Social skills, social outcomes, and cognitive features of childhood social phobia.

Social skills, social outcomes, self-talk, outcome expectancies, and self-evaluation of performance during social-evaluative tasks were examined with 27 clinically diagnosed social phobic children ages 7–14 and a matched nonclinical group. Results showed that, compared with their nonanxious peers, social phobic children demonstrated lower expected performance and a higher level of negative self-talk on social-evaluative tasks. In addition, social phobic children showed social skills deficits as assessed by self- and parent report, an assertiveness questionnaire, and direct behavioral observation. Furthermore, compared with the control group, social phobic children were rated by themselves and others as significantly less socially competent with peers and were found to be less likely to receive positive outcomes from peers during behavioral observation. Implications for the assessment and treatment of childhood social phobia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathology of social phobia and comparison to avoidant personality disorder.

Studied the clinical manifestations of social phobia in a diagnosed sample of 21 social phobics (aged 21–53 yrs). Social phobia was found to be a chronic and pervasive condition affecting a variety of life areas and producing significant emotional distress. In a 2nd study, individuals with a diagnosis of social phobia or avoidant personality disorder were compared using a subsample of 10 socially phobic Ss and a sample of 8 Ss with avoidant personality disorder (aged 30–60 yrs). Although physiological reactivity and cognitive content were essentially the same for both groups in a number of situational tasks, those Ss with a diagnosis of avoidant personality disorder were found to be more sensitive interpersonally, and exhibited significantly poorer social skill than did the social phobic Ss. Results are discussed in relation to Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for social phobia, the significance of social phobia as a clinical syndrome, and the research and treatment implications of the difference found between individuals with a diagnosis of social phobia and those with avoidant personality disorders. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social phobia and difficulties in occupational adjustment.

This study examined whether social phobics differed from nonanxious controls in occupational adjustment. Results indicated that generalized and nongeneralized social phobics, in contrast to controls, were underemployed and believed that their supervisor would rate them as less dependable. Nongeneralized social phobics and controls believed their supervisor would rate them higher in work role conformance and likelihood of advancement than did generalized social phobics. Generalized socially phobic women, in contrast to nongeneralized and control group women, were more likely to be employed in noninterpersonally oriented jobs. Generalized social phobics were more anxious than controls when starting their current job but did not differ in job satisfaction. Results are discussed relative to the nature of social phobia, subtype differences, and counseling services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism, negative social feedback, and interpersonal rumination in depression and social anxiety.

The current study investigated the associations among trait perfectionism, perfectionistic self-presentation, negative social feedback, interpersonal rumination, depressive symptoms, and social anxiety. New measures of negative social feedback and interpersonal rumination were used to evaluate their relevance to the social aspects of perfectionism and their roles in distress. A sample of 155 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionistic Self-Presentation Scale, the Social Feedback Questionnaire, Rumination About an Interpersonal Offense, and measures of depressive symptoms and social anxiety. The results confirmed that socially prescribed perfectionism and perfectionistic self-presentation were associated significantly with negative social feedback and rumination following interpersonal events (i.e., being hurt, humiliated, mistreated). Also, depressive symptoms and social anxiety were associated significantly with negative social feedback, interpersonal rumination, trait perfectionism, and perfectionistic self-presentation. Additional analyses indicated that negative social feedback and interpersonal rumination mediated the links between components of the perfectionism construct and distress. Overall, our findings suggest that self-reported receipt of frequent negative feedback from others and engaging in rumination about an interpersonal event play important roles in the distress experienced by certain individuals with high levels of perfectionism. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Impaired positive inferential bias in social phobia.

People with social phobia report anticipatory and retrospective judgments about social situations that appear consistent with a negative interpretative bias. However, it is not at all clear that biased interpretative inferences are made "on-line;" that is, at the time that ambiguous information is first encountered. In a previous study, volunteers who were anxious about interviews were found to lack the positive on-line inferential bias that was characteristic of nonanxious controls but also failed to show a bias favoring threatening inferences (C. R. Hirsch & A. Mathews, 1997). This finding was confirmed in the present study, in which social phobic patients showed no evidence of making on-line emotional inferences, in contrast with socially nonanxious controls who were again clearly biased in favor of positive inferences. The authors concluded that nonanxious individuals are characterized by a benign on-line inferential bias, but that this is impaired in people with social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Avoidant personality disorder and the generalized subtype of social phobia.

Social phobia and avoidant personality disorder (APD) may be given as comorbid diagnoses. However, it is not known if the labels provide independent, useful diagnostic information. The authors classified social phobics by social phobia subtype and presence of APD. Generalized social phobics with and without APD (ns?=?10 and 10) and nongeneralized social phobics without APD (n?=?10) were distinguished on measures of phobic severity. The generalized groups also showed earlier age at onset and higher scores on measures of depression, fear of negative evaluation, and social anxiety and avoidance than did the nongeneralized group. APD criteria of general timidity and risk aversion were more frequently endorsed by social phobics with AD. The data suggest that both the generalized subtype of social phobia and the presence of APD do provide useful diagnostic information, but the additional diagnosis of APD may simply identify a severe subgroup of social phobics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in Self-Perception During Treatment of Social Phobia.

