Rumination in Children with Social Anxiety Disorder: Effects of Cognitive Distraction and Relation to Social Stress Processing

According to cognitive models of social anxiety disorder (SAD), both anticipatory processing and post-event processing are core mechanisms in disorder maintenance leading to dysfunctional coping with social situations through negative self-evaluation and increased anxiety. To date, little is known about these processes during late childhood, a critical period for disorder development. Further, it remains unclear if dysfunctional rumination in children can be altered through psychotherapeutic interventions such as cognitive distraction. In the current study, children aged 9 to 13 years with SAD and age- and gender-matched healthy controls (HCs, each: n?=?30) participated in an experimental laboratory social stress task while anticipatory processing, post-event processing, subjective anxiety, self-evaluations, and autonomic arousal (skin conductance level) were assessed. Further, the impact of a brief cognitive distraction intervention on post-event processing was assessed. Children with SAD reported more negative anticipatory and post-event processing compared to HC children. Further, negative anticipatory processing was associated with higher subjective anxiety and reduced subjective performance ratings during the social stress task. In the aftermath of the stressor, distraction led to reduced subjective anxiety in the group with SAD and lower autonomic arousal in all children but did not alter post-event processing. The current study suggests that both anticipatory and post-event processing already play a key role in the maintenance of SAD in childhood. While distraction may be beneficial in reducing prolonged subjective anxiety and autonomic arousal after social situations, more research on interventions targeting ruminative processes is needed.

     

Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder

To further improve treatments, we need to better understand potential common treatment mechanisms, such as decentering, or the ability to observe thoughts and feelings as objective events in the mind rather than personally identifying with them (Safran & Segal, 1990). Therefore, this study examined whether 12 sessions of Cognitive Behavioral Group Therapy (CBGT) for 63 clients (57.6% female, 50.8% White) diagnosed with social anxiety disorder led to increases in decentering and whether increased decentering was associated with improved outcome. Furthermore, this study examined whether decentering was associated with outcome over and above a competing mechanism—cognitive reappraisal. Overall, results indicated that CBGT in this study led to similar outcomes compared to previous studies and decentering increased over CBGT (d’s from 0.81 to 2.23). Change in decentering predicted improvement on most, but not all, measures of outcome and those who no longer met criteria for social anxiety disorder at posttreatment had significantly greater change in decentering across therapy and significantly higher decentering scores at post-treatment compared to those who retained a social anxiety disorder diagnosis at posttreatment. Finally, changes in decentering predicted outcome over and above changes in reappraisal on all outcome measures. These results largely support the role of decentering in CBGT for social anxiety; however, the implications of the inconsistencies in results based on which outcome measure was used are discussed.     

Mediators in psychological treatment of social anxiety disorder: Individual cognitive therapy compared to cognitive behavioral group therapy

According to cognitive-behavioral models of social anxiety disorder (SAD), four of the important maintaining mechanisms are avoidance, self-focused attention, anticipatory processing and post-event cognitive processing. Individual cognitive therapy (ICT) and cognitive behavioral group therapy (CBGT) both have substantial empirical support. However, it is unclear whether they achieve their effects by similar or different mechanisms. The aim of this study was to investigate whether changes in the four maintenance processes mediate clinical improvement in ICT and CBGT for SAD. We analyzed data from participants (N = 94) who received either ICT or CBGT in two separate RCTs. The results showed that ICT had larger effects than CBGT on social anxiety and each of the four potential mediators. More pertinently, moderated mediation analyses revealed significant between-treatment differences. Whereas improvement in ICT was mainly mediated by reductions in avoidance and self-focused attention, improvement in CBGT was mediated by changes in self-focused attention and in anticipatory and post-event processing. These results support the importance of the putative mediators, but suggest that their relative weights are moderated by treatment type.     

Cognitive mechanisms of mindfulness: A test of current models

Existing models of mindfulness describe the self-regulation of attention as primary, leading to enhanced decentering and ability to access and override automatic cognitive processes. This study compared 23 experienced and 21 non-meditators on tests of mindfulness, attention, decentering, and ability to override automatic cognitive processes to test the cognitive mechanisms proposed to underlie mindfulness practice. Experienced meditators had significantly higher mindfulness and decentering than non-meditators. No significant difference between groups was found on measures of attention or ability to override automatic processes. These findings support the prediction that mindfulness leads to enhanced decentering, but do not support the cognitive mechanisms proposed to underlie such enhancement. Since mindfulness practice primarily involves internally directed attention, it may be the case that cognitive tests requiring externally directed attention and timed responses do not accurately assess mindfulness-induced cognitive changes. Implications for the models of mindfulness and future research are discussed.     

