Cognitive process in social phobia

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, U.K.
Behaviour Research and Therapy (Impact Factor: 3.85). 04/1993; 31(3):255-267. DOI: 10.1016/0005-7967(93)90024-O


Social phobics, anxious controls and non-patient controls took part in a brief videotaped conversation with a stooge in order to investigate the cognitive model of social phobia. Thoughts, behaviour, and attention during the conversation were assessed. Compared to the control groups, social phobics had more negative self-evaluative thoughts, performed less well, and systematically underestimated their performance. There were no differences in attention between the three groups. Content analysis of thought sampling data from the conversation, and from three hypothetical situations, revealed that few of the negative thoughts reported by social phobics explicitly mentioned evaluation by other people. This suggests that social phobics may not closely monitor other people's responses in social situations and hence that their thoughts are not data driven. The results are discussed in relation to the cognitive model of social phobia and suggestions are made for improvements in the treatment of social phobia.

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    • "Some studies, e.g. [3], have found that individuals with SAD are rated as performing noticeably differently in social situations, but this effect has not always been replicated [4], and it is also not known whether such differences in performance would attract other people's attention. Second, individuals with SAD may differ from individuals without SAD in their perception of the extent to which they are the focus of other people's attention. "
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    ABSTRACT: People with social anxiety disorder are afraid of being scrutinized by others and often feel that they are the excessive focus of other people's attention. This study investigated whether, when compared to low socially anxious individuals, high socially anxious individuals overestimate the proportion of people in a crowd who are observing them. It was hypothesized that any potential overestimation would be modulated by self-focused attention. Forty-eight high and 48 low socially anxious participants performed a “faces in a crowd” computer task during which they briefly saw matrices of faces, which varied in terms of the proportion of people who were looking at them. Participants estimated the proportion of people who were looking at them. The task was performed once with mirrors present (to induce an enhanced self-focused state) and once without mirrors present (neutral state). Participants' subjective estimates and the objective proportion of faces looking towards them were strongly correlated in both the high and low socially anxious groups. However, high socially anxious participants estimated that more people were looking at them than low socially anxious participants. In the first phase of the experiment, but not in the later phases, this effect was magnified in the mirror condition. This study provides preliminary evidence of a social anxiety related perceptual difference that may be amplified by self-focused attention. Clinical implications are discussed.
    PLoS ONE 09/2014; 9(9):e106400. DOI:10.1371/journal.pone.0106400 · 3.23 Impact Factor
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    • "Stereotype confirmation concerns (SCC) may be useful for understanding the treatment behavior of people with social anxiety. The negative, distorted image of oneself that is characteristic of socially anxious individuals [14] may include the stereotypes about the social groups to which they belong. A person with social anxiety disorder could fear acting in a way that confirms stereotypes because it may lead to her rejection and also perpetuate negative stereotypes about her social group. "
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    ABSTRACT: Background There are high attrition rates observed in efficacy studies for social anxiety disorder, and research has not identified consistent nor theoretically meaningful predictors of dropout. Pre-treatment symptom severity and demographic factors, such as age and gender, are sometimes predictive of dropout. The current study examines a theoretically meaningful predictor of attrition based on experiences associated with social group membership rather than differences between social group categories--fear of confirming stereotypes. Methods This is a secondary data analysis of a randomized controlled trial comparing two cognitive behavioral treatments for social anxiety disorder: virtual reality exposure therapy and exposure group therapy. Participants (N = 74) with a primary diagnosis of social anxiety disorder who were eligible to participate in the parent study and who self-identified as either “African American” (n = 31) or “Caucasian” (n = 43) completed standardized self-report measures of stereotype confirmation concerns (SCC) and social anxiety symptoms as part of a pre-treatment assessment battery. Results Hierarchical logistic regression showed that greater stereotype confirmation concerns were associated with higher dropout from therapy--race, age, gender, and pre-treatment symptom severity were not. Group treatment also was associated with higher dropout. Conclusions These findings urge further research on theoretically meaningful predictors of attrition and highlight the importance of addressing cultural variables, such as the experience of stereotype confirmation concerns, during treatment of social anxiety to minimize dropout from therapy.
    BMC Psychiatry 08/2014; 14(1):233. DOI:10.1186/s12888-014-0233-8 · 2.21 Impact Factor
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    • "In creating a model of the clinical presentations of these two patient groups, another critical aspect to examine is the perception of the self, as SAD is characterized by both negative self-perceptions and low self-esteem (Stopa and Clark, 1993; Clark and Wells, 1995; Smith et al., 2006; Taylor et al., 2013). In individuals with SAD, social anxiety negatively correlates with self-esteem (Clark and Wells, 1995), but this relationship is mediated by patients' perceptions regarding how they are viewed by others (Clark and Wells, 1995). "
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    ABSTRACT: Social anxiety disorder (SAD) represents a common comorbidity in schizophrenia, but questions remain regarding how this comorbidity is related to symptomatology and self-perceptions. Forty-two patients with recent-onset schizophrenia were evaluated for SAD, and assessed with the Positive and Negative Syndrome Scale (PANSS), as well as the Social Comparison Scale (SCS), which assessed how participants perceived themselves in relation with others (i.e. social rank). Eighteen patients met criteria for SAD (SZ+) while 24 patients did not (SZ-). Analysis of symptoms using a five-factor model of the PANSS revealed that the SZ- group had more severe symptoms than SZ+ on the Cognitive/Disorganization factor. Further analyses of individual symptoms demonstrated that the SZ- group was more affected in attention, abstract thinking, and cognitive disorganization (Cognitive/Disorganization symptoms), while the SZ+ group was more severely affected in anxiety, suspiciousness/persecution, and active social avoidance. Interestingly, severity of social anxiety symptom ratings correlated with certain PANSS symptoms only in the SZ- group. Perception of social rank, which was reduced in SZ+, displayed a trend level correlation with the positive symptoms in SZ-. Overall, the results suggest that SZ+ and SZ- may have different clinical profiles that could be important to consider when tailoring treatments for these patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Schizophrenia Research 04/2014; 153(1):S369-S370. DOI:10.1016/S0920-9964(14)71042-4 · 3.92 Impact Factor
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