Post-event processing in social anxiety

Body-related cognitions, affect and post-event processing in body dysmorphic disorder

BACKGROUND AND OBJECTIVES

Cognitive behavioural models postulate that individuals with BDD engage in negative appearance-related appraisals and affect. External representations of one's appearance are thought to activate a specific mode of processing characterized by increased self-focused attention and an activation of negative appraisals and affect.

METHODS

The present study used a think-aloud approach including an in vivo body exposure to examine body-related cognitions and affect in individuals with BDD (n = 30), as compared to individuals with major depression (n = 30) and healthy controls (n = 30). Participants were instructed to think aloud during baseline, exposure and follow-up trials.

RESULTS

Individuals with BDD verbalized more body-related and more negative body-related cognitions during all trials and reported higher degrees of negative affect than both control groups. A weaker increase of positive body-related cognitions during exposure, a stronger increase of sadness and anger after exposure and higher levels of post-event processing, were specific processes in individuals with BDD.

LIMITATIONS

Individuals with major depression were not excluded from the BDD group. This is associated with a reduction of internal validity, as the two clinical groups are somewhat interwoven. Key findings need to be replicated.

CONCLUSION

The findings indicate that outcomes such as negative appearance-related cognitions and affect are specific to individuals with BDD. An external representation of one's appearance activates a specific mode of processing in BDD, manifesting itself in the absence of positive body-related cognitions, increased anger and sadness, and high levels of post-event processing. These specific processes may contribute toward maintenance of BDD psychopathology.

Repetitive Negative Thinking in Anticipation of a Stressor

Repetitive negative thinking (RNT) has been confirmed as a transdiagnostic phenomenon, but most measures of RNT are contaminated with diagnosis-specific content. The first aim of this study was to examine the structure of an anticipatory version of the Repetitive Thinking Questionnaire (RTQ-Ant) as a trans-emotional measure of anticipatory RNT. The original RTQ was completed with reference to a past stressor, whereas the RTQ-Ant instructs respondents to link their responses to a future stressor. The second aim was to test if the associations between a range of emotions (anxiety, depression, shame, anger, general distress) and the original post-stressor version of the RTQ would be replicated. Undergraduates (N = 175, 61% women) completed the RTQ-Ant, along with measures of various emotions, with reference to upcoming university exams. Principal axis factor analysis yielded many similarities between the original post-event RTQ and the RTQ-Ant, and some differences. The RTQ-Ant was comprised of two subscales: the RNT subscale measures engagement in repetitive thinking, negative thoughts about oneself, and ‘why’ questions; and the Isolated Contemplation (IC) subscale included items referring to isolating oneself and reflecting on negative thoughts, feelings, loneliness, and listening to sad music. RNT was more strongly related to negative emotions than IC. The RTQ-Ant appears to be a reliable measure of anticipatory RNT that is associated with a broad array of emotions.

Self-Focused Attention and Post-Event Processing: Relevance to Social Performance Anxiety and Social Interaction Anxiety

This study examined the roles of self-focused attention and post-event processing in social performance anxiety and social interaction anxiety. College students (N = 101) completed measures of social performance anxiety, social interaction anxiety, self-focused attention, post-event processing, and beliefs related to social anxiety. Interoceptive self-focused attention and post-event processing predicted social performance anxiety after controlling for social interaction anxiety. The associations with social interaction anxiety were not significant after controlling for social performance anxiety. Associations of behavioral self-focused attention with social performance anxiety and social interaction anxiety were not significant after controlling for interoceptive self-focused attention. No evidence of an interaction between self-focused attention and post-event processing in the prediction of social anxiety was found. This study found no evidence that the associations of interoceptive self-focused attention and post-event processing with social performance anxiety were statistically mediated by high standards, conditional beliefs about self, and unconditional beliefs about self. These results and their theoretical implications are discussed.

Mental imagery and post-event processing in anticipation of a speech performance among socially anxious individuals

The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n=19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals' anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications are discussed.

