Negative Social Cognitions in Socially Anxious Youth: Distorted Reality or a Kernel of Truth?

We review studies that investigate negative social cognitions of socially anxious youth in relation to two specific domains: interpretation of ambiguous social situations and self-evaluation of social performance, including social skills and nervous behaviors. In this review, we address the question whether socially anxious youth’s negative perceptions are distortions of reality or reflect a kernel of truth as compared to other sources of information including independent adult observers and age peers. Studies key to this question are those that investigate not only the social perceptions themselves but also the social behavior of socially anxious youth. Hence the selection of studies for the review was based on this criterion. From the relevant literature it is, as yet, unclear whether the negative interpretations of ambiguous social situations shown by socially anxious youth are distorted or a reflection of reality. Socially anxious youth’s self-evaluations of social skills appear partly distorted and partly true, depending on the person judging the social skills. In contrast, self-evaluations of nervous behaviors appear distorted. The studies reviewed indicate that research would benefit from including a wider range of perceptions from persons relevant to the socially anxious youth’s daily social environment, not only parents and teachers but also their age peers.     

Posttraumatic stress disorder following political imprisonment: the role of mental defeat, alienation, and perceived permanent change

An interview study of 81 former political prisoners investigated whether posttraumatic stress disorder (PTSD) is related to the way individuals process the prison experience. In contrast to participants without PTSD, those with chronic or remitted PTSD were more likely to perceive mental defeat and an overall feeling of alienation from other people. Chronic PTSD was also related to perceived negative and permanent change in their personalities or life aspirations. The groups did not differ in their attempts to gain control during imprisonment. Evidence for a relationship between political commitment and PTSD was mixed. The results suggest that mental defeat, alienation, and permanent change are related to PTSD after interpersonal trauma and may need to be addressed in treatment.     

Unwanted memories of assault: what intrusion characteristics are associated with PTSD?

Intrusive memories are common in the immediate aftermath of traumatic events, but neither their presence or frequency are good predictors of the persistence of posttraumatic stress disorder (PTSD). Two studies of assault survivors, a cross-sectional study (N=81) and a 6-month prospective longitudinal study (N=73), explored whether characteristics of the intrusive memories improve the prediction. Intrusion characteristics were assessed with an Intrusion Interview and an Intrusion Provocation Task. The distress caused by the intrusions, their "here and now" quality, and their lack of a context predicted PTSD severity. The presence of intrusive memories only explained 9% of the variance of PTSD severity at 6 months after assault. Among survivors with intrusions, intrusion frequency only explained 8% of the variance of PTSD symptom severity at 6 months. Nowness, distress and lack of context explained an additional 43% of the variance. These intrusion characteristics also predicted PTSD severity at 6 months over and above what could be predicted from PTSD diagnostic status at initial assessment. Further predictors of PTSD severity were rumination about the intrusive memories, and the ease and persistence with which intrusive memories could be triggered by photographs depicting assaults. The results have implications for the early identification of trauma survivors at risk of chronic PTSD.     

Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study

The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.     

Selective attention in social phobia and the moderating effect of a concurrent depressive disorder

Studies using the modified Stroop colour naming task have provided results consistent with the hypothesis that social phobia is associated with an attentional bias towards negative social-evaluative words. However, these results could also have arisen as a consequence of non-attentional processes. For this reason, the present study uses a modified version of MacLeod et al.'s (J. Abnorm. Psychol. 95 (1986) 15) dot-probe task, which provides a more direct measure of attention. Patients with social phobia (n=28), patients with social phobia and a concurrent depressive disorder (n=33), and non-patients (n=40) were presented with word pairs each consisting of a neutral word and a threat word. The results indicated that patients with social phobia show an attentional bias towards social-threat words while non-patients tend to avoid social-threat words. Patients with social phobia and a concurrent depressive disorder behaved like non-patients, indicating that concurrent depression abolishes the attentional bias. Physical threat words were also included in the study. The main analysis indicated that social phobia is also associated with an attentional bias to physical threat. However, a post hoc analysis (which requires replication) suggested that the physical threat bias might have arisen because some social phobia patients also had another anxiety disorder in which physical concerns are likely to have been prominent. Overall, the results emphasise the importance of assessing comorbidity when investigating attentional biases.     

