Content uploaded by Randi E McCabe
Author content
All content in this area was uploaded by Randi E McCabe on Jan 15, 2014
Content may be subject to copyright.
Emotional Intelligence in Social Phobia
and Other Anxiety Disorders
Laura J. Summerfeldt & Patricia H. Kloosterman &
Martin M. Antony & Randi E. McCabe &
James D. A. Parker
Published online: 3 August 2010
#
Springer Science+Business Media, LLC 2010
Abstract This study examined the associations between
clinical anxiety, domains of emotional intelligence (EI), and
three clin ician-rated indices of maladjus tment. Of key
interest was whether social phobia (SP) is unique among
anxiety disorders in being characterized by low er levels of
Interpersonal and, particularly, Intrapersonal EI, and whether
these differentially predict maladjustment. Individuals with
SP (n=169) obsessive-compulsive disorder (n=65) and
panic disorder (n=64), and nonclinical controls (n=169)
completed the short form self-report Emotional Quotient
Inventory (EQ-i: S). All anxiety disorder groups showed
lower total EI than controls, and differed among themselves
with the SP group displaying the lowest levels of total EI
and lower scores on two EQ-i:S subscales (Interpersonal
and, more robustly, Intrapersonal). The Intrapersonal dimen-
sion alone predicted all indices of greater maladjustment in
the SP group. These findings indicate a negative relationship
between anxiety disorders and EI, and reaffirm the foremost
link between Intrapersonal EI and SP and its functional
outcomes.
Keywords Emotional intelligence
.
Anxiety disorder
.
Social phobia
.
Adjustment
.
Comorbidity
Emotional intelligence (EI) can be conceptualized as a set
of abilities and traits related to efficaciously perceiving,
expressing, unders tanding, utilizing, and managing emo-
tions in oneself and others (Austin et al. 2008; Mayer et al.
2008). Discussions of the EI construct often allude to its
potential clinical utility. However, these commonly cite
findings from research on constructs having conceptual
overlap with EI as surprisingly littl e empirical literature
exists on EI in adult clinical populations (Parker 2005).
Clearly the topic warrants additional research, and this may
be particularly true for certain conditions. One of these is
social phobia (SP), also known as social anxiety disorder.
SP is characterized by “ clinically significant anxiety
provoked by exposure to certain types of social or
performance situations, often leading to avoidance behavior”
(American Psychiatric Association 2000,p.393).Adefining
theme is therefore one’s ability to manage the behavioral and
emotional aspects of interacting with others.
The EI construct embodies the interpersonal and intra-
personal (i.e., emotional self-regulatory) competencies
essential to this ability. Difficulties with interpersonal
competencies, for example, are evidenced by the self and
other-ratings of impairment in social skills often found to
be correlated with high levels of social anxiety (e.g., Creed
and Funder 1998; Fydric h et al. 1998; Stangier et al. 2006;
see also Vertue 2003). Whether self-reports reflect actual
deficits or biased misperceptions thereof is a matter of
L. J. Summerfeldt (*)
:
P. H. Kloosterman
:
J. D. A. Parker
Department of Psychology, Trent University,
Peterborough, Ontario, Canada K9J 7B8
e-mail: lsummerfeldt@trentu.ca
L. J. Summerfeldt
:
M. M. Antony
:
R. E. McCabe
Anxiety Treatment and Research Centre,
St. Joseph’s Healthcare & Department of Psychiatry
and Behavioral Neurosciences, McMaster University,
Hamilton, Ontario, Canada
P. H. Kloosterman
Department of Psychology,
Queen’s University,
Kingston, Ontario, Canada
M. M. Antony
Department of Psychology,
Ryerson University,
Toronto, Ontario, Canada
J Psychopathol Behav Assess (2011) 33:69–78
DOI 10.1007/s10862-010-9199-0
debate. Cognitive approaches to SP maintain that they arise
from problematic beliefs about otherwise intact social
skills, with distorted appraisals leading to inaccurate
judgements of one’s own and others’ social behaviors (see
Beck et al. 2005; Cartwright-Hatton et al. 2005; Clark and
Wells 1995; Hofmann and Scepkowski 2006; Rapee and
Heimberg 1997). Though differing in their basis in fact,
actual versus self-perceived deficits may have comparable
impacts on functioning. Both may ultimately lead to
disruptive levels of situational distress, poor processing of
social cues, the appearance of social ineptness, and negative
evaluation by others (Turk et al. 2008). Intrapersonal
competencies, the other key component of EI, represent
the facility with which the individual manages and utilizes
his or her own emotional states. Such self-regulatory
failures as excessive self-focus, anxiety over one’s antici-
pated emotional responses, and inaccurate appraisals of
one’s displays of emotion figure prominently in cognitive
appraisal models of social anxiety (Clark and Wells 1995 ;
Rapee and Heimberg 1997; Stopa and Clark 1993; see also
Hofmann 2000).
In the words of Creed and Funder (1998), “social anxiety
is a trait with negative inter and intrapersonal consequences”
(p. 31). As such, the EI construct may be potentially useful
in research on social anxiety, and may aid with “theory
knitting” (see Kalmar and Sternberg 1988) by uniting
attributes and processes often captured in diverse ways by
different researchers and theorists. As an individual differ-
ences variable conceptualized as non-specific to situational
context (i.e., how one behaves typically) and emotional
valence (i.e., not just regarding negative or pathological
emotions), it also offers opportunities for understanding
continuities and discontinuities across clinical and non-
clinical populations.
In one of only two existing published studies of the
associations among EI, social anxiety and adjustment, our
group found that EI, as measured by the short version of the
self-report Emotional Quotient Invent ory (EQ-i:S; Bar-On
1997), was strongly negatively related to social inte raction
anxiety in a nonclinical sample (Summerfeldt et al. 2006).
EI was the foremost predictor of interpersonal adjustment,
accounting for most of its association with social interaction
anxiety. This was chiefly due to the strong correlations
between social interaction anxiety and the interpersonal
and, particularly, intrapersonal domains of EI. In the EQ-i:
S, the l atter comprises emotional self-awareness and
expres sion, as well as the ability to use emotions in
thought. Partly consistent results were found in a subse-
quent study of EI and clinical social anxiety, which
ascertained EI using a performance measure rather than
self-report. Jacobs et al. (2008), used the Mayor-Salovey-
Caruso Emotional Intelligence Test (MSCEIT; Mayer et al.
