Article

A Cognitive-Behavioral Model of Anxiety in Social Phobia

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

The current paper presents a model of the experience of anxiety in social/evaluative situations in people with social phobia. The model describes the manner in which people with social phobia perceive and process information related to potential evaluation and the way in which these processes differ between people high and low in social anxiety. It is argued that distortions and biases in the processing of social/evaluative information lead to heightened anxiety in social situations and, in turn, help to maintain social phobia. Potential etiological factors as well as treatment implications are also discussed.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Such attention bias may be particularly harmful. It can lead to the generation, maintenance and deterioration of social anxiety (Koster et al., 2004;Rapee & Heimberg, 1997). In addition, according to the cognitive-behavioral model of social anxiety, this pattern of attention bias seriously affects HSA individuals' inner emotional experience, social function and physiological level (Rapee & Heimberg, 1997). ...
... It can lead to the generation, maintenance and deterioration of social anxiety (Koster et al., 2004;Rapee & Heimberg, 1997). In addition, according to the cognitive-behavioral model of social anxiety, this pattern of attention bias seriously affects HSA individuals' inner emotional experience, social function and physiological level (Rapee & Heimberg, 1997). For example, the study of Gupta et al. (2019) has suggested that attention bias towards threatening stimuli in HSA individuals is a potentially important mechanism for maintaining early maladaptive emotional characteristics, leading to a high risk of clinical social anxiety disorders later in life. ...
... Our reduced P100 amplitudes for dynamic angry-neutral face pairs might be due to due to the fact that AMP group individuals' inhibition for early visual processing of threatening stimuli. Cognitive-behavioral model of social anxiety suggested that HSA individuals had an attention bias towards threatening stimuli at the early stage of emotional processing (Rapee & Heimberg, 1997). Based on previous literature (Helfinstein et al., 2008;Li et al., 2017), we could argued that ABM improved HSA individuals' early visual emotional processing, resulting in these individuals' inhibition for dynamic angry-neutral face pairs. ...
Article
Full-text available
Attention bias modification (ABM) is an intervention technique that reduces attention bias towards negative stimuli and improves anxiety symptoms. We examined the effect of attention bias modification towards dynamic-angry faces on various indices potentially related to social anxiety. Forty-eight participants with high social anxiety (HSA) were randomly divided into the attention modification program (AMP, n = 24) and attention control condition (ACC, n = 24). They were assessed by behavioral and event-related potential (ERP) methods in pre- and post-test. For results, ABM reduced social anxiety symptoms, changed the mean amplitudes of P100. Besides, we observed a significant correlation between the behavioral and ERP training effect. In sum, this study could provide evidence of the ABM effect of dynamic-angry face processing in HSA individuals.
... The detrimental consequence of this fear is a development of cognitive bias that others will recognize imperfections in an individual's appearance or behavior. Such bias may stimulate heightened social anxiety leading to social avoidance of perceived negative interactions (Carter et al., 2012;Rapee & Heimberg, 1997;Weeks et al., 2010). Individuals with elevated fear of positive evaluation tend to feel more apprehensively self-conscious and socially incomparable to others (Weeks et al., 2008). ...
... Despite extensive evidence for significant psychosocial dysfunction and biased social cognition in mood disorders (Caouette & Guyer, 2016;Schulz et al., 2008), fears of positive and negative evaluation were not examined in the context of these disorders. Instead, previous studies mostly focused on understanding the fear of positive evaluation (Fergus et al., 2009;Fredrick & Luebbe, 2020), and negative evaluation (Rapee & Heimberg, 1997;Rodebaugh et al., 2004) in the context of social anxiety disorders (SAD). Considering that fear of evaluation may be related to other mental illnesses (Downey & Feldman, 1996) and that fear of social rejection is a risk factor for developing depression (Kumar et al., 2017;Slavich et al., 2010), it is critically important to examine the relationship between mood disorders and the fear of evaluation. ...
... previous findings of the relationship between anxiety and fear of negative evaluation (Rapee & Heimberg, 1997;Watson & Friend, 1969) and fear of positive evaluation (Fredrick & Luebbe, 2020;Weeks et al., 2008Weeks et al., , 2010, we evaluated the relationship between trait anxiety (STAIY2 scores) and fears of positive and negative evaluation. In one set of models, trait anxiety was used as an additional covariate, while in the other set of models, trait anxiety was used as a third interaction term in the model described in Section 2.3.1. ...
Article
Full-text available
Fear of positive and negative evaluation is maladaptive and may result in psychosocial dysfunction. Although being diagnosed with mood disorders or experiencing childhood trauma may potentially affect fear of evaluation, previous studies examined this phenomenon mostly in social anxiety disorders. To fill this gap, we investigated the relationship between childhood trauma and fear of positive and negative evaluation in individuals with bipolar disorder (BD), depressive disorders (DD), and healthy controls (HC). 43 individuals with BD, 89 with DD, and 65 HC completed clinical interviews and self-report assessments. The relationship between participants' diagnoses and presence of trauma on fear of positive and negative evaluation was examined using ANCOVA. Independently of experiencing childhood trauma, fear of positive evaluation was significantly higher in individuals with mood disorders vs. HC. Fear of negative evaluation was significantly associated with diagnosis-by-trauma interaction. Significantly lower scores were observed in individuals with BD without childhood trauma compared to those with childhood trauma and individuals with DD. Compared to HC, more individuals with mood disorders experienced childhood trauma. While experiencing childhood trauma may increase vulnerability to mood disorders in general, it is especially detrimental for individuals with BD by increasing the risk for developing a fear of negative evaluation.
... The combined impact of attentional and interpretation biases is likely to increase perceptions of social threat, and prevent disconfitmation of socioevaluative concerns. Rapee and Heimberg (1997) Rapee and Heimberg's (1997) model proposes that a social situation triggers a series of processes that generate and maintain social phobia. According to the model, when someone with Social phobia encounters a social situation, they form a mental representation of their external appearance and behaviour, as seen by others. ...
... The combined impact of attentional and interpretation biases is likely to increase perceptions of social threat, and prevent disconfitmation of socioevaluative concerns. Rapee and Heimberg (1997) Rapee and Heimberg's (1997) model proposes that a social situation triggers a series of processes that generate and maintain social phobia. According to the model, when someone with Social phobia encounters a social situation, they form a mental representation of their external appearance and behaviour, as seen by others. ...
... As in Clark and Wells' (1995) model, this mental representation is based on information retrieved from negatively biased memories of past social situations, shaped by dysfunctional assumptions, and internal cues (e. g., physiological symptoms). However, consistent with revised predictions from Clark and McManus (2002), Rapee and Heimberg (1997) emphasise the importance of external audience feedback (e. g., others' facial expressions) in . the construction of this mental representation. ...
Thesis
p>Recent cognitive theories of social phobia suggest that the enduring nature of the disorder may result from the biased processing of information within feared social situations. It is important for health care professionals involved in treatment of social phobia to understand the information processing biases which maintain this disorder, in order to guide interventions. This thesis critically reviews models of threat processing in anxiety (e.g., Mogg & Bradley, 1998), cognitive models of social phobia (Clark & McManus, 2002); Rapee & Heimberg, 1997) and empirical evidence of information processing biases in anxiety disorders. Specific predictions regarding selective attention to stimuli of varying emotional intensity and interpretation of ambiguity in social phobia are examined. In the present study individuals with a diagnosis of generalised social phobia, and non-socially phobic controls completed a modified visual probe task that measured attention allocation to angry, happy and fearful expressions of varying emotion intensities (25%, 50%, 75% 100%). Participants subsequently classified ambiguous emotional faces blended from two component prototype emotional expressions: angry-happy, happy-fear and fear-angry. Measures of emotion recognition accuracy and response bias were computed for each of the three emotion-combinations. Individuals with social phobia demonstrated a significant attentional bias towards expressions of strong (100%) emotional content, irrespective of type of emotion, relative to controls. However, the social phobia and control groups did not differ in their sensitivity to correctly classify ambiguous expressions, or in their tendency to classify a presented face as angry, happy or fearful. Findings are considered in light of evidence from other studies of attention and interpretive bias, and possible implications for models of threat processing are discussed.</p
... Cognitive models of social phobia, propose that on entering a social situation individuals with social phobia become self-focused and use internal processing to generate a negative impression of their public self Rapee & Heimberg, 1997). This impression takes the form of a felt sense or a visual image, often seen from an observer perspective. ...
... Given that the content of SF A rather than the process is important in determining the specific negative affect associated with psychopathological disorders, understanding the interaction between the process and content would aid our conceptualisation of a number of disorders. Cognitive models of social phobia propose that SF A plays a crucial role in maintaining social anxiety Rapee & Heimberg, 1997). These models suggest that on entering a social situation individuals with social phobia become self-focused and use internal processing to generate an impression of their public self. ...
... These models suggest that on entering a social situation individuals with social phobia become self-focused and use internal processing to generate an impression of their public self. This impression can take the form of a mental representation ofthe self as seen by the audience (Rapee & Heimberg, 1997) and a felt sense or a visual image seen from the perspective of observer . This review will consider the role of SFA in social phobia; ...
Thesis
p>Cognitive models of social phobia, propose that on entering a social situation individuals with social phobia become self-focused and use internal processing to generate a negative impression of their public self (Clark & Wells, 1995; Heimberg, 1997). This impression takes the form of a felt sense or a visual image, often seen from an observer perspective. This impression is used to infer self-image and as it is usually distorted increases anxiety and impacts on evaluation of performance. Research supports the contention that self-focused attention has a negative impact on thinking, anxiety and evaluation of performance, and that socially anxious individuals experience negative self-images, seen from an observer perspective, particularly in high anxiety producing social situations. The current study tested the effects of self-focused attention on perspective taking, mental representations of the self, anxiety, shame, and evaluation of performance, with high and low socially anxious individuals in a social and a non-social task. The results indicate that high socially anxious participants reported more negative images and worse evaluation of performance than low socially anxious participants, however there was no difference in perspective taking, anxiety and shame between the groups in the social task. All participants spent a greater proportion of time in the observer perspective, reported more anxiety and shame and underrated their performance in the social task. Results partially support the cognitive models hypotheses; however it was demonstrated that for some variables self-focused attention has a causal effect in social anxiety irrespective of anxiety status.</p
... Cognitive models of social phobia have highlighted the role of dysfunctional beliefs regarding the perceived threat inherent in social situations (with the primary threat stimulus being an audience, and the primary threatening outcome being negative evaluation from the audience) in the maintenance of the disorder (e.g. Beck, Emery, & Greenberg, 1985;Clark & Wells, 1995;Hope, Rapee, Heimberg, & Dombeck, 1990, Rapee & Heimberg, 1997. ...
... Moreover, individuals with social phobia attach fundamental importance to being positively appraised by others; yet experience marked insecurity regarding their ability to convey a favourable impression of themselves to others. As a consequence, individuals with social phobia believe that their social behaviour will have a detrimental outcome regarding loss of worth, loss of status, and rejection (Clark & Wells, 1995;Rapee & Heimberg, 1997). ...
... The model describes the manner in which people with social phobia perceive and process information related to potential evaluation and the way in which these processes differ between people who are high and low in social anxiety. Rapee and Heimberg (1997) hypothesise that these processes are essentially similar regardless of whether a social! evaluative situation is actually encountered, anticipated, or ruminated upon. ...
Thesis
p>The Clark and Wells (1995) model of social phobia conceptualises post-event processing as one of four processes in the maintenance of this disorder. According to Clark and Wells (1995), post-event processing involves a review of events following a social interaction, during which individuals with social phobia dwell on anxious feelings and negative cognitions relating to their self-perception. As a consequence, the social situation is appraised negatively, subsequently exacerbating anxiety and lowering anticipation for success in future social situations. The literature review examines the limited empirical evidence for the role of post-event processing in the maintenance of social phobia, and considers literature from a number of theoretical perspectives that may serve to further understanding of the function of post-event processing. These include attention and memory bias, imagery and the observer perspective, rumination in depression, and emotional processing. The empirical study investigated the relationship between self-appraisals of performance and the frequency and valence of post-event processing in individuals high and low in social anxiety. Following a conversation with an unknown individual, high socially anxious individuals experienced more anxiety, predicted worse performance, underestimated actual performance, and engaged in more post-event processing than low socially anxious participants. The degree of negative post-event processing was linked to both the extent of social anxiety and negative appraisals of performance both immediately after the conversation task and one week later. Differnces were also observed in some metacognitive processes. The results replicate previous research findings and provide further support for Clark and Wells’ (1995) conceptualisation of post-event processing.</p
... Clark and McManus (2002) extended predictions from Clark and Wells (1995), and proposed that social phobics will: interpret ambiguous events negatively; have a bias towards detecting negative social responses; have a reduction in resources to process external cues; selectively recall negative information and undertake protracted post-event processing. Rapee and Heimberg (1997) also presented a cognitive model of social phobia (see figure 2), which shares some similarities with the Clark and Wells model.. When in a social situation the authors predicted that a person with social phobia will generate a distorted image of their appearance. ...
... This elicits anxiety and therefore feeds into the mental representation of self and hence creates a vicious cycle. (Rapee & Heimberg, 1997). ...
... It has been suggested in cognitive theories of social phobia that people with social anxiety appraise social cues with a negative bias (Clark & McManus, 2002;Rapee & Heimberg, 1997). The nature of the appraisal bias has been further specified by Mogg and Bradley (1998) in their description of the valence evaluation system as pre-attentive and operating outside of conscious awareness. ...
