Quincy J. J. Wong

Impact of rumination versus distraction on anxiety and maladaptive self-beliefs in socially anxious individuals.

A large body of experimental evidence has demonstrated the adverse effects of rumination on depressive mood and cognitions. In contrast, while prominent models of social phobia (Clark & Wells, 1995; Rapee & Heimberg, 1997) have proposed rumination as a key maintaining factor, the effects of rumination in social anxiety have not been extensively explored. In a sample of (N = 93) undergraduates, this study investigated the impact of rumination versus distraction following a social-evaluative task on anxiety and another key component of social phobia: maladaptive self-beliefs. Relative to distraction, rumination maintained anxiety in both high and low socially anxious individuals, and maintained unconditional beliefs in high socially anxious individuals. The results support models of social phobia and also suggest important theoretical extensions. Implications for the treatment of social anxiety are discussed.

Impact of anticipatory processing versus distraction on multiple indices of anxiety in socially anxious individuals.

In models of social phobia, anticipatory processing before a social-evaluative event is a key maintaining factor for the disorder. This study investigated the impact of anticipatory processing versus distraction before a social-evaluative task on affective (self-reported anxiety), psychophysiological (skin conductance), cognitive (self-reported maladaptive self-beliefs) and behavioural (in-situation performance) responses of participants. High and low socially anxious undergraduates were randomly allocated to either an anticipatory processing or distraction condition, and then completed an impromptu speech task. Relative to distraction, anticipatory processing increased self-reported anxiety in all participants, and increased skin conductance and the strength of conditional and high standard beliefs in the high (but not low) socially anxious participants. Unconditional beliefs were not affected. For high socially anxious individuals, anticipatory processing was also indirectly associated with poorer speech performance by increasing self-reported anxiety. Anticipatory processing appears to have multiple adverse effects in socially anxious individuals.

The aetiology and maintenance of social anxiety disorder: A synthesis of complimentary theoretical models and formulation of a new integrated model.

BACKGROUND Within maintenance models of social anxiety disorder (SAD), a number of cognitive and behavioural factors that drive the persistence of SAD have been proposed. However, these maintenance models do not address how SAD develops, or the origins of the proposed maintaining factors. There are also models of the development of SAD that have been proposed independently from maintenance models. These models highlight multiple factors that contribute risk to the onset of SAD, but do not address how these aetiological factors may lead to the development of the maintaining factors associated with SAD. METHODS A systematic review of the literature was conducted to identify aetiological and maintenance models of SAD. We then united key factors identified in these models and formulated an integrated aetiological and maintenance (IAM) model of SAD. A systematic review of the literature was then conducted on the components of the IAM model. RESULTS A number of aetiological and maintaining factors were identified in models of SAD. These factors could be drawn together into the IAM model. On balance, there is empirical evidence for the association of each of the factors in the IAM model with social anxiety or SAD, providing preliminary support for the model. LIMITATIONS There are relationships between components of the IAM model that require empirical attention. Future research will need to continue to test the IAM model. CONCLUSIONS The IAM model provides a framework for future investigations into the development and persistence of SAD.

Validation of the Self-Beliefs Related to Social Anxiety Scale: A Replication and Extension

The importance of self-beliefs in prominent models of social phobia has led to the development of measures that tap this cognitive construct. The Self-Beliefs Related to Social Anxiety (SBSA) Scale is one such measure and taps the three maladaptive belief types proposed in Clark and Wells’s model of social phobia. This study aimed to replicate and extend previous research on the psychometric properties of the SBSA. Replicating previous research, in an (undiagnosed) undergraduate sample (n = 235), the SBSA was found to have a correlated three-factor structure using confirmatory factor analyses, and the SBSA and its subscales demonstrated good internal consistency and test–retest reliability. The SBSA and its subscales also had unique relationships with social anxiety and depression, the majority of which replicated previous research. Extending previous research, the SBSA and its subscales showed good incremental validity in the undergraduate sample and good discriminative validity using the undergraduate sample and a sample of individuals with social phobia (n = 33). The SBSA’s strong theoretical basis and the findings of this study suggest that the SBSA is an ideal research and clinical tool to assess the cognitions characteristic of social phobia.

