The impact of verbal feedback about blushing on social discomfort and facial blood flow during embarrassing tasks

To investigate whether verbal feedback about blushing influences subsequent social discomfort or blushing itself, changes in facial blood flow and ratings of blushing and embarrassment were investigated in high (N=28) and low scorers (N=28) on the Blushing Propensity scale while singing and reading aloud, and while listening to audiotapes of their performance. After each task half of the participants were told that they had blushed, and the rest were told that they had not blushed. Blood flow increased progressively in participants with high blushing propensity scores who were given "blushing" feedback, but not in the other participants. This finding suggests that expecting to blush may become a self-fulfilling prophecy. Verbal feedback about blushing strongly influenced subsequent social discomfort, and mimicked the effects of blushing propensity on ratings of embarrassment and blushing intensity. In sum, the findings support the view that preconceptions about blushing propensity are shaped by past learning experiences, that concern about blushing is a major source of discomfort in embarrassing situations, and that these concerns are often unrelated to the actual intensity of blushing.     

The significance of blushing for fair- and dark-skinned people

Since blushing is difficult to detect in people with dark skin, their experience of blushing may differ fundamentally from people with fair skin. To investigate this issue, cheek temperature and forehead blood flow were measured in 16 Caucasians and 16 Indians during mental arithmetic and singing. Caucasians (particularly females) thought that they blushed more intensely than Indians, and also reported greater self-consciousness when singing. Vascular responses did not differ between groups. However, skin tone moderated the association between vascular responses and ratings of self-consciousness, blushing intensity, blushing propensity and fear of negative evaluation. These findings support the notion that the visibility of blushing influences the nature of emotions experienced in embarrassing social encounters.     

The relationship between blushing propensity,social anxiety and facial blood flow during embarrassment

To investigate blushing in relation to blushing propensity scores and core elements of social anxiety, facial blood flow was monitored in 86 normal volunteers during an embarrassing task (singing a children's song). Increases in facial blood flow were greater in women than men, as were scores on the Blushing Propensity and Fear of Negative Evaluation scales. In addition, high scores on the Blushing Propensity and Social Interaction Anxiety scales were associated with large increases in facial blood flow during singing. However, this appeared to be due primarily to social anxiety because the association between blushing propensity scores and changes in facial blood flow disappeared when social interaction anxiety scores were taken into account. These findings suggest that people generally base their beliefs about blushing on cues other than changes in facial blood flow. Social anxiety may augment increases in facial blood flow during embarrassment, independently of expected or perceived blushing.     

The effect of true and false feedback on blushing in women

The effect of true and false feedback of facial blood flow on blushing and embarrassment was investigated in high (n=24) and low (n=24) scorers on the Blushing Propensity Scale. Feedback was given while the participants sang and read aloud. Blushing while singing habituated rapidly in both groups and was not affected by true feedback. Blushing still developed in high scorers when given false-negative feedback of blushing when they first sang, whereas low scorers did not blush. False-positive feedback of blushing while reading aloud increased embarrassment, but facial blood flow decreased. High scorers gave higher ratings for embarrassment and blushing than low scorers during most of the tasks. The findings suggest that people who think that they are prone to blushing feel more self-conscious but generally do not blush more intensely or frequently than people with low blushing propensity scores during clearly embarrassing or innocuous social encounters. However, expecting to blush might actually increase the likelihood of embarrassment and blushing in potentially embarrassing situations.     

Task concentration training versus applied relaxation, in combination with cognitive therapy, for social phobia patients with fear of blushing, trembling, and sweating

Social phobia patients with fear of blushing, trembling, sweating and/or freezing as main complaint (N = 65) were randomly assigned to either task concentration training (TCT) or applied relaxation (AR) both followed by cognitive therapy (CT). Measurements took place before and after wait-list, after TCT or AR (within-test), after CT (post-test), at 3-months and at 1-year follow-up. Effects were assessed on fear of showing bodily symptoms (the central outcome variable), social phobia, other psychopathology, social skills, self-consciousness, self-focused attention, and dysfunctional beliefs. No changes occurred during wait-list. Both treatments were highly effective. TCT was superior to AR in reducing fear of bodily symptoms and dysfunctional beliefs at within-test. This difference disappeared after CT, at post-test and at 3-months follow-up. However, at 1-year follow-up the combination TCT-CT was superior to AR-CT in reducing fear of bodily symptoms, and effect sizes for TCT-CT reached 3. Furthermore, at all assessment moments TCT or the combination TCT-CT was superior to AR-CT in reducing self-consciousness and self-focused attention. The superior long-term effect of TCT on fear of showing bodily symptoms is explained by lasting changes in attentional focus.     