Thesis
p>This thesis addresses biases in appraisal that are thought to contribute to the development and maintenance of social anxiety. The literature review outlines several theories of anxiety, before focussing on cognitive theories of social anxiety which predict that individuals with social anxiety have a bias in threat appraisal. Contemporary cognitive-motivational and neurocognitive theories of anxiety are then detailed and their relevance to social anxiety is described. Recent theories make efforts to integrate cognitive theory of appraisal with functional neuroanatomy, proposing that the amygdala is involved in threat appraisal. Research has provided support for the presence of appraisal biases in social anxiety and recent neuroimaging evidence suggests that threat appraisal of social cues is associated with potentiation of the amygdala in social anxiety. The utility of the startle response, in further investigating the predictions of the neurocognitive theory is described. The empirical paper investigates the predictions of neurocognitive theory that sub-cortical appraisals of social cues are associated to potentiated amygdala response. The startle response, a behavioural index of sub-cortical appraisal, was used to investigate response to social cues (neutral and fear faces) and non-social fear cues (light and dark patches) in individuals high and low in social anxiety (HSA vs. LSA). It was found that both groups had a potentiated startle response to the dark condition compared to the light and face conditions and there were no group differences in the response to social cues contrary to theoretical predictions. The findings are discussed in relation to theory and previous research findings.</p
... These findings provide some support for current cognitive models of social phobia Rapee & Heimberg, 1997) and suggest the need for an understanding of both the content of cognition and the different kinds of dynamic, cognitive processing styles, namely, metacognitive and looming, that give the content of cognition its significance or salience. ...
... Current cognitive theories of social phobia incorporate factors such as cognitive schemas, selective attention, and retrieval of information, and distorted processing of the self before, during, and after social situations. Two highly influential contemporary cognitive theories of social phobia are those developed by Clark and Wells (1995; also see Clark, 2001 andClark &McManus, 2002) and Rapee and Heimberg (1997;Turk, Lerner, Heimberg, & Rapee, 2001). These two theories were developed to explain why social phobia is maintained despite repeated exposure to social situations. ...
... Clark (2001) suggests that socially phobic individuals engage in a number of safetyseeking behaviours in order to reduce or prevent feared catastrophes from happening. Rapee and Heimberg (1997) refer to these as "subtle behaviours" (p. 750). ...
Thesis
p>This thesis examined socially anxious individuals’ biases in anticipatory processing, perspective-taking, self-focused attention, intensifying danger or threat, which may be construed as ‘loomingness’, and metacognitive knowledge or beliefs. Experiment 1 examined the effects of anticipatory processing on a subsequent speech in high and low socially anxious individuals ( N = 40). In anticipation, high socially anxious individuals were more anxious and experienced more negative and unhelpful self-images than low socially anxious individuals. They also tended to use the observer perspective more in an anticipated speech, while in an unanticipated speech, they may have been switching between observer and field perspectives. Low socially anxious individuals tended to use the field perspective in both speeches. Experiment 2 explored using a qualitative approach, the phenomenology of anticipatory processing in high socially anxious individuals ( N = 11). Thematic analysis of coded interviews revealed seven broad deductive themes : (1) prior preparation; (2) catastrophic thoughts; (3) recollection of past similar social events; (4) impressions; (5) self-images; (6) avoidance of social situations; and (7) physical symptoms of anxiety; and three Inductive themes : (1) bad dreams and nightmares; (2) biased estimates in intensifying threat; and (3) metacognitives. Experiments 3 and 4 used the same sample of volunteers ( n = 152) to explore the relationship between looming vulnerability and metacognition, respectively, and social anxiety. In Experiment 3, volunteers completed the Looming Maladaptive Style Questionnaire-Two, which assessed social and physical looming. In Experiment 4, volunteers completed the Thought Control Questionnaire, the Metacognitions Questionnaire-30 (MCQ-30), and the Cognitive Self-Consciousness Scale-Expanded. Experiment 5 used two concepts developed in social psychology, that is, the spotlight effect and the illusion of transparency, to help explain the types of processes that might contribute to the construction of the self as a social object in social anxiety. Participants ( N = 60) performed a memory task under either a high or a low social-evaluation condition. Findings provide some support for current cognitive models of social phobia (Clark & Wells, 1995; Rapee & Heimberg, 1997) and suggest the need for an understanding of both the content of cognition and the different kinds of dynamic, cognitive processing styles, namely, metacognitive and looming, that give the content of cognition its significance or salience.</p
... Interestingly Clark and Wells (1995) and Rapee and Heimberg (1997) developed a model of social phobia in which both the allocation of attentional resources and the evaluation of stimuli are taken into account. In Clark and Wells's (1995) model it is hypothesised that in social phobic individuals, attentional allocation away from external cues is biased in favour of detecting from others cues that can be interpreted negatively. ...
... The authors argue that the individuals are placing their attentional resources to their self image. In Rapee and Heimberg's (1997) model it is hypothesised that in social phobic individuals, both attentional allocation towards and away external stimuli is biased in favour of detecting potential social threats such as frowns or signs of boredom as negative. The authors argue that the individuals are placing their attentional resources to both their self image and potential external threats (i.e. ...
... frowns).ln fact Rapee and Heimberg (1997) considered external cues as crucial in the individual's reinforcement of negative interpretations about social encounters. Although the models differ in the explanation of attentional processes linked to social phobia they both suggest that the evaluation of external stimuli as negative may contribute to social phobia. ...
Thesis
p>The thesis investigates cognitive and family factors linked to childhood anxiety in a non-referred population taking a developmental approach. It examines whether children with symptoms of anxiety exhibit a threat-related cognitive bias. Attentional and interpretive biases are specifically looked at. It also examines maternal variables that would be influential to the child’s levels of anxiety. Maternal parenting behaviours, maternal mental health and maternal beliefs and attitudes towards the child are specifically looked at. Cognitive and maternal factors are integrated in the explanation of childhood anxiety. Whether links between maternal factors and childhood anxiety are mediated by the development of biased cognitive styles is explored. A total of 129 children aged 7-14 years and their mothers participated in the study. Children are assessed on cognitive tasks tapping into attentional and interpretive biases. Their levels of anxiety are assessed with questionnaire reports completed by themselves and their mothers. Maternal parenting behaviours and maternal mental health variables are assessed with questionnaire reports completed by the mothers. Maternal beliefs and attitudes towards the child are assessed with the Expressed Emotion index following five minute interviews. The results show that children with symptoms of anxiety exhibit a threat-related cognitive bias. In support of developmental theories of cognition and anxiety, threat-related attentional biases (Abs) emerged for children aged over 10 years. The results also single out maternal variables that are contributing to a child’s anxiety. The association between maternal parenting behaviours or maternal beliefs and attitudes and a child’s anxiety however is shown to not be consistent. In contrast maternal depression is found to be consistently associated with a child’s symptoms of separation anxiety independent of the age of the child. Support for a cognitive mediated pathway in which threat-related ABs are partially mediating a link between maternal overprotection and a child’s separation anxiety is found. These findings add to developmental models of childhood anxiety.</p
... Recent cognitive models propose a variety of information processing biases considered to play a key role in the etiology and maintenance of social phobia (e. g. Clark & Wells, 1995;Rapee & Heimberg, 1997). The present thesis examined high and low socially anxious individuals' biases in attention, appraisal, interpretation andjudgment, when processing external social cues (facial expressions). ...
... While a detailed review of the empirical limitations of schema and network theories is beyond the scope of the present thesis, the observation that information processing biases do not appear to operate consistently across the whole range of emotional disorders highlights limitations with the early cognitive theories of Beck and Bower (reviews by Williams, Watts, Macleod, & Mathews, 1988;Williams, Watts, Macleod, & Mathews, 1997). As a result, over recent years, a variety of cognitive models outlining the threatprocessing biases common to anxiety disorders (Williams et at., 1988;Eysenck, 1992;Williams et al., 1997;Mathews & Mackintosh, 1998) and specifically related to social phobia have been developed (Clark & Wells, 1995;Wells & Clark, 1997;Rapee & Heimberg, 1997;Clark & Wells, 1999;Clark, 2001). Williams, Watts, MacLeod and Mathews (1988) Williams et al. (1988 propose that different emotional disorders are associated with different patterns of cognitive bias. ...
... A recent cognitive model of social phobia proposed by Rapee and Heimberg (1997) whilst sharing certain features with the model proposed by Clark and Wells (1995) also makes several important theoretical distinctions. ...
Thesis
p>Recent cognitive models propose a variety of information processing biases considered to play a key role in the etiology and maintenance of social phobia (e.g. Clark and Wells, 1995; Rapee and Heimberg, 1997). The present thesis examined high and low socially anxious individuals’ biases in attention, appraisal, interpretation and judgement, when processing external social cues (facial expressions). Experiments 1 and 2 monitored eye-movements to pictures of faces and objects in high socially anxious and low socially anxious individuals. Under no-stress conditions (Experiment 1), high socially anxious individuals initially directed their gaze towards neutral faces, relative to objects, more often than low anxious individuals. However, under social-evaluative stress (Experiment 2), high socially anxious individuals showed reduced biases in initial orienting and maintenance of gaze on faces (cf. objects), compared with the low anxious participants. High socially anxious individuals were also relatively quicker to look at emotional faces than neutral faces, but looked at emotional faces for less time, compared with low socially anxious individuals. In a third experiment (Experiment 3, task 1), participants’ general tendency initially to orient towards and maintain attention for longer on a variety of social cues (angry, happy and neutral faces) relative to non-social cues (objects) was unaffected by social anxiety group. However, reduced maintenance of attention on face cues in general, relative to non-social cues was demonstrated in high compared to low socially anxious individuals in Experiment 4. Results from a modified visual probe task (Experiment 5 task 1) provided no evidence of selective attention in either social anxiety group. In Experiments 3 and 4, explicit (valence and arousal ratings) and implicit (EAST, startle magnitude, skin conductance) measures of stimulus appraisal for social relative to non-social cues were unaffected by social anxiety group (Exp. 3,4). However, high socially anxious individuals negatively rated and produced greater startle amplitude in response to all face/object cues compared to low anxious individuals in Experiment 4. Using a modified illusory correlation paradigm (Experiment 5, task 2), low socially anxious individuals demonstrated a relatively persistent tendency to over-associate positive social cues with pleasant outcomes. High socially anxious lacked this positive bias, and instead were biased in selectively recalled negative social cues. Finally, in a novel emotion classification paradigm (Experiment 5, task 3), high socially anxious individuals tended to interpret ambiguous (computer manipulated) emotional facial expressions in a negative fashion. Results provide evidence of biases in various aspects of processing in social anxiety: reduced attention to external social cues; enhanced detection and recall of negative social cues; and negative inferential processes. These findings provide some support for recent cognitive models that emphasise the role of these biases in maintaining the concerns of individuals with social phobia.</p
... This creates ambiguous social cues, requiring accurate and unbiased interpretation in order to select effective behavioral and affective responses. Misclassifying or misinterpreting facial emotional expressions as negative, critical or disapproving can contribute to the maintenance of SAD symptoms and could form a target for intervention (Rapee & Heimberg, 1997;Schulz et al., 2013). ...
... Instead, we expected that children with SAD would display a negative interpretation bias in the processing of ambiguous emotional expressions. The interpretation bias should be particularly strong for anger because it is the emotion that conveys rejection and social threat most strongly (Philippot & Douilliez, 2005), 1 and has therefore been the main focus of similar research into social anxiety and emotional processing (e.g., Broeren et al., 2011), in line with cognitive SAD models (Rapee & Heimberg, 1997). However, cognitive models of anxiety disorders in general suggest that anxiety is characterized by sensitivity to general threat, e.g., physical attacks, which can also be conveyed by angry faces (D. A. Clark & Beck, 2010). ...
... Although cognitive models of SAD specifically predict a negative bias in response to stimuli that possibly convey negative evaluations (D. M. Clark & Wells, 1995;Rapee & Heimberg, 1997), cognitive models on general anxiety predict a negative bias for all anxiety subtypes in response to (physical) threat (Clark & Beck, 2010). The latter would have been supported by differences between the anxious groups and the non-anxious group. ...
Article
Objective: The current study examined whether children with a social anxiety disorder (SAD) demonstrate divergent facial emotion processing and a disorder-specific negative interpretation bias in the processing of facial emotional expressions. This study aimed to overcome previous study limitations by including both a nonsocially anxious control group and a healthy control group to examine whether childhood SAD is characterized by a general emotion labeling deficit, and/or by a negative interpretation bias, indicated by systematic misclassifications, or a lower threshold for recognizing threatening emotions. Method: Participants were 132 children aged 7-12 years (Mage = 9.15; 45.5% female). Children with SAD (n = 42) were compared to children with other, nonsocial, anxiety disorders (n = 40) and healthy control children (n = 50) on a novel facial emotion recognition task. Children judged ambiguous happy/neutral, angry/neutral and fear/neutral faces that were morphed at different intensities (10%, 30%, 50%, 70%). Results: Children with SAD did not differ from other groups in their accuracy of identifying emotions. They did not show systematic misclassifications or a heightened sensitivity to negative, threatening faces either. Rather, children with nonsocial anxiety disorders showed a generally heightened sensitivity to emotional faces. Conclusions: The current study does not provide evidence for a general deficit in labeling of emotional faces in childhood SAD. Childhood SAD was not characterized by an interpretation bias in processing emotional faces. Children with nonsocial anxiety disorders may benefit from assistance in accurately interpreting the degree of emotionality in interpersonal situations.
... Although aetiological models of SoAD have been proposed [e.g., 16], there are currently no theoretical models describing the factors involved in the maintenance of SoAD in children and young people. In contrast, there are a number of theoretical maintenance models of adult social anxiety disorder that have been extensively evaluated [e.g., 17,18]. Strong empirical support for these models has led to the development of novel treatment programs that target the unique maintenance processes, such as the individual's negative view of the self, self-focused attention, overestimation of cost, safety behaviours, and excessive post-event rumination. ...
... Adult disorder-specific programs also include the use of video feedback, so that the client is able to obtain more realistic information about performance in social situations. Consistent with this idea, adult programs target the individual's mental representation of themselves, incorporating feedback not only from video footage but also from other people, suggesting this may be more effective than only using cognitive restructuring to alter the client's selfperception [18]. ...
... The reduction of safety behaviours is another key component of adult SoAD CBT programs given individuals with social anxiety engage in specific safety behaviours to minimise the perceived risk of negative evaluation (such as avoiding eye contact). These subtle safety behaviours not only prevent the individual from gathering evidence to disconfirm their fears, but also tend to result in poorer social performance, thus exacerbating and maintaining the individual's negative self-perception [18]. To combat this, gradual exposure tasks are performed without using the maladaptive behaviours. ...