Processing mode during repetitive thinking in socially anxious individuals : evidence for a maladaptive experiential mode

BACKGROUND AND OBJECTIVES Evidence from the depression literature suggests that an analytical processing mode adopted during repetitive thinking leads to maladaptive outcomes relative to an experiential processing mode. To date, in socially anxious individuals, the impact of processing mode during repetitive thinking related to an actual social-evaluative situation has not been investigated. We thus tested whether an analytical processing mode would be maladaptive relative to an experiential processing mode during anticipatory processing and post-event rumination. METHODS High and low socially anxious participants were induced to engage in either an analytical or experiential processing mode during: (a) anticipatory processing before performing a speech (Experiment 1; N = 94), or (b) post-event rumination after performing a speech (Experiment 2; N = 74). Mood, cognition, and behavioural measures were employed to examine the effects of processing mode. RESULTS For high socially anxious participants, the modes had a similar effect on self-reported anxiety during both anticipatory processing and post-event rumination. Unexpectedly, relative to the analytical mode, the experiential mode led to stronger high standard and conditional beliefs during anticipatory processing, and stronger unconditional beliefs during post-event rumination. LIMITATIONS These experiments are the first to investigate processing mode during anticipatory processing and post-event rumination. Hence, these results are novel and will need to be replicated. CONCLUSIONS These findings suggest that an experiential processing mode is maladaptive relative to an analytical processing mode during repetitive thinking characteristic of socially anxious individuals.

The relationship between the maladaptive self-beliefs characteristic of social anxiety and avoidance.

The Clark and Wells (1995) model of social phobia proposes that there are three types of maladaptive self-beliefs responsible for persistent social anxiety (high standard, conditional, and unconditional beliefs). Another prominent feature of social phobia is the avoidance of social-evaluative situations. To our knowledge, there have been no studies that have examined the relationship between these specific maladaptive self-belief types and avoidance. We hypothesised that while accounting for potential confounding variables (i.e., fear of negative evaluation and general symptomology), each of the three maladaptive self-belief types would be significantly and positively associated with cognitive and behavioural avoidance in the social domain, but not these forms of avoidance in the non-social domain. In a sample of undergraduates (N = 361), we found only partial support for our hypotheses. In the social domain, stronger high standard beliefs predicted less behavioural avoidance, stronger unconditional beliefs predicted more behavioural avoidance, and stronger conditional beliefs predicted more cognitive avoidance. In the non-social domain, stronger unconditional beliefs predicted more cognitive avoidance. These relationships were obtained at all levels of social anxiety. Additionally, the unconditional beliefs partially mediated the relationship between social anxiety and behavioural avoidance in the social domain, and the conditional beliefs fully mediated the relationship between social anxiety and cognitive avoidance in the social domain. These results emphasise the distinct nature of each of the maladaptive self-belief types and the need to elucidate their relationship with other components in theoretical models of social phobia.

Maladaptive social self-beliefs in alcohol-dependence: a specific bias towards excessive high standards.

Background Emotional and interpersonal impairments associated with alcohol-dependence have been recently explored, but the distorted cognitive representations underlying these deficits remain poorly understood. The present study aims at exploring the presence of maladaptive social self-beliefs among alcohol-dependent individuals, as these biased self-beliefs have been recently shown to play a crucial role in the development and maintenance of other psychopathological states (social anxiety and depression). Methodology/Principal findings Twenty-five recently detoxified alcohol-dependent participants and 25 matched controls filled in self-report questionnaires evaluating maladaptive social self-beliefs, interpersonal problems and several comorbid states (anxiety, social anxiety, depression). As compared to controls, alcohol-dependent individuals showed higher scores than controls for the three subcategories of maladaptive social self-beliefs (high standards, conditional beliefs and unconditional beliefs). Our key finding was that when comorbidities were controlled for, alcohol-dependence was associated with a specific bias towards exaggerated high standards in social contexts. Moreover, these high standards beliefs were strongly correlated with interpersonal problems. Conclusions/Significance These results provide the first insights into the influence of cognitive biases on interpersonal problems in addictive states, and suggest that maladaptive self-beliefs could have a central influence on the development and maintenance of alcohol-dependence.