2001) to compare individuals with social phobia (n=28) to
nonclinical controls. Though the two groups did not differ
on any EI domains, a strong negative correlation was found
between severity of social anxiety and Experiential EI, or
basic-level emotional processing involving the abilities to
perceive one’s own and others emotions and to use
emotions in communication and thought. The two studies’
findings are somewhat difficult to compare, as one’s
operationalization differentiates the locus of EI (i.e.,
Interpersonal versus Intrapersonal) and the other’s empha-
sizes levels of processing across loci. Nonetheless both
studies’ findings are in line with cognitive models of social
anxiety that i nclu de the perpetuating ro les played by
problematic appraisals of one’s own emotional state (Clark
and Wells 1995; Rap ee and Heimberg 1997; Wells 1997).
The study by Summerfeldt et al. (2006) pointed to the
potential utility of the EI construct in research on social
anxiety and suggested hypotheses for further study, but
had some notable limitations. Firstly, the research was done
with a nonclinical sample. It is unclear to what extent these
findings generalize to the clinical population, and if so,
whether the relationships between social anxiety and the
interpersonal and intrapersonal facets of EI have specificity
or are true of anxiety conditions in general. To date there has
been no research published on the topic of EI across the
anxiety disorders. However, researchwithconceptually
similar constructs, such as emotional self-awareness
(Novick-Kline et al. 2005), and alexithymia (e.g., Cox et al.
1995; Fukunishi et al. 1997;Turketal.2005) suggests that
difficulties with monitoring, identifying, and using
emotional information may characterize anxiety disorders
other than SP.
An additional and more fundamental limitation of our
previous study was its exclusive reliance on self-report
data. The study had several methodological strengths: it
used data from a large multi-cohort sample, permitting
approximation of population values, and operationalized
the constructs as latent var iables, thus opti mizing the
reliability of the findings. Nonetheless, all variables used
in the analyses were assessed by Likert-style question-
naires, completed at a single session by a sole informant.
The possibility cannot therefore be ruled out that some
results may have reflected the influence of measurement
variance or systematic response bias, whereby individuals
answering in a negative or positive direction on one
measure did so on others for reasons other than the valid
correlation of the constructs being measured. These often
influence responses to personality questionnaires, and can
be accentuated when psychopathology variables are included
(see Furnham 1986). Multiple factors may contribute,
including response sets, impressionistic global responding,
or the systematic influence at the time of reporting of such
fluctuating variables as state affect or current stress (Paulhus
1991; Podsakoff et al. 2003). Whatever the source, the
70 J Psychopathol Behav Assess (2011) 33:69–78
absence of (a) a mixed method of data collection (e.g.,
interview and self-report questionnaire); (b) a buffering
time interval between ascertainment of key variables; or
(c) an objective source of information about, for
example, functional outcomes or symptoms of social
anxiety, limited the conclusions that could be drawn from
the empirical relationships observed by Summerfeldt et al.
(2006).
The present study sought to further examine the
relationship between social anxiety, EI, and functional
outcomes while addressing these limitations. In order to
determine the generalizability of our previously reported
findings and their specificity to social anxiety, data were
collected with samples of individuals with one of three
clinical anxiety disorders: SP, obsessive-compulsive disorder,
and panic disorder, as well as with a community sampled
nonclinical control group. To minimize the influence of
measurement variance and response biases, only EI was
assessed using self-report questionnaire; all other variables
were ascertained by carefully conducted diagnostic inter-
view, with interview and questionnaire completed at different
times. The metrics employed for the two key variables were
also different: EI scores were measured continuously
whereas social anxiety was operationalized as a categorical
diagnostic variable. Finally, the indices of maladjustment
used for comparisons among the clinical groups—DSM-IV-
TR Axis V Global Assessment of Functioning scores, and
number of current and lifetime co-occurring disorders—were
objective and interviewer rated. Based on findings reported
in Summerfeldt et al. (2006), we hypothesized that interper-
sonal and intrapersonal EI scores would differentiate the
clinical and control groups, with the greatest contrast seen
for the SP group, as well as predict maladjustment in the SP
group.
Method
Participants
Clinical participants were 298 individuals s equentially
presenting for assessment at an outpatient anxiety clinic,
whose principal diagnosis met criteria for one of three
categories of anxiety disorder: obsessive-compulsive disor-
der (OCD; n=65, 77% female, mean age = 34.69±12.34),
panic disorder with or without agoraphobia (PD; n=64,
75% female, mean age = 37.31±11.22), or SP (n=169,
50% female, mean age = 34.41±11.44) in accordance with
the fourth edition of the Diagnostic and Statistical Manual
(DSM-IV-TR; American Psychiatric Association 2000) and
assessed using the Structured Clinical Interview for DSM-
IV (SCID; First et al. 1996). Exclusion criteria included the
following: (a) having more than one of the target disorders
as a principal diagnosis (i.e., of equal severity), and (b) for
those in the PD and OCD groups, having a current or
lifetime additional diagnosis of SP.
Diagnostic Interviews were conducted by psycholo-
gists, postdoctoral fellows, and senior graduate students,
all of whom received extensive training and supervision
in the SCID-IV. To ensure t hat diagnosti c cri teria were
being applied consistently, the re sult s o f e ach intervi ew
for this study were presented at a weekly team meeting
chaired by a psychologist with more than 10 years of
experience in training others to administer the SCID-IV.
At the meeting, diagnostic questions and r esponses
were reviewed, and a consensus diagnosis was reached.
When multiple disorders were present, a diagnosis was
considered principal if it caused the most distress and/or
impairment.
Clinical participants completed the EQ-i:S as part of
their initial asses sment along with other questionnaires not
relevant to the present study, and consented to the use of
assessment data for research purpos es. Questionnaires were
completed approximately 1 week prior to a scheduled
diagnostic interview.
The nonclinical control group consisted of a convenience
sample of 169 community sampled volunteers (50% female,
mean age = 34.41±11.44), case-matched by age and gender
to those in the SP group. These participants were recruited
by advertisements posted in the community seeking
participants for research on emotions and personality.
They received no monetary compensation, and completed
the EQi:S in their own homes under the supervision of
one of several research assistants. Community sample
participants were not screened for current or past mental
disorder diagnoses.
Measures
Structured Clinical Interview for DSM-IV (SCID-IV) The
SCID-IV (Research Version with Psychotic Screen; First
et al. 1996) was used for all diagnoses with clinical
participants. This semi-structured interview provides
comprehensive coverage of DSM-IV-TR Axis I disor-
ders, with the exception of psychotic disorders for which
screening questions are provided. The SCID-IV was also
used to assess clinical participants’ scores on DSM-IV-
TR Axis V, the Global A ssessment of Functioning Scale
(GAF), which provides a global score of 1–10 0 rep re -
senting the individual’s overall psychological, social, and
occupational adjustment. The SCID -IV h as strong psy-
chometric qualities and is the most widely used diagnos-
tic interview in North American research (Summerfeldt and
Antony 2002). Earlier versions of the SCID have been found
to have good inter-rater reliability for all diagnoses (kappa
range: .69–1.0; Zanarini and Frankenburg 2001).
