When ambiguity hurts: social standards moderate self-appraisals in generalized social phobia

Thirty-nine individuals with generalized social phobia (social anxiety disorder) and 39 nonclinical controls performed a public speech after receiving cues about social standards. Using a novel video manipulation paradigm, one third of participants received cues indicating that standards for performance were high, one third received cues that standards were low, and the remaining third were given no explicit information about expected standards (i.e., standards were ambiguous). Individuals with social phobia performed objectively worse than controls in all conditions, but rated their performance as being worse only in the high and ambiguous standards conditions. These results suggest that in social phobia, negative self-perception is context-dependent. Implications for the cognitive model and treatment are discussed.     

Social phobia and interpretation of social events

It has been suggested that social phobia may be characterized by two interpretation biases. First, a tendency to interpret ambiguous social events in a negative fashion. Second, a tendency to interpret unambiguous but mildly negative social events in a catastrophic fashion. To assess this possibility, patients with generalized social phobia, equally anxious patients with another anxiety disorder, and non-patient controls were presented with ambiguous scenarios depicting social and non-social events, and with unambiguous scenarios depicting mildly negative social events. Interpretations were assessed by participants' answers to open-ended questions and by their rankings and belief ratings for experimenter-provided, alternative explanations. Compared to both control groups, patients with generalized social phobia were more likely to interpret ambiguous social events in a negative fashion and to catastrophize in response to unambiguous, mildly negative social events.     

Biases in interpretation and memory in generalized social phobia

Two experiments examined the link between interpretation and memory in individuals diagnosed with Generalized Social Phobia (GSP). In Experiment 1, GSP and control participants generated continuations for nonsocial and ambiguous social scenarios. GSP participants produced more socially anxious and negative continuations for the social scenarios than did the controls. On the subsequent test of recalling the social scenarios, intrusion errors that shared meaning with the original continuations were made more frequently by the GSP group, producing false recall with emotionally negative features. To examine whether nonanxious individuals would also produce such errors if given emotional interpretations, in Experiment 2 the authors asked university students to read the scenarios plus endings produced by GSP participants in Experiment 1. The students either constructed vivid mental images of themselves as the main characters or thought about whether the endings provided closure. Low-anxious students in the closure condition produced fewer ending-based intrusions in recalling the social scenarios than did students in the other 3 conditions. Results illustrate the importance of examining the nature of source-monitoring errors in investigations of memory biases in social anxiety.     

Social interpretation bias and generalized social phobia: the influence of developmental experiences

Patients with generalized social phobia (N = 42) and non-phobic community controls (N = 42) engaged in a social interaction with an experimental assistant whose behavior was used to create either a positive or an ambiguous social environment. Participants then rated their own performance and their partner's behavior. As a group, social phobic patients displayed negatively biased self-judgments, but failed to display biased social interpretations. Among the social phobia group, a social developmental history marked by parental hostility was associated with negative interpretations of partner behavior and a history of parental overprotection was associated with less sensitivity to partner behavior. The results supported cognitive models of social phobia, which implicate negative learning experiences in the development of information processing biases.     

The interpretation of negative social events in social phobia: changes during treatment and relationship to outcome

Catastrophic interpretations of negative social events are considered to be an important factor underlying social phobia. This study investigated the extent to which these interpretative biases change during cognitive-behavioural treatment for social phobia, and examined whether within-treatment changes in different types of interpretations predict longer-term treatment outcome. Results showed that treatment was associated with decreases in various types of maladaptive interpretations of negative social events, but that social phobia symptoms 3 months after treatment were independently predicted only by within-treatment reductions in the degree to which individuals personally believed that negative social events were indicative of unfavourable self-characteristics. These findings are discussed in relation to cognitive models of the maintenance of social anxiety, and implications for treatment are considered.     

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.     