Article
Full-text available
Cognitive behavioural therapy is the first line of treatment for social anxiety disorder; however, children with social anxiety disorder do not respond as well to generic cognitive behavioural therapy programs, compared to children with other anxiety disorders. The aim of the study was to provide a preliminary examination of the efficacy and applicability of a new disorder specific intervention for children with social anxiety disorder. Five children aged 7–13 years, with a primary or secondary DSM-5 diagnosis of social anxiety disorder were provided with an adapted version of the Cool Kids anxiety program. Three out of the five children were in remission from social anxiety disorder at the end of the intervention and at 3-month follow-up. Statistically significant improvements were also noted in overall anxiety symptoms and functioning. Preliminary evidence was found for the efficacy of a social anxiety version of the Cool Kids program.
... According to the cognitive behavioral models of SAD (Clark and Wells, 1995;Rapee and Heimberg, 1997;Hofmann and Otto, 2008), self-focused attention, cost/probability bias, and avoidance behavior are maintaining and exacerbating factors of social anxiety. Self-focused attention refers to the perception of internal self-related information, such as body state, thoughts, feelings, and behaviors in threatening social situations (Bögels et al., 1996;Noda et al., 2021a). ...
... Individuals with high selffocused attention have a higher degree of social anxiety symptoms than those with low self-focused attention (Noda et al., 2021a). Furthermore, heightened self-focused attention increases negative cognitions such as cost/probability bias, and contributes to the exacerbation of social anxiety and avoidance behavior (Clark and Wells, 1995;Rapee and Heimberg, 1997;Hofmann and Otto, 2008). ...
... Based on the above hypotheses, we constructed Model A (Figure 1). Selffocused attention has been emphasized as being associated with cognitive maintaining factors in SAD (Clark and Wells, 1995;Rapee and Heimberg, 1997;Hofmann and Otto, 2008), but manipulation of self-focused attention has been reported to improve social anxiety (Bögels, 2006). Thus, we assumed a path from self-focused attention bias to social anxiety and constructed Model B (Figure 2) by adding that path to Model A. Furthermore, Calamaras et al. (2015) reported that probability bias has a direct positive impact on social anxiety. ...
Article
Full-text available
Self-focused attention, cost/probability bias, and avoidance behavior are maintaining factors for social anxiety. In particular, cost bias and avoidance behavior predict social anxiety. It has been shown that the enhancement of trait mindfulness improves these maintaining factors. This study examines the relationships among trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety, and clarifies whether they mediate the relationship between trait mindfulness and social anxiety. A cross-sectional design was used to examine the relationships among these variables. Participants were recruited from three universities in Japan (January 2019–December 2019). Undergraduate students (N = 367) completed a set of self-report measures assessing trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Results of path analyses revealed that the hypothesized model’s goodness-of-fit indices had high values. Trait mindfulness showed a direct negative association with self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Moreover, trait mindfulness was negatively associated with social anxiety via self-focused attention, cost/probability bias, and avoidance behavior. These findings indicate that mindfulness plays an important role in social anxiety and provide impetus for future research involving clinical studies of mindfulness-based interventions for social anxiety.
... It is important to note that standard approaches to social anxiety, such as Clark and Well's (1995) or Rapee & Heimberg's (1997) models that are recommended by the National Institute for Health and Clinical Excellence (NICE, 2013) are not wholly appropriate for this population due to the very real discrimination and prejudice that they experience from other people (Thompson & Kent, 2001) and due to the impact that their visible difference has on their own body image and associated sense of stigma (Sharratt et al, 2020). However, the Face IT model broadly follow the active elements of intervention that are included within Rapee & Heimberg's (1997) These elements are also the key focus for cognitive restructuring whereby individuals with visible differences may assume, in some cases wrongly, that they are experiencing prejudice from other people (Zuchelli et al, 2021). ...
... It is important to note that standard approaches to social anxiety, such as Clark and Well's (1995) or Rapee & Heimberg's (1997) models that are recommended by the National Institute for Health and Clinical Excellence (NICE, 2013) are not wholly appropriate for this population due to the very real discrimination and prejudice that they experience from other people (Thompson & Kent, 2001) and due to the impact that their visible difference has on their own body image and associated sense of stigma (Sharratt et al, 2020). However, the Face IT model broadly follow the active elements of intervention that are included within Rapee & Heimberg's (1997) These elements are also the key focus for cognitive restructuring whereby individuals with visible differences may assume, in some cases wrongly, that they are experiencing prejudice from other people (Zuchelli et al, 2021). The use of social skills is also of fundamental importance to ensure a reduction in the safety behaviours that individuals with visible differences often display that can lead to increased staring (Partridge, 1994). ...
Article
To increase access to support, an online psychosocial support tool for adults with visible differences was adapted for use without referral or supervision. This intervention combines a cognitive behavioural and social skills model of support. This study aimed to assess the usability and acceptability of FaceIT@home as a self-help intervention. Eighty-one participants were recruited (32 with visible differences). Stage one included 14 participants (11 female, all with visible differences) who viewed two sessions of FaceIT@home and undertook a semi-structured telephone interview. Stage two consisted of 14 think-aloud sessions (13 female, none with visible differences) with participants, supervised by researchers. Stage three employed 53 participants (47 female; 19 with visible differences), to view one session of FaceIT@home and complete an online survey to evaluate usability and acceptability. User interviews, think-aloud studies and questionnaires identified usability and acceptability factors of FaceIT@home that make it fit for purpose as a self-help tool. Participants suggested some changes to the FaceIT@home program to improve usability. Participants reported that FaceIT@home was a useful tool for people with visible differences and could be effective. The CBT-based model was considered a useful approach to addressing psychosocial concerns. The online self-help format will increase access to psychological support for adults with visible differences.
... Our finding is at odds with the tendency of individuals with social anxiety to continually monitor the environment for signs of potential negative evaluations by others, and with studies on objective measures of olfactory processing, in which social anxious individuals have been associated with enhanced startle reactivity (Pause et al., 2009) and faster processing of social odor anxiety signals compared to healthy controls (Pause et al., 2010). A possible explanation of the observed conflicting findings of this study could arise from the fact that with self-report questionnaires we focused specifically on the cognitive/behavioral domain of social anxiety, whereas studies analyzing the physiological responses toward social odors focused on the physical domain (Rapee and Heimberg, 1997). Several models (e.g., Clark and Wells, 1995;Hartman, 1983;Hope et al., 1990;Rapee and Heimberg, 1997) propose that, at a cognitive level, social anxiety is associated with increased self-focus attention, rather than external attention to social cues. ...
... A possible explanation of the observed conflicting findings of this study could arise from the fact that with self-report questionnaires we focused specifically on the cognitive/behavioral domain of social anxiety, whereas studies analyzing the physiological responses toward social odors focused on the physical domain (Rapee and Heimberg, 1997). Several models (e.g., Clark and Wells, 1995;Hartman, 1983;Hope et al., 1990;Rapee and Heimberg, 1997) propose that, at a cognitive level, social anxiety is associated with increased self-focus attention, rather than external attention to social cues. For instance, Mellings and Alden (2000) reported that socially anxious individuals focused their attention more on themselves than on their partner during social interaction. ...
Article
Background Diminished olfactory functioning has been reported in depression, whereas evidence in anxiety disorders is still controversial. Olfactory meta-cognitive abilities (i.e., olfactory awareness, imagery and reactivity, and the importance of odors) are essential in shaping olfaction. Few studies examined these meta-cognitive abilities in relation to depressive, anxiety, and social anxiety symptoms, and none of them considered the awareness of social odors (i.e., body odors). Methods This pre-registered study examined the relationship between olfactory meta-cognitive abilities and symptoms of depression, general anxiety, and social anxiety in 429 individuals. Self-report measures of symptoms of depression, general anxiety, and social anxiety, along with self-report olfactory meta-cognitive scales, were collected using an online survey. Results Linear regression analyses revealed that olfactory awareness and importance of common odors were significantly directly predicted by symptoms of general anxiety, while affective importance to odors was negatively predicted by symptoms of depression. Regarding social odors, higher symptoms of depression and lower symptoms of social anxiety predicted increased awareness. Limitations Higher prevalence of women and narrow age range of the participants. Depressive and anxiety symptoms were assessed only with self-report questionnaires. Conclusions Symptoms of anxiety seem to be associated with higher levels of common odor awareness, corroborating the importance of olfactory functions in anxiety. In addition, results on social odors seem to reflect dysfunctional social behaviour that characterized symptoms of depression and social anxiety. Hence, the assessment of meta-cognitive abilities may represent a useful tool in the prevention and assessment of depressive, anxiety, and social anxiety symptoms.
... Several distinct attentional profiles have been implicated. These include attentional hypervigilance to social evaluative cues (Rapee & Heimberg, 1997), attentional avoidance (Cisler & Koster, 2010), self-focused attention (Clark & Wells, 1995), attentional switching between internal and external social-evaluative threat cues (Rapee & Heimberg, 1997) and attentional hyperscanning (Chen et al., 2015). ...
... Several distinct attentional profiles have been implicated. These include attentional hypervigilance to social evaluative cues (Rapee & Heimberg, 1997), attentional avoidance (Cisler & Koster, 2010), self-focused attention (Clark & Wells, 1995), attentional switching between internal and external social-evaluative threat cues (Rapee & Heimberg, 1997) and attentional hyperscanning (Chen et al., 2015). ...
Article
Biased attention to social threats has been implicated in social anxiety disorder. Modifying visual attention during exposure therapy offers a direct test of this mechanism. We developed and tested a brief virtual reality exposure therapy (VRET) protocol using 360°-video and eye tracking. Participants (N = 21) were randomized to either standard VRET or VRET + attention guidance training (AGT). Multilevel Bayesian models were used to test (1) whether there was an effect of condition over time and (2) whether post-treatment changes in gaze patterns mediated the effect of condition at follow-up. There was a large overall effect of the intervention on symptoms of social anxiety, as well as an effect of the AGT augmentation on changes in visual attention to audience members. There was weak evidence against an effect of condition on fear of public speaking and weak evidence supporting a mediation effect, however these estimates were strongly influenced by model priors. Taken together, our findings suggest that attention can be modified within and during VRET and that modification of visual gaze avoidance may be casually linked to reductions in social anxiety. Replication with a larger sample size is needed.
... Symptoms of social anxiety are associated with bias socially threatening information in young people and adults (Abend et al., 2019). According to cognitive theories, self-related negative cognitions play a significant role in development (Spence & Rapee, 2016) and maintenance (Clark & Wells, 1995;Rapee & Heimberg, 1997) of social anxiety. The ability to understand personal capacities in a field ensures that one performs well in that particular field (Leduc & Bouffard, 2017). ...
... Individuals who suffer from SAD and MDD(Major Depressive Disorder) have difficulty using positive information to moderate initial negative perceptions, and this is one of the reasons of the coexistence of SAD and MDD (Everaert et al., 2018). In other studies, ignoring positive interpretations and focusing more on negative interpretations are considered as factors affecting the severity of depression and SAD, and even as a transdiagnostic process in SAD and depression, these factors have been mentioned (Hirsch et al., 2016;Rapee & Heimberg, 1997). Social anxiety is associated with fear of positive and negative evaluation while interacting with others (Weeks et al., 2010). ...
Article
Full-text available
Due to the high rate of comorbidity of social anxiety disorder and major depressive disorder, this study aimed to examine the mediation effect of depressive symptoms on the association between emotion regulation, negative self-evaluation, and social anxiety symptoms. The population of this study consisted of all students of the Faculty of Architecture, Islamic Azad University. The sample included 284 of the students based on convenience sampling method. Depressive symptoms were measured by Beck Depression Inventory-II (Beck et al., 1996), emotion regulation was measured by Cognitive Emotion Regulation Questionnaire (Garnefski et al., Personality and Individual Differences, 30(8), 1311–1327, 2001), social anxiety was measured by Social Phobia Inventory (Connor et al., Depression and Anxiety, 14(2), 137–140, 2001) and, negative self-evaluation was measured by Consequences of Negative Social Events Questionnaire (Wilson and Rapee, Journal of Anxiety Disorders, 19(3), 245–274, 2005). We used Path analysis to test the significance of mediation. The result of the study indicated that the direct and indirect effects of all maladaptive emotion regulation strategies, negative self-evaluation and evaluation from the others’, and depression components on social anxiety symptoms components was positive and significant.From these results, we conclude that high levels of depressive symptoms accompanied by high levels of maladaptive emotion regulation and high levels of negative self-evaluation can lead to increased social anxiety symptoms. The theoretical and practical issues have been discussed.
... Social anxiety is characterized by negative self-perceptions, communication apprehension, and fear or overestimation of negative interpersonal evaluation by others during anticipated or actual social interactions (Leary, 1983;Rapee & Heimberg, 1997). Socially anxious individuals, in comparison with their less-anxious counterparts, hold greater expectations that consequences of interpersonal evaluation by others will be more serious and negative. ...
... Socially anxious individuals, in comparison with their less-anxious counterparts, hold greater expectations that consequences of interpersonal evaluation by others will be more serious and negative. Furthermore, those higher in social anxiety may avoid, withdraw, or escape from, social situations and interactions, use maladaptive coping strategies, and aim to reduce the likelihood of social evaluation by adopting safety behaviors such as speaking quickly, avoiding eye contact, and showing fewer facial expressions (Henderson et al., 2014;Rapee & Heimberg, 1997;Watson & Friend, 1969). ...
