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ABSTRACT: Social anxiety is associated with low positive affect (PA), a factor that can significantly affect psychological well-being and adaptive functioning. Despite suggestions that individuals with high levels of social anxiety would benefit from PA enhancement, the feasibility of doing so remains an unanswered question. Accordingly, in the current study, individuals with high levels of social anxiety (N = 142) were randomly assigned to conditions designed to enhance PA (Kind Acts), reduce negative affect (NA; Behavioral Experiments), or a neutral control (Activity Monitoring). All participants engaged in the required activities for 4 weeks and completed prepost questionnaires measuring mood and social goals, as well as weekly email ratings of mood, anxiety, and social activities. Both the prepost and weekly mood ratings revealed that participants who engaged in kind acts displayed significant increases in PA that were sustained over the 4 weeks of the study. No significant changes in PA were observed in the other conditions. The increase in hedonic functioning was not due to differential compliance, frequency of social activities, or an indirect effect of NA reduction. In addition, participants who engaged in kind acts displayed an increase in relationship satisfaction and a decrease in social avoidance goals, whereas no significant changes in these variables were observed in the other conditions. This study is the first to demonstrate that positive affect can be increased in individuals with high levels of social anxiety and that PA enhancement strategies may result in wider social benefits. The role of PA in producing those benefits requires further study. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Emotion 05/2012; · 3.88 Impact Factor
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ABSTRACT: Social anxiety is associated with judgmental biases, wherein individuals overestimate the probability that negative social
events will occur and the costs associated with these events. Researchers have suggested that these biases may be central
to social anxiety and treatment techniques that target judgmental biases are being evaluated (e.g. Hofmann, J Consult Clin
Psychol 72:392–399, 2004; Voncken and Bögels, J Cogn Psychother 20:59–73, 2006). The present study investigated whether judgmental
biases are specific to social anxiety or are also associated with depression. Four hundred and eighteen undergraduates completed
measures of social anxiety, depression, and judgmental bias. Hierarchical regression analyses indicated that both social anxiety
and depression make significant independent contributions to the prediction of judgmental biases. The interaction between
social anxiety and depression did not contribute significantly to prediction, suggesting that depression has an additive rather
than an interactive effect on bias. This carries potential implications for treatments that target judgmental bias and for
research on affective confounding.
Cognitive Therapy and Research 04/2012; 33(4):432-438. · 1.33 Impact Factor
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ABSTRACT: Models of self-regulation suggest that social goals may contribute to interpersonal and affective difficulties, yet little research has addressed this issue in the context of social anxiety. The present studies evaluated a hierarchical model of approach and avoidance in the context of social interaction anxiety, with affect as a mediating factor in the relationship between motivational tendencies and social goals. This model was refined in one undergraduate sample (N = 186) and cross-validated in a second sample (N = 195). The findings support hierarchical relationships between motivational tendencies, social interaction anxiety, affect, and social goals, with higher positive affect predicting fewer avoidance goals in both samples. Implications for the treatment of social interaction anxiety are discussed.
Cognitive behaviour therapy 04/2012; 41(2):174-83.
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ABSTRACT: Individuals with posttraumatic stress disorder (PTSD) are hypothesized to have a "sense of current threat." Perceived threat from the environment (i.e., external threat), can lead to overestimating the probability of the traumatic event reoccurring (Ehlers & Clark, 2000). However, it is unclear if external threat judgments are a pre-existing vulnerability for PTSD or a consequence of trauma exposure. We used trauma analog methodology to prospectively measure probability estimates of a traumatic event, and investigate how these estimates were related to cognitive processes implicated in PTSD development.
151 participants estimated the probability of being in car-accident related situations, watched a movie of a car accident victim, and then completed a measure of data-driven processing during the movie. One week later, participants re-estimated the probabilities, and completed measures of reexperiencing symptoms and symptom appraisals/reactions.
Path analysis revealed that higher pre-existing probability estimates predicted greater data-driven processing which was associated with negative appraisals and responses to intrusions. Furthermore, lower pre-existing probability estimates and negative responses to intrusions were both associated with a greater change in probability estimates. Reexperiencing symptoms were predicted by negative responses to intrusions and, to a lesser degree, by greater changes in probability estimates.
The undergraduate student sample may not be representative of the general public. The reexperiencing symptoms are less severe than what would be found in a trauma sample.
Threat estimates present both a vulnerability and a consequence of exposure to a distressing event. Furthermore, changes in these estimates are associated with cognitive processes implicated in PTSD.
