Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

大学生评价恐惧在自尊与社交焦虑间的中介效应分析

为探讨评价恐惧在自尊与社交焦虑间的作用,本研究采用正向评价恐惧量表、负向评价恐惧量表、自尊量表、社交互动焦虑量表,以大学生作为研究对象进行问卷调查,得到655份有效问卷。研究结果表明:(1)正向评价恐惧量表在本研究大学生样本中具有良好的信、效度。(2)正向评价恐惧、负向评价恐惧在自尊与社交焦虑间起着部分中介作用,中介效应值为47.17%,即自尊一方面直接影响社交焦虑,另一方面通过负向评价恐惧、正向评价恐惧影响社交焦虑。     

树大招风：社交焦虑者的正性评价恐惧

正性评价恐惧是社交焦虑能够有效鉴别于抑郁症的核心特征。正性评价恐惧是指对他人给予的积极评价感到恐惧, 并因此而担忧的一种情绪反应。正性评价恐惧不仅会使社交焦虑者表现出否认积极认知、回避关注及情绪消极化等特点, 还会通过去正性化思维和解释偏向进一步加剧其认知偏差并抑制其正性情绪, 从而维持和加剧个体的社交焦虑症状。未来研究应关注正性评价恐惧在教育和咨询中的应用, 以及本土倡导谦虚文化背景下正性评价恐惧特点的研究。     

Testing the Bivalent Fear of Evaluation Model of Social Anxiety: The Relationship between Fear of Positive Evaluation,Social Anxiety,and Perfectionism

The Bivalent Fear of Evaluation (BFOE) model of social anxiety proposes that fear of negative evaluation (FNE) and fear of positive evaluation (FPE) play distinct roles in social anxiety. Research is however lacking in terms of how FPE is related to perfectionism and how these constructs interact to predict social anxiety. Participants were 382 individuals from the general community and included an oversampling of individuals with social anxiety. Measures of FPE, FNE, perfectionism, and social anxiety were administered. Results were mostly consistent with the predictions made by the BFOE model and showed that accounting for confounding variables, FPE correlated negatively with high standards but positively with maladaptive perfectionism. FNE was also positively correlated with maladaptive perfectionism, but there was no significant relationship between FNE and high standards. Also consistent with BFOE model, both FNE and FPE significantly moderated the relationship between maladaptive perfectionism and social anxiety with the relationship strengthened at high levels of FPE and FNE. These findings provide additional support for the BFOE model and implications are discussed.     

大学生社会排斥对社交焦虑的影响：负面评价恐惧与人际信任的作用

为探讨大学生社会排斥对社交焦虑的影响以及负面评价恐惧和人际信任在二者之间的作用机制,研究采用大学生社会排斥问卷（SEQU）、社交焦虑量表（SASSCS）、负面评价恐惧量表（BFNES）及人际信任量表（ITS）对450名大学生进行测试。结果表明：（1）大学生社会排斥不仅对个体的社交焦虑水平产生影响,还会通过负面评价恐惧的中介作用对社交焦虑产生影响;（2）人际信任能够调节大学生社会排斥对社交焦虑的直接作用,具体而言,与高人际信任的大学生相比较,较低人际信任的大学生的社会排斥对社交焦虑的预测作用更加显著。     

大学生社会排斥对社交焦虑的影响：负面评价恐惧与人际信任的作用

为探讨大学生社会排斥对社交焦虑的影响以及负面评价恐惧和人际信任在二者之间的作用机制,研究采用大学生社会排斥问卷（SEQU）、社交焦虑量表（SASSCS）、负面评价恐惧量表（BFNES）及人际信任量表（ITS）对450名大学生进行测试。结果表明：（1）大学生社会排斥不仅对个体的社交焦虑水平产生影响,还会通过负面评价恐惧的中介作用对社交焦虑产生影响;（2）人际信任能够调节大学生社会排斥对社交焦虑的直接作用,具体而言,与高人际信任的大学生相比较,较低人际信任的大学生的社会排斥对社交焦虑的预测作用更加显著。     

The bivalent fear of evaluation model of social anxiety: further integrating findings on fears of positive and negative evaluation

