# Improving Psychosocial Functioning among Veterans with Social Anxiety: A Pilot Evaluation of Self-Monitoring Intervention to Reduce Safety Behaviors

> **NIH VA I21** · RALPH H JOHNSON VA MEDICAL CENTER · 2024 · —

## Abstract

Background: Social anxiety (SA), which broadly consists of fears related to being negatively
evaluated and avoidance of social situations (Alden & Taylor, 2010), is prevalent among both civilians
and Veterans (Byrne et al., 2021; Kessler et al., 2007). SA is associated with impairment across a
range of social/interpersonal domains. As a result, individuals with SA are at heightened risk for
experiencing loneliness, low self-efficacy, depression, and substance use, as well as unemployment
and poorer workplace productivity relative to individuals without SA. Despite its prevalence and
impact on functioning, the majority of individuals with SA do not seek treatment. Significance: The
proposed project has significant and immediate relevance to Veterans and the VHA in that it seeks to
assess the feasibility and acceptability of a self-monitoring intervention to decrease safety behaviors
(DSB-I) among Veterans with SA and SA associated functional impairment. The proposed
intervention is informed by a successful trial of the intervention in a community setting (Cougle et al.,
2020) and will be further developed and refined for optimal use with Veterans and for the VA in the
proposed SPiRE. Aside from addressing the critical need for targeted intervention within VA for SA
related impairment, the proposed study is innovative in its use of a novel technology-based intervention
that is resource light in terms of patient and provider demands and mitigates traditional barriers to
care. The proposed study design is also strengthened by a mixed methods approach heavily
informed by patient stakeholder feedback. Specific Aims: Aim 1: Establish feasibility and
acceptability of study methods and recruitment strategy using a single-arm study design of N=30
Veterans with SA and SA related impairment enrolled in a VA Compensated Work Therapy (CWT)
program. All Veterans will be enrolled to receive DSB-I. Variables of interest will include feasibility of
recruitment (e.g., proportion of Veterans approached/enrolled, proportion of Veterans who complete
the study assessments and intervention); Aim 2: Evaluate response to the intervention using post-
intervention survey data collected as part of Aim 1, and qualitative data (i.e., individual thematic
interviews) from a subset of Veterans who start DSB-I, to better evaluate participant response to the
intervention (e.g., ease of use of DSB-I, credibility/expectancy related to DSB-I, satisfaction with
DSB-I) as well as solicit suggestions for refinement of the intervention; Aim 3: Based on Veteran
feedback, refine the intervention and study methods as indicated for optimal use within VA and for
Veterans enrolled in CWT to support a future large scale RCT focused on efficacy of outcomes related
to improved functional recovery, social integration, and quality of life among Veterans seeking
reintegration into the workforce. Research Design & Methods: The proposed study will employ a
mixed-methods (quantitative/qualitative) appro...

## Key facts

- **NIH application ID:** 10807462
- **Project number:** 1I21RX004401-01A1
- **Recipient organization:** RALPH H JOHNSON VA MEDICAL CENTER
- **Principal Investigator:** ANOUK L GRUBAUGH
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10807462

## Citation

> US National Institutes of Health, RePORTER application 10807462, Improving Psychosocial Functioning among Veterans with Social Anxiety: A Pilot Evaluation of Self-Monitoring Intervention to Reduce Safety Behaviors (1I21RX004401-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10807462. Licensed CC0.

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