Journal of behavior therapy and experimental psychiatry 03/2012; 43(3):947-51. · 2.48 Impact Factor
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Ronald M Rapee,
Jinkwan Kim,
Jianping Wang,
Xinghua Liu,
Stefan G Hofmann,
Junwen Chen,
Kyung Ya Oh,
Susan M Bögels,
Soroor Arman,
Nina Heinrichs, Lynn E Alden
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ABSTRACT: The current study compared the predicted social and career impact of socially withdrawn and reticent behaviors among participants from Western and East Asian countries. Three hundred sixty-one college students from 5 Western countries and 455 students from 3 East Asian countries read hypothetical vignettes describing socially withdrawn and shy behaviors versus socially outgoing and confident behaviors. Participants then answered questions following each vignette indicating the extent to which they would expect the subject of the vignette to be socially liked and to succeed in their career. Participants also completed measures of their own social anxiety and quality of life. The results indicated significant vignette-by-country interactions in that the difference in perceived social and career impact between shy and outgoing vignettes was smaller among participants from East Asian countries than from Western countries. In addition, significant negative correlations were shown between personal level of shyness and experienced quality of life for participants from both groups of countries, but the size of this relationship was greater for participants from Western than East Asian countries. The results point to the more negative impact of withdrawn and socially reticent behaviors for people from Western countries relative to those from East Asia.
Behavior therapy 09/2011; 42(3):485-92. · 2.85 Impact Factor
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ABSTRACT: Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants' interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD.
Behaviour research and therapy 07/2011; 49(10):665-75. · 3.00 Impact Factor
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ABSTRACT: The current study investigated the mechanism through which safety behaviors perpetuate perceived and actual negative social outcomes hypothesized to maintain social anxiety disorder (SAD). Eighty individuals diagnosed with generalized SAD took part in a "getting acquainted" conversation with a trained experimental confederate. Participants were then randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition and completed a 2nd conversation with the same interaction partner. Mediation analyses revealed that participants instructed to reduce their idiosyncratic safety behaviors displayed significantly greater increases in both perceived and actual positive interpersonal outcomes relative to the EXP group. However, whereas the safety behavior manipulation influenced participants' appraisals of their partner's reaction to them through reducing self-judgments about the visibility of anxiety-related behaviors, in reality, the SB + EXP group elicited more positive partner reactions because they displayed a greater increase in social approach behavior. Thus, although both parties recognized positive changes in the social exchange following the safety behavior manipulation, different sources of social information accounted for participant versus partner interpersonal judgments. The current findings point to the potential value of considering both the intra and interpersonal consequences of safety behaviors in SAD.
Journal of Abnormal Psychology 02/2011; 120(1):129-41. · 4.86 Impact Factor
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ABSTRACT: We incorporated strategies based on relational and interpersonal circumplex research within a standard cognitive-behavioral regimen for Generalized Social Anxiety Disorder (GSAD, Generalized Social Phobia) to determine whether these techniques increased the social approach behaviors that facilitate relationship development. Individuals seeking treatment for GSAD were randomly assigned to either the integrated interpersonal cognitive-behavioral group treatment (ICBT) or a wait list condition (WL). Results revealed that the interpersonal techniques were readily implemented by the majority of patients. ICBT produced significant increases in frequency of social approach behaviors and relationship satisfaction, in addition to GSAD symptom reductions comparable to other group CBT regimens. The current research highlights the feasibility and potential benefit of incorporating strategies based on relational and circumplex theories into cognitive-behavioral regimens for GSAD.
Journal of anxiety disorders 10/2010; 25(3):309-18. · 2.68 Impact Factor
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ABSTRACT: Two experiments were conducted to examine the link between safety behaviors and social judgments in social anxiety disorder (SAD). Safety behaviors were manipulated in the context of a controlled laboratory-based social interaction, and subsequent effects of the manipulation on the social judgments of socially anxious participants (N = 50, Study 1) and individuals meeting diagnostic criteria for generalized SAD (N = 80, Study 2) were examined. Participants were randomly assigned to either a safety behavior reduction plus exposure condition (SB + EXP) or a graduated exposure (EXP) control condition, and then took part in a conversation with a trained experimental confederate. Results revealed across both studies that participants in the SB + EXP group were less negative and more accurate in judgments of their performance following safety behavior reduction relative to EXP participants. Study 2 also demonstrated that participants in the SB + EXP group displayed lower judgments about the likelihood of negative outcomes in a subsequent social event compared to controls. Moreover, reduction in safety behaviors mediated change in participant self-judgments and future social predictions. The current findings are consistent with cognitive theories of anxiety, and support the causal role of safety behaviors in the persistence of negative social judgments in SAD.
