS total score decreased significantly at week 8 (Hedges' g = 1.35, n = 23) and at week 12 (Hedges' g = 1.80, n = 22). The subjects also showed significant improvement in all secondary outcomes. No adverse events, except dry eye, were reported. Conclusion: The ECOM gaze training shows potential as a new treatment for SAD.

Keywords

• Social anxiety disorder
• Eye communication training device
• Cognitive behavioral therapy
• Psychiatric treatment