Abstracts in English

S D Rose: Assertive Training in Groups: Research in Clinical Setting. Soand J Behav Thev, 6S 61-86, 1977. Under auspices of the Interpersonal Skill Training and Research Program a series of seven research projects have recently been completed in which the effectiveness of assertive training in groups with various clinical and professional populations has been evaluated. These populations included young adults, women, social workers and the elderly. The programs for assertive training included a variety of procedures such as modeling, coaching, overt behaviour rehearsal, covert rehearsal, group feedback, buddy contacts, selected readings, homework assignments, and contingency contracts. Data were collected on outcome by means of assertion inventories and audiotaped role play tests, and on process by means of observation of interaction, attendance, completion rate of assignments, and self report at the end of each meeting. Results on the role play tests tended to support the efficacy of assertive training for all the populations, however, strongest results were obtained for the women and young adults and the weakest for the elderly. Evidence also supported the use of contingecy contracts as a means of increasing the rate of assignment completion.

O Hordlund, S Ronnberg & Gohlsson: The Functional Importance of "Showing Responses" in the Creative Activity in Children. Soand J Behav Ther, 6, 87-93, 1977. A child's creative activity is often terminated by the child showing the accomplished product to a parent or a teacher. This "showing response" was hypothezised to be of central importance in maintaining creative behaviour, as it "mediates" social reinforcement for this activity. The hypothesis was tested on four children, two of which followed an A-B-A design and two a B-A design, where in the A condition the child was not given the opportunity to show his drawings. In the B condition this opportunity was provided. During the A condition the number of accomplished drawings rapidly dropped to zero. It is pointed out that the showing response seems to be a natural instance of "self-reinforcement".     

Abstracts in English

F R Quale: A Behaviour Contracting Approach to Weight Control. Saand J Behav Ther, 4, 117-124, 1975. A weight control program employing behaviour modification techniques is presented. In the first phase the clients were trained to use different techniques to achieve weight loss. A weight control contract, specifying a penalty for weight gain or lack of weight loss, was established. In the second phase, the goal was maintenance of weight loss during the following year. The success rate reported was 62 % in Phase I and 91 % in Phase II.C Botella & L Wadelius: Behavioural and Traditional Treatment of Obesity. SaandJ Behav Ther, 4, 125-136, 1975. After a summarized background to the overweight problem the literature on behavioural treatment of obesity is reviewed. An experimental comparison between behavioural treatment of obesity and traditional medical treatment is reported. Both treatment groups lost weight significantly. At the one-year follow-up, only the behaviourally treated group had maintained a significant weight loss, although less than immediately after the end of treatment.

H Fries: Anorectic Behaviour: Nosological Aspects and Introduction of a Behaviour Scale. Saand J Behav Ther, 4, 137-148, 1975. The anorectic behaviour is typical for patients with primary or "true" anorexia nervosa. It may also be of a more unspecific character, as in mitigated forms of anorexia nervosa or "pseudo-anorectic" conditions. A valid and easily applicable anorectic behaviour scale is introduced, which seems well suitable for diagnostic purpose and routine evaluation of therapeutic effects.T Aim & L-G Kall: Anorexia Nervosa and Behaviour Therapy. Saand J Behav Ther, 4, 159–163, 1975. The historical development of the treatment of anorexia nervosa is reviewed. Experimental evaluations of active components in therapy, by means of single—subject designs are discussed. Some concluding remarks are given pointing at the importance of including the patient's natural environment in the treatment.M Lindquist & K G Gotestam: Self—Control over Eating. Saand J Behav Ther, 4, 159–163,. 1975. The effect of environmental planning and self—administration of consequences was studied in an A-B-C design in the treatment of a client with incorrect eating habits. The combination of the techniques proved to be effective for this problem.     