Accumulating evidence supports the premise that fear of evaluation in general is important in social anxiety, including fear of positive evaluation (FPE) as well as fear of negative evaluation (FNE). This study tested various hypotheses pertaining to a novel, expanded conceptualization of social anxiety involving these two distinct fears: the bivalent fear of evaluation (BFOE) model. Responses from a large undergraduate sample (N = 585) were examined. In addition, responses from a subsample of participants qualifying for a probable diagnosis of social anxiety disorder (SAD; n = 133) were examined, via mediational analyses, for potential mechanisms underlying FPE within highly socially anxious individuals. FPE exhibited a unique and significantly stronger relationship with concerns of social reprisal due to making positive impressions than did FNE. FPE related uniquely and negatively to trait positive affect/automatic thoughts, whereas FNE, FPE, and social anxiety all related uniquely and positively to trait negative affect/automatic thoughts. FPE, FNE, and social anxiety all related uniquely and positively to disqualification of positive social outcomes (DPSO). However, FPE related most strongly to DPSO attributions at the level of the self, and these attributions mediated the relationship between FPE and negative automatic thoughts in an analog clinical sample. Concerns of social reprisal due to making positive impressions on others mediated the relationship between FPE and DPSO attributions to others in an analog clinical sample. The obtained findings replicate and extend support for the BFOE model of social anxiety. Implications for the theoretical conceptualization and treatment of SAD are discussed.     

A Multi-informant Approach to Assessing Fear of Positive Evaluation in Socially Anxious Adolescents

Fears of positive evaluation form important components of social anxiety. Researchers developed the Fear of Positive Evaluation Scale (FPES) to assess these fears. The FPES reliably and validly assesses fears of positive evaluation in undergraduates and adult social anxiety patients. However, it remains unclear if the FPES reliably and validly assesses these fears in clinic-referred adolescents. Further, implementing the FPES in clinical assessments of adolescents likely requires a multi-informant approach. Indeed, long lines of work indicate low cross-informant correspondence in reports of anxiety and anxiety-related constructs, and support the combined use of multiple informants’ reports (e.g., parents and adolescents). We examined the FPES in a clinic-referred sample of adolescents aged 14–17 years (M = 15.11; 20 females; 59.5 % African American). Thirty-seven parent-adolescent pairs completed the FPES, as well as reports of adolescent social anxiety, safety-seeking behaviors, and depressive symptoms. Both parent and adolescent reports on the FPES evidenced adequate levels of internal consistency. Further, when taking both parent and adolescent reports into consideration, the FPES significantly and positively related to measures of social anxiety and safety-seeking behaviors, over and above other widely used measures of adolescent social anxiety and depressive symptoms. The findings indicate that a multi-informant administration of the FPES yields internally consistent and valid estimates of fears of positive evaluation in a clinical sample of adolescents. These findings have important implications for properly assessing and treating social anxiety concerns in adolescents.     

Cognitive risk factors explain the relations between neuroticism and social anxiety for males and females

The hierarchical model of vulnerabilities to emotional distress contextualizes the relation between neuroticism and social anxiety as occurring indirectly through cognitive risk factors. In particular, inhibitory intolerance of uncertainty (IU; difficulty in uncertain circumstances), fear of negative evaluation (FNE; fear of being judged negatively), and anxiety sensitivity (AS) social concerns (fear of outwardly observable anxiety) are related to social anxiety. It is unclear whether these risk factors uniquely relate to social anxiety, and whether they account for the relations between neuroticism and social anxiety. The indirect relations between neuroticism and social anxiety through these and other risk factors were examined using structural equation modeling in a sample of 462 individuals (M age = 36.56, SD = 12.93; 64.3% female). Results indicated that the relations between neuroticism and social anxiety could be explained through inhibitory IU, FNE, and AS social concerns. No gender differences were found. These findings provide support for the hierarchical model of vulnerabilities to emotional distress disorders, although the cognitive risk factors accounted for variance beyond their contribution to the relation between neuroticism and social anxiety, suggesting a more complex model than that expressed in the hierarchical model of vulnerabilities.     