Anticipatory Processing and Post‐Event Processing in Social Anxiety Disorder: An Update on the Literature

Two repetitive thinking processes that have been proposed in prominent maintenance models of social anxiety disorder (SAD) are anticipatory processing and post‐event processing. Research into these two processes has steadily increased over the last 20 years. This review highlights the main lines of existing research on anticipatory processing and post‐event processing, including studies on the nature of these processes, their association with social anxiety, the predictors, and consequences of these processes, as well as how these processes respond to treatments for SAD. The review also highlights some of the conceptual and methodological issues that have prevented the literature on anticipatory processing and post‐event processing from being more integrated and focused. Finally, the review draws together some new directions in terms of theory and research to further advance the field.     

The Influence of Anticipatory Processing on Attentional Biases in Social Anxiety

Research on cognitive theories of social anxiety disorder (SAD) has identified individual processes that influence this condition (e.g., cognitive biases, repetitive negative thinking), but few studies have attempted to examine the interaction between these processes. For example, attentional biases and anticipatory processing are theoretically related and have been found to influence symptoms of SAD, but they rarely have been studied together (i.e., Clark & Wells, 1995). Therefore, the goal of the current study was to examine the effect of anticipatory processing on attentional bias for internal (i.e., heart rate feedback) and external (i.e., emotional faces) threat information. A sample of 59 participants high (HSA) and low (LSA) in social anxiety symptoms engaged in a modified dot-probe task prior to (Time 1) and after (Time 2) an anticipatory processing or distraction task. HSAs who anticipated experienced an increase in attentional bias for internal information from Time 1 to Time 2, whereas HSAs in the distraction condition and LSAs in either condition experienced no changes. No changes in biases were found for HSAs for external biases, but LSAs who engaged in the distraction task became less avoidant of emotional faces from Time 1 to Time 2. This suggests that anticipatory processing results in an activation of attentional biases for physiological information as suggested by Clark and Wells.     

Cognitive change processes in psychotherapy

Several types of cognitive-behavioral therapy are now practiced that use different sets of theoretical concepts and propose different kinds of change mechanisms. None, however, is directly grounded in experimental research in cognitive and social psychology, and few address basic issues such as the relevance of conscious versus nonconscious cognitive processes and the validity of the self-report data on which therapy depends. Put forward in this article is a model that describes the conscious and nonconscious processing of emotional stimuli and distinguishes between knowledge that is verbally accessible and knowledge that can only be recovered by exposure to situational cues. Also proposed are three mechanisms of cognitive change that involve altering verbally accessible knowledge, the accessibility of nonconscious situational memories, and self-regulatory strategies. These mechanisms are related to the current practices of behavioral and cognitive-behavioral therapists.     

Parental guidance as children learn to use cultural tools: The case of pictorial plans

This study examines how social interaction with more experienced partners may help children learn about cultural tools that aid thinking. Thirty-two children between the ages of 4 and 7 years and their mothers were observed as they constructed a toy made up of multiple pieces using a pictorial, step-by-step plan of construction. Before and after the interaction, children participated in a similar activity on their own. Results indicate that with increasing age, children referred to the plan more often, and these references were both anticipatory and confirmatory. Working with mother was related to greater anticipatory use of plans during the posttest for younger but not older children. Results are discussed in relation to how the social context may assist children as they learn about the meaning and use of cultural tools for representing knowledge that supports cognitive activity.     

Perfectionism and its relationship with anticipatory processing in social anxiety

Cognitive‐behavioural models suggest that perfectionistic beliefs and anticipatory processing are key maintaining factors of social anxiety. The present study examined the moderating and mediating role that anticipatory processing has on the relationship between perfectionism and social anxiety. The sample consisted of 245 individuals from the general community who completed an online questionnaire package comprising depression, perfectionism, and social anxiety measures. Participants also rated their levels of anticipatory processing in response to vignettes describing an upcoming social interaction and performance situation. Results showed that maladaptive perfectionism and maladaptive anticipatory processing were positively associated with social anxiety. Furthermore, maladaptive anticipatory processes (stagnant deliberation and outcome fantasy) remained significantly and positively associated with social anxiety even after controlling for depression and maladaptive perfectionism, whereas adaptive anticipatory processes (plan rehearsal and problem analysis) were not significantly associated with social anxiety. These findings support current classifications of anticipatory processing in social anxiety. Contrary to predictions, maladaptive anticipatory processing did not moderate the relationship between maladaptive perfectionism and social anxiety. An exploratory analysis indicated that maladaptive anticipatory processing mediated the relationship between maladaptive perfectionism and social anxiety. Implications for therapeutic intervention are discussed.     