Recognition bias for critical faces in social phobia: a replication and extension

Studies using linguistic stimuli have provided little support for explicit memory biases among individuals with social phobia (SP). However, using facial stimuli rated on their criticalness, Lundh and Ost (1996) found that individuals with SP recognized more critical than accepting faces, whereas non-anxious controls tended to show the opposite pattern. Since the publication of Lundh and Ost's findings, additional studies using a variety of facial stimuli have produced inconsistent findings (J. Anxiety Disord. 14 (2000) 501; Behav. Res. Ther. 39 (2001) 967). Unfortunately, these inconsistencies are difficult to reconcile given great variation in methods and stimuli. Therefore, we designed a study to replicate and extend the work of Lundh and Ost (Behav. Res. Ther. 34 (1996) 787). Similar to Lundh and Ost, individuals with SP identified a significantly higher proportion of old critical faces as old than did non-anxious controls. Further, extending the work of Lundh and Ost, signal detection analyses revealed group differences on response bias according to face type. Specifically, controls showed a response bias towards indicating that accepting faces were previously seen, whereas individuals with SP did not. Finally, signal detection analyses failed to reveal group differences in the accuracy of memory.     

Predicting anxious response to a social challenge: the predictive utility of the social interaction anxiety scale and the social phobia scale in a college population

Trait anxiety is believed to be a hierarchical construct composed of several lower-order factors (Adv. Behav. Res. Therapy, 15 (1993) 147; J. Anxiety Disorders, 9 (1995) 163). Assessment devices such as the Social Interaction Anxiety Scale, the Social Phobia Scale (SIAS and SPS; Behav. Res. Therapy, 36 (4) (1998) 455), and the Anxiety Sensitivity Index (ASI; Behav. Res. Therapy, 24 (1986) 1) are good measures of the presumably separate lower-order factors. This study compared the effectiveness of the SIAS, SPS, ASI-physical scale and STAI-T (State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press (1970)) as predictors of anxious response to a social challenge (asking an aloof confederate out on a date). Consistent with the hierarchical model of anxiety, the measures of trait anxiety were moderately correlated with each other and each was a significant predictor of anxious response. The specific measures of trait social anxiety were slightly better predictors of anxious response to the social challenge than was either the ASI-physical scale or the STAI-T. The results provide evidence of the predictive validity of these social trait measures and some support for their specificity in the prediction of anxious response to a social challenge.     

Self-focused attention before and after treatment of social phobia

It has been hypothesized that effective psychological treatment for social phobia changes the person's representation of the self in a more positive direction. In order to test this hypothesis, we analyzed 506 thoughts that were endorsed by 23 social phobic individuals while anticipating socially stressful situations before and after exposure therapy. Treatment efficacy was assessed with the Social Phobia and Anxiety Inventory (SPAI) [Turner, S. M., Beidel, D. C., Dancu, C. V., & Stanley M. A. (1989) An empirically derived inventory to measure social fears and anxiety: the Social Phobia and Anxiety Inventory. Psychological Assessment, 1, 35-40)]. Subjects endorsed significantly fewer negative self-focused thoughts after treatment (on average 8.7% of the thoughts) than before treatment (26.5%, p < 0.005). These changes were highly correlated with pre-post difference scores in the social phobia subscale of the SPAI (r = 0.74, p < 0.0001). Implications of the results for the cognitive model of social phobia will be discussed.     

And Yet it Moves! A Reply to “Rectifying Misconception: A Comprehensive Response to Gardner,Moore, and Marks Comments on ‘Some Concerns About the Psychological Implications of Mindfulness: A Critical Analysis’ ”

In this brief article I reply to Gardner et al. (J Ration Emot Cogn Behav Ther. doi:10.1007/s10942-014-0196-1, 2014)’s comments to my previous article titled “Some concerns about the psychological implications of mindfulness. A critical analysis” (David, in J Ration Emot Cogn Behav Ther. doi:10.1007/s10942-014-0198-z, 2014). While initially—humorously and for the sake of debate—adopting an attitude towards mindfulness based on a modified version of Galileo’s Abjuration, I then critically argued that Gardner et al.’s criticism is focused on a priori defending a construct and its associated practices that, by the very nature of empirically supported constructs/interventions, are not perfect (i.e., panacea), but subject to clarifications, limitations, and improvements.     