J Psychopathol Behav Assess (2011) 33:69–78 71
Bar-On Emotional Quotien t Inventory: Short (EQ-i:S) The
EQ-i:S (Bar-On 2002) is a 5 1-item self-report measure
derived from the 133-item Bar-On Emotional Quotient
Inventory (EQ-i; Bar-On 1997) to assess the core features
of EI. It has four composite scales. The Intrapersonal
subscale measures how well one understands, recognizes,
and expresses one’s own emotions (e.g., “It’s hard for me to
describe my feelings”). Items on the Interpersonal subscale
tap the ability to relate to, empathize with, and identify the
emotions of, other people (e.g., “I’m good at understanding
the way other people feel”). The Adaptability subscale
measures one’s ability to adapt to changing demands and
use emotions to facilitate problem solving (e.g., “My
approach in overcoming difficulties is to move step by
step”). The final subscale, Stress Management, assesses the
ability to regulate strong negative emotions and control
impulses (e.g., “ I believe that I can stay on top of tough
situations”).
The scales on this short form correlate highly with their
corresponding scales on the long form (EQ-i), ranging from
0.73 to 0.96 for men and from 0.75 to 0.97 for women
(Bar-On 2002). Respondents are asked to rate how a
statement describes them using a five-point Likert rating
scale (1 = very seldom true of me; 5 = very often true of
me). The EQ-i:S subscales and total scale possess good
reliability (e.g., five-month total test-retests between .58
and .70; subscale alphas between .76 and .84), and display
strong factorial and discriminant (Bar-On 2002), predictive
(Parker et al. 2004), convergent (Parker et al. 2001) and
divergent (Wood et al. 2009) validities.
Results
Group means and standard deviations for the EQ-i:S total
and four subscales are shown in Table 1. All EQ-i:S
subscales showed satisfactory internal reliability, with Cron-
bach’s alphas for clinical participant data ranging from .81
for the Intrapersonal subscale to .85 for the Adaptability
subscale. Similar values were observed for the nonclinical
control group, with the exception of the Adaptability
subscale, with an alpha of .71.
1
Group Comparisons
An initial analysis of variance (ANOVA) was performed,
with EQ-i:S total score as the dependent variable and
diagnostic group (three anxiety disorder groups and
nonclinical controls) as the independent variable.
2
The
omnibus effect was significant, F (3,463)=71.43, p<.001,
η
2
=.32. Post hoc Newman-Keuls tests showed that all three
diagnostic groups scored significantly (p<.05) lower than
the nonclinical control group on total EQ-I:S. The only
differences observed among the clinical groups were for the
SP group, which displayed a significantly lower mean total
score than did both the PD and OCD groups (see Table 1).
In order to examine group effects at the subscale level,
four univariate ANOVAs were conducted, with a Bonfer-
roni adjustment of α=.013. There were significant effects
of group for all subscales: Interpersonal, F (3, 463)=
21.31, η
2
=.12, Intrapersonal, F (3, 463)=68.78, η
2
=.31,
Adaptability, F (3, 463)=19.84, η
2
=.11, and Stress, F (3,
463)=38.63, η
2
=.20, p <.00001 in all cases. As shown in
Table 1, Post-hoc Newman-Keuls comparisons showed
that all three diagnostic groups scored significantly lower
than the nonclinical control group on the EQ-I:S Intraper-
sonal, Adaptability, and Stress subscales. Only the SP group
scored significantly lower than the nonclinical control group
on the Interpersonal subscale. The SP group scored
significantly lower than the PD and the OCD groups on
both the Interpersonal and Intrapersonal subscales, but not
on the Adaptability and Stress subscales. No differences
were found between the PD and OCD groups.
3
Predicting Impairment: Past Year Functioning
We sought to determine whether the EQ-I:S Intrapersonal
and Interpersonal subscales—found to distinguish the SP
group from the other clinical groups—also contributed to
any differences among these groups in highest level of
overall functioning in the past year. In order to increase
power, the PD and OCD group data were combined into a
1
This is consistent with community sample psychometric data
reported in the EQ-i:S manual, wherein alpha coefficients for the
Adaptability subscale are the lowest for each age group for men, and
tie for lowest for most age-groups in women.
3
To rule out the possibility that differences between the SP group and
the other two clinical groups’ Intrapersonal and Interpersonal EQ-I:S
scores were due to state negative affect at time of self-report, analyses
were conducted with data from a majority subset (74%, n=218) of
clinical participants that had completed the short Depression Anxiety
and Stress Scale (DASS-21; Lovibond and Lovibond 1995) at the
same time as the EQ-I:S. The DASS21 is a measure of current (last
week) state affect, and its Depression and Anxiety subscales display
sound psychometric properties in clinical anxiety samples (Antony
et al. 1998a). We compared the three clinical groups’ scores on the two
EQ-I:S subscales, with DASS Anxiety and Depression subscale scores
entered simultaneously as covariates. With the state affect variables
controlled for, differences between the groups remained significant for
both Interpersonal, F (2, 213)=6.20, p < .01 [DASS Depression
β=−.41, t (213)= −4.94, p<.0001, Anxiety β=.10, t (213)=1.22, n.s.]
and Intrapersonal EQ-I:S scores F (2, 213)=9.43, p<.0001 [DASS
Depression β=−.42, t (213)=−5.46, p<.0001, Anxiety β=−.06, t
(213)=−.82, n.s.].
2
Levene’s test showed homogeneity of variances across the four
groups for the EQ-i:S total score and all subscales.
72 J Psychopathol Behav Assess (2011) 33:69–78
single “other anxiety disorder” group (n=129), which was
then compared with the SP group.
4
An ANOVA with
diagnostic group as the independe nt variable and past-year
GAF score as the outcome variable was significant, F
(1,207)=4.54, p<.05, η
2
=.02, reflecting the lower mean
GAF score for the SP group (54.88±7.65) than for the other
anxiety disorders groups (57.22±8.10). In order to deter-
mine whether either the Intrapersonal or Interpersonal EI
variables contributed to this difference, the analysis was
conducted a second time with these two EQ-I:S subscales
entered simultaneously as covariates.
5
The two variables
were correlated at r=.40 (p<.0001). When they were
controlled for, the difference between groups in past-year
GAF score was no longer significant, F (1,205)=.13; n.s.
Results for the covariates showed a significant effect for the
Intrapersonal variable, β=.31, t (205)=4.49, p<.00001, but
not the interpersonal variable, β=.10, t (205)=1.47, n.s.