Article
A growing area of research has begun to explore the opportunities that social media and the Internet provide for social connection. In contributing to this literature, the current study aimed to examine links between young adults’ perceptions of protection and control in the online environment, social Internet use, and social connectedness. Furthermore, as online communication has been suggested to be beneficial for those who are socially anxious, we tested social anxiety as a moderator of the aforementioned associations. A sample of Australian young adults (N = 687; 59.8% female; Mage = 19.45 years, SD = 2.07) were included in the study. A multigroup mediation model tested the effects of perceptions of protection and control online on social connectedness, via social Internet use, for groups of young adults classified as socially anxious, or low to moderate in social anxiety. For all young adults, social Internet use was positively associated with social connectedness, but there were key differences in the associations between Internet perceptions and social connectedness among young adults with and without social anxiety. For example, for socially anxious young adults, perceptions of control online were directly associated with lower social connectedness. Furthermore, although perceptions of protection online were linked to lower social connectedness of those without social anxiety, the negative effect was not significant for socially anxious young adults. These findings may have implications for clinical practice, and importantly, highlight links between perceptions of online contexts and connectedness that may be driven by social anxiety. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
... This negative learning forms the schema, a system of beliefs and expectations through which future self-relevant social information is processed (Clark and Wells, 1995;Rapee and Heimberg, 1997). Once activated, the self-schema acts as an information filter, influencing attention, perception, learning and memory, such that the dysfunctional self-views are maintained (Beck, 2008). ...
Thesis
Anxiety disorders are the most common mental health disorders and comprise a large number of years lost to disability. The work in this thesis is oriented towards understanding anxiety using a computational approach, focusing on uncertainty estimation as a key process. Chapter 1 introduces the role of uncertainty within anxiety and motivates the subsequent experimental chapters. Chapter 2 is a review of the computational role of the amygdala in humans, a key area for uncertainty computation. Chapter 3 is an experimental chapter which aimed to address gaps in the literature highlighted in the preceding chapters, namely the link between sensory uncertainty processing and anxiety and the role of the amygdala in this process. This chapter focuses on the development of a novel computational hierarchical Bayesian model to quantify sensory uncertainty and its application to neuroimaging data, with intolerance of uncertainty relating to greater neural activation in the insula but not amygdala. Chapter 4 targets the computational mechanisms underlying the negative self-bias observed in subclinical social anxiety. Again, this chapter focuses on the development of novel computational belief-update models which explicitly model uncertainty. Here, we see that a reduced trait self-positivity underpins this negative social evaluation process. The final experimental chapter presented in Chapter 5 investigates the link between different computational mechanisms, such as uncertainty, and a range of mood and anxiety symptomatology. This study revealed cognitive, social and somatic computational profiles that share a threat bias mechanism but have distinct negative-self bias and aversive learning signatures. Contrary to expectations, none of the uncertainty measures showed any associations with anxiety symptom subtypes. Finally, chapter 6 brings together the work in this thesis and alongside limitations of the work, discusses how these experiments contribute to our understanding of anxiety and the role of uncertainty across the anxiety spectrum.
... Both treatments targeted the cognitive maintenance mechanisms of SAD reported in this study (Clarke & Wells, 1995;Heimberg et al., 2014;Moscovitch, 2009;Rapee & Heimberg, 1997), and no differential changes were observed on fears of negative or positive evaluation or indeed on comorbid anxiety and depression symptoms. These findings provide evidence that both interventions were associated with reductions in these maintaining factors, which were associated with concurrent improvements on self-report, clinician-reported, and diagnostic outcomes. ...
Article
Social anxiety disorder (SAD) is associated with marked physiological reactivity in social-evaluative situations. However, objective measurement of biomarkers is rarely evaluated in treatment trials, despite potential utility in clarifying disorder-specific physiological correlates. This randomized controlled trial sought to examine the differential impact of imagery-enhanced vs. verbal-based cognitive behavioral group therapy (IE-CBGT, n = 53; VB-CBGT, n = 54) on biomarkers of emotion regulation and arousal during social stress in people with SAD (pre- and post-treatment differences in heart rate variability (HRV) and skin conductance). We acquired psychophysiological data from randomized participants across four social stress test phases (baseline, speech preparation, speech, interaction) at pre-treatment, and 1- and 6-months post-treatment. Analyses revealed that IE-CBGT selectively attenuated heart rate as indexed by increases in median heart rate interval (median-RR) compared to VB-CBGT at post-treatment, whereas one HRV index showed a larger increase in the VB-CBGT condition before but not after controlling for median-RR. Other psychophysiological indices did not differ between conditions. Lower sympathetic arousal in the IE-CBGT condition may have obviated the need for parasympathetic downregulation, whereas the opposite was true for VB-CBGT. These findings provide preliminary insights into the impact of imagery-enhanced and verbally-based psychotherapy for SAD on emotion regulation biomarkers.
... This pathway supports the transactional model of stress coping, which demonstrates that interpreting stress as threatening accounts for the impacts of stressful experiences on negative emotions [5,6]. When people experience more stressful events, they may tend to interpret stress as a threat and damage [48] and experience more emotional symptoms such as anxiety, anger, and depression [49]. Exposure to stressful life events or daily hassles and holding a stress-is-threat mindset are risk factors for mental health issues [12,16]. ...
Article
Full-text available
Personality affects the vulnerability to the emotional symptoms of depression and anxiety. This study investigated whether stress mindset (general belief about the nature of stress) and coping flexibility (the ability to terminate ineffective coping strategies and adopt alternative ones) mediate the relations of the Big Five personality traits to psychological distress. A total of 260 undergraduate students (60.4% female) in Singapore completed self-reported questionnaires. A series of path analyses was performed. Firstly, a dual-pathway model of stress coping was established, which consisted of (a) a stress–threat–distress pathway where a stress-is-a-threat mindset mediated the association between stressful experiences and psychological distress and (b) a challenge–flexibility–enhancement pathway where coping flexibility mediated the relation of a stress-is-a-challenge mindset to a lower level of psychological distress, without being influenced by stressful experiences. Furthermore, Neuroticism was associated with the stress–threat–distress pathway, with stressful experiences and a stress-is-a-treat mindset mediating the relation of Neuroticism to psychological distress. Conscientiousness was associated with the challenge–flexibility–enhancement pathway, with a stress-is-a-challenge mindset and coping flexibility mediating the relation of Conscientiousness to less psychological distress. Extraversion, Agreeableness, and Openness were directly associated with greater coping flexibility. The findings enrich the literature on personality and stress coping and inform future interventions to promote mental health.
... Clark and Wells (1995) cognitive model of SAD has been extensively used as a theoretical framework for studies investigating the effects of SAD regarding face-to-face social interactions (Leigh & Clark, 2018). However, few studies have explored this model for social media interactions (Hodson et al., 2008;Rapee & Heimberg, 1997). To our knowledge, Carruthers et al. (2019) were the first researchers to examine the cognitive processes that individuals with high and low SA engage in while completing several Facebook-related tasks, such as making a post. ...
... The theoretical understanding of SAD has been focused on the appraisal of threats to the social self [24]. In line with this, it has been argued that the maintenance of SAD is partially due to the misreading of others' facial expressions [25]. ...
Article
Full-text available
Background and objectives Facial expression recognition has been studied extensively, including in relation to social anxiety. Nonetheless, a limited number of studies examined recognition of disgust expressions. Results suggest that disgust is perceived as more threatening than anger, and thus may invite more extreme responses. However, few studies have examined responses to facial expressions. These studies have focused on approach-avoidance responses. Our primary aim was to examine to what extent anger and disgust expressions might invite interpersonal responses in terms of quarrelsomeness-agreeableness and dominance-submissiveness. As social anxiety has been previously associated with a heightened sensitivity to anger and disgust expressions, as well as with alterations in quarrelsomeness-agreeableness and dominance-submissiveness, our secondary aim was to examine whether social anxiety would moderate these responses. Methods Participants were 55 women and 43 men who completed social anxiety measures, including the Brief Fear of Negative Evaluation scale, and two tasks that involved “targets” expressing anger, disgust, or happiness at 0%, 50%, or 100%. Participants first indicated how quarrelsome or agreeable and how dominant or submissive they would be towards each target, and then how much they would avoid or approach each target. Results While 100% disgust and anger expressions invited similar levels of quarrelsomeness and avoidance, 50% disgust invited more quarrelsomeness and stronger avoidance than 50% anger. While these patterns were not meaningfully moderated by social anxiety, individuals with higher BFNE scores showed a relatively strong approach of happy faces. Limitations Actual interpersonal behaviour in response to facial expressions was not assessed. Conclusions Findings support the relevance of disgust as an interpersonal signal and suggest that, especially at mild intensity, disgust may have a stronger impact than anger on people’s quarrelsomeness and avoidance responses. Findings provided no support for the view that people with social anxiety would be particularly responsive to disgust (or anger) expressions.
... This may result from mental imagery about feared outcomes. Distressing mental imagery is common in anxiety disorders, including social anxiety disorder (Clark & Wells, 1995;Rapee & Heimberg, 1997; for a review, see; Ng, Abbott, & Hunt, 2014), in which it is commonly related to social memories (Hackmann, Clark, & McManus, 2000) and represents feared outcomes (e.g., 'looking foolish'; Hackmann, Surawy, & Clark, 1998). Such negative self-imagery appears to play a role in the maintenance of social anxiety disorder. ...
Article
Full-text available
Distressing mental images are common in anxiety disorders and can make it difficult for patients to confront feared situations. This study examined whether imagery rescripting focused on a feared social situation prepares participants to engage in a feared situation. Sixty healthy individuals were asked to formulate a behavioral experiment to test negative beliefs about a social situation they feared. They were assigned to one of two groups: imagery rescripting focused on the feared outcome of the behavioral experiment or no imagery rescripting (i.e., a break). All participants were then asked to complete ratings scales and to conduct the behavioral experiment. Before the behavioral experiment, the imagery rescripting condition, compared to the control condition, showed reduced anticipated probability and severity of the feared outcome, lower anxiety and helplessness levels, and increased willingness to conduct the behavioral experiment. Imagery-based interventions focused on feared outcomes seem promising to prepare anxious individuals to engage in treatment.
... The understanding of SAD has been advanced by cognitive models framing effective conceptualization as well as treatment (e.g., Clark & Wells 1995;Rapee & Heimberg, 1997). One similarity among these cognitive models is the primary focus on cognitive aspects, such as, negative automatic thoughts (Normann et al., 2016). ...
Article
Full-text available
Theoretical and empirical evidence has found that negative automatic thoughts (ATs) are vital in the occurrence of social anxiety in youth population; however, the mechanism is rarely investigated in Chinese adolescents. This study aimed to discover the mediating mechanism of meta-worry (including meta-worry belief and frequency) on negative automatic thoughts and social anxiety in Chinese adolescents. Cross-sectional research design was used. Three hundred and fifty-seven adolescents were recruited to complete measures of meta-worry, social anxiety, negative automatic thoughts, depression, and demographic information. After controlling for depression, we found that meta-worry frequency mediated partially the relation between negative automatic thoughts and social anxiety in adolescents. In addition, participants’ age moderated the relation between negative automatic thoughts and meta-worry frequency. Our results shed the light on the metacognitive therapy in adolescents. Results are informative for metacognitive therapy suggesting that it could be more effective by targeting changes in the frequency of thoughts rather than changes in meta-worry beliefs.
... Social anxiety disorder (SAD) is characterized by intense and persistent fear and avoidance elicited by a wide range of social-or performance-related situations (American Psychiatric Association, 2013;Fehm et al., 2005), including participating in group activities, interacting one-on-one, performing in front of others, and being observed while engaging in various daily activities. It is a highly prevalent psychiatric disorder, with a lifetime prevalence rate of 4-to-13% (Mennin et al., 2002, Leichsenring & Leweke, 2017Stein et al., 2017), and is often chronic and debilitating (Stein et al., 1996;Baker et al., 2002;Rapee & Heimberg, 1997), negatively impacting social, occupational, and academic functioning (Wittchen & Fehm, 2003;Stein & Stein, 2008). ...
Article
Accurate assessment is crucial for determining appropriate therapeutic interventions for social anxiety and conducting sound clinical research. While self-report measures of social anxiety are widely used in both research and clinical settings, they have several drawbacks inherent to their textual nature. Here, we describe the development and initial validation of the Visual Social Anxiety Scale (VSAS), a novel picture-based self-report measure of social anxiety, based on the well-established widely-used Liebowitz Social Anxiety Scale (LSAS). Specifically, the 24 items of the LSAS were used as the basis for social situations to be included in the VSAS. First, pictures to serve as VSAS items were selected using a rigorous two-phase process (four pilot studies; n=225). Next, reliability (internal consistency, test-retest) and validity (convergent, discriminant) were explored with new participants (n=304) who completed the VSAS and a battery of additional self-report questionnaires, delivered in a random order. The VSAS was completed again a month later (n=260/304). The VSAS showed high internal consistency and test-retest reliability, and good convergent and discriminant validities. VSAS correlations with convergent measures were significantly greater than its correlations with discriminant measures. Thus, the VSAS shows initial promise as a novel picture-based self-report measure of social anxiety. Data Availability The data that support the findings of this study, as well as the 24 VSAS single items, are openly available in Open Science Foundation (OSF) at https://osf.io/tajn6/?view_only=da6cd75f10834303af87d87d08895ae8
... In this regard, numerous patterns have been introduced for examining the influential factors and the range of factors correlated with social anxiety disorder. In 1990 decade, two cognitive behavioral patterns, Clark and Wells [4] and Rapee and Heimberg [5], in the area of social anxiety disorder were developed, which have been considered as the basis for studies examining etiology of social anxiety disorder. However, it seems that cognitive behavioral factors are diverse and complex due to the heterogeneous symptomatic profile and generally, inadequate understanding of the causes of anxiety disorders [6]. ...
Article
Full-text available
Abstract: (15914 Views) Social anxiety is one of the most debilitating anxiety disorders that can negatively affect all aspects of a person's life. Yet, despite the fact that its prevalence rates are relatively high, factors associated it are still poorly understood. The study aimed at determining the prediction model of social anxiety through investigating variables like: depression, shame, behavioral Inhibition, shyness,and anger aspredictors of social anxiety. The study applied a correlative method and a Sample of 581 participants (235 males and 346 females) selected through Cluster Sampling from among Shahed University students. Data were collected through Social Fobia Inventory, Revised Check and Buss Shyness Scale, The third Scale of Adult Self-Conscious Affection, Carver and White Behavioral Activation/Inhibition System Scale, Depression Anxiety Stress Scale-21 and the State-Trait Anger Expression Inventory-2. Data were then analyzed using Pearson correlation coefficient and Simultaneous Multiple Regression Analysis in SPSS-16 software. All variables were significantly correlated with social anxiety. Simultaneous multiple regression analysis suggested that with the exception of anger which cannot predict social anxiety, other studied variables (depression, shame, behavioral inhibition, and shyness) can predict social anxiety. Although part of the obtained results are in line with other research findings, the rest should be encountered carefully and more cross-cultural and inter-cultural research can help scrutinize the findings. Keywords: Anger, Anxiety, Behavioral, Depress Shame, Shyness
... The social anxiety spectrum ranges from undiagnosed trait levels of social anxiety through to a clinically diagnosed social phobia / social anxiety disorder (Rapee & Heimberg, 1997). Trait social anxiety can manifest as anxiety concerning interactions with others (trait social interaction anxiety), and as a fear of social scrutiny whilst performing tasks when under observation from others (trait social phobia). ...
