Role of prior negative cognitions on the development of intrusive thoughts

This analogue study examined how individuals' prior negative cognitions influenced intrusion frequency, intrusion‐related distress and thought suppression. Participants at high (HR) and low risk (LR) for interpreting their intrusive thoughts in a negative manner viewed a graphic trauma film and their subsequent intrusion development was assessed. HR participants experienced a greater frequency of intrusions and intrusion‐related distress compared to LR participants. Trait thought suppression moderated the relationship between risk for the negative interpretation of intrusions and intrusion frequency. The findings suggest that pre‐existing negative cognitions are influential in the development of intrusions following exposure to an analogue trauma.     

Attempted suppression of social threat thoughts: Differential effects for social phobia and healthy controls?

Thought suppression research in the area of social phobia provides conflicting evidence regarding whether individuals demonstrate a general deficit or successful suppression. This paper reports the outcome of two studies using an online thought suppression paradigm measuring activation of target thoughts. Study 1 examined the effects of suppressing social threat stimuli with a healthy control group. Surprisingly, the results showed that participants demonstrated non-suppression of this stimuli class. Study 2 compared individuals with social phobia to a control group using the same stimuli as Study 1. Results revealed that following instructions to suppress social threat stimuli, individuals with social phobia demonstrated successful suppression, whilst the control group, as in Study 1, did not. The lack of suppression of social threat information by the control group may reflect functional impression-management of social threat stimuli. Whereas, successful suppression of these stimuli by individuals with social phobia, may contribute to diminished habituation to such information.     

Effects of suppressing neutral and obsession-like thoughts in normal subjects: beyond frequency

Recent cognitive-behavioral theories on obsessive-compulsive disorder (OCD) show that deliberate attempts to suppress intrusive and undesirable thoughts lie at the genesis of clinical obsessions. In this paper the results of an experimental study on the suppression of neutral and obsession-like thoughts in normal subjects are presented. Eighty-seven university students performed in three experimental periods: (1) base-line monitoring, (2) experimental instruction, and (3) monitoring. For each of these periods, the frequency of the occurrence of a "white bear" thought or a personally relevant intrusive thought was registered. Half of the subjects received instructions to suppress the target-thought in period 2, and the other half were instructed to only monitor the target-thought in each of the experimental periods. Several measures were also obtained before and after the experiment: annoyance caused by the intrusion, suppression effort, subjective success, and evaluative appraisals of the target-thought. The results showed neither immediate nor delayed frequency increases of the target thought. However, evidence was found that deliberate thought suppression efforts, regardless of their content, had greater negative consequences than did non suppression. These results are discussed in relation to the recent cognitive proposals about OCD.     

Comorbid anxiety and mood disorders among persons with social anxiety disorder.

Axis I comorbidity is associated with greater severity of social anxiety disorder. However, the differential effects of comorbid mood and anxiety disorders on symptom severity or treatment outcome have not been investigated. We evaluated 69 persons with uncomplicated social anxiety disorder, 39 persons with an additional anxiety disorder, and 33 persons with an additional mood disorder (with or without additional anxiety disorders). Those with comorbid mood disorders reported greater duration of social anxiety than those with uncomplicated social anxiety disorder. They were also judged, before and after 12 weeks of cognitive-behavioral group treatment and at follow-up, to be more severely impaired than those with no comorbid diagnosis. In contrast, persons with comorbid anxiety disorders were rated as more impaired than those with no comorbid diagnosis on only a single measure. Type of comorbid diagnosis did not result in differential rates of improvement of social anxiety disorder.     

The observer perspective: effects on social anxiety and performance

The cognitive model of social phobia by Clark and Wells (Social phobia : Diagnosis, Assessment and treatment (1995)) proposes that individuals with social phobia generate a negative impression of how they appear to others, constructed from their own thoughts, feelings and internal sensations. This impression can occur in the form of a visual image from an external, or "observer", perspective. Although social phobics use this perspective more than controls, the impact of the observer perspective has not been tested experimentally. This study investigated the effects of taking the observer perspective on thinking, anxiety, behaviour and social performance in high and low socially anxious participants. Forty-four participants (N=22 in each group) gave two speeches, one in the observer and one in the field perspective. Use of the observer perspective produced more frequent negative thoughts, more safety behaviours, and worse self-evaluation of performance in both groups. There were also clear trends demonstrating increases in anxiety and in thought belief ratings in the observer perspective compared to the field perspective. Results are consistent with the Clark and Wells model of social phobia. This study also suggests that in low socially anxious individuals, the observer perspective may contain positive information.     