The Role of Social and Cognitive Processes in the Relationship Between Fear Network and Psychological Distress Among Parents of Children Undergoing Hematopoietic Stem Cell Transplantation

The current study examined whether cognitive and social processing variables mediated the relationship between fear network and depression among parents of children undergoing hematopoietic stem cell transplant (HSCT). Parents whose children were initiating HSCT (N = 179) completed survey measures including fear network, Beck Depression Inventory, cognitive processing variables (positive reappraisal and self-blame) and social processing variables (emotional support and holding back from sharing concerns). Fear network was positively correlated with depression (p < .001). Self-blame and holding back emerged as individual partial mediators in the relationship between fear network and depression. Together they accounted for 34.3 % of the variance in the relationship between fear network and depression. Positive reappraisal and emotional support did not have significant mediating effects. Social and cognitive processes, specifically self-blame and holding back from sharing concerns, play a negative role in parents’ psychological adaptation to fears surrounding a child’s HSCT.     

Validity of Two Questionnaires to Assess Social Fears: The Dutch Social Phobia and Anxiety Inventory and the Blushing, Trembling and Sweating Questionnaire

This report evaluates some psychometric properties of the Dutch Social Phobia and Anxiety Inventory (SPAI-N) as well as a newly developed instrument to assess fear of showing somatic symptoms among social phobic, the Blushing, Trembling and Sweating Questionnaire (BTS-Q). Results support the reliability and discriminative validity of the Dutch SPAI and the BTS-Q. Both questionnaires are able to discriminate social phobics from a community sample. Social phobics with fear of blushing, trembling, and sweating as the main complaint could be discriminated from social phobics without fear of blushing, trembling, and sweating as the main complaint using the BTS-Q. In contrast with expectations derived from cognitive models of social phobia, social phobics with fear of blushing, trembling, and sweating did not have stronger dysfunctional beliefs about (the social consequences of) blushing, trembling, and sweating than social phobics without such fears.     

Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder

The Fear of Positive Evaluation Scale (FPES; J. W. Weeks, R. G. Heimberg, & T. L. Rodebaugh, 2008) was designed to assess fear of positive evaluation, a proposed cognitive component of social anxiety. Although previous findings on the psychometric properties of the FPES have been highly encouraging, only 1 previous study has examined the psychometric profile of the FPES in a sample of patients with social anxiety disorder (T. A. Fergus et al., 2009). The primary purpose of the present study was to conduct a large multisite examination of the psychometric profile of the FPES among patients with a principal diagnosis of social anxiety disorder (n = 226; generalized subtype = 97.8%). Responses of nonanxious control participants (n = 42) were also examined. The factorial validity, internal consistency, test-retest reliability, construct validity, and treatment sensitivity of the FPES were strongly supported by our findings. Furthermore, an FPES cutoff score was identified for distinguishing levels of fear of positive evaluation characteristic of patients with social anxiety disorder from those characteristic of the control group. Results provide additional support for the psychometric properties of the FPES in clinical samples.     

Social evaluation fear in childhood and adolescence: Normative developmental course and continuity of individual differences

Using cross‐sectional (N =910) and longitudinal (N =261) data from Gullone and King's (1993, 1997 ) studies of normal fear in children and adolescents aged 7 to 18 years, the normative developmental pattern of social evaluation fear and the continuity of individual differences were investigated. Participants' responses were analysed according to two subscales (Social Evaluation and Punishment) within the Failure and Criticism scale of the Fear Survey Schedule. The findings indicated that: (a) social evaluation fear increased between childhood and adolescence, while punishment fear decreased, (b) individual differences in social evaluation fear displayed only modest continuity over the 3‐year follow‐up period, (c) continuity of social evaluation fear increased with increased age and (d) discontinuity was particularly salient for relatively high fear levels.     