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional imagery in simple and social phobia: Fear versus anxiety.

In a 1st study, 60 phobic volunteer Ss reacted psychophysiologically with greater vigor to imagery of their own phobic content than to other fearful or nonaffective images. Imagery heart rate responses were largest in Ss with multiple phobias. For simple (dental) phobics, cardiac reactivity was positively correlated with reports of imagery vividness and concordant with reports of affective distress; these relationships were not observed for social (speech) phobics. In a 2nd study, these phobic volunteers were shown to be similar on most measures to an outpatient clinically phobic sample. In an analysis of the combined samples, fearful and socially anxious subtypes were defined by questionnaires. Only the fearful subtype showed a significant covariation among physiological responses, imagery vividness, and severity of phobic disorder. This fearful–anxious distinction seems to cut across diagnostic categories, providing a heuristic perspective from which to view anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blushing and physiological arousability in social phobia.

Blushing is the most prominent symptom of social phobia, and fear perception of visible anxiety symptoms is an important component of cognitive behavioral models of social phobia. However, it is not clear how physiological and psychological aspects of blushing and other somatic symptoms are linked in this disorder. The authors tested whether social situations trigger different facial blood volume changes (blushing) between social phobic persons with and without primary complaint of blushing and control participants. Thirty social phobic persons, 15 of whom were especially concerned about blushing, and 14 control participants were assessed while watching an embarrassing videotape, holding a conversation, and giving a talk. Only when watching the video did social phobic persons blush more than controls blushed. Social phobic persons who complained of blushing did not blush more intensely than social phobic persons without blushing complaints but had higher heart rates, possibly reflecting higher arousability of this subgroup. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stressful life events and personality styles: relation to impairment and treatment outcome in patients with social phobia

Forty-five patients with social phobia and 15 individuals with no mental disorder were compared on number and type of life events experienced. Social phobia patients were further examined to evaluate the effect of negative life events and of the interaction between personality style and life events on severity of impairment and reactions to cognitive-behavioral group therapy. Patients with social phobia reported more negative life events than participants with no mental disorder. Among patients with social phobia, more frequent negative life events were associated with higher scores on measures of depression and general anxiety. Patients high on autonomy who reported more negative autonomous (i.e., achievement-oriented) life events also scored higher on measures of social anxiety and general anxiety. There were no significant interactions between sociotropy and the frequency of reported socially oriented negative life events. However, patients high on sociotropy scored higher on measures of social anxiety, depression, and general anxiety. Patients who had experienced more negative life events improved more after treatment on measures of social anxiety than did those who had experienced fewer negative life events. Implications of these findings and recommendations for future research are discussed.     

Psychophysiological differences between subgroups of social phobia.

Individuals meeting criteria of the revised third edition of Diagnostic and Statistical Manual for Mental Disorders (American Psychiatric Association, 1987) for social phobia with a fear of speaking in front of people were subdivided into those with (n?=?16) and without (n?=?14) avoidant personality disorder (APD). These individuals and nonanxious controls (n?=?22) spoke in front of a small audience while speaking time, subjective anxiety, fearful thoughts, and electrocardiographic and respiratory measures were recorded. Controls spoke for longer than either social phobia group. Those with social phobia and APD reported more subjective anxiety and more fear cognitions than the other two groups; phobic individuals without APD showed greater heart rates in the phobic situation than either social phobics with APD or controls. The latter two groups did not differ in heart rate. These results indicate incongruent subjective and heart rate responses to the feared situation. A similar pattern of results was found when participants were divided into generalized and specific social phobia groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administration of alcohol before and after a public speaking challenge by individuals with social phobia.

[Correction Notice: An erratum for this article was reported in Vol 16(3) of Psychology of Addictive Behaviors (see record 2009-17717-001). On page 121, in the abstract, the penultimate sentence incorrectly reads, “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities.” The sentence should read as follows: “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking preceding the 2 activities.”] K. Abrams, M. Kushner, K. Medina, and A. Voight (2001) showed that alcohol attenuates social anxiety symptoms in socially phobic individuals. This article examines whether social anxiety symptoms can lead to increased alcohol use in this same population. Forty-four individuals with social phobia attended 2 laboratory sessions, spaced 1 week apart, in groups of approximately 10. Participants underwent a social anxiety challenge during 1 session and a control task during the other. Half of the sample self-administered alcohol immediately before, and half immediately after, these 2 activities. As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities. These findings add to an understanding of why social phobia and alcohol problems tend to co-occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major depression and phobias: the genetic and environmental sources of comorbidity

In a population based sample of 2163 personally interviewed female twins, substantial comorbidity was observed between DSM-III-R defined major depression (MD) and 4 subtypes of phobia: agoraphobia, social phobia, animal phobia and situational phobia. However, the level of comorbidity of MD with agoraphobia was much greater than that found with the other phobic subtypes. We concluded bivariate twin analyses to decompose the genetic and environmental sources of comorbidity between MD and the phobias. Our results suggest that a modest proportion of the genetic vulnerability to MD also influences the risk for all phobic subtypes, with the possible exception of situational phobias. Furthermore, the magnitude of comorbidity resulting from this shared genetic vulnerability is similar across the phobic subtypes. By contrast, the non-familial environmental experiences which predispose to depression substantially increase the vulnerability to agoraphobia, have a modest impact on the risk for social and situational phobias and no effect on the risk for animal phobias. The increased comorbidity between MD and agoraphobia results, nearly entirely, from individual-specific environmental risk factors for MD which also increase the risk for agoraphobia but not for other phobias.     