Coming to grips with the past: effect of repeated simulation on the perceived plausibility of episodic counterfactual thoughts

When people revisit previous experiences, they often engage in episodic counterfactual thinking: mental simulations of alternative ways in which personal past events could have occurred. The present study employed a novel experimental paradigm to examine the influence of repeated simulation on the perceived plausibility of upward, downward, and neutral episodic counterfactual thoughts. Participants were asked to remember negative, positive, and neutral autobiographical memories. One week later, they self-generated upward, downward, and neutral counterfactual alternatives to those memories. The following day, they resimulated each of those counterfactuals either once or four times. The results indicate that repeated simulation of upward, downward, and neutral episodic counterfactual events decreases their perceived plausibility while increasing ratings of the ease, detail, and valence of the simulations. This finding suggests a difference between episodic counterfactual thoughts and other kinds of self-referential simulations. Possible implications of this finding for pathological and nonpathological anxiety are discussed.

Are Positive Beliefs about Post-Event Processing Related to Social Anxiety?

Although positive metacognitive beliefs have been found to be associated with symptoms of depression and generalised anxiety disorder, surprisingly few studies have focused on the degree to which positive metacognitive beliefs are associated to social phobia symptoms. In response to this limitation, the primary goal of the current study was the development and validation of the Positive Beliefs about Post-Event Processing Questionnaire (PB-PEPQ). It was anticipated that the PB-PEPQ would exhibit adequate psychometric properties. Based on a non-referred sample of 300 undergraduate students, the PB-PEPQ was found to be positively associated with measures of post-event processing and social anxiety symptoms. Further, support was found for the incremental validity of the PB-PEPQ, as the measure predicted variance in social phobia symptoms after controlling for other metacognitive variables, including positive beliefs about worry and positive beliefs about rumination. Overall, the findings may have implications for cognitive models of social phobia. Further, the current findings have possible treatment implications, as individuals with social phobia may benefit from interventions focused on the identification and modification of positive metacognitive beliefs.

Mechanisms driving pre- and post-stressor repetitive negative thinking: metacognitions, cognitive avoidance, and thought control

BACKGROUND AND OBJECTIVES

Repetitive negative thinking (RNT) is common to multiple emotional disorders and occurs before, during, and following a stressor. One replicated difference between common forms of RNT such as worry and rumination is temporal orientation towards a stressor, with worry being more future-oriented and rumination more past-oriented. Different mechanisms may drive RNT at these different time points. The aim of Study 1 was to examine whether previously demonstrated relationships between post-stressor RNT and mechanisms theorized to drive engagement in RNT, including metacognitive beliefs, cognitive avoidance strategies, and thought control strategies, would be replicated with anticipatory (pre-stressor) RNT. The aim of Study 2 was to replicate these associations in a new sample that completed measures of both pre- and post-stressor RNT.

METHOD

Participants in Study 1 (N = 175) completed the RNT-L in anticipation of a stressor, along with measures of metacognitive beliefs, cognitive avoidance strategies, and thought control strategies. Participants in Study 2 (N = 91) completed the measures both before and after a stressor.

RESULTS

Pre- and post-stressor RNT were significantly correlated with all three mechanism measures. Metacognitive beliefs that RNT is uncontrollable and dangerous, and the thought control strategy of punishment, were most consistently and uniquely associated with RNT at both time-points.

LIMITATIONS

Replication with clinical samples and with reference to a broader array of stressors is required. The correlational design precluded causal conclusions.

CONCLUSIONS

Common and possibly some distinct mechanisms drive RNT before and after a stressor.