Cognitive processes in social anxiety: the effects of self-focus, rumination and anticipatory processing

We examined three cognitive processes hypothesized to contribute to biases in judgments about and memory for social events: self-focused attention, post-event rumination, and anticipatory processing. Socially anxious (N = 58) and nonanxious (N = 58) subjects participated in a social interaction and then completed measures of self-focused attention and anxiety-related physiological sensations and behavior. The next day, subjects completed measures that assessed frequency of post-event processing and recall of the interaction. The results indicated that selective attention to negative self-related information led to biases in social judgments and recollections and that post-event processing contributed to the recall of negative self-related information. No evidence was found for selective retrieval of negative self-related information prior to a second social interaction. The results reconcile inconsistent previous findings related to memory bias in social anxiety.     

The cognitive miser's perspective: Social comparison as a heuristic in self-judgements

The metaphor of the cognitive miser is a milestone in the development of social cognitive research. It highlights the limited cognitive resources of the social thinker and the demand for fast and efficient processing of information. In marked contrast to the impact of this metaphor on social cognition research in general, it has so far been mostly overlooked in research on social comparison. In this article we want to lay out the potential of social comparison research if one takes on the perspective of a cognitive miser. Specifically, we consider social comparison as a heuristic for evaluating the self. First, we look for evidence for the ease of comparative self-evaluations. Second, we analyse the standard selection process and identify routine standards that facilitate the comparison process. Third, we investigate the cognitive mechanisms in social comparisons and suggest that comparison mechanisms leading to assimilation are more efficient than mechanisms leading to contrast effects.     

Cognition About Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers a level of formulation and intervention that does not focus predominantly on challenging the content of negative thoughts and beliefs that are emphasized in traditional cognitive therapy. The focus of treatment in GAD is on erroneous beliefs about worry and unhelpful mental regulation strategies. In treating social phobia, a greater emphasis is placed on modifying attention and worry processes and on configuring processing during and after behavioral experiments.     

前瞻性情绪作为社会风险的信息源假说：公共场景下风险决策的情绪及文化机制探讨

本研究从梳理决策的情绪理论入手, 在综合几种主要理论的基础上提出了“前瞻性情绪作为社会风险信息源”的假说。前瞻性情绪是在决策过程中产生的, 由于对决策选择的预期而感受到的, 进而影响决策行为的情绪。社会环境下的风险事件具有突发和稍纵即逝的特征, 如果一个公民对这类风险事件做出反应, 其结果的概率难于量化。在这种情况下, 前瞻性情绪能够为决策者快速提供有关信息, 并形成对决策预期结果严重性和可能性的综合表征, 从而成为公众场景下风险决策的有效线索。不同前瞻性情绪的组合在面对社会性风险事件时具有针对性的作用。近年来在文化比较中对于面子、荣誉和尊严文化的划分, 也为我们研究文化的情绪特征和行为效应提供了理论框架。本研究拟通过四项研究和多个实验探讨前瞻性情绪如何影响公众场景下人们的风险应对行为, 并对三种文化的情绪特征进行比较, 探索情绪性决策中个人因素、群体因素、及文化因素如何共同决定公共场景下风险决策(如亲社会行为或反社会行为)的发生与发展, 同时也期望为公共政策的制定及风险管理提供科学依据。     

Infants' goal anticipation during failed and successful reaching actions

The ability to interpret and predict the actions of others is crucial to social interaction and to social, cognitive, and linguistic development. The current study provided a strong test of this predictive ability by assessing (1) whether infants are capable of prospectively processing actions that fail to achieve their intended outcome, and (2) how infants respond to events in which their initial predictions are not confirmed. Using eye tracking, 8‐month‐olds, 10‐month‐olds, and adults watched an actor repeatedly reach over a barrier to either successfully or unsuccessfully retrieve a ball. Ten‐month‐olds and adults produced anticipatory looks to the ball, even when the action was unsuccessful and the actor never achieved his goal. Moreover, they revised their initial predictions in response to accumulating evidence of the actor's failure. Eight‐month‐olds showed anticipatory looking only after seeing the actor successfully grasp and retrieve the ball. Results support a flexible, prospective social information processing ability that emerges during the first year of life.     