Who's afraid of the big bad wolf: a prospective paradigm to test Rachman's indirect pathways in children.

Rachman's theory [The conditioning theory of fear insition: a critical examination. Behav. Res. Ther. 15 (1977) 375-387] of fear acquisition suggests that fears and phobias can be acquired through three pathways: direct conditioning, vicarious learning and information/instruction. Although retrospective studies have provided some evidence for these pathways in the development of phobias during childhood [see King, Gullone, & Ollendick, Etiology of childhood phobias: current status of Rachman's three pathway's theory. Behav. Res. Ther. 36 (1998) 297-309 for a review], these studies have relied on long-term past memories of adult phobics or their parents. The current study was aimed towards developing a paradigm in which the plausibility of Rachman's indirect pathways could be investigated prospectively. In Experiment 1, children aged between 7 and 9 were presented with two types of information about novel stimuli (two monsters): video information and verbal information in the form of a story. Fear-related beliefs about the monsters changed significantly as a result of verbal information but not video information. Having established an operational paradigm, Experiment 2 looked at whether the source of verbal information had an effect on changes in fear-beliefs. Using the same paradigm, information about the monsters was provided by either a teacher, an adult stranger or a peer, or no information was given. Again, verbal information significantly changed fear-beliefs, but only when the information came from an adult. The role of information in the acquisition of fear and maintenance of avoidant behaviour is discussed with reference to modern conditioning theories of fear acquisition.     

Fear information and social phobic beliefs in children: a prospective paradigm and preliminary results

This paper presents a first attempt to develop a prospective paradigm to test Rachman's (Behav. Res. Ther. 15 (1977) 375) theory of fear acquisition for social fears. Following the prospective paradigm for animal fears developed by Field et al. (Behav. Res. Ther. 39 (2001) 1259) an attempt is made to adapt this paradigm to look at the effect of fear information in the development of social fears. A large group of normal children (N=135) who were at an age (10-13 years) at which social concerns are most pertinent were tested using this paradigm. They were given positive, negative or neutral information about three social situations: public speaking, eating in public, and meeting a new group of children. Children's fear beliefs were measured before and after the information was given and the information was given by a teacher, a same age peer or no information was given (a control). The results indicate that although information can change social fear beliefs it is dependent upon the type of social activity and who provides the information. The implications of these initial results for our understanding of both the role of fear information in the development of social fear beliefs, and the limitations of this current paradigm are discussed.     

A Multivariate Genetic Analysis of Specific Phobia, Separation Anxiety and Social Phobia in Early Childhood

BACKGROUND: Comorbidity amongst anxiety disorders is very common in children as in adults and leads to considerable distress and impairment, yet is poorly understood. Multivariate genetic analyses can shed light on the origins of this comorbidity by revealing whether genetic or environmental risks for one disorder also influence another. We examined the genetic and environmental influences on the comorbidity between three common childhood anxiety disorders: Specific Phobia, Separation Anxiety and Social Phobia. METHODS: Using a two-phase design 4,662 twin-pairs were screened in the first phase and 854 pairs were assessed in the second phase by maternal-informant diagnostic interview using DSM-IV criteria. RESULTS: Multivariate genetic analysis revealed significant shared environmental over-lap between Specific Phobia and Separation Anxiety and significant familial and non-shared environmental over-lap between Specific Phobia and Social Phobia. CONCLUSIONS: Familial influences, especially shared environment, are central to the comorbidity between Specific Phobia and both Separation Anxiety and Social Phobia.     

An Assessment of Social Phobia and Social Anxiety and their Relation to Self-Consciousness

Abstract

The translation of the Social Phobia and Anxiety Inventory (SPAI) into Icelandic was submitted to a psychometric assessment. Two hundred sixty-three university students participated in the study. In addition to the SPAI they filled in Fenigstein, Scheier and Buss' (1975) Self-Consciousness Scale (SCS) as well as Spielberger's (1983) State-Trait Anxiety Inventory (STAI). A principal components analysis of the SPAI yielded as expected an agoraphobia and a social phobia factor. As expected the Social Anxiety Scale of the SCS correlated much more strongly with the Social Phobia than the Agoraphobia Scale. The correlation of the Social Phobia Scale with the Social Anxiety Scale was substantially higher than its correlation with any other anxiety measure. The relationships between the Social Phobia Scale and Public versus Private Self-Consciousness were moreover in accordance with theoretical expectations as well as prior research. Generally the discriminant and convergent validity of the Icelandic translation of the Social Phobia Scale as a measure of social anxiety is supported.     