Contribution of cognitive factors to the prediction of post-traumatic stress disorder, phobia and depression after motor vehicle accidents

Past research into the psychological consequences of traumatic events has largely focused on post-traumatic stress disorder (PTSD), although other anxiety disorders and depression are also common in the aftermath of trauma. Little is known about differential predictors of these conditions. The present study investigated the extent to which theoretically derived cognitive variables predict PTSD, phobias and depression after motor vehicle accidents. The cognitive predictors were compared to a set of established, mainly non-cognitive predictors. In addition, we tested how disorder-specific the cognitive predictors are. Participants (n=101) were interviewed within a year after having been injured in a motor vehicle accident. Diagnoses of PTSD, travel phobias and depression, symptom severities and predictor variables were assessed with self-report questionnaires and structured interviews. In multiple regression analyses, the sets of cognitive variables derived from disorder-specific models explained significantly greater proportions of the variance of the symptom severities than the established predictors (PTSD 76% vs. 45%, depression 72% vs. 46% and phobia 66% vs. 40%), and than cognitive variables derived from the models of the other disorders. In addition, the majority of individual cognitive variables showed the expected pattern of differences between diagnostic groups. The results support the hypothesis that disorder-specific sets of cognitive factors contribute to the development and maintenance of PTSD, phobias and depression following traumatic events.     

Patients with generalized social phobia direct their attention away from faces

The experiment tested whether patients with social phobia direct their attention to or away from faces with a range of emotional expressions. A modified dot probe paradigm (J. Abnorm. Psychol. 95 (1986) 15) measured whether participants attended more to faces or to household objects. Twenty patients with social phobia were faster in identifying the probe when it occurred in the location of the household objects, regardless of whether the facial expressions were positive, neutral, or negative. In contrast, controls did not exhibit an attentional preference. The results are in line with recent theories of social phobia that emphasize the role of reduced processing of external social cues in maintaining social anxiety.     

Overgeneral memory and suppression of trauma memories in post-traumatic stress disorder

The study investigated the relationship between the suppression of trauma memories and overgeneral memory in 42 assault survivors with and without PTSD. Overgeneral memory (OGM) was assessed with a standard autobiographical memory test (AMT). Participants completed two further AMTs under the instructions to either suppress or not suppress assault memories, in counterbalanced order. Participants with PTSD retrieved fewer and more general memories when following the suppression instruction than participants without PTSD, but not under the control instruction. OGM correlated with PTSD symptom severity, and measures of cognitive avoidance. The results are discussed with reference to current theories of overgeneral memory and its possible relationship with PTSD.     

Intrusive memories and rumination in patients with post-traumatic stress disorder: a phenomenological comparison

The aim of the study was to investigate the phenomenological differences between intrusive memories and rumination in PTSD. The study population consisted of 31 patients with PTSD referred for cognitive behavioural therapy to specialist services. A semi-structured interview was used to examine the characteristics of the most prominent intrusive memory and rumination. Intrusive memories were predominantly sensory experiences of short duration, whereas rumination was predominantly a thought process of longer duration. Shame was associated more with rumination than with intrusive memories. Anxiety, helplessness, numbness, and threat were greater at the time of the trauma than when experiencing the intrusive memory. In contrast, feelings like anger and sadness were greater when experiencing intrusive memories than at the time of the event. The distinction between intrusive memories and rumination is of clinical importance as intrusive memories usually decrease with imaginal reliving of the trauma, whereas rumination may require different therapeutic strategies, such as rumination-focused or mindfulness-based cognitive therapy.     

Movement adaptations in 7- to 10-year-old typically developing children: evidence for a transition in feedback-based motor control

We used a modified double-step pointing task to study movement adaptations in 7- to 10-year-old typically developing children. We found that the majority (63%) were able to optimally adapt fast, goal-directed visually-guided movements to a late change in target location meeting the requirements of speed and accuracy. A minority (35%) failed to meet the requirement of accuracy resulting in a less optimal adaptation. The results showed that the ability to adapt movements optimally develops before the age of 7 years in typically developing children. Literature proposes a transition in development of motor control around the age of 8 years. The present results replicate and extend this by suggesting that this transition affects the later phases of fast, goal-directed visually-guided movements rather than the early phases, such as movement programming and acceleration. Finally, the results indicate that the optimally adapted movements were the result of a specific strategy in which a specific component of movement execution was slowed on all trials. This suggests that 7- to 10-year-old typically developing children have developed implicit knowledge about which movement components are the most efficient to adapt.