Autobiographical memory bias in social anxiety

In social anxiety the psychological self is closely related to the feared stimulus. Socially anxious individuals are, by definition, concerned about how the self is perceived and evaluated by others. As autobiographical memory is strongly related to views of the self it follows that biases in autobiographical memory play an important role in social anxiety. In the present study high (n = 19) and low (n = 29) socially anxious individuals were compared on autobiographical memory bias, current goals, and self-discrepancy. Individuals high in social anxiety showed a bias towards recalling more negative and more social anxiety-related autobiographical memories, reported more current goals related to overcoming social anxiety, and showed larger self-discrepancies. The pattern of results is largely in line with earlier research in individuals with PTSD and complicated grief. This suggests that the relation between autobiographical memory bias and the self is a potentially valuable trans-diagnostic factor.     

The paradoxical effects of suppressing anxious thoughts during imminent threat

In line with the ironic processing theory of Wegner (Psychol. Rev. 101 (1994) 34), it is often argued that the suppression of anxiety-related thoughts results in a paradoxical increase of anxiety and thought intrusions, both after and during the thought suppression. In a sample of undergraduate students (14 men, 18 women), we investigated the effects of suppressing anxious thoughts about an imminent painful electrocutaneous stimulus. During thought suppression, self-reported anxiety and frequency of anxious thoughts did not increase, and duration of anxious thoughts decreased. After thought suppression, participants experienced an increase in self-reported anxiety and the frequency of anxious thoughts. There was no effect upon thought duration. The results support the idea that suppression of anxiety-related thoughts may result in a paradoxical increase in anxiety, and may cause and/or maintain anxiety problems.     

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.     

Ageing and thought suppression performance: Its relationship with working memory capacity,habitual thought suppression and mindfulness

A study investigated how the ability to suppress thoughts in the laboratory was affected by type of thought suppressed (positive, negative, neutral), participants’ age and working memory capacity (WMC). Linked variables (Use of thought suppression, social desirability, and mindfulness) were measured to assess whether they modified susceptibility to thought intrusion.Younger, middle aged and older adults suppressed three different valenced thoughts in a counterbalanced order for 5-min per thought. Participants then completed a WMC task and questionnaire measures of the linked variables.Valence had no effect on intrusions. WMC was positively related to intrusions; higher WMC corresponded to greater intrusions. Age was negatively related to intrusions; with increasing age intrusions decreased. Hierarchical regression showed only age and backward digit span (WMC) significantly predicted intrusions. The relationship between WMC and intrusions was not moderated by age. WMC and age both independently predict level of intrusion, and no synergistic effect was found.     

Differential effects of safety behaviour subtypes in social anxiety disorder

Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants’ interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD.     

Social anxiety and the effects of negative self-imagery on emotion, cognition, and post-event processing

Numerous studies have shown that social phobia patients experience negative self-impressions or images during social situations. Clark and Wells (1995) posited that such negative self-images are involved in the maintenance of social phobia. Thus, the present study investigated the effects of negative self-imagery on cognition and emotion during and following a brief social situation. Specifically, high and low socially anxious participants (N = 77) were instructed to hold either a negative or control self-image as they engaged in a brief speech. Participants then rated their anxiety, performance, cognitions, and focus of attention. Twenty-four hours later, they returned to the laboratory and completed questionnaires assessing the amount of post-event processing (PEP) they engaged in. The results showed that, irrespective of the level of social anxiety or depressive symptoms, participants that held the negative self-image experienced higher levels of anxiety, were more self-focused, experienced more negative thoughts, rated their anxiety as more visible, appraised their performance more negatively, and engaged in more negative and less positive PEP than participants that held the control self-image. Collectively the results indicate that negative imagery is causally involved in the maintenance of social phobia, as well as in the generation of social anxiety among non-anxious individuals.     