Thus, the signifi cantly lower level of past year functioning
observed in the SP group compared to the other anxiety
disorders group was entirely accounted for by differences in
Intrapersonal EQ-I:S scores, with the Intrapersonal variable
acting as a positive predictor of past year GAF score.
Predicting Impairment: Current and Lifetime Comorbidity
In order to determine whether the Intrapersonal and
Interpersonal subscales contributed to any group differences
in either current or lifetime comorbidity rates, two sets of
analyses using ANOVA were conducted again comparing
the SP group to the composite other anxiety disorder group.
The first analysis, with number of current additional
diagnoses (i.e., other than the principal diagnosis) as the
outcome variable, was significant, F (1,296) =19.31, p
<.00001, η
2
=.06, reflecting the greater mean number of
additional diagnoses in the SP group (2.05±1.59) than in
the other anxiety disorders group (1.29±1.36).
6
To deter-
mine whether Intrapersonal or interpersonal EI contributed
to this difference, the analysis was conducted a second time
as an analysis of covariance (ANCOVA), with these EQ-I:S
subscales entered simultaneously as covariates. With the
two variables controlled for, the difference between groups
in current comorbidity rates was diminished but remained
significant, F (1, 294)=9.11,p<.005, η
2
=.03. Results for
the covariates showed a significant effect for the Intraper-
sonal variable, β=−.24, t (294)=−3.93, p<.0001, but not
the interpersonal variable, β=.05, t (294)=.76, n.s..
The second analysis, with number of lifetime additional
diagnoses as the outcome variable, also show ed a signifi-
cant difference between the two groups, F (1,296)=15.74,
p<.0001, η
2
=.05, with a greater number seen in the SP
group (2.42±1.64) than in the other anxiety disorders group
(1.68±1.52). Whe n this analysis was conducted a second
time with the Intrapersonal and Interpersonal subscales
entered simultaneously as covariates the difference
between groups was diminished but remained significant,
F (1, 294)=7.49, p<.01, η
2
=.02. Results for the covariates
showed a significant effect for the Intrapersonal variable,
β=−.22, t (294)=−3.72, p<.0005, but not the interpersonal
variable, β=.06, t (294)=.97, p=n.s.. Thus, the significantly
greater numbers of both current and lifetime comorbid
disorders observed in the SP group compared to the other
anxiety disorders g roup were partly accounted for by
5
Tests of parallelism showed homogeneity of regression to b e
achieved across diagnostic groups for intrapersonal and Interpersonal
subscale scores for all outcome variables analyzed with ANCOVA.
6
Current and lifetime comorbidity counts are ordinal data, and the
distributions for both were positively skewed for both groups. Given
the large sample sizes and the fact that the skew and spread was
comparable across groups, both ANOVA and ANCOVA can be
expected to be robust to violations of the assumptions of normality
and homogeneity of variance (Tabachnick and Fidell 1996). As a
further check, Levene’s tests confirmed homogeneity of variance
across groups for both comorbidity outcomes, and nonparametric
Kruskal-Wallis ANOVAs confirmed the ANOVA results.
EQ-i:S scale Group
PD (n=64) SP (n=169) OCD (n=65) NC controls (n=169)
Total 130.39±20.21
a
116.79±19.72 127.88±18.99
a
146.31±16.64
Interpersonal 41.08±5.11
a
37.01±7.10 40.43±5.83
a
42.06±5.11
a
Intrapersonal 32.83±8.45
a
26.67±8.00 32.18±8.39
a
38.62±6.61
Adaptability 24.36±5.94
a
23.59±6.17
a
23.95±5.20
a
27.78±4.20
Stress 32.13±7.91
a
29.52±8.07
a
31.31±7.44
a
37.85±6.22
Table 1 Means and standard
deviations for emotional quo-
tient inventory: short (EQ-i:S)
scores across diagnostic group
PD panic disorder with or with-
out agoraphobia, SP social pho-
bia, OCD obsessive-compulsive
disorder, NC nonclinical. Means
in the same row sharing super-
scripts do not differ at p<.05 in
the Neuman-Keuls comparison
4
Current (past month) GAF rating is conventionally used at our site,
but for the present study’s purposes it was considered less meaningful
than a rating of the individual’s highest level of functioning in the past
year—an indicator of impairment conceivably less influenced by
week-to-week fluctuations in symptoms and life events. However, past
year GAF ratings were not assigned for the full duration of the data
collection, thus sample sizes were reduced for analyses with the GAF
(SP group n=121; other anxiety group n=88). As there was no
difference between the PD (n=39) and OCD (n=49) groups in past-
year GAF rating [t (86)=.33, p=n.s.], and there were no research
questions about differences among SP and these specific diagnoses,
their merger into a composite “other anxiety disorders” group seemed
sensible for this and subsequent analyses. The control group was not
included in these analyses as they were not administered the SCID-IV.
J Psychopathol Behav Assess (2011) 33:69–78 73
differences in Intrapersonal EQ-I:S scores, with lower scores
associated with higher rates of both types of comorbidity.
A final analysis was performed in order to determine to
what extent the difference observed between the SP and
other anxiety d isorder group in level of past year
functioning was accounted for by differences in current
(i.e., past year) comorbidity rates, and whether the
Intrapersonal EI variable contributed to the difference
above-and-beyond the effect of comorbidity. This issue
was i nvestigated with a single ANCOVA, with past-year
GAF score as the outcome variable, diagnostic group (SP,
other anxiety disorder group) as the independent variable, and
number of current additional diagnoses and the Intrapersonal
EQ-i:S subscale score as covariates. When these two variables
were controlled for, the difference between groups was not
significant, F (1,205)=.39, p=n.s. Results for the covariates
showed significant effects for both the current additional
diagnoses variable, β=−.19, t (205)=−2.85, p<.005, and the
intrapersonal variable, β=.31, t (205)=4.69, p<.00001.
Thus, Intrapersonal EI remained a significant predictor of
the lower past year functioning observed in the SP group
compared to the other anxiety disorders group, even when
group differences in current comorbidity rates were taken
into account.