Behaviour research and therapy 11/2009; 48(3):226-37. · 3.00 Impact Factor
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ABSTRACT: Anger and the way that anger is expressed have been linked to attrition and poorer treatment outcomes in patients with Social Anxiety Disorder (e.g., Erwin, B. A., Heimberg, R. G., Schneier, F. R. & Liebowitz, M. R. (2003). Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behavior Therapy, 34, 331-350). Understanding the connection between social anxiety and anger may be one way to improve outcomes in this population. A cross-sectional regression design was used in a sample of 363 undergraduates to examine the suggestion that ruminative thought is a critical factor linking social anxiety to anger. In support of this hypothesis, brooding fully mediated the relationship between social anxiety and trait anger and partially mediated the relationship between social anxiety and outward anger expression. The relationship between brooding and anger suppression became non-significant after depression was controlled. In contrast, reflective pondering partially mediated the relationship between social anxiety and anger suppression. These results suggest that addressing rumination may be useful in the treatment of socially anxious patients who struggle with anger. They also support the utility of considering multiple forms of rumination and multiple anger outcomes in a single study.
Behaviour research and therapy 09/2009; 47(12):1079-84. · 3.00 Impact Factor
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ABSTRACT: Structural equation modeling was used to develop and test an integrated model of how emotional and cognitive factors contribute to the development of intrusive memories after a distressing event.
The emotional constructs included preexisting emotion and emotional reactivity to the distressing event. Cognitive constructs included peritraumatic cognitive processing and maladaptive coping strategies.
Using a prospective design, 148 undergraduate students viewed a distressing film and recorded their film-related intrusive memories over the following week.
The results indicated that emotional reactivity and, to a lesser extent, preexisting emotion, predicted peritraumatic cognitive processing during the film, which in turn predicted the use of maladaptive coping strategies (i.e., rumination, thought suppression, and safety behaviors). Furthermore, emotional reactivity and maladaptive coping strategies directly predicted intrusive memories.
The observed model supported the importance of cognitive variables central to cognitive models, placing them in a broader context.
Depression and Anxiety 03/2009; 26(2):155-66. · 4.18 Impact Factor
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ABSTRACT: Patients with social anxiety disorder (SAD) not only fear social rejection, but accumulating evidence also shows that they are indeed less liked than their non-anxious counterparts. Three factors are hypothesized to play a role in this social anxiety-social rejection relationship: (1) social performance; (2) elicited negative emotions, and (3) perceived similarity.
Patients with SAD (N=63) and control participants (N=27) were observed during a 5 minutes 'getting acquainted' conversation with a male and female confederate who rated their social performance. Video-observers rated their own negative emotions and perceived similarity with the patients, while other video-observers rated their wish to engage in future contact with them (a measure of social rejection).
Analysed by way of structural equation modelling (SEM), the results supported the social anxiety-social rejection relationship. More specifically, poor social performance was associated with perceived dissimilarity ratings and mediated by evoked negative emotions, both of which were in turn associated with social rejection.
These results suggest that a sequence of events links social anxiety to social rejection. Treatment should aim to improve social performance and perceived similarity to reverse SAD's vicious, negative interpersonal cycle.
British Journal of Clinical Psychology 11/2008; 47(Pt 4):439-50. · 1.90 Impact Factor
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ABSTRACT: We examined culture-related influences on willingness to seek treatment for social anxiety in first- and second-generation students of Chinese heritage (Ns=65, 47, respectively), and their European-heritage counterparts (N=60). Participants completed measures that assessed their willingness to seek treatment for various levels of social anxiety. Results showed that participants were similar on willingness to seek treatment at low- and high-severity levels of social anxiety; however, at moderate levels, first-generation Chinese participants were significantly less willing to seek treatment compared to their European-heritage counterparts. The reluctance of first-generation Chinese participants to seek treatment was associated with greater Chinese-heritage acculturation, and was not related to perceiving symptoms of social anxiety as less impairing. The findings support the general contention that Asians in North America tend to delay treatment for mental health problems.
Cultural Diversity and Ethnic Minority Psychology 08/2008; 14(3):215-23. · 1.36 Impact Factor
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ABSTRACT: We report four independent studies that examined the relationship between social interaction anxiety and the tendency to interpret positive social events in a threat-maintaining manner. Study 1 described the development of a scale that measures negative interpretations of positive social events, the interpretation of positive events scale (IPES). Study 2 cross-validated the structure of the IPES and established that social interaction anxiety explained significant variance in negative interpretations of positive social events beyond negative affect in general. Study 3 demonstrated that negative interpretation of positive events was significantly greater in a clinical sample of patients with generalized social anxiety disorder (GSAD) than a matched group of non-anxious community controls. In addition, within the GSAD group, the IPES was associated with negative social predictions following a positive interaction. Finally, study 4 confirmed that negative interpretations of positive social events mediated the relationship between social interaction anxiety and low positive affect.