Article
Full-text available
Social anxiety is related to normal variation in personality and manifests as anxiety concerning interactions with others (social interaction anxiety), and/or as a fear of social scrutiny whilst performing tasks when under observation from others (social phobia). In revised Reinforcement Sensitivity Theory (rRST) a behavioral inhibition system (BIS) facilitates defensive approach behaviors and anxiety in situations of uncertainty. A fight-flight-freeze system (FFFS) facilitates fear and avoidance behaviors, and a behavioral approach system (BAS) facilitates anticipated reward and/or approach-based behaviors. rRST suggests that a socially anxious phenotype would experience elevated BIS sensitivity, elevated FFFS sensitivity, and dampened BAS sensitivity. We used self-report measures to test if the effects of social interaction anxiety and social phobia (which reflects the fear of social scrutiny) are separable within rRST, as in rRST anxiety and fear are separate constructs. Low levels of self-esteem are a risk factor for social anxiety, thus we tested how two sub-components of self-esteem referred to as self-acceptance and self-assessment predict social interaction anxiety and social phobia. 405 participants (mean age = 30.6; 86% female) completed the online study. Social interaction anxiety and social phobia were positively correlated with BIS and FFFS-flight sensitivity, and were negatively correlated with BAS, and FFFS-fight sensitivity in males and females. Social interaction anxiety and social phobia were negatively correlated with self-acceptance in males and females. Multiple regression showed that for females BIS and FFFS-flight scores were prominent positive predictors of social interaction anxiety whereas BIS was a prominent positive predictor of social phobia. For males the FFFS-fight subscale was a prominent negative predictor of social interaction anxiety. Overall, a synthesis of the present study and previous studies suggests that there may be subtle differences in how trait social interaction anxiety and trait social phobia relate to reinforcement sensitivity.
... Cognitive models of SAD (Clark & Wells, 1995;Hofmann, 2007;Rapee & Heimberg, 1997) emphasize the centrality of interpretation bias in the development, maintenance, and treatment of this disorder (e.g., see Chen et al., 2020 andHirsch et al., 2016, for reviews). Much of the focus within the literature on interpretation bias has been on negative interpretation bias of negative, ambiguous, or neutral social events. ...
Article
Full-text available
Background Individuals with social anxiety disorder (SAD) report interpreting social events negatively regardless of valence. Fear of causing discomfort to others and intolerance of uncertainty (IU) are associated with negative interpretations of positive social situations. However, no studies have examined whether these negative interpretations change over CBT for SAD, nor predictors of such changes. This study examined if: negative interpretations of positive social events improve during CBT for SAD; these negative interpretations correlate with social anxiety symptom severity, fear of causing discomfort to others, and IU at the start of treatment; and fear of causing discomfort to others, IU and its subfactors at the start of treatment predict changes in these negative interpretations over treatment. Methods Eighty-five treatment-seeking DSM diagnosed individuals with primary SAD completed measures of the tendency to interpret positive events negatively pre-post CBT, and IU and fears of causing discomfort to others at pre-treatment. Results Results demonstrated significant pre-post decreases after CBT for SAD in negative interpretations of positive social events. All measures were significantly correlated with each other. None of the pre-treatment variables significantly predicted decreases in negative interpretations of positive social events over treatment. Conclusions CBT may be effective in reducing these negative interpretations.
... Fear of public speaking is the most commonly endorsed fear, at least among a large sample of American university students (Dwyer & Davidson, 2012). It is often tied to social phobia, which is the fear of social interaction, having to perform in social situations, or being judged by others (Rapee & Heimberg, 1997) as what the person is afraid of in a public speaking situation is the negative judgement of others. They fear they will make a mistake, or act in a way that is humiliating or embarrassing and the audience will make a negative evaluation of them. ...
Article
Full-text available
The definition of courage has been widely debated, though most agree it involves an element of ‘persistence despite fear’. However, even with its correlation to fear and anxiety, courage as a concept has received minimal research in psychology. This study aimed to explore the role of courage in predicting behavior. Twenty-eight participants who indicated during a pre-screening that they feared public speaking completed a measure of courageousness (Courage Measure; CM) undertook a behavioral approach task (BAT) where they gave a short speech on a topic of their choice and were timed. Results indicated that the CM significantly predicted speech duration after controlling for scores on a measure of public speaking fears. Interestingly, and inconsistent with prior studies using the CM, self-reported courage at both the pre-screen and immediately before the BAT both predicted speech duration. Implications for the assessment of courageousness are discussed.
... 社交焦虑障碍(social anxiety disorder or social phobia)是一种较为普遍的焦虑症亚种,患者表现出自尊 感低下(low self-esteem)和自我批评倾向高(high self-criticism)的特征,惧怕在公开场合说话,担心由于语 言或行为的失误可能引发的批评 (Rapee & Heimberg, 1997;Heimberg, Brozovich, & Rapee, 2010 ...
Article
Full-text available
While there are several “SheKong” classifications, there are also numerous ways to categorize “SheKong”. Human perception, action, and speech are all founded on categorization, which influences how we see the outside world and ourselves. The fuzziness of the term “SheKong”, as well as the absence of the embodied experiences of people who identify themselves as “SheKong” when talking about them, are due, in part, to the fact that different groups of people base the categorizations of “SheKong” on their experiences and pre-existing beliefs. It is thus critical to pay attention to what has happened, is happening, and will happen to the “SheKong”. The questionnaire data has revealed the uniqueness of self-identified SheKongs’ experience. The article seeks to clarify the need for, and reason for, recognizing this embodied experience as the genuine source of the categorization of “SheKong”, as well as to demonstrate the possibility of employing it as a key window into exploring the causes of social anxiety disorder.
... In addition, it includes behavioral experiments to test ominous predictions, a technique bearing a resemblance to exposure. Based on Rapee and Heimberg's conceptualization [96], a model includes psychoeducation, exposure, and cognitive restructuring. Despite the differences between these packages, they share significant similarities, thus being reviewed as a single interventional modality. ...
Article
Social anxiety disorder (SAD) is a prevalent condition negatively affecting one’s sense of self and interpersonal functioning. Relying on cognitive but integrating interpersonal and evolutionary models of SAD as our theoretical base, we review basic processes contributing to the maintenance of this condition (e.g., self-focused attention, imagery, avoidance), as well as the treatment techniques geared to modify such processes (e.g., exposure, attention modification, imagery rescripting). We discuss cognitive-behavioral treatments (CBT) as combining multiple treatment techniques into intervention “packages.” Next, we review the existing empirical evidence on the effectiveness of CBT. Although CBT has accumulated the most support as superior to other credible interventions, we suggest that many treatment challenges remain. We conclude by discussing the ways to enhance the efficacy of CBT for SAD. Specifically, we highlight the need to (a) elucidate the complex relationship between basic processes and techniques, (b) advance personalized interventions, and (c) include a more diverse and comprehensive array of outcome measures.
... Cognitive therapy aims to treat SAD by changing the key maintenance processes specified in Clark and Wells (1995) and similar (Hofmann, 2007;Rapee & Heimberg, 1997) cognitive models. To test whether improvements associated with the treatment are at least partly attributable to its ability to change these processes, a mediation analysis was conducted. ...
Article
Full-text available
Background Cognitive therapy for social anxiety disorder (CT-SAD) is recommended by NICE (2013) as a first-line intervention. Take up in routine services is limited by the need for up to 14 ninety-min face-to-face sessions, some of which are out of the office. An internet-based version of the treatment (iCT-SAD) with remote therapist support may achieve similar outcomes with less therapist time. Methods 102 patients with social anxiety disorder were randomised to iCT-SAD, CT-SAD, or waitlist (WAIT) control, each for 14 weeks. WAIT patients were randomised to the treatments after wait. Assessments were at pre-treatment/wait, midtreatment/wait, posttreatment/wait, and follow-ups 3 & 12 months after treatment. The pre-registered (ISRCTN 95 458 747) primary outcome was the social anxiety disorder composite, which combines 6 independent assessor and patient self-report scales of social anxiety. Secondary outcomes included disability, general anxiety, depression and a behaviour test. Results CT-SAD and iCT-SAD were both superior to WAIT on all measures. iCT-SAD did not differ from CT-SAD on the primary outcome at post-treatment or follow-up. Total therapist time in iCT-SAD was 6.45 h. CT-SAD required 15.8 h for the same reduction in social anxiety. Mediation analysis indicated that change in process variables specified in cognitive models accounted for 60% of the improvements associated with either treatment. Unlike the primary outcome, there was a significant but small difference in favour of CT-SAD on the behaviour test. Conclusions When compared to conventional face-to-face therapy, iCT-SAD can more than double the amount of symptom change associated with each therapist hour.
... At present, cognitive behavioural therapy (CBT) is the gold standard treatment for SAD (Lincoln et al., 2003;Mayo-Wilson et al., 2014;Taylor, 1996). CBT involves addressing unhelpful behaviours which are believed to maintain SAD, such as avoidance, safety behaviours, and self-focused attention (see further, Clark and Wells, 1995;Rapee and Heimberg, 1997). Studies have shown that CBT can significantly reduce anxiety symptoms (e.g., Andersson, 2009). ...
Article
Full-text available
Individuals with social anxiety disorder (SAD) commonly receive non-evidence based, ineffective treatments. Cognitive behaviour therapy (CBT) has been demonstrated to be the gold standard treatment for treating SAD. Scalable web-based CBT programs ensure evidence-based treatment procedures, but low treatment adherence remains problematic. This study aimed to test whether adding group sessions to a fully automated web-based CBT program, Overcome Social Anxiety (OSA), would increase treatment adherence. A total of 69 participants were provided access to a web-based program, and randomly allocated to three conditions: 1) An experimental condition involving an addition of three online group psychoeducation sessions; 2) a placebo condition involving an addition of three online progressive muscle relaxation (PMR) group sessions, or 3) a control condition where participants did not receive group sessions. Adherence was operationalised as number of OSA modules completed. Treatment adherence significantly differed between the conditions. On average, participants assigned to the placebo condition completed significantly more of the program compared to those in the control condition. Further, all conditions produced a significant improvement in BFNE and QOLS. No significant difference in treatment efficacy was found between groups on the SIAS, BFNE or QOLS. The current results indicate PMR can improve treatment adherence for scalable social anxiety interventions.
... Cognitive behavioural accounts emphasise the role of mental imagery (also known as self-imagery) in the maintenance of SAD (Clark & Wells, 1995;Hofmann, 2007;Rapee & Heimberg, 1997). It has been proposed that selfimagery that is excessively negative, vivid, and seen from an observer perspective functions as a maintenance mechanism by directly increasing anxiety, confirming negative self-evaluations, enhancing self-focused attention, and motivating the use of safety behaviours (Clark & Wells, 1995). ...
Article
Full-text available
Background Understanding the role of self-imagery in the development of social anxiety in adolescence holds promise for improving intervention. Cross-sectional studies indicate that imagery characteristics are associated with social anxiety symptoms, however, prospective studies are lacking. The current study examined concurrent and prospective associations between two image characteristics, namely observer-perspective and vividness, with social anxiety symptoms in a community adolescent sample (N = 616; 53% girls; aged 11–15 years). In addition, we examined common themes in the negative social anxiety-related images. Methods Negative self-imagery and social anxiety symptoms were assessed using questionnaires at baseline and at 4–6-month follow-up. A series of multiple linear regression analyses were performed to see if each image characteristic predicts concurrent and prospective social anxiety symptoms. Topic modelling was performed to infer key topics from verbal data. Results Observer-perspective and vividness significantly predicted concurrent social anxiety symptoms beyond the influence of age and gender. Observer-perspective significantly predicted prospective levels of social anxiety symptoms beyond the influence of age, gender, and baseline social anxiety and depression symptoms. Negative self-images clustered into two themes: the fear of appearing anxious and the fear of being judged or viewed as unacceptable. Conclusions Specific characteristics and contents of negative self-images may be particularly relevant to the development of adolescent social anxiety.
... Cognitive models of SAD (e.g. [5,6]) propose that the disorder is maintained by biased cognitive processing of social information, such as abnormalities in visual attention during social situations (e.g., direct eye contact) and negatively distorted self-evaluations. Specifically, the attentional avoidance of social information, such as eye gaze and human faces in general, is considered an important feature of the disorder. ...
Article
Full-text available
This study measured visual attention (fixation count, dwell time) during two real-life social stress tasks using mobile eye-tracking glasses in children (9–13 years) diagnosed with social anxiety disorder (SAD; n = 25) and a healthy control group (HC; n = 30). The influence of state anxiety on attention allocation and negative self-evaluation biases regarding gaze behavior were also examined. Compared to the HC group, children with SAD showed visual avoidance (i.e., fewer fixations) of the faces of interaction partners during the second social stress task. While visual avoidance in HC children decreased with declining state anxiety from the first to the second social stress task, no such effect was found in children with SAD. A negative self-evaluation bias regarding gaze behavior in children with SAD was not found. In sum, measuring visual attention during real-life social situations may help enhance our understanding of social attention in childhood SAD.
... Staff training should ideally be co-designed and codelivered with service users. CMO 4.4a: Service users finding it easier to establish a therapeutic relationship online [50,71,90,116,119,139,156,165,175,176] When delivering telemental health to some services users who feel uncomfortable in clinical settings and social situations (C), these service users find it easier to build a therapeutic relationship and are more willing to use telemental health (O), as they feel safer, are more relaxed and less anxious being in their own environment and/or outside of clinical settings and in-person social situations and thus feel more empowered and comfortable to open up and speak freely (M). ...