Discussion
This study sought to expand upon and address limitations
of existing research by examining the associations between
clinical anxie ty, domains of EI, a nd th ree in dices of
maladjustment: GAF ratings and current and lifetime
comorbidities. Of particular interest was whether SP is
unique among the three anxiety disorders examined in
being characterized by lower levels of Interpersonal and
Intrapersonal EI, and whether these variables predict
differences among the anxiety groups in levels of malad-
justment. Partial support was found for the hypotheses
related to the Interpersonal EI domain. Although the SP
group did show significantly lower Interpersonal EI scores
than did both other diagnostic groups, contrary to expec-
tation, the SP group was alone among the diagnostic groups
in having lo wer scores than nonclinic al controls. In
contrast, all diagnostic groups scored lower than nonclinical
controls on the Intrapersonal EI domain, with, as predicted,
the greatest contrast found for the SP group. Intraperso nal
EI scores also differentiated the SP group from the other
diagnostic groups, and, unlike Inter personal EI scores, were
found to predict all indices of great er maladjustment in the
SP group. These findings, which reaffirm earlier ones with
a nonclinical sample (Summerfeldt et al. 2006), allow us to
make conclusions more confidently about the importance in
SP of competencies related to the understanding of
emotions in self, more so than the interpersonal ones
implicit in the disorder’s appellation.
Lower scores on two EI subscales—Stress Management
and Adaptability—distinguished all anxiety groups from
the nonclinical comparison group, but not from one
another. These two EI variables gauge one’s ability to
manage and utilize emotions in challenging contexts and of
the four domains of EI examined here show the greatest
overlap with traditional conceptions of “emotion regula-
tion” (e.g., Frijda 1986; Gross 2002). This finding, then, is
consistent with a body of literature showing such abilities to
be fundamental to adjustment (Mayer et al. 2004) and
mental health (Kring and Werner 2004).
The SP group had a lower Interpersonal EI score than
did all comparison groups. This was also the only EQ-I:S
subscale that did not differentiate the other anxiety disorder
groups from nonclinical controls. Though these findings are
noteworthy in replicating an association found with
nonclinical participants (Summerfeldt et al. 2006), they
are perhaps best viewed as evidence for the validity of this
EQi-S subscale. It is well demonstrated that individuals
with SP self-rate their social competencies as weak, often
more so than do their interaction partners (e.g., Rapee and
Lim 1992; Segrin and Kinney 1995; Stopa and Clark 1993).
It is also noteworthy that the other anxiety groups’
Interpersonal EI sc ores were comparable to thos e of
nonclinical controls. Although social and relational prob-
lems often accompany anxiety disorders other than SP (see
Mendlowicz and Stein 2000) these likely arise from factors
other than specific interpersonal deficits, such as negative
affect and phobic avoidance (see Telch et al. 1995).
All the anxiety disordered groups had lower Intraper-
sonal EI scores than did nonclinical controls, a finding
consistent wi th the well established l ink between diffi-
culties identifying and describing emotions, and disorders
that involve problems in the modulation of distressing
affects (see Taylor et al. 1997). However, consistent with
Summerfeldt et al. (20 06 ), intrapersonal EI emerged as an
extraordinarily salient dimension of EI for the SP group.
Lower intrapersonal EI scores differentiated this group
from nonclinical controls and, most notably, from the
other clinic al anxiet y group s , with an effe ct size for the
group differences almost three times greater than that for
the interpersonal EI domain.
A specific link between social anxiety and inadequate
awareness and comprehension of one’semotionsissuggested
by research on emotion regulation. In a factor analytic
study with a nonclinical sample, Menni n et al. (2007)
identified “poor understanding”, “negative reactivity,” and
“maladaptive m anagement of emotions” as sub-factors of
a higher-order “emotion dysregulation” factor. Poor
understanding and maladaptive management both pre-
dicted levels of social anxiety, but when overlap with self-
74 J Psychopathol Behav Assess (2011) 33:69–78
reported GAD and major depression symptoms was
controlled only poor understanding remained as a unique
predictor of social anxiety. Poor understanding of emo-
tions, however, may be further deconstructed accordingly
to how “purely” intrapersonal, or private, is its expression.
In a study of anxiety conditions and emotion in a l arge
nonclinical sample, Turk et al. (2005) found that greater
difficulty identifying emotions, but not describing them,
distinguished social anxiety from GAD as well as cont rols.
This is somewhat counter-intuitive: describing emotions,
by definition, entails an interpersonal context that ought to
be more negatively impacted by social anxiety (e.g., a
sample item from the measure used by Turk et al. was “It
is difficult for me to find the right words for my feelings”).
Combined with the results of the present study, these
findings suggest that poor self-awareness and comprehen-
sion and differentiation of one’s emotions are a funda-
mental problem in social anxiety independent of
interpersonal context.
The importance of the Intrapersonal variable in our
findings is underscored by its unique prediction of
differences between the SP and other anxiety disorder
group on all three indices of maladjustment. Our earlier
research found Interpersonal and, particularly, Intraper-
sonal EI to be significant contributors to the strong
negative relationship between social anxiety and adjust-
ment, as measured by self-rated life satisfaction
(Summerfeldt et al. 2006). Does this effect hold true for
objective indicators of general functioning and life
adjustment? Consistent with reports of high functional
impairment in SP (e.g., Antony et al. 1998b;Schneier
et al. 1994), the SP group exhibited poor past-year social
and occupational adjustment relative to the other anxiety
group, as ascertained by GAF scores. More notably, this
difference in GAF ratings was completely accounted for
by the SP group’s lower Intrapersonal EI s cores. The
significance of adaptive functioning in GAF scores can be
obscured by variance contributed by the presence of
symptoms (Skodol et al. 1988). However our analyses
showed that even when number of symptoms (i.e., comor-
bidity) was statistically accounted for, GAF differences
among the diagno stic grou ps were still significantly
impacted by Intrapersonal EI scores.
In keeping with clinical population studies of anxiety
disorders (e.g., Brown et al. 2001) the SP group had more
current and lifetime comorbidities than thei r counterparts
with PD and GAD . Again, Intrapersonal EI scores were a
robust predictor of these differences, whereas Interpersonal
EI was not. It seems sensible to c onsider range of
comorbidity, particula rly over the lifespan, as an index of
general vulnerability to psychological maladjustment. If
this reflected poor coping or regulation of strong emotions
then one would expect differences among the clinical
groups in the Adaptability and Stress Management sub-
scales of the EQ-I:S. However, there were no such group
differences. This is congruent with Jacob et al.’s(2008)
finding that social anxiety severity was unrelated to
Strategic EI (higher-level conscious emotional processing).
Both sets of results implicate difficulties early in the
process of emotion regulation (i.e., initial labelling and
identifying of emotions) more than downstream efforts at
repair and management (see Gross 2002; Rottenberg and
Gross 2003).
Given the self-report and cross-sectional nature of these
data, our findings raise important questions. Are individuals
with SP more likely to appraise their intrapersonal
competencies as weak, in effect displayi ng a memory or
attentional bias for negative information about the self?