A weighty issue: explaining the association between body mass index and appearance-based social anxiety.

Research has indicated that individuals who are overweight or obese are more likely to experience mental health difficulties. One line of research has indicated that body mass index (BMI) is positively associated with appearance-based social anxiety, rather than social anxiety more generally. However, there is a lack of research that has attempted to explain this association. Thus, the current study recruited an undergraduate sample (N=90) and aimed (a) to replicate previous research by examining the associations between BMI, social anxiety, and appearance-based social anxiety and (b) to extend previous research by examining two potential mediators in the relationship between BMI and appearance-based social anxiety suggested in the literature (i.e., body image dissatisfaction and emotional eating). Analyses indicated that BMI was not associated with social anxiety but positively associated with appearance-based social anxiety. The association between BMI and appearance-based social anxiety was only mediated by body image dissatisfaction, and the model of these relationships emerged as the best fitting model relative to a plausible alternative model. The findings replicate and extend previous research on weight status and psychological factors and highlight the need for future longitudinal research on BMI, appearance-based social anxiety, and body image dissatisfaction so that interventions for obesity and weight loss maintenance programs can be ultimately enhanced.

Psychometric evaluation of the English version of the Extended Post-event Processing Questionnaire

Background: The importance of post-event processing (PEP) in prominent models of social anxiety disorder has led to the development of measures that tap this cognitive construct. The 17-item Extended Post-event Processing Questionnaire (E-PEPQ) is one of the most comprehensive measures of PEP developed to date. However, the measure was developed in German and the psychometric properties of the English version of the E-PEPQ have not yet been examined. Design: The current study examined the factor structure, internal consistency, and construct validity of the English version of the E-PEPQ. Methods: English-speaking participants (N = 560) completed the English version of the E-PEPQ, a measure of social anxiety and a measure of depression. Results: A 15-item version of the E-PEPQ with a correlated three-factor structure (referred to as the E-PEPQ-15) emerged as the best fitting model using confirmatory factor analyses, and the E-PEPQ-15 and its subscales demonstrated good internal consistency. The E-PEPQ-15 and two of its three subscales also had significantly stronger positive associations with the social anxiety measure than with the depression measure. Conclusions: The psychometric properties of the E-PEPQ-15 obtained in the current study justify the use of the measure in research, particularly in the domain of social anxiety.

The Developmental Psychopathology of Social Anxiety and Phobia in Adolescents

The highest incidence rates for social anxiety disorder (SAD) occur during the period from late childhood to early adulthood. A number of factors that increase vulnerability for the development of SAD have been proposed in the literature, including genes, temperament, biological factors, cognitive factors, parent factors, life events, peer experiences, performance deficits, general learning mechanisms, and cultural factors. These proposed aetiological factors have been given different weightings in theoretical accounts of the aetiology of SAD. Genes, temperament, cognitive factors, parent factors, life events, and peer experiences are generally emphasised in theoretical accounts, while biological factors, performance deficits, general learning mechanisms, and cultural factors have received less emphasis. The proposed aetiological factors have also been empirically examined to varying extents in the literature. In general, the majority of research into the proposed aetiological factors has been limited by the use of cross-sectional designs and the recruitment of individuals already diagnosed with SAD. Further research is needed to obtain better evidence to evaluate the aetiological role of the proposed factors. Such research will ultimately help to develop efficacious early intervention and prevention strategies for SAD.