Stephanos P. Vassilopoulos

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10-11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test-retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.

Social anxiety and the vigilance-avoidance pattern of attentional processing

A modified version of the probe detection task was used to investigate the time course of attentional biases for emotional words in high and low socially anxious individuals. Word pairs were presented at two exposure durations, 200 and 500 msec, in order to investigate the different components of attentional bias in anxiety (e.g., vigilance or avoidance of threat). There was evidence of an attentional bias favouring initial vigilance towards (social and physical) threat words and subsequent avoidance of the same stimuli in high social anxiety. In contrast, low socially anxious individuals did not exhibit an attentional preference. The interaction of social anxiety and exposure duration for threat words remained when controlling for general negative affect. Theoretical and clinical implications of the results are discussed.

Anticipatory processing plays a role in maintaining social anxiety

Abstract The cognitive model of social phobia by Clark and Wells (Social phobia: diagnosis, assessment and treatment) (1995) proposes that, while anticipating a social situation, individuals with social phobia engage in several biased cognitive processes which enhance anticipatory anxiety. Prior to giving a speech, high and low socially anxious individuals (N=40 per group) were instructed to either engage in anticipatory processing (think about what could go right or wrong in the impending situation, predict how they will appear to others and recall past similar situations) or perform a distraction task. Compared to high socially-anxious individuals whose anticipatory processing was inhibited, high socially-anxious participants engaging in anticipatory processing reported more anxiety feelings and predicted more negative overall appearance. High socially-anxious individuals also recalled more negative and less positive information about their public selves, but only when their anticipatory processing was inhibited rather than facilitated. For the low socially-anxious individuals there was no significant difference between the two anticipation conditions on measures of anxiety, self-perception, and memory for emotional information. The results are discussed in relation to the Clark and Wells model.

ANTICIPATORY PROCESSING IN SOCIAL ANXIETY

A psychometric study was conducted with the aim of collecting basic information about anticipatory processing and its relationship to social anxiety. A self-report measure of anticipatory processing was developed and utilized in a large student sample. The results confirmed that such processing is very common before an anticipated feared social event and a significant correlation ( r =0.49) between anticipatory processing scores and social anxiety was found, which remained when trait anxiety and depression were controlled. A factor analysis indicated that all items of the measure except for two loaded significantly on one factor and accounted for the 47.3% of the variance. Socially anxious individuals in the study reported that their thoughts about the event were recurrent, intrusive, interfered with their concentration and increased their state of anxiety. Also, they reported that they wished they could avoid the situation. The results are discussed in terms of the Clark and Wells cognitive model of social phobia.

Interpretations and judgments regarding positive and negative social scenarios in childhood social anxiety

The present study extended our understanding of cognitive biases in childhood social anxiety. A non-clinical sample of 11-13-year olds completed social anxiety and depression scales and were presented with scenarios depicting positive and mildly negative social events. Social anxiety was associated with tendencies to interpret positive social events in a discounting fashion, to catastrophize in response to mildly negative social events, and to anticipate more negative emotional reactions to the negative events. Implications for understanding and treating social anxiety are discussed.

Social Anxiety and the Effects of Engaging in Mental Imagery1

Previous research has shown that patients with social phobia often experience negative, observer-perspective self-images when in anxiety-provoking social situations [Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610]. The present experiment investigated whether negative images play a role in the maintenance of social anxiety. High and low socially anxious individuals (n = 40 in each group) were asked to give a speech in front of a camera. Half of the samples were instructed to hold in mind a negative, observer-perspective self-image during the speech, whereas the other half held a positive image of themselves. High socially anxious participants in the negative imagery condition perceived more bodily sensations, rated specific aspects of their performance unfavourably, and rated the self-image as a more accurate reflection of the self, compared to high socially anxious individuals in the positive imagery condition. For the low socially anxious individuals there was no significant difference between the two imagery conditions on measures of anxiety and performance. These results support the hypothesis that negative self-imagery may be involved in the maintenance of social anxiety.