Discriminant validity of the Social Phobia and Anxiety Inventory (SPAI), the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS)

Three measures commonly used in assessment of social phobia, the Social Phobia and Anxiety Inventory (SPAI [Turner, S. M., Beidel, D. C. & Dancu, C. V. (1996). Social phobia and anxiety inventory: manual. Toronto, Ont.: Multi-Health Systems Inc.), the Social Phobia Scale (SPS [Mattick, R. P. & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470] and the Social Interaction Anxiety Scale (SIAS [Mattick, R. P. & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455-470], were compared for their ability to discriminate between social phobia and other anxiety disorders (panic disorder with or without agoraphobia). Participants were 117 patients attending a specialized anxiety disorders unit for treatment. While all three measures were able to detect differences between social phobic patients and patients with panic disorder with or without agoraphobia, a logistic regression analysis showed that the SPAI, but not the SPS and SIAS, was a significant predictor of membership of the social phobia group. Receiver operating characteristic (ROC) analysis also showed that the SPAI was the better measure for discriminating between social phobia and panic disorder with and without agoraphobia. Analysis of the sensitivity, specificity and positive and negative predictive power of the measures at the optimum cutoff scores produced by the ROC analysis are presented.     

Fear information and the development of fears during childhood: effects on implicit fear responses and behavioural avoidance

Field, Argyris and Knowles (Behav Res Ther 39 (2001) 1259), and Field, Hamilton, Knowles and Plews (Behav Res Thera 41 (2003) 113) have developed a prospective paradigm for testing Rachman's (Behav Res Ther 15 (1977) 375) proposition that fear information is important in the development of fears and phobias in children. Despite this paradigm being an advance on retrospective reports, the research so far has been restricted to self-reported fear beliefs measured after the information is given. This gives rise to two possible shortcomings: (1) the effects could simply reflect demand characteristics resulting from children conforming to the experimental demands, and (2) although fear information changes beliefs, this might not translate into the behavioural change that would be expected if this information has a powerful effect relevant to the development of pathological fear. This paper describes an experiment that attempts to address these concerns by improving Field et al.'s (2001, 2003) basic paradigm but with the addition of two measures: (1) a behavioural measure of avoidance, and (2) an implicit attitude task that should not be susceptible to deliberate attempts to conform to experimental demands. The result showed that negative and positive information have dramatic, and opposite, effects on self-reported fear beliefs, behavioural avoidance and implicit attitudes. There were no effects of gender on any of these results. This study fully supports Rachman's model and suggests that past work does not merely reflect demand characteristics and that fear information increases behavioural avoidance as well as fear beliefs.     

Peer victimization and social anxiety in adolescence: a prospective study

This study reports a one‐year prospective investigation of the relations between overt and relational victimization and social anxiety and phobia in a sample of adolescents. The Social Experience Questionnaire—Self Report Form (SEQ‐S), Social Anxiety Scale for Adolescents (SAS‐A), and Social Phobia and Anxiety Inventory for Children (SPAI‐C) were administered to 144 ninth grade adolescents. A follow‐up assessment with the SEQ‐S, SAS‐A, and SPAI‐C was conducted one year later. Results indicated that relational victimization predicted symptoms of social phobia but not general social anxiety and avoidance one year later. Overt victimization was not a significant predictor of social anxiety and phobia one year later. Social anxiety and phobia did not predict peer victimization one year later. However, increases in social anxiety and social phobia symptoms (for boys) over time were positively associated with increases in relational victimization over time. Implications of these findings for peer victimization and social anxiety in the development of social phobia and negative peer experiences are discussed. Aggr. Behav. 00:1–16, 2005. © 2005 Wiley‐Liss, Inc.     