Article
Full-text available
Background: Telemental health (delivering mental health care via video calls, telephone calls or text messages) is increasingly widespread. Telemental health appears to be useful and effective in providing care to some service users in some settings, especially during an emergency restricting face-to-face contact such as the COVID-19 pandemic. However, important limitations have been reported, and telemental health implementation risks reinforcing pre-existing inequalities in service provision. If it is to be widely incorporated in routine care, a clear understanding is needed of when and for whom it is an acceptable and effective approach, and when face-to-face care is needed. Objective: The aim of this rapid realist review was to develop theory about which telemental health approaches work, or do not work, for whom, in which contexts and through what mechanisms. Methods: Rapid realist reviewing involves synthesising relevant evidence and stakeholder expertise to allow timely development of context-mechanism-outcome (CMO) configurations in areas where evidence is urgently needed to inform policy and practice. The CMOs encapsulate theories about what works for whom, and by what mechanisms. Sources included eligible papers from (a) two previous systematic reviews conducted by our team on telemental health, (b) an updated search using the strategy from these reviews, (c) a call for relevant evidence, including "grey literature", to the public and key experts, and (d) website searches of relevant voluntary and statutory organisations. CMOs formulated from these sources were iteratively refined, including through (a) discussion with an expert reference group including researchers with relevant lived experience and front-line clinicians and (b) consultation with experts focused on three priority groups: 1) children and young people, 2) users of inpatient and crisis care services, and 3) digitally excluded groups. Results: A total of 108 scientific and grey literature sources were included. From our initial CMOs, we derived 30 overarching CMOs within four domains: 1) connecting effectively; 2) flexibility and personalisation; 3) safety, privacy, and confidentiality; and 4) therapeutic quality and relationship. Reports and stakeholder input emphasised the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation, and a need to ensure that face-to-face care of equivalent timeliness remains available. Mechanisms underlying successful and unsuccessful application of telemental health are discussed. Conclusions: Service user choice, privacy and safety, the ability to connect effectively and fostering strong therapeutic relationships, need to be prioritised in delivering telemental health care. Guidelines and strategies co-produced with service users and frontline staff are needed to optimise telemental health implementation in real-world settings. Clinicaltrial:
Article
Behavioral and cognitive therapies are today the most effective toolbox and the most evidenced-based therapy for social anxiety. The purpose of this article is to provide an overview of some of the most popular methods for treating social anxiety. A selective review of literature published between 1997 and 2022 on social anxiety management. We have found that the majority of behavioral and cognitive treatment protocols are based on the following pillars: exposure to avoided situations, cognitive restructuring, assertiveness, and social skills training, as well as decentration techniques such as getting out of self-observation and cognitive fusion. Several psychotherapists agree on some components of social anxiety management while others do not. Within these agreements and disagreements, the path to the sketch of a new model should open. We argue that some techniques may ultimately be useless, counterproductive, and time-consuming. Alter the existing models and improve them in a different way in light of the multiple information and clinical examples is much needed. We suggest reconfiguring the theoretical and clinical elements to derive a new therapeutic combination of old techniques. In this new theoretical model of social anxiety, we scrupulously suggest including the cognitive and emotional elements and opt for primacy to be given to behavioral inhibition and the role of the biological part such as amygdala.
Article
Individuals with social anxiety disorder commonly engage in safety behaviors (SBs), which are behavioral and cognitive strategies employed in an effort to avoid or decrease the likelihood of a feared threat outcome and decrease anxiety in social situations. These behaviors are thought to be dysfunctional and play a key role in contemporary models of the disorder. The current experimental study sought to expand upon existing research by examining the role of SBs in social anxiety and self-disclosure. Participants with elevated social anxiety symptoms (N = 115) were randomized to either a two-week SB fading manipulation or a no-instruction control. Self-report measures were administered pre- and post-manipulation, and participants completed an in-vivo speech task at post. SB fading led to lower social anxiety symptoms at post relative to the control. SB fading also led to greater self-reported openness to general self-disclosure and emotional disclosure compared to the control, though these effects were modest. No condition effect on emotional reactivity to a speech task was observed. SB fading led to greater observer-rated disclosure on the speech task than control, though this was only found among those high in dispositional self-disclosure at baseline. The present study provides further evidence for the importance of SBs in social anxiety and suggests SB fading might lead to greater comfort with self-disclosure. Limitations and directions for future research are discussed.
Article
Full-text available
Abstract The aim of this study was to investigate the relationship of meta-cognitivebeliefs with social anxiety symptoms in non-clinical population. The sample consisted of 300 (166 females and 134 males) Ilam University students who selected by cluster sampling method. The participants completed the Meta-Cognations Questionnaire-30 (MCQ-30) and Social Phobia Inventory (SPIN). The results showed that meta-cognitive beliefs were positively correlated with social anxiety symptoms (P<0.05). Also, the results of regression analysis of MCQ-30 subscales showed that uncontrollability danger and cognitive self– consciousness are predictors of avoidance, negative beliefs about uncontrollability of thought and danger are predictors of fear, negative beliefs about uncontrollability of thought and danger and positive beliefs about worry and cognitive security are predictors of physiological arousal. These were the significant predictors of social anxiety symptoms (P≤0.05). Results of this study support the meta- cognitive Wells and Matthew's model of social anxiety and indicates that meta-cognitive beliefs have an important role in social anxiety symptoms. Therefore, the modification of meta- cognitive beliefs with regard to the importance of their role in avoidance, fear and physiological arousal, can be a preventative factor in intensification and continuity of social anxiety symptoms. Keywords: meta meta-cognitive beliefs ,cognitive beliefs, avoidance, fear, physiological arousal
Article
Background Extant models of the association between harsh parenting and social anxiety among adolescents are mostly partial mediation models, leaving much of the relationship unaccounted for. Objective The current study intends to test a two-mediator model in which adolescents' cognitive reactivity and emotional dysregulation were assumed to mediate the potential impact of harsh parenting on their social anxiety. Participants and settings A sample of 726 adolescent students with their parents was recruited from two middle schools located in a provincial city of Northern China. Methods Both fathers and mothers were required to report on their spouse's harsh parenting practices. The “Behind your back” task was used to assess cognitive reactivity of adolescents who also reported on their emotional dysregulation and social anxiety. Moderated mediation model and simple slope analyses were used to examine the meditational relations and the moderating role of child sex. Results For the current model, cognitive reactivity and emotional dysregulation could completely mediate the potential influence of harsh fathering and harsh mothering on adolescents' social anxiety. Moreover, harsh fathering has a greater effect on adolescents' social anxiety than harsh mothering, especially for girls. Conclusions Cognitive reactivity in conjunction with emotional dysfunction can better account for the relationship from harsh fathering and harsh mothering to adolescents' social anxiety.
Article
Objective: Although previous studies have demonstrated the association between social anxiety symptom severity and the tendency to appraise positive social events negatively among individuals with social anxiety disorder, no study has examined mediators of this relationship. The current study sought to examine whether intolerance of uncertainty and its subfactors mediate the relationship between social interaction anxiety and the tendency to interpret positive social events negatively. Method: One hundred and sixty-five individuals with social anxiety disorder completed measures of social interaction anxiety symptom severity, intolerance of uncertainty, and negative interpretations of positive social events. Results: Total intolerance of uncertainty and the inhibitory-intolerance of uncertainty subscale scores significantly mediated the relationship between social interaction anxiety and negative interpretations of positive events. Exploratory post-hoc analyses regarding the possible contributing role of depression demonstrated mixed results. The same mediation pattern was found in the full sample as well as those without a secondary comorbid mood disorder diagnosis. In contrast, serial mediation showed a mediating role of depressive symptom severity. Conclusion: Inhibitory-intolerance of uncertainty plays a role in the relationship between social interaction anxiety and negative interpretations of positive social events.
Thesis
p>Over the past decade, there has been a growing interest in autobiographical memory (AM) and its application to psychopathology. The literature review provides an overview of AM and its application to depression and anxiety. The conceptualisation of AM is outlined from a historical perspective and its reciprocal relationship with the self-concept is considered. Conway and Pleydell-Pearce’s (2000) recent framework for AM, the self-memory system, is described and its clinical implications are discussed. Finally, current understanding of the role of AM in the maintenance of depression and anxiety is reviewed, with a special emphasis upon major depressive disorder, post-traumatic stress disorder and social anxiety. A number of gaps in the literature are identified and areas for future research are suggested. Using Clark and Wells’ (1995) model of social phobia as a basis, the empirical paper addresses several of the gaps in the social anxiety literature. This study comprised three main parts; an exploratory analysis of memory phenomenology in undergraduates with high and low social anxiety; an examination of the use of observer and field perspectives; and, investigation of the effect of switching memory perspective on associated affect and self-appraisal. The findings provided some limited support for Clark and Wells’ (1995) model but further work is required to develop current understanding of the role of AM in social anxiety.</p
Article
Background: Fear of negative evaluation (FNE), referring to negative expectation and feelings toward other people's social evaluation, is closely associated with social anxiety that plays an important role in our social life. Exploring the neural markers of FNE may be of theoretical and practical significance to psychiatry research (e.g., studies on social anxiety). Methods: To search for potentially relevant biomarkers of FNE in human brain, the current study applied multivariate relevance vector regression, a machine-learning and data-driven approach, on brain morphological features (e.g., cortical thickness) derived from structural imaging data; further, we used these features as indexes to predict self-reported FNE score in each participant. Results: Our results confirm the predictive power of multiple brain regions, including those engaged in negative emotional experience (e.g., amygdala, insula), regulation and inhibition of emotional feeling (e.g., frontal gyrus, anterior cingulate gyrus), and encoding and retrieval of emotional memory (e.g., posterior cingulate cortex, parahippocampal gyrus). Conclusions: The current findings suggest that anxiety represents a complicated construct that engages multiple brain systems, from primitive subcortical mechanisms to sophisticated cortical processes. Author summary: The current findings indicate that fear of negative evaluation, an anxiety-related trait, could be decoded from the structural features of individual brains. These findings advance our understanding on the neural signatures of anxiety and implicate potential clinical applications of brain imaging measures.
Article
Background Negative silence in the classroom is a usual passive behavior, which means students tend to keep silent and are unwilling to participate in the teaching interaction. It hinders the classroom teaching quality severely. Previous studies have shown both self-efficacy and fear of negative evaluation are related to silent behavior. However, little research has explained whether self-efficacy affects passive silence in the classroom through fear of negative evaluation. Purpose To investigate the relationships between self-efficacy, fear of negative evaluation and negative silence in the classroom. Methods A cross-sectional survey using convenience sampling was conducted to collect data from 568 undergraduate nursing students from a higher medical institution in Guizhou Province, west of China, from October to November 2021. the T-test or analysis of variance was used as a univariate analysis and the Bootstrap test was applied to verify the mediating effect. Findings Nursing students' self-efficacy was negatively related to both fear of negative evaluation and negative silence in the classroom(r=-0. 188, P<0. 05; r=-0. 298, P<0. 05, respectively; fear of negative evaluation was positively related to negative classroom silence(r=0. 392, P<0. 05; mediation analysis showed the mediating effect of fear of negative evaluation accounted for 23. 53% of the total [Effect Value=-0. 08, 95%CI(-0. 12,-0. 03]. Discussion Fear of negative evaluation partially mediates the relationship between self-efficacy and negative silence in the classroom. Therefore, reducing nursing students' negative evaluation fear can be used as a target for interventions to address nursing students' negative classroom silence issue, promoting the quality of classroom teaching and learning.
Article
Objective: Affectionate touch promotes psychological well-being likely through inducing cognitive and neurobiological changes, which implies the inverse association of affectionate touch to negative cognitive and psychosocial outcomes. Our aim was to explore relationships between attitudes toward interpersonal touch and social anxiety through fear of negative evaluation and self-critical rumination as mediating variables.Method: Data from 250 participants (69.6% females, n = 174) ranging in age from 18 to 65 years were collected through self-report inventories assessing attitudes toward physical touch from friends and family, nonromantic intimate person and unfamiliar person, fear of negative evaluation, self-critical rumination, and social anxiety. A moderated-mediation analysis was conducted. Results: No direct link was seen between attitudes toward friends and family touch experiences and social anxiety in both genders, but mediation through fear of negative evaluation was significant (p < .05). Attitudes toward nonromantic intimate touch were related to social anxiety only in females and only indirectly through self-critical rumination (p < .05). In both males and females, attitudes toward touch from unfamiliar persons were linked to social anxiety directly (p < .05) but indirect paths through fear of negative evaluation (p < .05) and self-critical rumination were seen only in females (p < .05). Conclusions: Findings indicate that attitudes toward interpersonal affectionate touch may be predictive of social anxiety and the negative cognitions associated with it, extending previous findings on social pain and attesting to the potential clinical utility of touch-based interventions for social anxiety.
Article
Zusammenfassung. Hintergrund: Personen mit olfaktorischer Referenzstörung (ORS) befürchten einen unangenehmen Körpergeruch zu verbreiten. Für andere ist dieser Geruch jedoch nicht objektivierbar. Fragestellung: Studienziele waren, zu eruieren, welche Situationen bei Betroffenen spezifische Verhaltens- und Denkmuster auslösen, welche Emotionen, Kognitionen, Körperempfindungen und Verhaltensweisen beschrieben werden, und wie diese Personen auf Andere bezüglich Aussehen, Habitus und Körpergeruch wirken. Methode: 38 ORS-Betroffene und 38 gematchte Kontrollpersonen durchliefen qualitative Interviews, es wurden Videoaufnahmen (Habitus), Fotos (Aussehen) und Schweißproben (Körpergeruch) durch unabhängige, verblindete Personen beurteilt. Ergebnisse: Als auslösende Situationen werden überwiegend soziale Situationen beschrieben. Als Reaktionen werden Sicherheitsverhalten (motorisch), Scham (affektiv), Selbstabwertungen (kognitiv) und Schwitzen (vegetativ) am häufigsten genannt. Die objektiven Beurteilungen unterschieden sich nicht signifikant zwischen den Gruppen. Diskussion: Es sind vorwiegend soziale Situationen, die ORS-spezifische Symptome auslösen. Dabei lassen sich die befürchteten Symptome (insbesondere der unangenehme Geruch oder die negative soziale Bewertung) durch unabhängige Beurteilende nicht objektivieren, was den sozialen Aspekt der Befürchtungen verdeutlichen könnte.