Effects of false feedback on affect, cognition, behavior, and postevent processing: the mediating role of self-focused attention

Current social phobia models (e.g., Clark & Wells, 1995; Leary & Kowalski, 1995) postulate that socially anxious individuals negatively appraise their anxiety sensations (e.g., sweating, heart racing, blushing) as evidence of poor social performance, and thus fear these anxiety symptoms will be noticed and judged negatively by others. Consequently, they become self-focused and hypervigilant of these sensations and use them to judge how they appear to others. To test this model, high (N=41) and low (N=38) socially anxious participants were shown false physiological feedback regarding an increase or decrease in heart rate prior to and during an impromptu speech task. Relative to participants who observed a false heart rate decrease, those in the increase condition reported higher levels of negative affect, more negative performance appraisals, and more frequent negative ruminative thoughts, and these effects were mediated by an increase in self-focused attention. The unhelpful effects of the physiological feedback were not specific to high socially anxious participants. The results have implications for current cognitive models as well as the treatment of social phobia.

Depersonalization/derealization during acute social stress in social phobia

The present study aimed at investigating how frequently and intensely depersonalization/derealization symptoms occur during a stressful performance situation in social phobia patients vs. healthy controls, as well as testing hypotheses about the psychological predictors and consequences of such symptoms. N=54 patients with social phobia and N=34 control participants without mental disorders were examined prior to, during, and after a standardized social performance situation (Trier Social Stress Test, TSST). An adapted version of the Cambridge Depersonalization Scale was applied along with measures of social anxiety, depression, personality, participants' subjective appraisal, safety behaviours, and post-event processing. Depersonalization symptoms were more frequent in social phobia patients (92%) than in controls (52%). Specifically in patients, they were highly positively correlated with safety behaviours and post-event-processing, even after controlling for social anxiety. The role of depersonalization/derealization in the maintenance of social anxiety should be more thoroughly recognized and explored.

Mediators of the relationship between social anxiety and post-event rumination

A variety of cognitive and attentional factors are hypothesised to be associated with post-event rumination, a key construct that has been proposed to contribute to the maintenance of social anxiety disorder (SAD). The present study aimed to explore factors contributing to post-event rumination following delivery of a speech in a clinical population. 121 participants with SAD completed measures of trait social anxiety a week before they undertook a speech task. After the speech, participants answered several questionnaires assessing their state anxiety, self-evaluation of performance, perceived focus of attention and probability and cost of expected negative evaluation. One-week later, participants completed measures of negative rumination experienced over the week. Results showed two pathways leading to post-event rumination: (1) a direct path from trait social anxiety to post-event rumination and (2) indirect paths from trait social anxiety to post-event rumination via its relationships with inappropriate attentional focus and self-evaluation of performance. The results suggest that post event rumination is at least partly predicted by the extent to which socially anxious individuals negatively perceive their own performance and their allocation of attentional resources to this negative self-image. Current findings support the key relationships among cognitive processes proposed by cognitive models.

Decentering as a common link among mindfulness, cognitive reappraisal, and social anxiety

BACKGROUND

The tendency to employ both cognitive reappraisal and mindfulness are associated with reduced trait social anxiety; however, it is unclear whether reappraisal and mindfulness are associated with social anxiety through the same mechanisms. It has been proposed that decentering, or the process of seeing thoughts or feelings as objective events in the mind rather than personally identifying with them, may be a key mechanism underlying both cognitive reappraisal and mindfulness.

AIMS

To examine the relationships between reappraisal, mindfulness, decentering, and social anxiety.

METHOD

This study utilized structural equation modeling to examine the relationships among cognitive reappraisal, mindfulness, decentering, and social anxiety in a large cross-sectional study.

RESULTS

Results indicate that the relationship between mindfulness and social anxiety is partially accounted for by decentering, whereas the relationship between cognitive reappraisal and social anxiety is more fully accounted for by decentering.

CONCLUSIONS

These results imply that decentering may be a common mechanism underlying both cognitive reappraisal and mindfulness, although mindfulness may also affect social anxiety through additional mechanisms. However, given the cross-sectional nature of these findings, results should be considered preliminary, with future research being needed to further elucidate these relationships.