The effect of attentional focus on social anxiety

The aim of the present study was to examine the effect of attentional focus on social anxiety in a group of high and low blushing-anxious subjects. One hundred and fourteen psychology undergraduate students were screened using the Fear of Blushing subscale of the Blushing Questionnaire [B?gels, S. M., & Reith, W. (1999). Validity of two questionnaires to assess social fears: The Dutch social phobia and anxiety questionnaire and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavioral Assessment, 21, 51-66]. Those with the most extreme scores in the top and bottom 20% of the distribution were selected to form a high (n=22) and a low (n=22) blushing-anxious group. Subjects were randomly allocated to either a self-focused attention (SFA) condition or a task-focused attention (TFA) condition. They were asked to engage in a 5 min conversation with the first author, and were instructed to either self-focus (SFA condition) or task-focus (TFA condition). Levels of social anxiety and self-awareness were measured using visual analogue scales. Results suggest that the there was a significant condition by group interaction, with high blushing individuals showing considerably higher levels of social anxiety in the SFA condition compared to the TFA condition while low blushing individuals showed no significant difference across the two conditions.     

The causal role of self-awareness in blushing-anxious,socially-anxious and social phobics individuals

This study examined the effect of attentional focus on social anxiety in three groups of subjects: high versus low blushing-anxious participants (n=48); high versus low socially anxious participants (n=60); and social phobic patients compared to patients with other anxiety disorders (n=48). Participants were asked to imagine two series of social situations, in which the hero was in the centre of others' attention. In the first series of stories, the type of feedback from the audience (positive, negative and neutral) and the direction of attention of the hero (self- versus task-focused) were manipulated, and in the second series of stories, the presence or absence of blushing and the direction of attention of the hero were manipulated. In line with the expectations, self-focused attention (SFA) led to more social anxiety than task-focused attention (TFA) in all the three experiments, and high blushing-anxious, socially anxious, and social phobic groups reported higher levels of self-awareness than their low-anxious comparison groups. No evidence was found for the idea that self-focusing is specifically detrimental for participants who are already socially anxious, blushing-anxious, or socially phobic. Also, attentional focus did not interact with the valence of social feedback. Finally, results provided some support for the hypothesis that fear of blushing is mediated by self-focusing. The results suggest that irrespective of trait social anxiety, and irrespective of the outcome of a social situation (positive, neutral or negative), SFA increases state social anxiety, or TFA decreases state social anxiety.     

Learning history in fear of blushing

Two studies, investigating the learning history (i.e. traumatic conditioning experiences, vicarious learning, informational learning) of individuals with and without fear of blushing, are presented. In study 1, individuals high (n=61) and low (n=59) in fear of blushing completed the (revised) Phobic Origin Questionnaire [POQ; Öst, L. G., & Hugdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behavior Research and Therapy, 19, 439–447]. In study 2, individuals who applied for treatment for fear of blushing (n=31) and a nonfearful, matched control group (n=31) were interviewed with the same instrument, taking into account only specific memories. High fearful individuals reported more negative learning experiences in connection with blushing than low fearful individuals, irrespective of the type of questioning. Meanwhile, study 1 (written POQ) produced higher percentages of negative learning experiences for both high and low fearful individuals than study 2 (interview). It is concluded that the POQ interview showed a more realistic picture than the written POQ. The possible role of learning history in the acquisition of fear of blushing is discussed.     