Article
Social anxiety disorder (SAD) is a common psychological disorder associated with broad interpersonal impairment. Most previous studies have examined nonverbal behavior in SAD using human coders. However, one recent study utilized a machine-based analysis of nonverbal behavior and dyadic synchrony in SAD (Asher, Kauffmann, & Aderka, 2020). In the present study, we compared human and computer assessments of nonverbal behavior in social anxiety to enhance our knowledge about their commonalities and unique differences in capturing nonverbal behavior in the context of SAD. Specifically, the present study included 152 individuals: 38 individuals diagnosed with SAD and 114 individuals without SAD. Participants formed 76 opposite-sex interaction dyads comprising either two individuals without SAD (n = 39 control dyads) or one individual with SAD and one individual without SAD (n = 37 SAD dyads). All participants underwent a getting-acquainted task and were videotaped during the conversation. Half of the interactions were small talk interactions and half were closeness-generating interactions that required significant self-disclosure. We found that both types of coding were associated with self-reported social anxiety but that machine-based coding was superior in capturing social anxiety in closeness-generating contexts. Implications for research on nonverbal behavior in SAD are discussed.
Article
Recurrent, negative self-imagery is common in social anxiety disorder (SAD). Imagery rescripting (ImRs) is an effective therapeutic technique that aims to target past aversive memories to modify their associated meanings, and update the encapsulated negative schematic beliefs. The current study aimed to extend previous research by investigating the cognitive and affective shifts during each phase of ImRs delivered within a group cognitive behavioural therapy protocol. Participants (N = 32) retrieved an aversive memory associated with social anxiety and were guided through brief cognitive restructuring, prior to completing ImRs. Core beliefs associated with the memory (strength and valence) and fear of negative evaluation were assessed before and after ImRs and affect was assessed following each phase. Strength and affective valence of encapsulated core beliefs about the self, others, the world, and the image itself significantly reduced following ImRs, and core beliefs were updated to become more positive. Participants reported large affective shifts early in the process, with smaller shifts in the later stages. Fear of negative evaluation did not significantly reduce following ImRs. Outcomes provide some support for cognitive and affective changes during group ImRs for SAD and suggest future research directions to investigate longer-term impacts and to better understand the underlying mechanisms of the technique.
Article
To better understand how social anxiety develops, it is crucial to identify mechanisms that influence anxiety following social stressors. Anxiety sensitivity social concerns (ASSC; fear of publicly observable anxiety symptoms) and fear of negative evaluation (FNE; distress arising from concerns about negative judgment) are constructs that amplify anxiety following social stressors. However, it is unclear how ASSC and FNE influence acute anxiety following stressors in naturalistic settings. In the current study, the impact of ASSC and FNE on anxious arousal and anxious apprehension following stressors was examined in community adults (N = 83; M age = 29.66 years, SD = 12.49, 59.0% female) who completed questionnaires five times per day for two-weeks. Dynamic structural equation modeling was used to examine predictors of overall levels of anxiety as well as anxiety following social and nonsocial stressors. ASSC interacted with the presence of social stressors, such that ASSC positively predicted anxious arousal following social stressors. FNE interacted with the presence of nonsocial stressors to predict both forms of anxiety, such that FNE positively predicted anxiety following nonsocial stressors. These findings suggest ASSC may specifically amplify anxious arousal following social stressors, whereas FNE may broadly amplify anxiety following nonsocial stressors.
Article
Full-text available
The validity of the social phobia subtype distinction was examined in a large sample of carefully diagnosed social phobics (N=89). Generalized and specific subtypes were diagnosed reliably, and the generalized subtype showed a consistent pattern of greater symptom severity than dit the specific subtype. In addition, generalized social phobics with and without avoidant personality disorder were compared, and a difference was found for only 1 of 4 parameters. The results are discussed in terms of the validity of subtyping in social phobia and the diagnostic boundary between social phobia and avoidant personality disorder
Article
Full-text available
The strength of the relationship between anxiety and performance varies from study to study with correlations from extreme negative to positive values. In order to reveal the sources of this inconsistency, a series of meta-analyses was conducted using the Schmidt-Hunter algorithm for effect sizes r.One hundred and twenty-six studies published from 1975 to 1988, based on a total sample of 36,626 subjects, were located after a comprehensive literature search. They include 156 independent samples. An overall analysis with the 156 effect sizes yielded a population effect size of r = −.21. Further analyses aimed at exploring moderator variables that would account for the residual variance, but tests of gender, culture (USA, West Germany and others), and anxiety stability (state/trait) failed to unveil the expected moderator impact. However, analyses with the anxiety components worry and emotionality, kinds of anxiety such as general and test anxiety, and the anxiety measurement point in time yielded systematic differences: the more cognitively determined and the more specific the anxiety measure, the closer was its association with academic performance. A closer relationship was also found if anxiety was measured after the performance situation compared to being measured before.
Article
Full-text available
58 female 1st-yr college students completed a shyness (SH) scale developed by J. M. Cheek and A. H. Buss (1981), conversed with another S for 5 min, and rated themselves and their partner immediately after the conversation ended. Shy Ss reported more time spent self-focusing and more anxious thoughts and other SH symptoms than Ss who were not shy. Shy Ss who conversed with a socially self-confident partner experienced the greatest difficulties during the interaction and rated themselves more negatively than their partners rated them. Results are interpreted as supporting the distribution-of-attention model of shyness as a propensity for engaging in anxious self-preoccupation.
Article
Full-text available
This study examined the relative efficacy of rational restructuring and attentional training for the cognitive treatment of test anxiety. Both treatments were presented in an identical format, which involved imaginal exposure to anxiety-provoking testing situations. In the rational restructuring condition subjects were trained to identify and modify irrational beliefs, and in the attentional training condition subjects were trained to reduce attention to task-relevant variables. The results suggested that both cognitive treatments were superior to the waiting-list control group in reducing test anxiety and improving performance on analogue tasks, and that treatment effects were maintained at an 8-month follow-up. The lack of significant differences between cognitive treatments was discussed in the context of Bandura's self-efficacy theory. In addition, anxiety-reduction scores (derived from the in-session coping exercises) were found to be significant predictors of treatment outcome.
Article
Full-text available
A greater understanding of the origins of social phobia is much needed. The research to date is limited by the relatively small number of studies that sample clinical populations of individuals with social phobia. There is, however, research derived from related areas such as shyness, social anxiety, self-consciousness, peer neglect, and social withdrawal that contributes to a richer understanding of the etiology of social fears. Combining these areas of research, this review addresses 4 main factors that may be important to the origins of social phobia: (a) genetic factors; (b) family factors; (c) other environmental factors; and (d) developmental factors. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Article
• In 2163 personally interviewed female twins from a population-based registry, the pattern of age at onset and comorbidity of the simple phobias (animal and situational) — early onset and low rates of comorbidity—differed significantly from that of agoraphobia—later onset and high rates of comorbidity. Consistent with an inherited "phobia proneness" but not a "social learning" model of phobias, the familial aggregation of any phobia, agoraphobia, social phobia, and animal phobia appeared to result from genetic and not from familial-environmental factors, with estimates of heritability of liability ranging from 30% to 40%. The bestfitting multivariate genetic model indicated the existence of genetic and individual-specific environmental etiologic factors common to all four phobia subtypes and others specific for each of the individual subtypes. This model suggested that (1) environmental experiences that predisposed to all phobias were most important for agoraphobia and social phobia and relatively unimportant for the simple phobias, (2) environmental experiences that uniquely predisposed to only one phobia subtype had a major impact on simple phobias, had a modest impact on social phobia, and were unimportant for agoraphobia, and (3) genetic factors that predisposed to all phobias were most important for animal Phobia and least important for agoraphobia. Simple phobias appear to arise from the joint effect of a modest genetic vulnerability and phobia-specific traumatic events in childhood, while agoraphobia and, to a somewhat lesser extent, social phobia result from the combined effect of a slightly stronger genetic influence and nonspecific environmental experiences.
Article
Background: To investigate whether each of three DSM-III-R phobic disorders (simple phobia, social phobia, and agoraphobia with panic attacks) is familial and "breeds true."Design: Rates of each phobic disorder were contrasted in first-degree relatives of four proband groups: simple phobia, social phobia, agoraphobia with panic attacks, and not ill controls. Phobia probands were patients who had one of the phobia diagnoses but no other lifetime anxiety comorbidity.Results: We found moderate (two- to fourfold increased risk) but specific familial aggregation of each of the three DSM-III-R phobic disorders.Conclusions: These results support a specific familial contribution to each of the three phobia types. However, conclusions are limited to cases occurring without lifetime anxiety comorbidity and do not imply homogeneity within categories.
Article
In this theoretical paper, it is argued that social anxiety arises from the activation of an evolved mechanism for dealing with intra-species (conspecific) threat, a mechanism which has played a vital role in the evolution of social groups. A model is developed showing how this “agonic” mode of defense, working through the psychological systems of appraisal and coping, leads the socially anxious to perceive others as hostile dominants, to fear negative evaluation from them and to respond, at one level of the disorder, by appeasement and submissive behavior, and at a more severe level of the disorder, by more primitive actions such as escape or avoidance. A further theme put forward is that the socially anxious person appears unable to recruit another evolved mechanism for social relating called the “hedonic” mode, in which social groups are structured in terms of cooperation, equality, and mutual support. Some therapeutic implications of these concepts are explored.
Article
A cognitive view of anxiety is outlined that emphasizes the role self-preoccupation plays in attention and information processing. Two applications of this theoretical approach are given, one in the area of test anxiety and the other relating to cognitive therapies for anxiety.
Article
Research on the etiology of social phobia is virtually nonexistent in part because relevant theories about family and childhood antecedents have not been advanced. The present study was designed to assess the relevance of Buss' (1980) formulations regarding antecedents of social evaluative fears for understanding the development of social phobia. Social phobic patients' perceptions of early parental and childhood characteristics presumed to be associated with social evaluative concerns were compared to those of agoraphobic patients. Social phobics perceived their mothers as more avoidant of social phobic situations, their parents as seeking to isolate them, their parents as overemphasizing the opinions of others, and their parents as deemphasizing family sociability. Social phobics also reported greater self-consciousness and fewer dating partners during adolescence. A discriminant function analysis revealed that these criterion variables accurately classified 91% of social phobics and 77.3% of agoraphobics.
Article
College male undergraduates, either high frequency (HFD) or low frequency daters (LFD), were compared on a variety of self-report, peer rating, and behavioral measures of social competence in heterosexual interactions. Self-report measures of social anxiety and peer ratings of social anxiety and skill showed highly significant differences between the two groups. On an audiotaped social performance task, HFD subjects responded with shorter latencies and more words per response than did LFD subjects. There were relatively few behavioral differences between the groups on two social performance tasks involving live interaction with a female confederate. Only rated social skill and number of silences in the conversations significantly discriminated between the groups. Further, intercorrelations within and across tasks suggested that many of the specific verbal activity measures were highly intercorrelated, and were also related to other indices of social competence, including self-report, observer rating, and peer rating indices. The discussion centered around an analysis of the behavioral components of social competence, and the need for more refined behavioral analysis of interactional sequences, apart from simple frequency measures.
Chapter
Discusses recent research in personality and developmental psychology that has focused on key individual and interpersonal variables that relate to child and adolescent shyness / shyness is the normal personality characteristic that most closely parallels social phobia, in that they both share the antecedent of fear of negative evaluation / although shyness and social phobia share cognitive and affective manifestations of fear of negative evaluation, it is not assumed that they are synonymous, because social phobia may involve a more pervasive pattern of avoidance and impairment in social and occupational functioning / review selected research from 4 areas of the personality development literature that have provided insight about the origins and course of shyness / these 4 areas include research on temperament characteristics, family factors, socialization processes, and disturbance in self-esteem (PsycINFO Database Record). [ Bruch, M.A., & Cheek, J.M. (1995). Developmental factors in childhood and adolescent shyness. In R. G. Heimberg, M.R. Liebowitz, D.A. Hope, & F.R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 163-182). New York: Guilford.]
Article
Sixty subjects classified as high or low in social anxiety participated in a structured heterosocial interaction under conditions of either high or low social-evaluative threat. Following the interaction, subjects were asked to recall detailed information about the interaction partner's appearance and the content of the conversation. Socially anxious subjects recalled less information and made more errors in recall than nonanxious subjects. Contrary to prediction, social-evaluative threat did not affect recall. Anxious subjects also reported greater self-focused attention during the interaction. High self-focused attention was associated with superior recall for nonanxious subjects but associated with more frequent omission errors for anxious subjects. Results support cognitive-behavioral formulations of social anxiety which propose that socially anxious individuals engage in self-focused thinking which may impair their ability to process social information.