评价恐惧理论及相关研究述评

社交焦虑认知行为模型将负面评价恐惧作为社交焦虑的核心特征, Weeks和Heimberg提出评价恐惧概念并认为, 无论是正面评价恐惧还是负面评价恐惧, 都是社交焦虑的核心特征。Watson和Friend提出负面评价恐惧至今已有40年, 负面评价恐惧的测量工具、遗传特质、注意偏向及其在学习等领域中的应用已有相关研究。而正面评价恐惧的研究才刚刚开展。评价恐惧测量工具的完善、研究内容的拓展、临床干预的充实、跨文化研究的加强等都是未来的研究方向。     

负面评价恐惧与大学生网络过度使用的关系：社交焦虑和自我控制的中介作用

本研究以864名大学生为被试，探讨负面评价恐惧与网络过度使用的关系以及社交焦虑和自我控制在这一关系中的中介作用。结果发现：（1）负面评价恐惧与社交焦虑和网络过度使用之间均呈显著正相关，与自我控制存在显著负相关；（2）负面评价恐惧通过社交焦虑和自我控制的中介作用对网络过度使用产生影响，这一中介作用包含了三条路径：社交焦虑和自我控制的单独中介作用以及社交焦虑-自我控制的序列中介作用。这一结论有助于促进对大学生网络过度使用的干预与预防。     

Fear of fear,trait anxiety and aerobic fitness in relation to state anxiety during adrenalin provocation

Abstract

Psychological explanations of both spontaneous and experimentally induced panic anxiety stress the role of fear of fear, especially fear of bodily symptoms of arousal. Fear of fear is conceptually different from trait anxiety but may be associated with repeated experience of arousal symptoms in fearful situations, while frequent physical exercise may lead to habituation to these symptoms. To test this hypothesis, 44 healthy male volunteers, classified as having high or low trait anxiety and high or low aerobic fitness, underwent a single-dose adrenalin infusion (80 nanogram/kilogram bodyweight/minute). In both groups, during the experiment a significant rise in state anxiety was found; compared to the group with low trait anxiety, subjects with high trait anxiety reported higher levels of state anxiety, which could be attributed to differences in aerobic fitness. In the high-anxious group, subjects showed a greater decrease in state anxiety during the recovery phase. State anxiety during adrenalin was strongly associated with fear of bodily symptoms only in the high-anxious group. Correlations between trait anxiety and somatic anxiety were not significant; state anxiety scores tended to correlate negatively with physical fitness. It is concluded that these results lend support to a fear of fear-model of panic anxiety.     

负面评价恐惧对社交焦虑的影响:基于社交焦虑的认知行为模型

在社交焦虑认知行为模型的理论视角下，本研究拟探讨负面评价恐惧、不确定性容忍度和依赖型自我构念对社交焦虑的影响及其作用机制。以424名大学生为被试，使用问卷调查法的研究结果表明：（1）负面评价恐惧对社交焦虑有显著预测作用，且不确定性容忍度在这一关系中的中介作用显著；（2）不确定性容忍度的间接效应受到依赖型自我构念的调节。具体而言，该中介效应在高依赖型自我构念群体中更为显著。本研究结果不仅有助于揭示负面评价恐惧对社交焦虑的影响及其作用机制，而且对社交焦虑的预防和干预也有一定的理论和实践指导价值。     

Social anxiety,self‐regulation,and fear of negative evaluation

Social anxiety was investigated in a self‐regulation framework in a sample of 174 undergraduates (124 females; 50 males). As expected, individuals higher in social anxiety were lower on the expectancy to achieve goals, lower on self‐esteem and lower on the frequency on self‐reinforcement. Multiple regression analyses revealed that expectancy to achieve goals, fear of negative evaluation, and public self‐consciousness accounted for 33 per cent of the variance in social anxiety. Fear of negative evaluation was found to mediate between (i) self‐esteem and social anxiety (as hypothesized) and (ii) self‐reinforcement and social anxiety (investigated in an exploratory nature). Copyright © 2000 John Wiley & Sons, Ltd.     

Specific fears as predictors of generalized anxiety

Three hundred thirty-seven female undergraduates completed the Trait Form of the State-Trait Anxiety Inventory (STAI) and the Fear Survey Schedule-II (FSS) to determine if any specific fear factor was significantly related to STAI score. All fear factor scores and the total FSS-II score were significantly correlated with the STAI score and with each other. A stepwise regression procedure indicated that Factor 1, Fear of Social Interaction, accounted for 25.2% of the variance in STAI scores (p <.001), while Factor 4, of Negative Social Evaluation, accounted for an additional 1.8% of the variance (p <.01). The implications for theory, assessment, and intervention are discussed.