Some cognit ive models posit a global tendency on the part
of socially phobic i ndividuals to appraise their own
competencies in the worst possible light; perhaps as part
of a negatively biased mental representation of how they
appear to others (see Clark and Wells 1997; Turk et al
2008). However, presumably this negative bias would have
led to comparably deflated scores on all EQ-i:S subscales.
This was not the case. Alternatively, did these self-reports
reflect actual deficits, with lower Intrapersonal EI poten-
tially leading to an increased risk for the development of
SP? More subtly, might such diminished self-reports arise
from intact competencies, but a lesser confidence or
propensity to apply them? Although this study
’s cross-
sectional data are not able to answer these questions, it
seems unlikely that biases in self-report alone would be so
predictive of the clinician-rated impairment variables. Nor
would they account for the association between social
anxiety severity and lower performance EI reported by
Jacobs et al. (2008). Whether due to faulty appraisals or
actual deficits, problems with Intrapersonal EI are associ-
ated with substantial, objectively discernable, life problems
for this population.
This study’s findings have potential theoretical implica-
tions. Contemporary cognitive models of SP posit the
perpetuating roles played by inaccurate appraisals of one’s
own emotional state (Clark and Wells 1995; Rapee and
Heimberg 1997; Wells 1997), but usually reference emotion
and situation-specific difficulties (i.e., perceptions of
anxiety states in social situations). The finding that adults
with SP endorse having poor abilities to compre hend and
express their own emotions—outside of a social interaction
context and without reference to type of emotion—supports
Summerfeldt et al.’s(2006) suggestion that social anxiety is
linked with more global self-perceived intrapersonal diffi-
culties than are suggested by much existing research. If
these findings are replicated, potential clinical implications
include support for the value of early preventative measures
that incorporate a focus on strengthening the accuracy and
J Psychopathol Behav Assess (2011) 33:69–78 75
confidence with which one reads then uses one’s own
emotional states (see Lock and Barrett 2003), and the need
in therapy to address socially anxious individuals’ percep-
tions of their abilities to access, differentiate, and express
their own emotional states.
Accounts of functional impairment in S P usually
consider interpersonal problems to be the mediator (e.g.,
occupational failures may occur due to difficulties relating
to others; Antony et al. 1998b), but there was no evidence
of this in our data. In particular, our findings do not support
the “ social skills deficit” account of SP. A criticism of
classic research on social skills in SP has been of its use of
molecular behaviors (e.g., gaze duration) rather than global
and dynamic competencies (e.g., general sensitivity and
attunement) to operationalize interpersonal skills (see Alden
and Cappe 1986; Fischetti et al. 1977; Vertue 2003). The
self-rated behaviors assessed by the Interpersonal EI
domain are more consistent with the latter, and though
they were lower in the SP group than in all other groups,
their lack of association with objective indices of malad-
justment suggests that they may reflect biased appraisals
and low social confidence more than actual major social
skills imp airments (c.f., Dannahy and Stopa 2007; Rapee
and Lim 1992; Stopa and Clark 2000). Even so, cognitive
models of SP maintain that even inaccurate self-appraisals
of social competencies can detrimentally impact functioning
(e.g.,Clark and Wells 1995). Our finding that Interpersonal
EI contributed no unique variance to GAF outcomes does
not support this.
This study has limitations, all of which suggest d irec-
tions for future research. We did not include measures of
conceptually overlapping constructs such as alexithymia
and emotion regulation and so cannot determine whether EI
offers incremental value in accounting for differences
among clinical anxiety groups. Existing research shows EI
and alexithymia to be correlated but independent variables,
with EI the broader concept of the two (Parker et al. 2001).
Less is known about the relationship between trait EI and
emotion regulation. The two constructs come from different
traditions. EI is widely regarded as a multidimensional trait-
like individual differences variable with cross-situational
stability. Emotion regulation, in contrast, is generally
conceptualized and operationalized as situation and
emotion-specific (see Rottenberg and Gross 2003; Sloan
and Kring 2007). The degree and nature of the relationship
between the two constructs warrants research attention.
Secondly, our findi ngs with the single-item GAF provide
preliminary evidence of a disorder-specific link between
Intr aper sonal EI and functional im pairment. Use of a
multidimensional measure of functioning would al low
inquiry into how specific domains of impairment may be
differentially related to emotional competencies and possible
differences in these relationships for different anxiety
conditions (see Antony et al. 1998b). In addition, the present
study’s analyses were limited to those anxiety disorder
diagnoses most prevalent at our site. Expanding upon this to
include other anxiety diagnoses, particularly generalized
anxiety disorder (see Turk et al. 2005), would be informa-
tive. Replication of our findings with diagnostically-screened
nonclinical controls would address the limitations posed by
our use of a community sample comparison group. Finally,
the present research relied on categorical DSM-IV diagnoses
to characterize participants so did not analyse potential
relationships between EI domains and differing levels of
severity of the anxiety conditions. Continuous measures of
disorder-specific symptom severity would allow a more
sensitive analysis, as would inclusion in the same analysis of
participants with clinical, subclinical, and nonclinical levels
of symptom severity.
Although we have o ffered interpretations of how
intrapersonal competencies may contribute to the onset
and perpetuation of SP, these are inferences based on cross-
sectional comparisons of differences between groups of
individuals with existing diagnoses. An important unre-
solved issue is the direction of relationship between SP and
low Intrapersonal EI. Do such difficulties render people
more vulnerable to SP an d a host of accompanyi ng
problems, or does SP make people more likely to describe
themselves in this way? Might Intrapersonal EI, as a stable
trait, be detrimentally shaped by the experience of having
significant social anxiety (i.e., the “scar” hypothesis)? A
substantial literature supports the idea that Intrape rsonal
competencies appear early in the course of development,
and are relatively stable (e.g., Lane and Schwartz 1987;
Saarni 2000). Nonetheless, research on anxiety disorders
and alexithymia suggests that such attributes may not only
develop after the onset of psychopathol ogy, but be specific
to it (e.g., Fukunishi et al. 1997). Freyberger (1977)
described l this as “secondary alexithymia”—a reversible
state reaction to inte nse negative affect, like clinical anxiety.
This symptom-specific interpretation of the link between
Intrapersonal EI and social anxiety is not supported by
Summerfeldt et al.’s(2006) finding of a similar relationship
in a high functioning nonclinical sample. Nonetheless,
better understanding of the nature of EI in SP might be
gained by prospective designs with at-risk child and youth
populations, or pre and post-treatment research with adults.