Article
[Correction Notice: An erratum for this article was reported in Vol 35(4) of Journal of Counseling Psychology (see record 2008-10690-003). The date of receipt indicated for the original manuscript of this article was incorrect. The correct of date of receipt is provided in the erratum.] We designed this study to test the relation between shyness and dysfunction in behaviors that are essential to career development in young adulthood. Specifically we hypothesized that shyness would be inversely related to (a) interpersonal orientation of expressed interests, (b) frequency of career information-seeking, (c) career decidedness, and (d) expectations about the value of assertiveness in job interviews. Results from a 2 (shy vs. nonshy)&×&2 (gender) multivariate analysis of variance were consistent with all of the predictions. Shy undergraduates of both genders were less likely to express interest in interpersonally oriented career fields and to engage in fewer information-seeking activities and were more undecided. With regard to expectations about job interview behavior, a shyness&×&gender interaction was observed that indicated that shy men were significantly less likely than all other groups to expect that various assertive interview behaviors would lead to favorable evaluations from employers and that both shy men and shy women, compared with nonshy men, were less likely to expect that they would actually engage in such assertive behaviors when interviewing. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This research tested questions related to J. M. Cheek and A. H. Buss's (see record 1982-07755-001) prediction that sociability moderates the relation between shyness and dysfunction interaction. In Study 1, a confirmatory factor analysis of Shyness and Sociability scales revealed that these factors are more inversely related than previously recognized. In Study 2, the relations of shyness, sociability, and gender and their interactions with dysfunctional behavior were tested during a conversation with an opposite-sex partner. Using analyses that tested the unique influence of each variable, the results failed to confirm that shy-sociable Ss evidenced more dysfunctional behavior than shy low-sociable Ss. Instead, shyness was the most consistent predictor of behavioral, physiological, and cognitive indexes of anxiety, and shy men were more dysfunctional on some criteria. In particular, shyness differences in perceived visibility of one's nervous behaviors are discussed relative to the role of cognition in shyness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
begin . . . with a brief historical overview of psychoanalytic theory and its application to issues of social functioning / the major portion of the paper is an elaboration and extension of P. Gilbert's psychobiological model of social anxiety and social phobia (Gilbert 1989, Trower and Gilbert 1989) / the defense/safety model . . . incorporates important ideas of a psychodynamic nature but draws on many other disciplines, particularly ethological theory, with which to interpret the experience of social anxiety present recent social and biological research that allows us to speculate on biological and environmental variables that may be relevant to the development of the defense/safety system / present a case history of an individual with social phobia that received a dynamic interpretation . . . and apply the defense/safety model in order to extend the interpretation of the case as well as to identify additional treatment suggestions (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
78 high and low socially anxious female undergraduates (measured by a modification of the Social Avoidance and Distress Scale) participated in a brief, videotaped conversation with a male confederate. Ss then viewed the videotape of that interaction, a videotape of a high or low anxious female in a similar interaction, or no videotape, as part of a 2 (social anxiety) × 4 (videotape condition) factorial design. Ss completed several questionnaires assessing self-statements, self-evaluations, irrational beliefs, and self-report of social skills (e.g., the Survey of Heterosexual Interactions, the Irrational Beliefs Test). Judges and confederates also evaluated Ss' performance. The main purpose of the study was to explore the effects of social anxiety and videotape feedback on various cognitions. There were no effects for videotape feedback. Results indicate that high socially anxious females (a) emitted significantly more negative and (b) fewer positive self-statements than low socially anxious females and (c) scored significantly lower in social skills on a self-report questionnaire. Self-evaluations and performance ratings made by judges and confederates did not differentiate the high from low socially anxious females. Findings support cognitive factors as mediators of social anxiety in women. (24 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Describes the development of a scale to assess individual differences in self-consciousness. Construction of the scale involved testing the 38 initial items with 130 female and 82 male undergraduates. A principal components factor analysis of the data yielded 3 factors accounting for 43% of the variance: Private Self-Consciousness, Public Self-Consciousness, and Social Anxiety. The final version of the scale, which contained 23 items, was administered to several groups of undergraduates (N = 668) to obtain norms, test-retest (2 wks), subscale correlation, and reliability data. Test-retest reliabilities were .84 for the Public Self-Consciousness scale, .79 for the Private Self-Consciousness scale, .73 for the Social Anxiety scale, and .80 for the total score. Public Self-Consciousness correlated moderately with both Private Self-Consciousness and Social Anxiety, while the correlation of Private Self-Consciousness with Social Anxiety fluctuated around zero. No sex differences in scores were observed. Implications for research and therapy are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Proposes a theory of social impact specifying the effect of other persons on an individual. According to the theory, when other people are the source of impact and the individual is the target, impact should be a multiplicative function of the strength, immediacy, and number of other people. Furthermore, impact should take the form of a power function, with the marginal effect of the Nth other person being less than that of the ( N–2)th. When other people stand with the individual as the target of forces from outside the group, impact should be divided such that the resultant is an inverse power function of the strength, immediacy, and number of persons standing together. The author reviews relevant evidence from research on conformity and imitation, stage fright and embarrassment, news interest, bystander intervention, tipping, inquiring for Christ, productivity in groups, and crowding in rats. (27 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Patients with circumscribed speech phobia, generalized social phobia, and generalized social phobia with avoidant personality disorder were assessed with modified Stroop color-naming tests. The two generalized social phobia groups demonstrated cognitive interference on a General Social Stimuli Stroop Test (e.g., party), which was not evident in the circumscribed speech phobia group. As expected, cognitive interference was manifested across all groups in a Specific Speech Stimuli Stroop Test (e.g., speech). Interference effects were found among all groups in a Negative Social Evaluative Stroop Test (e.g., foolish) as well. No differences were noted on any test between the generalized social phobia patients with and without avoidant personality disorder. Results support the distinctiveness of the circumscribed speech phobia group. Together with the similarity of response between the generalized social phobia groups with and without avoidant personality disorder, findings are consistent with contemporary conceptualizations of subtypes of social phobia.
Article
Heterosocial anxiety has been assessed in a variety of ways, but little emphasis has been placed on collecting data in the person's social environment. The present study employed a behavioral diary to examine the daily heterosocial interactions of high- and low-socially-anxious students in the natural environment. Highanxious students participated in fewer interactions over a two-week period and reported higher anxiety, poorer performance, and less satisfaction with their performance than low-anxious students. Total and mean duration of interactions did not discriminate between groups, and subjects' sex made little difference. The impact of a variety of situational variables was also assessed. Issues regarding the use of heterosocial diaries for behavioral assessment are discussed.
Article
Causal attributions of three groups of subjects varying in social anxiety according to the Social Interaction Self-Statement Test were assessed, either from the perspective of the self or from the viewpoint of another person in three negative situations. Interactions between self-other perspective and anxiety reached significance for the stability and globality dimensions as well as for affect. These interactions supported the major hypothesis that self—other biases in causal attribution, typically reported in the social psychological literature which are favorable to the self, are absent or reversed in situations which are problematic for socially anxious individuals. The main effect of perspective was modified by the above interactions and indicated that the typical self-other bias was demonstrated but only in the low-anxious group. The expectancy variable showed only main effects of perspective and, anxiety. Higher anxious groups had higher expectancies for the occurrence of the negative events. Expectancies were higher for others than for the self. There were no significant main effects or interactions for the causal dimensions of locus and control. A general implication of the present data is that adequate adjustment may require attributionaJ sets which enhance one's sense of competency relative to others. Furthermore, attribution-based approaches to counseling may need to focus on a network of causal ascriptions and specifically address self-other discrepancies in perceptions of causality.
Article
Using a thought-listing protocol that directed subjects to separately list their thoughts for self and an interaction partner, this study tested the unique contribution of perceptions of the other person to social anxiety when interacting with a stranger. After viewing a picture of their partner in an upcoming interaction, undergraduate men completed two thought-listing protocols and then engaged in a 5-min conversation with an attractive female confederate. Multivariate hierarchical regression indicated that the percentage of negative self-thoughts was inversely related to self-efficacy ratings collected prior to and early during the conversation and positively related to subjective anxiety at the end of the interaction. After controlling for self-thoughts, perceptions about the partner's positive attributes contributed to prediction of behavioral signs of anxiety, but not self-efficacy or subjective anxiety. The results are consistent with the hypothesis that an attentional focus on positive attributes of the other person may increase one's social anxiety beyond that attributable to negative self-thoughts. Possible mechanisms that may account for this relationship are discussed.
Article
Socially anxious and nonanxious men participated in a practice interaction with an experimental assistant, ostensibly in preparation for a second interaction with another student. The success of the practice interaction was varied by manipulating the assistant's behavior and the experimenter's feedback about the subject's performance. Subjects then rated their perceived social ability (i.e., self-efficacy), their personal standard, and their perception of others' standards for evaluating their social performance for an upcoming interaction. Nonanxious men expected their ability to match or exceed both their own and others' standards of evaluation in all feedback conditions. Socially anxious men, on the other hand, believed their ability would fall short of what others expected in all three conditions. Unlike nonanxious men, socially anxious men who experienced a successful social interaction believed others would expect more from them in upcoming interactions than did anxious men who experienced social failure.
Article
Children, ages 9 through 12, who were either high or low in test anxiety were matched on sex and grade level, then randomly assigned to one of three conditions: (1)attentional training, (2)placebo training, and (3)notraining control. The attentional training group was rewarded for successful inhibition of irrelevant responses and correct attending behavior on a task similar to the Stroop Color Word Test. The placebo training group experienced the same training task but received rewards that were not contingent on inhibition of the irrelevant responses. For the younger children, posttraining assessement on the Stroop test revealed that attentional training enabled high test-anxious children to perform as well as low test-anxious children, while high test-anxious children in the placebo and control groups continued to make more errors than low test-anxious children. This effect did not occur for the older subjects. A second test measuring central-incidental learning was included to test for generalization effects of training, but this task yielded nonsignificant results.
Article
Socially anxious and nonanxious college students provided detailed personal information and were led to believe that they would soon interact with a person of the opposite sex who was either similar or dissimilar to them in terms of background, experience, and other attributes. In accord with the social psychological literature, nonanxious students greatly preferred similar to dissimilar partners. Socially anxious students showed no difference between their ratings of similar and dissimilar partners and assigned much less extreme ratings to both partners than did nonanxious subjects. Subjects' predictions about partners' likely anxiety and how partners would evaluate subjects' anxiety also differed according to subjects' anxiety levels, but these differences did not parallel attraction scores. Results are compared with other research on social anxiety and contrasted to past research on social anxiety, attitude similarity, and attraction. Directions for future research are addressed, and questions about the validity of the thought-listing technique are discussed.
Article
Forty-nine patients participated in a study comparing cognitive-behavioral group treatment (CBGT) for social phobia with a credible placebo control. CBGT consisted of exposure to simulated phobic events, cognitive restructuring of maladaptive thoughts, and homework for self-directed exposure and cognitive restructuring between sessions. Control patients received a treatment package consisting of lecture-discussion and group support that was comparable to CBGT on measures of treatment credibility and outcome expectations. At pretest, posttest, and 3- and 6-month follow-ups, patients completed assessments that included clinician ratings, self-report measures, and behavioral, physiological, and cognitive-subjective measures derived from a behavioral simulation of a personally relevant phobic event. Both groups improved on most measures, but, at both posttest and follow-up, CBGT patients were rated as more improved than controls and reported less anxiety before and during the behavioral test. At follow-up, CBGT patients also reported significantly fewer negative and more positive self-statements than controls on a thought-listing task following the behavioral test. Regardless of treatment condition, follow-up changes in clinician-rated phobic severity were significantly related to changes on the thought-listing measure.
Article
Previous studies of the modified Stroop Color-Naming Task with social phobics have demonstrated increased latencies for the color-naming of social threat words in comparison to neutral or physical threat words. However, these effects could be partially due to differences in the semantic relatedness of the words in these various categories and/or the blocked format (i.e., all words of one type presented sequentially) in which words have been presented. To examine these issues, color-naming latencies of individuals with social phobia to social threat, semantically related neutral, and unrelated neutral words were examined in both blocked and randomly intermixed formats. Significant differences in color-naming were found for word stimuli presented in the blocked format only. In the blocked format, social phobics were significantly slower to color-name social threat words than related neutral words and significantly slower to color-name related neutral words than unrelated neutral words. Color-naming latencies also increased across trials regardless of word type. There were no effects of word type in the random format. Thus, both presentation format and semantic priming, as well as threat value, may have contributed to color-naming interference for the social threat words. Possible interpretations of our findings along with implications for future Stroop research in persons with social phobia are discussed.
Article
This study examined the discrepancy between self-established standards and self-efficacy in social situations. Socially anxious and nonanxious men rated a series of standards for judging the adequacy of their performance in an upcoming social interaction; subjects also rated their social self-efficacy, or perceived ability to handle the interaction. Nonanxious subjects expected their ability to equal or exceed all standards of evaluation. Anxious subjects expected their ability to equal that of the average subject and also believed their performance would match their personal standard. However, anxious subjects believed their social behavior would fall short of what they believed the experimenter expected of them. No support was found for the idea that socially anxious men establish perfectionistic standards. Rather, they believed that others held standards for them that they could not achieve. The results are congruent with cognitive theories of social anxiety.
Article
A revised Stroop color-naming task was used to test hypotheses derived from Beck's cognitive theory of anxiety disorders which proposes that social phobics are hypervigilant to social-evaluative threat cues. Color-naming latencies for social and physical threat words were compared to matched neutral words for both social phobics and individuals with panic disorder. As predicted, social phobics showed longer latencies for social threat words, and panickers had longer latencies for physical threat words. Latency for color-naming social threat words correlated with self-reported avoidance among social phobics. These results are consistent with Beck's notion of self-schemata which facilitate the processing of threat cues. Methodological issues and clinical implications are discussed.
Article
This study examined perfectionism and standard-setting within a self-regulation framework and systematically compared the roles of both factors in dysphoria and social anxiety. Four groups of subjects representing all combinations of social anxiety and dysphoria completed measures of self-oriented and socially prescribed perfectionism. They then rated three aspects of self-regulation (standard-setting, frequency of self-appraisal, and self-efficacy) in the context of a social task. Socially prescribed perfectionism was associated with frequent self-appraisal during the interaction, but not with standard-setting. Self-oriented perfectionism was associated with establishing goals that exceeded one's perceived social ability and with importance of meeting personal goals. The extent to which either type of perfectionism was associated with dysphoria or social anxiety was dependent on social self-efficacy.
Article
To evaluate a measurement procedure for a clinically relevant analog target behavior (social anxiety), college males (23 socially anxious and 23 nonanxious) were exposed to two brief interactions, 3 wk apart, with a female confederate. Half of each anxiety group was given low-demand-for-imporovement posttest instructions, while half was presented high-demand instruction. The procedure validly discriminated the two anxiety groups on several self-report, behavioral, and heart-rate measures. Demand manipulations had no positive effect on any measure. Physiological arousal was substantial and showed no evidence of habituation from pre- to posttest exposures.