Attentional bias for words and faces in social anxiety

Conflicting findings concerning the nature and presence of attentional bias in social anxiety and social phobia have been reported in the literature. This paper reports the findings of two studies comparing people with high and low social anxiety on dot probe tasks using words, faces photographed in front view, and faces photographed in profile as stimuli. In Study 1 those with high social anxiety displayed an attentional bias towards negative faces. The low social anxiety group showed an attentional bias towards positive faces. No significant effects were observed on the dot probe using words as stimuli. Study 2 used pairs of faces presented in profile as though looking at each other. One of the faces displayed either a positive, negative or neutral expression. The second face always had a neutral expression, and in half of the trials it was the subject's own face. The findings of this more ecologically valid procedure replicated those of Study 1. Facilitated attention to dots following emotional faces was specific to threatening facial stimuli. From these studies it appears that the facial dot probe task is a more sensitive index of attentional bias than the word task in a non-clinical sample with social anxiety.     

Latent growth curve analysis of fear during a speech task before and after treatment for social phobia

Models of social phobia highlight the importance of anticipatory anxiety in the experience of fear during a social situation. Anticipatory anxiety has been shown to be highly correlated with performance anxiety for a variety of social situations. A few studies show that average ratings of anxiety during the anticipation and performance phases of a social situation decline following treatment. Evidence also suggests that the point of confrontation with the feared stimulus is the peak level of fear. No study to date has evaluated the pattern of anxious responding across the anticipation, confrontation, and performance phases before and after treatment, which is the focus of the current study. Socially phobic individuals (N = 51) completed a behavioral avoidance task before and after two types of manualized cognitive behavioral therapy, and gave ratings of fear during the anticipation and performance phases.Results from latent growth curve analysis were the same for the two treatments and suggested that before treatment, anxiety sharply increased during the anticipation phase, was highly elevated at the confrontation, and gradually increased during the performance phase. After treatment, anxiety increased during the anticipation phase, although at a much slower rate than at pretreatment, peaked at confrontation, and declined during the performance phase. The findings suggest that anticipatory experiences are critical to the experience of fear for public speaking and should be incorporated into exposures.     

Attention allocation in social anxiety during a speech

Cognitive models assume that social anxiety is associated with and maintained by biased information processing, leading to change in attention allocation, which can be measured by examining eye movement. However, little is known about the distribution of attention among positive, neutral and negative stimuli during a social task and the relative importance of positive versus negative biases in social anxiety. In this study, eye movement, subjective state anxiety and psychophysiology of individuals with high trait social anxiety (HSA) and low trait social anxiety (LSA) were measured during a speech task with a pre-recorded audience. The HSA group showed longer total fixation on negative stimuli and shorter total fixation on positive stimuli compared to the LSA group. We observed that the LSA group shifted attention away from negative stimuli, whereas the HSA group showed no differential attention allocation. The total duration of fixation on negative stimuli predicted subjective anxiety ratings. These results point to a negative bias as well as a lack of a positive bias in HSA individuals during social threat.     

The effects of verbal information on children's fear beliefs about social situations

Two experiments explored the role of verbal information in changing children's fear-related beliefs about social situations. In Experiment 1, 118 6- to 8- and 12- to 13-year-olds heard positive, negative, or no information about individuals' experiences of three social situations. Fear beliefs regarding each situation were assessed before and after this manipulation. Verbal information had no significant influence on children's fear beliefs. In Experiment 2, the same paradigm was used with 80 12- to 13-year-olds, but the information took the form of multiple attitude statements about the situations expressed by groups of peers, older children, or adults. An affective priming task of implicit attitudes was used to complement the explicit questions about fear beliefs. Negative information influenced both explicit and implicit fear beliefs. The source of information and the child's own social anxiety did not moderate these effects. Implications for our understanding of the socialisation of childhood fears are discussed.     

Modelling relationships between cognitive variables during and following public speaking in participants with social phobia

Cognitive models of social phobia predict that several cognitive processes will mediate the relationship between trait levels of social anxiety and the extent of anxiety experienced in a specific social-evaluative situation. The current study aimed to provide a test of these relationships. Over 200 clinical participants with social phobia completed measures of their general social anxiety and a week later performed a brief impromptu speech. They completed a measure of state anxiety in response to the speech as well as questionnaires assessing several cognitive constructs including focus of perceived attention, perceived performance, and probability and cost of negative evaluation. A week later, they completed measures of negative rumination experienced over the week, as well as a measure of the recollection of their perceived performance. Path analysis provided support for a model in which the cognitive factors mediated between general social anxiety and the degree of anxiety experienced in response to the speech. A second model supported the theory that negative rumination mediated between characteristic social anxiety and negative bias in the recollection of performance.     