Deficits in perceived social support associated with generalized social phobia

Social phobia is a common anxiety disorder associated with significant impairment in social and occupational functioning. To date, few studies have examined the relationship between social phobia and perceived social support, a construct with important relationships to physical and mental health. The present study examined data from 2 widely used measures of perceived social support administered to 132 individuals with DSM-IV generalized social phobia. These data were compared with those obtained from a healthy control group and from several clinical and non-clinical samples reported in the literature. Persons with generalized social phobia scored significantly lower on both measures of social support compared with all other groups. It is suggested that deficits in perceived social support associated with generalized social phobia may play a role in the development of co-morbid problems and should be explicitly targeted by treatments for social phobia. Low correlations between perceived social support and social anxiety measures suggest that perceived support should be specifically evaluated in this population.     

Deficits in perceived social support associated with generalized social phobia

Social phobia is a common anxiety disorder associated with significant impairment in social and occupational functioning. To date, few studies have examined the relationship between social phobia and perceived social support, a construct with important relationships to physical and mental health. The present study examined data from 2 widely used measures of perceived social support administered to 132 individuals with DSM‐IV generalized social phobia. These data were compared with those obtained from a healthy control group and from several clinical and non‐clinical samples reported in the literature. Persons with generalized social phobia scored significantly lower on both measures of social support compared with all other groups. It is suggested that deficits in perceived social support associated with generalized social phobia may play a role in the development of co‐morbid problems and should be explicitly targeted by treatments for social phobia. Low correlations between perceived social support and social anxiety measures suggest that perceived support should be specifically evaluated in this population.     

The effect of practice on recall of emotional information in individuals with generalized social phobia

Understanding memory processes in social anxiety is important because these individuals often report negative memories of anxiety-provoking situations and because of the recent emphasis on learning and memory in models of anxiety. The authors examined the effect of learning on memory for negative social, positive social, and nonsocial information using the retrieval-induced forgetting paradigm in individuals with generalized social phobia (GSPs) and in nonanxious controls (NACs). Words were presented in 1 of 3 practice conditions: practiced words from a practiced category, unpracticed words from a practiced category, and unpracticed words from an unpracticed category. GSPs and NACs showed the same patterns of memory for practice categories for positive social and nonsocial words. However, for negative social words, GSPs benefited less from practice and were hurt less from the effect of practicing competing negative social information than were NACs. This pattern of processing may hamper GSPs' learning of, and habituation to, negative social information.     

Parental overprotection and interpersonal behavior in generalized social phobia

Forty-one people with generalized social phobia (GSP) and 42 community controls completed a measure of social developmental experiences and then participated in a social interaction with an experimental assistant whose behavior was either friendly or ambiguous. Following the interaction, confederates rated participants' behavior and their desire to interact with their partner again. In people with social phobia, but not controls, perceptions of parental overprotection were associated with less responsiveness to partner behavior. Moreover, failure to reciprocate the friendly partner's behavior led to social rejection. The results support the value of incorporating social developmental concepts into cognitive-behavioral models of social phobia and highlight the contribution of social learning experiences to the development of maladaptive interpersonal behavior in these individuals.     

The effect of masked pictures on the interpretation of ambiguous pictures

Two experiments investigated whether the initial organization of ambiguous pictures presented supraliminally could be influenced by the presentation of semantically related pictures that had been pattern masked to prevent conscious representation. Twenty-two pictures were presented tachistoscopically in a counterbalanced sequence, each alternating with the supraliminal presentation of its ambiguous counterpart. The results supported the hypothesis that pictures precluded from consciousness by pattern masking could nevertheless influence the interpretation of ambiguous pictures. Although the possibility of structural priming could not be completely ruled out in these experiments, there is evidence to suggest that semantic priming is a component. The research potential of semantic priming is also discussed.     

Anxiety and the interpretation of ambiguous information: beyond the emotion-congruent effect

The authors investigated how anxiety influences the use of contextual information in the resolution of ambiguity. Participants heard ambiguous homophones (threat/neutral, positive/neural, and neutral/neutral) with related contextual information. State anxiety was manipulated experimentally. The interpretations of anxious participants were influenced by context to a greater extent than those of control participants. Some mood-incongruent effects were observed where anxious participants were more likely to adopt neutral interpretations of potentially threatening stimuli. Effects were observed in a spelling task (Experiments 1 and 2) and in a lexical decision task (Experiment 3), with supraliminal, and subliminal presentation of contextual cues, and with 2 different anxiety-induction procedures. Results show how anxiety affects both the content and the process of resolution of ambiguity.     