Such designs would also permit study of how Intraper-
sonal EI fits into the collection of variables thought to
comprise the vulnerability profile of SP. These include
dispositional constructs like behavioral inhibition (see
Kimbrel 2008, for a recent review), reactivity to environ-
mental stimuli, and emotional intensity (see Gross 2002;
Rottenberg and Gross 2003). A number of questions might
be asked about the pattern of relationships among Interper-
sonal and Intrapersonal EI and these variables, and in turn
76 J Psychopathol Behav Assess (2011) 33:69–78
between them and key developmental and interpersonal
markers and experiences (see Beidel and Turner 2007; Neal
and Edelmann 2003). Determining their respective roles,
causally and chronologically, in the unfolding of social
anxiety is an imp ortant goal for future research.
References
Alden, L. E., & Cappe, R. (1986). Interpersonal process training for
shy clients. In W. H. Jones, J. M. Cheek, & S. R. Briggs (Eds.),
Shyness: Perspectives on research and treatment (pp. 343–355).
New York: Plenum.
American Psychiatric Association. (2000). Diagnostic and statistical
manual of mental disorders (4th ed., text revision). Washington,
DC: Author.
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R.
P. (1998a). Psychometric properties of the 42-item and 21-item
versions of the Depression Anxiety Stress Scales (DASS) in
clinical groups and a community sample. Psychological Assess-
ment, 10, 176–181.
Antony, M. M., Roth, D., Swinson, R. P., Huta, V., & Devins, G. M.
(1998b). Illness intrusiveness in individuals with panic disorder,
obsessive-compulsive disorder, or social phobia. The Journal of
Nervous and Mental Disease, 186,311–315.
Austin, E. J., Parker, J. D. A., Petrides, K. V., & Saklofske, D. H.
(2008). Emotional intelligence. In G. J. Boyle, G. Matthews, &
D. H. Saklofske (Eds.), The SAGE handbook of personality
theory and assessment: Personality theories and models (Vol. 1,
pp. 576–596). Thousand Oaks: Sage.
Bar-On, R. (1997). Bar-On emotional quotient inventory (EQ-I):
Technical manual. Toronto: MultiHealth Systems.
Bar-On, R. (2002). Bar-On emotional quotient inventory: Short
version—technical manual. Toronto: Multi-Health Systems.
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders
and phobias: A cognitive perspective. New York: Basic Books.
Beidel, D. C., & Turner, S. M. (2007). Etiology of social anxiety disorder.
In D. C. Beidel & S. M. Turner (Eds.), Shy children, phobic adults:
Nature and treatment of social anxiety disorders (2nd ed., pp. 91–
119). Washington, DC: American Psychological Association.
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., &
Macell, R. B. (2001). Current and lifetime comorbidity of the
DSM-IV anxiety and mood disorders in a large clinical sample.
Journal of Abnormal Psychology, 110, 585–599.
Cartwright-Hatton, S., Tschernitz, N., & Gomersall, H. (2005). Social
anxiety in children: social skills deficit, or cognitive distortion?
Behaviour Research and Therapy, 43, 131–141.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia.
In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R.
Schneier (Eds.), Social phobia: Diagnosis, assessment, and
treatment (pp. 69–93). New York: Guilford.
Cox, B. J., Swinson, R. P., Shulman, I. D., & Bourdeau, D. (1995).
Alexithymia in panic disorder and social phobia. Comprehensive
Psychiatry, 36, 195–198.
Creed, A. T., & Funder, D. C. (1998). Social anxiety: from the inside
and outside. Personality and Individual Differences, 25,19–33.
Dannahy, L., & Stopa, L. (2007). Post-event processing in social
anxiety. Behaviour Research and Therapy, 45, 1207–1219.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996).
Structured clinical interview for DSM-IV axis I disorders—
patient edition. New York: New York State Psychiatric Institute,
Biometrics Research Department.
Fischetti, M., Curran, J. P., & Wessberg, H. W. (1977). Sense of
timing: a skill deficit in heterosexual-socially anxious males.
Behavior Modification, 1, 179–194.
Freyberger, H. (1977). Supportive psychotherapeutic techniques in
primary and secondary alexithymia. Psychotherapy and Psycho-
somatics, 28, 337–342.
Frijda, N. H. (1986). The emotions. New York: Cambridge University
Press.
Fukunishi, I., Kikuchi, M., Wogan, J., & Takubo, M. (1997).
Secondary alexithymia as a state reaction in panic disorder and
social phobia. Comprehensive Psychiatry, 38, 166–170.
Furnham, A. (1986). Response bias, social desirability and dissimu-
lation. Personality and Individual Differences, 7, 385–400.
Fydrich, T., Chambless, D. L., Perry, K. J., Buergener, F., & Beazley,
M. B. (1998). Behavioral assessment of social performance: a
rating system for social phobia. Behaviour Research and
Therapy, 36, 995–1010.
Gross, J. J. (2002). Emotion regulation: affective, cognitive, and social
consequences. Psychophysiology, 39, 281–291.
Hofmann, S. G. (2000). Treatment of social phobia: potential
mediators and moderators. Clinical Psychology: Science and
Practice, 7,3–16.
Hofmann, S. G., & Scepkowski, L. A. (2006). Social self-reappraisal
therapy for social phob ia: preliminary findings. Journal of
Cognitive Psychotherapy, 20,45–57.
Jacobs, M., Snow, J., Geraci, M., Vythilingam, M., Blair, R. J. R.,
Charney, D. S., et al. (2008). Association between level of
emotional intelligence and severity of anxiety in generalized
social phobia. Journal of Anxiety Disorders, 22, 1487–1495.
Kalmar, D. A., & Sternberg, R. J. (1988). Theory knitting: an
integrative approach to theory development. Philosophical
Psychology, 1, 153–170.
Kimbrel, N. (2008). A model of the development and maintenance of
generalized social phobia. Clinical Psychology Review, 28 , 592–
612.
Kring, A. M., & Werner, K. H. (2004). Emotion regulation and
psychopathology. In P. Philippot & R. S. Feldman (Eds.), The
regulat ion of emotion (pp. 359–385). Mahwah: Lawrence
Erlbaum Associates.
Lane, R. D., & Schwartz, G. E. (1987). Levels of emotional awareness: a
cognitive-developmental theory and its application to psychopa-
thology. The American Journal of Psychiatry, 144,133–143.
Lock, S., & Barrett, P. M. (2003). A longitudinal study of
developmental differences in universal preventive intervention
for child anxiety. Behaviour Change, 20, 183–199.
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression
anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.
Mayer, J. D., Roberts, R. D., & Barsade, S. G. (2008). Human
abilities: emotional intelligence. Annual Review of Psychology,
59, 507–536.
Mayer, J. D., Salovey, P., & Caruso, D. (2001). Mayer-Salovey-
Caruso Emotional Intelligence Test (MSCEIT). Toronto: Multi-
Health Systems.