A Psychoeducational School-Based Group Intervention for Socially Anxious Children

This study investigated the impact of a psychoeducational group for social anxiety aimed at elementary children. An 8-week psychoeducational program based on empirically validated risk factors was designed. Interventions included cognitive restructuring, anxiety management techniques, and social skills training. Pre- and posttest data from 3 groups conducted over the course of 3 months were combined for a total of 40 participants. Results indicate completion of the group led to a significant decrease on scales measuring social anxiety and negative interpretation of ambiguity, as well as a significant increase in childrens self-reported likeability. Implications for practice and future research are discussed.

Experimentally modifying interpretations for positive and negative social scenarios in children: a preliminary investigation.

BACKGROUND Past research suggests that socially anxious individuals display a tendency to interpret ambiguous and clearly valenced information in a threatening way. Interpretation training programs, in which individuals are trained to endorse benign rather than negative interpretations of ambiguous social scenarios, have proven effective for reducing anxiety-related cognitive biases. However, it is not clear whether the same paradigms are effective in modifying interpretation biases for clearly valenced social information. METHOD In this experiment, a group of unselected children (aged 10-13 years) was trained to endorse the more positive of two possible interpretations of mildly negative and positive social events. RESULTS Data revealed that this group (n = 77) showed a decrease in catastrophic interpretations and an increase in neutral interpretations of mildly negative events compared to children in a no-training control group (n = 76). Furthermore, participants in the training condition showed an increase in positive interpretations and a trend for a decrease in discounting interpretations of positive events. However, training did not affect emotional ratings of mildly negative and positive events or trait social anxiety. CONCLUSIONS Notwithstanding certain limitations of this pilot study, we believe that the results are promising with regard to modifying interpretative biases for clearly valenced vignettes, and that further study regarding the effects of training on mood is warranted.

A Multi-Session Attribution Modification Program for Children with Aggressive Behaviour: Changes in Attributions, Emotional Reaction Estimates, and Self-Reported Aggression

BACKGROUND Research suggests that aggressive children are prone to over-attribute hostile intentions to peers. AIMS The current study investigated whether this attributional style can be altered using a Cognitive Bias Modification of Interpretations (CBM-I) procedure. METHOD A sample of 10-12-year-olds selected for displaying aggressive behaviours was trained over three sessions to endorse benign rather than hostile attributions in response to ambiguous social scenarios. RESULTS Compared to a test-retest control group (n = 18), children receiving CBM-I (n = 16) were less likely to endorse hostile attributions and more likely to endorse benign attributions in response to a new set of ambiguous social situations. Furthermore, aggressive behaviour scores reduced more in the trained group than in the untrained controls. Children who received attribution training also reported less perceived anger and showed a trend to report more self-control than those in the control group. CONCLUSIONS Implications of these findings are discussed.

The Differential Effects of Written and Spoken Presentation for the Modification of Interpretation and Judgmental Bias in Children

Background: Interpretation training programs, in which individuals are trained to interpret ambiguous scenarios in either a negative or benign way, have proven effective in altering anxiety-related cognitive biases in both children and adults. Aims: The current study investigated whether the effects of the interpretation training procedure in children are differentiated according to the mode of presentation of the training. Method: Ninety-four primary school children (aged 10–12 years) scoring above the mean on a social anxiety scale were randomly allocated to four groups, in which they were trained using written or spoken presentation of training materials in either the negative or benign direction. Results: For the negative training, children who heard the training material spoken aloud (spoken presentation) made more negative interpretations of ambiguous social events, compared to children who read the training material (written presentation). However, for the benign training, there was less clear evidence for a differentiation of the effects between the two modes of presentation, although children in the spoken presentation group performed better in a stressful task and showed a trend to rate their mood as more positive after the task than children in the written presentation group. Conclusions: These results not only forward our understanding of the mechanism of the genesis of cognitive bias in children, but also highlight the need for further investigation of how to optimize the effectiveness of interpretation training in children.