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.     

Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: the SIAS-6 and the SPS-6

Shortened forms of the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS) were developed using nonparametric item response theory methods. Using data from socially phobic participants enrolled in 5 treatment trials (N = 456), 2 six-item scales (the SIAS-6 and the SPS-6) were developed. The validity of the scores on the SIAS-6 and the SPS-6 was then tested using traditional methods for their convergent validity in an independent clinical sample and a student sample, as well as for their sensitivity to change and diagnostic sensitivity in the clinical sample. The scores on the SIAS-6 and the SPS-6 correlated as well as the scores on the original SIAS and SPS, with scores on measures of related constructs, discriminated well between those with and without a diagnosis of social phobia, providing cutoffs for diagnosis and were as sensitive to measuring change associated with treatment as were the SIAS and SPS. Together, the SIAS-6 and the SPS-6 appear to be an efficient method of measuring symptoms of social phobia and provide a brief screening tool.     

Psychometric properties of the social phobia inventory: further evaluation

This study investigated the psychometric properties of the Social Phobia Inventory [SPIN; Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Foa, E., Wesler, R.H., 2000. Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry, 176, 379-386], a measure of severity in social phobia (social anxiety disorder). Participants included 132 participants with social phobia, 57 participants with panic disorder and agoraphobia (PDA), and 62 participants with obsessive-compulsive disorder (OCD). Confirming findings from an initial validation study, the SPIN was found to have excellent internal consistency and good test-retest reliability. It also distinguished well between those with social phobia and those with either PDA or OCD. Good convergent and discriminant validity were established by examining correlations with other conceptually related and unrelated scales. Finally, the SPIN was sensitive to changes in social phobia severity following cognitive behavioral group treatment. In conclusion, the SPIN is both reliable and valid for the measurement of social phobia severity and outcome following psychological treatment.     

Behavioral assessment of public-speaking anxiety using a modified version of the Social Performance Rating Scale

The current study aimed to extend the evaluation of the utility of the Social Performance Rating Scale (SPRS) [Behav. Res. Ther. 36 (1998) 995]. We examined the utility of a modified SPRS for the behavioral assessment of public-speaking anxiety among patients with social phobia (n = 49). The videotaped performance of public-speaking fearful patients in a public-speaking task was rated using four of the five SPRS ratings and was compared to global ratings by patients and observers, as well as to self-report and clinician-administered measures of social anxiety. The pattern of correlations with criterion measures of social anxiety provided evidence for the convergent and divergent validity of this modified SPRS for the behavioral assessment of public-speaking anxiety.     

Non-associative fear acquisition: a review of the evidence from retrospective and longitudinal research

It is axiomatic that the capacity to experience fear is adaptive, enabling rapid and energetic response to imminent threat or danger. Despite the generally accepted utility of functional fear, the nature of maladaptive fear remains controversial. There is still no consensus about how specific fears and phobias are acquired and modulated. Two major schools of thought are apparent: those suggesting dysfunctional fear arises largely as the result of associative-conditioning processes versus those who favour more biologically based etiological explanations. In this regard, the non-associative model of fear acquisition postulates the existence of a limited number of innate, evolutionary-relevant fears, while emphasising conditioning modes of onset for evolutionary-neutral fears. Recent retrospective and longitudinal studies have tested predictions from the non-associative model. In general, findings support non-associative hypotheses and are difficult to reconcile with neo-conditioning explanations of fear acquisition. These data suggest that four pathways to fear may provide the most parsimonious theory of fear etiology. The theoretical and practical implications of adding a fourth, non-associative path to Rachman's (Behav. Res. Ther. (1977) 15, 375-387) three 'associative' pathways are discussed. Unresolved issues requiring further investigation are considered.     

The social phobia and anxiety inventory: psychometric properties in a Spanish sample

This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for differentiating between a nonclinical sample and participants with a social phobia, and its adequate reliability.