The effects of different types of goal pursuit on experience and performance during a stressful social task

Researchers have recently suggested that anxiety research may benefit from the examination of motivational factors, such as the difference between approach and avoidance goals. This suggestion is consistent with the literature on self-regulation, which indicates that affect serves as feedback for goal pursuit, with anxiety primarily providing feedback regarding avoidance. However, no data are available on participant goals for a task that generates social anxiety. Data from 120 speech anxious participants who engaged in a public speaking task were used to test the following hypotheses: (1) avoidance goals would be more specific than approach goals; (2) goals regarding social anxiety would have a negative impact on public speaking experience and performance; and (3) participants would tend to organize approach and avoidance goals not as separate goals, but as opposite poles of the same overarching goal. Hypotheses (1) and (3) were fully supported and hypothesis (2) was partially supported. The results highlight the possibility that approach goals may be particularly important to anxiety reduction.     

Jumping to interpretations: social anxiety disorder and the identification of emotional facial expressions

A small body of research suggests that socially anxious individuals show biases in interpreting the facial expressions of others. The current study included a clinically anxious sample in a speeded emotional card-sorting task in two conditions (baseline and threat) to investigate several hypothesized biases in interpretation. Following the threat manipulation, participants with generalized social anxiety disorders (GSADs) sorted angry cards with greater accuracy, but also evidenced a greater rate of neutral cards misclassified as angry, as compared to nonanxious controls. The controls showed the opposite pattern, sorting neutral cards with greater accuracy but also misclassifying a greater proportion of angry cards as neutral, as compared to GSADs. These effects were accounted for primarily by low-intensity angry cards. Results are consistent with previous studies showing a negative interpretive bias, and can be applied to the improvement of clinical interventions.     

Assessment of dispositional embarrassability

Abstract

Embarrassability, the propensity for an individual to experience embarrassment, has been frequently acknowledged as an important personality characteristic. The present research sought to explore the dispositional features of embarrassability by the psychometric development of 25-item measure, the Susceptibility to Embarrassment Scale (SES). The SES was designed to describe the personality characteristics of easily embarrassed persons rather than reactions to potentially embarrassing situations. The results indicated that the SES was an internally consistent and temporally stable measure. Its items were uncontaminated by social desirability. Assessments of construct validity suggested that the scale was a valid measure of embarrassability, and specifically a better measure of dispositional components of embarrassability than the only alternative measure of the construct. The location of the SES within the Big Five structure of normal adult personality is presented as well as its relationship with measures of deviant personality.     

The structure of feared social situations among individuals with a lifetime diagnosis of social anxiety disorder in two independent nationally representative mental health surveys

The present study employed both exploratory and confirmatory factor analytic approaches with nationally representative samples of individuals with a lifetime diagnosis of social anxiety disorder (n=1123; n=3091, respectively) using split-halves of the National Comorbidity Replication Survey (n=9282) and cross-validated with the Canadian Community Health Survey on Mental Health and Wellbeing (n=36,984). Strong support was found for a three-factor solution. This model was obtained from exploratory factor analysis and was further evaluated using two confirmatory factor analytic investigations in the two national samples. The three social situational domains reflected (1) Social Interaction Fears, (2) Observation Fears, and (3) Public Speaking Fears. Individuals with generalized social anxiety disorder (i.e., those who endorsed 7 or more of 13 feared social situations assessed in the survey) were significantly more likely to report Social Interaction Fears and Observation Fears compared to individuals with non-generalized social anxiety disorder (i.e., those who endorsed only 6 or fewer of 13 feared social situations). Individuals with generalized social anxiety were particularly characterized by combinations of Public Speaking Fears plus Social Interaction Fears and Observation Fears. The clinical and classification implications of our study for DSM-V are discussed.     

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.     

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.