Attentional networks and visuospatial working memory capacity in social anxiety

Social anxiety is associated with attentional bias and working memory for emotional stimuli; however, the ways in which social anxiety affects cognitive functions involving non-emotional stimuli remains unclear. The present study focused on the role of attentional networks (i.e. alerting, orienting, and executive control networks) and visuospatial working memory capacity (WMC) for non-emotional stimuli in the context of social anxiety. One hundred and seventeen undergraduates completed questionnaires on social anxiety. They then performed an attentional network test and a change detection task to measure visuospatial WMC. Orienting network and visuospatial WMC were positively correlated with social anxiety. A multiple regression analysis showed significant positive associations of alerting, orienting, and visuospatial WMC with social anxiety. Alerting, orienting networks, and high visuospatial WMC for non-emotional stimuli may predict degree of social anxiety.     

Not self-focused attention but negative beliefs affect poor social performance in social anxiety: An investigation of pathways in the social anxiety-social rejection relationship

Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety-social rejection relationship. This study studied two pathways hypothesized to lead to poor social performance in social anxiety: increased self-focused attention and negative beliefs. State social anxiety was experimentally manipulated in high and low-blushing-fearful individuals by letting half of the participants believe that they blushed intensely during a 5 min getting-acquainted interaction with two confederates. Participants rated their state social anxiety, self-focused attention, and level of negative beliefs. Two confederates and two video-observers rated subsequently likeability (i.e., social rejection) and social performance of the participants. In both groups, the social anxiety-social rejection relationship was present. Although state social anxiety was related to heightened self-focused attention and negative beliefs, only negative beliefs were associated with relatively poor social performance. In contrast to current SAD models, self-focused attention did not play a key-role in poor social performance but seemed to function as a by-product of state social anxiety. Beliefs of being negatively evaluated seem to elicit changes in behavioral repertoire resulting in a poor social performance and subsequent rejection.     

Disclosure of anxiety in everyday life: Effects of social anxiety

The current study examined the likelihood of disclosing one’s anxiety to others during anxiety-provoking conversations, as reported by individuals high or low in social anxiety. It investigated to whom these disclosures are made, and the content and intended purposes of these disclosures. Undergraduate students and community members low (n = 79) or high (n = 81) in social anxiety completed the Anxiety Disclosure in Everyday Life questionnaire, as well as several other measures as part of another study. Analyses indicated that individuals high in social anxiety were significantly less likely to disclose their anxiety as compared to individuals low in social anxiety. The likelihood of disclosing one’s anxiety varied significantly depending on to whom one was speaking, with intimate partners being disclosed to the most. The content of the disclosures typically involved stating that one is feeling shy or nervous without offering an explanation, or attributing it to one’s personality traits (e.g., shyness), with the intended purpose often being to elicit assistance or reassurance from their conversation partner or to manage the impressions of others.     

Post-event processing in social anxiety

Clark and Wells’ [1995. A cognitive model of social phobia. In: R. Heimberg, M. Liebowitz, D.A. Hope, & F.R. Schneier (Eds.) Social phobia: Diagnosis, assessment and treatment (pp. 69-93). New York: Guildford Press.] cognitive model of social phobia proposes that following a social event, individuals with social phobia will engage in post-event processing, during which they conduct a detailed review of the event. This study investigated the relationship between self-appraisals of performance and post-event processing in individuals high and low in social anxiety. Participants appraised their performance immediately after a conversation with an unknown individual and prior to an anticipated second conversation task 1 week later. The frequency and valence of post-event processing during the week following the conversation was also assessed. The study also explored differences in the metacognitive processes of high and low socially anxious participants. The high socially anxious group experienced more anxiety, predicted worse performance, underestimated their actual performance, and engaged in more post-event processing than low socially anxious participants. The degree of negative post-event processing was linked to the extent of social anxiety and negative appraisals of performance, both immediately after the conversation task and 1 week later. Differences were also observed in some metacognitive processes. The results are discussed in relation to current theory and previous research.     