Journal of Anxiety Disorders 06/2008; 22(4):577-90. · 2.96 Impact Factor
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ABSTRACT: We compared post-traumatic stress disorder (PTSD) symptom severity and symptom cluster profiles in hospital emergency department (ED) medical staff (N=100) who experienced an emotionally distressing work event that presented either a direct threat to themselves or a witnessed threat to patients. The two groups displayed similar levels of PTSD symptoms, however, they differed on symptom profiles and work consequences. The direct threat group experienced significantly greater fear during the event, more ongoing arousal symptoms, and more job dissatisfaction than the witnessed threat group. The witnessed threat group was more likely to appraise their PTSD symptoms as reflecting personal weakness. Overall, the results point to the need for further research to identify distinctive features of responses to different types of traumatic stressors.
Journal of Anxiety Disorders 03/2008; 22(8):1337-46. · 2.96 Impact Factor
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ABSTRACT: This study examined how pre-existing emotional and personality vulnerability factors affect responses to an analogue trauma experience. Sixty-eight undergraduate participants viewed a distressing film and completed measures of trait anxiety, intelligence, depression, trait dissociation, as well as changes in state anxiety, then recorded intrusions over the following week. Results revealed that trait anxiety, depression, trait dissociation, change in anxiety, and post-state anxiety were associated with intrusion frequency. Post-state anxiety mediated the relationship between trait anxiety, depression and trait dissociation, and intrusions. Implications for PTSD theories and laboratory trauma analogue research examining specific elements of cognitive models of PTSD are discussed.
Journal of Behavior Therapy and Experimental Psychiatry 02/2008; 39(4):424-35. · 1.86 Impact Factor
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ABSTRACT: According to cognitive and interpersonal models, safety behaviors in social phobia (e.g., avoiding eye contact, hiding blushing) erroneously induce negative evaluation by interaction partners. Presumably, a bias about the social outcome of safety behaviors causes this negative interaction cycle. Such a bias might be subject to double standard in social phobia (i.e., having more stringent rules for oneself than for others). Female students (n=81) predicted more negative social outcomes for a prominent type of safety behavior, hiding anxiety, than for the opposite behavior, acknowledgment of anxiety and ongoing behavior (control condition) in scripts of self- and other-target persons. The relation between social anxiety and double standard was robust. Social anxiety did not relate to a cognitive bias regarding hiding ones anxiety, as we expected, but was associated with the belief that acknowledgment of anxiety has negative social outcomes specifically for them. These results are evaluated in light of the interpersonal consequences anxiety-related behaviors have in social interactions.
Behaviour Research and Therapy 12/2006; 44(11):1673-9. · 3.30 Impact Factor
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ABSTRACT: According to cognitive theorists, intrusive trauma memories have their origin in how information during the event is processed. Two studies investigated functional cognitive strategies during medical crises that might protect against intrusions. In Study 1, interviews with health-care professionals were used to identify cognitive strategies judged to be effective in controlling emotions and dealing with medical crises. Study 2 systematically manipulated the use of those strategies in a trauma analogue film paradigm. Experimental participants reported fewer intrusions, and less fear and avoidance of film-related stimuli during the subsequent week than controls. The manipulation did not affect anxiety during the film or memory disorganization. Implications for cognitive theories of intrusion development are discussed.
Behaviour Research and Therapy 08/2006; 44(7):925-46. · 3.30 Impact Factor
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ABSTRACT: Forty-one people with generalized social phobia (GSP) and 42 community controls completed a measure of social developmental experiences and then participated in a social interaction with an experimental assistant whose behavior was either friendly or ambiguous. Following the interaction, confederates rated participants' behavior and their desire to interact with their partner again. In people with social phobia, but not controls, perceptions of parental overprotection were associated with less responsiveness to partner behavior. Moreover, failure to reciprocate the friendly partner's behavior led to social rejection. The results support the value of incorporating social developmental concepts into cognitive-behavioral models of social phobia and highlight the contribution of social learning experiences to the development of maladaptive interpersonal behavior in these individuals.
Behavior Therapy 04/2006; 37(1):14-24. · 2.43 Impact Factor
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ABSTRACT: The current study examined how the social developmental experiences of people with generalized social phobia (GSP) affect their therapeutic relationships and treatment response. GSP patients (N = 27) completed measures of social learning experiences, and then participated in a 12-session group cognitive-behavioral treatment program. Both patients and therapists completed the Working Alliance Inventory (WAI) and rated their perceptions of each other at sessions 3 and 8. Self-reported childhood parental abuse was associated with a weaker working alliance and a more negative patient-therapist relationship. Childhood abuse also increased the risk of a poor treatment outcome, as reflected in less change in symptoms of social phobia and depression.
Journal of Cognitive Psychotherapy 02/2006; 20(1):7-16.