The etiology of childhood spider phobia

Twenty-six girls with a clinical spider phobia and 26 matched control girls were interviewed about conditioning, modeling, and negative information experiences in connection with spiders. In addition, parents of the phobic girls were independently interviewed about the origins of their child's phobia. Phobic children more often reported aversive conditioning experiences with spiders than did control children. Also, in a number of cases, conditioning events described by the phobic children were confirmed by their parents, a result that replicates the findings of Merckelbach, Muris and Schouten (1996; Behaviour Research and Therapy, 34, 935-938). Taken together, the results contradict a strong version of the non-associative account of phobias and suggest that in at least some cases, conditioning events may contribute to the development of (childhood) spider phobia.     

Working memory capacity in generalized social phobia.

Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with generalized social phobia. Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with generalized social phobia and nonanxious controls using an operation span task with threat-relevant and neutral stimuli. Results revealed that nonanxious individuals demonstrated better WMC than individuals with generalized social phobia for neutral words but not for social threat words. Individuals with generalized social phobia demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with generalized social phobia may have relatively enhanced working memory performance for salient, socially relevant information. This enhanced working memory capacity for threat-relevant information may be the result of practice with this information in generalized social phobia. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Medical utilisation and costs in panic disorder: a comparison with social phobia

There is considerable evidence that people with panic disorder utilise the physical health care system more frequently than people in the general community and so incur for themselves, and impose on the public health care system, considerably greater costs. Although this is probably because of specific characteristics to do with panic disorder, it may also be a function of having any anxiety disorder where panic is prominent. This study represents one of the few comparisons of medical utilisation and costs incurred by people with panic disorder to those incurred by people with another anxiety disorder, in this case, social phobia. Before treatment, 41 people with panic disorder, 15 with social phobia and 43 nonanxious controls were interviewed about their use of the medical care system over the previous 12 months. As expected, people with panic disorder had significantly higher utilisation rates than either the nonanxious controls or the socially phobic subjects, and incurred substantially higher costs. Adequate screening for panic disorder at the primary medical care level together with appropriate treatment referral therefore have the potential to substantially reduce the personal and community costs incurred by people with panic disorder.     

Is this happiness I see? Biases in the identification of emotional facial expressions in depression and social phobia.

The present study was designed to examine the operation of depression-specific biases in the identification or labeling of facial expression of emotions. Participants diagnosed with major depression and social phobia and control participants were presented with faces that expressed increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expression. The authors assessed individual differences in the intensity of facial expression of emotion that was required for the participants to accurately identify the emotion being expressed. The depressed participants required significantly greater intensity of emotion than did the social phobic and the control participants to correctly identify happy expressions and less intensity to identify sad than angry expressions. In contrast, social phobic participants needed less intensity to correctly identify the angry expressions than did the depressed and control participants and less intensity to identify angry than sad expressions. Implications of these results for interpersonal functioning in depression and social phobia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive therapy during discontinuation of alprazolam for social phobia.

Describes a woman (aged 31 yrs) suffering from social phobia who displayed difficulty discontinuing alprazolam, but who was able to do so without return of the symptoms when cognitive therapy was introduced. Intervention was based on A. Beck's (1986) model of anxiety (ANX) that suggests that panic or ANX results from the catastrophic misinterpretation of physical symptoms. A trigger stimulus (thought, image, situation) is processed or perceived as dangerous. This precipitates ANX and an increase in bodily sensations, which then create thoughts that signal that some catastrophic event (physical or social) will occur, which increases the danger and restarts the cycle. For the socially phobic, this intervention can instill a sense of control over physical symptoms that are otherwise perceived as uncontrollable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coherence and Specificity of Information-Processing Biases in Depression and Social Phobia.

Research has not resolved whether depression is associated with a distinct information-processing bias, whether the content of the information-processing bias in depression is specific to themes of loss and sadness, or whether biases are consistent across the tasks most commonly used to assess attention and memory processing. In the present study, participants diagnosed with major depression, social phobia, or no Axis I disorder, completed several information-processing tasks assessing attention and memory for sad, socially threatening, physically threatening, and positive stimuli. As predicted, depressed participants exhibited specific biases for stimuli connoting sadness; social phobic participants did not evidence such specificity for threat stimuli. It is important to note that the different measures of bias in memory and attention were not systematically intercorrelated. Implications for the study of cognitive bias in depression, and for cognitive theory more broadly, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)