Thought suppression and its effects on thought frequency, appraisal and mood state in individuals with obsessive-compulsive disorder

Leading models of obsessive-compulsive disorder (OCD) implicate thought suppression as a key factor in the escalation and persistence of the disorder. This experiment examined the effects of suppression on the frequency of obsessional thoughts in 50 individuals with a primary diagnosis of OCD, and also investigated the effects of participants' appraisals regarding their failures in thought control on distress about intrusive thoughts and on mood. Participants' most upsetting obsessional thought was primed and they then monitored its occurrence over two 4-min intervals. In the first interval, half of the participants were instructed to suppress their obsessional thought and half were instructed not to suppress any thoughts. In the second interval, all participants were given the 'Do Not Suppress' instructions. Participants rated their suppression effort and discomfort over thought occurrences after each interval and recorded their appraisals of thought recurrences during the first interval. Mood state was then reassessed. No ironic effect of suppression on frequency was noted. However, negative appraisals of thought recurrences were associated with more discomfort over thought occurrences and more negative mood at Time 2. These findings suggest that interpretations regarding failures in thought control may be of central importance in understanding obsessional problems.     

Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure

High (n = 41) and low (n = 39) socially anxious (SA) participants completed the Waterloo Images and Memories Interview (WIMI), a new assessment tool that measures the accessibility and properties of mental images and associated autobiographical memories that individuals may experience across both anxiety-provoking (negative) and non-anxiety-provoking (positive) social situations. Results indicated that both high and low SA individuals experience negative images and associated autobiographical memories in anxiety-provoking social situations, but the rates of endorsement of such images and memories among high SA participants were substantially lower than those reported in recent studies. Moreover, whereas low SA individuals were capable of accessing a relatively balanced array of both negative and positive self-representations that were rich in episodic detail, high SA individuals retrieved a higher, more unbalanced ratio of negative-to-positive images and memories, as well as impoverished positive images that were significantly degraded in episodic detail. Finally, negative images influenced the two groups differently, with high SA individuals experiencing more negative emotional and cognitive consequences associated with bringing such images to mind. These results are discussed in relation to theoretical models of learning and memory within the context of contemporary cognitive behavioral models of social anxiety.     

Social anxiety and interpersonal perception: a social relations model analysis

Cognitive models of social phobia posit that an individual's negative beliefs about the way he or she is perceived by others (metaperceptions) are a core feature of the disorder. The social relations model () was used to analyze interpersonal perception data collected following unstructured social interactions in 62 socially anxious (SA) and 62 not socially anxious (NSA) individuals. Using this model, the interpersonal perceptions were analyzed to evaluate whether pathological levels of social anxiety are associated with self-perceptions, metaperceptions, and perceptions from others. SA participants saw themselves negatively and believed others saw them negatively. Although seen as more nervous by others, SA participants were not seen as less likeable. A mediational model demonstrated that the negative metaperceptions of SA individuals were more a function of their own self-perceptions than the negative perceptions of others. These findings were not attributable to depressive symptoms. Implications for theory and treatment of social phobia are discussed.     

Working memory load moderates late attentional bias in social anxiety

The vigilance–avoidance hypothesis suggests that socially anxious individuals attempt to detect signs that they are being evaluated (vigilance) and subsequently direct attention away from such stimuli (avoidance). Although extensive evidence supports vigilance, data concerning subsequent avoidance is equivocal. Drawing from models of attention, the current study hypothesised that working memory load moderates late attentional bias in social anxiety such that avoidance occurs if working memory load is low, and difficulty disengaging attention occurs if working memory load is high. Forty-one undergraduates (19 socially anxious; 22 non-anxious controls) completed a dot-probe task with emotional (happy and disgust) and neutral facial expressions and a concurrent n-back task. Results supported the hypothesis such that socially anxious subjects demonstrated avoidance of disgust faces when working memory load was absent, but had difficulty disengaging attention during high working memory load. Theoretical implications and directions for future research are discussed.