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. We 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 APD. 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.     

Phenomenal characteristics of autobiographical memories for social and non-social events in social phobia

Previous studies failed to show clear differences between people with social phobia and non-anxious individuals regarding the specificity and affective intensity of their autobiographical memories for social events. However, these studies did not assess the subjective experience associated with remembering. In this study, people with social phobia and non-anxious control participants recalled social and non-social events, and rated the phenomenal characteristics of their memories. The memories of people with social phobia for social events contained fewer sensorial details but more self-referential information than controls' memories. In addition, people with social phobia remembered social situations from an observer perspective, viewing themselves as if from outside, to a greater extent than controls. By contrast, the two groups did not differ concerning their memories for non-social events. These findings are discussed in relation to cognitive models of social phobia.     

Threat is in the eye of the beholder: social anxiety and the interpretation of ambiguous facial expressions

The current study investigated the tendency of individuals with high levels of social anxiety to interpret ambiguous facial expressions in a threatening manner. Results obtained from self-report measures were consistent with previous studies in which highly socially anxious individuals endorsed threatening interpretations for ambiguous social information. More importantly, highly socially anxious participants showed relative facilitation of processing of threatening faces following neutral faces when a priming technique was used to eliminate artifact due to response selection bias. These findings support the hypothesized social anxiety-linked interpretive bias.     

Implicit memory bias for threat-relevant information in individuals with generalized social phobia

The authors used a noise judgment task to investigate implicit memory bias for threat in individuals with generalized social phobia (GSP). Participants first heard neutral sentences (e.g., "The manual tells you how to set up the tent.") and social-threat sentences (e.g., "The classmate asks you to go for drinks."). Implicit memory for these sentences was then tested by asking participants to rate the volume of noise accompanying the presentation of these "old" sentences intermixed with "new" sentences that had not been previously presented. Implicit memory for old sentences is revealed when participants rate the noise accompanying old sentences as less loud than the noise accompanying new sentences. Those with GSP demonstrated an implicit memory bias for social-threat sentences, whereas controls did not. This differential priming effect suggests that information about threat may be automatically accessed in GSP.     

Validity of the distinction between generalized social phobia and avoidant personality disorder.

Disorders of pervasive social anxiety and inhibition are divided into 2 categories, generalized social phobia (GSP) and avoidant personality disorder (APD). We explored the discriminative validity of this categorization by examining the comorbidity of GSP and APD and by comparing these groups on anxiety level, social skills, dysfunctional cognitions, impairment in functioning, and presence of concurrent disorders. Results from 23 subjects showed high comorbidity of the 2 diagnoses: All subjects who met criteria for APD also met criteria for GSP. APD was associated with greater social anxiety, impairment in functioning, and comorbidity with other psychopathology, but no differences in social skills or performance on an impromptu speech. GSP and APD seem to represent quantitatively different variants of the same spectrum of psychopathology rather than qualitatively distinct disorders. We also investigated a proposed social phobia subtyping scheme.     

Recognition and evaluation of emotional prosody in individuals with generalized social phobia: a pilot study

Studies using facial emotional expressions as stimuli partially support the assumption of biased processing of social signals in social phobia. This pilot study explored for the first time whether individuals with social phobia display a processing bias towards emotional prosody. Fifteen individuals with generalized social phobia and fifteen healthy controls (HC) matched for gender, age, and education completed a recognition test consisting of meaningless utterances spoken in a neutral, angry, sad, fearful, disgusted or happy tone of voice. Participants also evaluated the stimuli with regard to valence and arousal. While these ratings did not differ significantly between groups, analysis of the recognition test revealed enhanced identification of sad and fearful voices and decreased identification of happy voices in individuals with social phobia compared with HC. The two groups did not differ in their processing of neutral, disgust, and anger prosody.