Intensive mindfulness training-related changes in cognitive and emotional experience

This study examined the role of intensive mindfulness training on changes in day-to-day experiential processing, psychological symptoms, resilience, and well-being in two groups of community adults (N = 69). Using both quasi-experimental and longitudinal methods, the study found that intensive training, operationalized as 10–12 hours of formal mindfulness practice per day for 1 month, was significantly related to increases in training-specific experiential processing capacities, namely trait mindfulness and decentering (reperceiving), in comparison to pre–post-training wait-list controls. In both training groups combined, mindfulness, decentering, and acceptance increased over the pre-training to 1-month follow-up period. Intensive mindfulness training was also related to declines in anxiety and enhanced both subjective well-being and self-compassion from pre-training to follow-up in the two training groups. Finally, increases in trait mindfulness and acceptance were related to improvements in psychological symptoms, well-being, and resilience. Future directions for this novel area of mindfulness research are discussed.     

发散性思维与幽默的认知神经机制比较——基于双加工理论的视角

在双加工理论视角下对发散性思维与幽默的认知神经机制进行了系统整理。发现二者的认知加工过程具有相似性：前期都依赖于自动化加工;而后期随着认知负荷的增加,越来越依赖控制化加工。脑机制方面：控制化加工条件下,二者的神经机制重叠部分比自动化加工条件下多,其中负责控制化加工的前额皮层是二者共同的关键脑区。未来可从两类加工协同合作的角度深入揭示发散性思维与幽默的内在机制。     

A Multidimensional Approach to Apathy after Traumatic Brain Injury

Apathy is commonly described following traumatic brain injury (TBI) and is associated with serious consequences, notably for patients’ participation in rehabilitation, family life and later social reintegration. There is strong evidence in the literature of the multidimensional nature of apathy (behavioural, cognitive and emotional), but the processes underlying each dimension are still unclear. The purpose of this article is first, to provide a critical review of the current definitions and instruments used to measure apathy in neurological and psychiatric disorders, and second, to review the prevalence, characteristics, neuroanatomical correlates, relationships with other neurobehavioural disorders and mechanisms of apathy in the TBI population. In this context, we propose a new multidimensional framework that takes into account the various mechanisms at play in the facets of apathy, including not only cognitive factors, especially executive, but also affective factors (e.g., negative mood), motivational variables (e.g., anticipatory pleasure) and aspects related to personal identity (e.g., self-esteem). Future investigations that consider these various factors will help improve the understanding of apathy. This theoretical framework opens up relevant prospects for better clinical assessment and rehabilitation of these frequently described motivational disorders in patients with brain injury.     

The Development and Initial Validation of the Cognitive Fusion Questionnaire

Acceptance and Commitment Therapy (ACT) emphasizes the relationship a person has with their thoughts and beliefs as potentially more relevant than belief content in predicting the emotional and behavioral consequences of cognition. In ACT, “defusion” interventions aim to “unhook” thoughts from actions and to create psychological distance between a person and their thoughts, beliefs, memories, and self-stories. A number of similar concepts have been described in the psychology literature (e.g., decentering, metacognition, mentalization, and mindfulness) suggesting converging evidence that how we relate to mental events may be of critical importance. While there are some good measures of these related processes, none of them provides an adequate operationalization of cognitive fusion. Despite the centrality of cognitive fusion in the ACT model, there is as yet no agreed-upon measure of cognitive fusion. This paper presents the construction and development of a brief, self-report measure of cognitive fusion: The Cognitive Fusion Questionnaire (CFQ). The results of a series of studies involving over 1,800 people across diverse samples show good preliminary evidence of the CFQ’s factor structure, reliability, temporal stability, validity, discriminant validity, and sensitivity to treatment effects. The potential uses of the CFQ in research and clinical practice are outlined.     

Is the moral domain unique? A social influence perspective for the study of moral cognition

The nature of the cognitive processes that give rise to moral judgment and behavior has been a central question of psychology for decades. In this paper, we suggest that an often ignored yet fruitful stream of research for informing current debates on the nature of moral cognition is social influence. We introduce what we call the “social‐moderation‐of‐process” perspective, a methodological framework for leveraging insights from social influence research to inform debates in moral psychology over the mechanisms underlying moral cognition and the moral domains in which those mechanisms operate. We demonstrate the utility of the social‐moderation‐of‐process perspective by providing a detailed example of how research on social influence in behavioral ethics can be utilized to test a research question related to a debate between two prominent theories in moral psychology. We then detail how researchers across the field of moral psychology can utilize our social‐moderation‐of‐process perspective.