Mayer, J. D., Salovey, P., & Caruso, D. R. (2004). Emotional
intelligence: theory, findings, and implications. Psychological
Inquiry, 15, 197–215.
Mendlowicz, M. V., & Stein, M. B. (2000). Quality of life in
individuals with anxiety disorders. The American Journal of
Psychiatry, 157, 669–682.
Mennin, D. S., Holaway, R. M., Fresco, D. M., Moore, M. T., &
Heimberg, R. G. (2007). Delineating components of emotion and
its dysregulation in anxiety and mood psychopathology. Behavior
Therapy, 38, 284–302.
Neal, J., & Edelmann, R. (2003). The etiology of social phobia:
toward a developmental profile. Clinical Psychology Review, 23,
761–786.
J Psychopathol Behav Assess (2011) 33:69–78 77
Novick-Kline, P., Turk, C. L., Mennin, D. S., Hoyt, E. A., &
Gallagher, C. L. (2005). Level of emotional awareness as a
differentiating variable between individuals with and without
generalized anxiety disorder. Journal of Anxiety Disorders, 19,
557–572.
Parker, J. D. A. (2005). The relevance of emotional intelligence for
clinical psychology. In R. Schulze & R. D. Richard (Eds.),
Emotional intelligence: An international handbook (pp. 271–
287). Ashland: Hogrefe.
Parker, J. D. A., Taylor, G., & Bagby, R. M. (2001). The relationship
between emotional intelligence and alexithymia. Personality and
Individual Differences, 30, 107–115.
Parker, J. D. A., Summerfeldt, L. J., Hogan, M. J., & Majeski, S.
(2004). Emotional intelligence and academic success: examining
the transition from high school to university. Personality and
Individual Differences, 36, 163–172.
Paulhus, D. L. (1991). Measurement and control of response bias. In J. P.
Robinson, P. R. Shaver, & L. S. Wrightsman (Eds.), Measures of
personality and social psychological attitudes: Measures of social
psychological attitudes (Vol. 1, pp. 17–59). San Diego: Academic.
Podsakoff, P. M., MacKenzie, S. M., Lee, J., & Podsakoff, N. P.
(2003). Common method variance in behavioral research: a
critical review of the literature and recommended remedies. The
Journal of Applied Psychology, 88, 879–903.
Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral
model of anxiety in social phobia. Behaviour Research and
Therapy, 35, 741–756.
Rapee, R. M., & Lim, L. (1992). Discrepancy between self and
observer ratings of performance in social phobics. Journal of
Abnormal Psychology, 101, 727–731.
Rottenberg, J., & Gross, J. J. (2003). When emotion goes wrong:
realizing the promise of affective science. Clinical Psychology:
Science and Practice, 10, 227–232.
Saarni, C. (2000). Emotional competence: A developmental perspec-
tive. In R. Bar-On & J. D. A. Parker (Eds.), Handbook of
emotional intelligence (pp. 68–91). San Francisco: Jossey-Bass.
Schneier, F. R., Heckelman, L. R., Garfinkell, R., Campeas, R.,
Fallon, B. A., Gitow, A., et al. (1994). Functional impairment in
social phobia. Journal of Clinical Psychology, 55, 322–331.
Segrin, C., & Kinney, T. (1995). Social skills deficits among the
socially anxious: rejection from others and loneliness. Motivation
and Emotion, 19,1–24.
Skodol, A. E., Link, B. G., Shrout, P. E., & Horwath, E. (1988). The
revision of axis V in DSM-III-R: should symptoms have been
included? The American Journal of Psychiatry, 145, 825–829.
Sloan, D. M., & Kring, A. M. (2007). Measuring changes in emotion
during psychotherapy: conceptual and methodological issues.
Clinical Psychology: Science and Practice, 14, 307–322.
Stangier, U., Heidenreich, T., & Schermelleh-Engel, K. (2006).
Safety behaviors and social performance in patients with
generalized social phobia. Journal of Cognitive Psychothera py,
20,17
–31.
Stopa, L., & Clark, D. M. (1993). Cognitive processes in social
phobia. Behaviour Research and Therapy, 31, 255–267.
Stopa, L., & Clark, D. M. (2000). Social phobia and the interpretation
of social events. Behaviour Research and Therapy, 38, 273–283.
Summerfeldt, L. J., & Antony, M. M. (2002). Structured and
semistructured diagnostic interviews. In M. M. Antony & D. H.
Barlow (Eds.), Handbook of assessment and treatment plan-
ning for psychological disorders (pp. 3–37). New York:
Guilford.
Summerfeldt, L. J., Kloosterman, P. H., Antony, M. M., & Parker, J.
D. A. (2006). Socia l anxiety, emotion al intellig ence, and
interpersonal adjustment. Journa l of Psy chopat hology and
Behavioral Assessment, 28,57–68.
Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics
(3rd ed.). New York: HarperCollins.
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1997). Disorders of
affect regulation: Alexithymia in medical and psychiatric illness.
New York: Cambridge University Press.
Telch, M. J., Schmidt, N. B., Jaimez, T. L., Jacquin, K. M., &
Harrington, P. J. (1995). Impact of cognitive-behavioral treatment
on quality of life in panic disorder patients. Journal of Consulting
and Clinical Psychology, 63, 823–830.
Turk, C. L., Heimberg, R. G., Luterek, J. A., Mennin, D. S., & Fresco,
D. M. (2005). Emotion dysregulation in generalized anxiety
disorder: a comparison with social anxiety disorder. Cognitive
Therapy and Research., 29,89–106.
Turk, C. L., Heimberg, R. G., & Magee, L. (2008). Social anxiety
disorder. In D. H. Barlow (Ed.), Clinical handbook of psycho-
logical disorders: A step-by-step treatment manual (4th ed., pp.
123–163). New York: Guilford.
Vertue, F. M. (2003). From adaptive emotion to dysfunction: an
attachment perspective on social anxiety disorder. Personality
and Social Psychology Review, 7, 170–191.
Wells, A. (1997). Cognitive therapy of anxiety disorders: A practice
manual and conceptual guide. New York: Wiley.
Wood, L. M., Parker, J. D. A., & Keefer, K. V. (2009). The emotion
quotient inventory: A review of the relevant research. In C.
Stough, D. H. Saklofske, & J. D. A. Parker (Eds.), Assessing
emotional intelligence: Theory, research and applications (pp.
67–84). New York: Springer.
Zanarini, M. C., & Frankenburg, F. R. (2001). Attainment and
maintenance of reliability of axis I and II disorders over the
course of a longitudinal study. Comprehensive Psychiatry, 42,
369–374.
78 J Psychopathol Behav Assess (2011) 33:69–78