Constructive Effects of Engaging in Post-Event Processing in High and Low Socially Anxious Individuals

Post-event processing (PEP), the act of engaging in a detailed, self-focused, and negative analysis of a prior social situation, has been hypothesised to contribute to the maintenance of social phobia (Clark & Wells, 1995). In light of this proposal, the present study investigated whether deliberate engagement in PEP as opposed to distraction following a speech task elicits unhelpful effects on emotion, cognition, and behaviour in a subsequent speech task in high and low socially anxious participants. The PEP manipulation instructed participants to focus on the anxious thoughts, images, feelings, and somatic sensations relating to the first speech. Contrary to hypotheses, results demonstrated that engaging in PEP as opposed to distraction led to a number of constructive outcomes such as: increased willingness among low socially anxious participants to give the second speech, a reduction in negative performance appraisals and underestimation of performance among high socially anxious participants, and better self-perceived speech quality irrespective of social anxiety level. However, there were no effects of response condition on anxiety, performance appraisals, observable behaviour, and negative cognitions. The findings underscore the need for additional research identifying the precise contents, construals, and processing modes that distinguish between adaptive and maladaptive forms of PEP.

Does social anxiety predict rumination and co-rumination among adolescents?

Social anxiety in adolescence is manifested by anxiety about and avoidance of social interactions. The present study examined whether social anxiety predicts higher levels of both rumination and co-rumination over time. Rumination and co-rumination were studied as possible outcomes because the cognitive content of these processes often involves interpersonal concerns. A three-wave longitudinal study of 575 adolescents (aged 13-16 years old) was conducted over 6 months. Adolescent girls reported higher levels of social anxiety, rumination, and co-rumination than boys. Structural equation modelling analysis showed that social anxiety directly predicted higher levels of rumination and indirectly predicted higher levels of co-rumination over time. A gender difference was noted in that these relationships were more robust for girls than for boys.

Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation

The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

Do Socially Anxious Individuals Hold Positive Metacognitive Beliefs About Rumination?

The Self-Regulatory Executive Function (S-REF) model of affective dysfunction (Wells & Matthews, 1994) suggests that metacognitive beliefs are important for initiating and maintaining repetitive thought processes in emotional disorders. Rumination is reported by socially anxious individuals, yet it is not known whether this group endorse positive beliefs about the utility of rumination. We predicted that higher levels of social anxiety would be positively associated with stronger positive metacognitive beliefs about rumination. In Study 1 (N= 250 undergraduates), a measure of social anxiety was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender and level of depression. Given this result, we then attempted to replicate the finding in another sample, as well as test whether positive metacognitive beliefs about rumination would mediate the relationship between social anxiety and trait rumination. In Study 2 (N= 124 undergraduates), a social anxiety composite measure was positively correlated with a measure of positive metacognitive beliefs about rumination, even when controlling for gender, level of depression and level of rumination. Positive metacognitive beliefs about rumination were also shown to partially mediate the relationship between social anxiety and trait rumination. These results support the S-REF model and provide a potential account of why socially anxious individuals engage in rumination. Implications for the treatment of social anxiety are discussed.

Culturally Competent CBT

A 21-year-old Korean, single, and immigrant male presented to therapy with significant symptoms of social anxiety disorder (SAD) for treatment at a university training clinic. At the time of intake, he was experiencing intense distress and remarkable adaptations in his life to accommodate rather chronic physiological symptoms related to social interactions. He immigrated to the United States 5 years prior to treatment from Seoul, Korea. He endured social anxiety for 6 years preceding treatment. The case was conceptualized and treated from a cognitive-behavioral framework. Treatment gains were measured using behavioral markers and a reliable change index using standardized outcome measures. This case illustrates the ability to adhere to a cognitive-behavioral treatment model for SAD while considering pertinent cultural factors. Furthermore, it highlights the generalizability of a specific treatment model when working with Korean immigrants. The authors discuss the need for future research, and treatment implications of this case are described.

Global and local evaluations of public speaking performance in social anxiety

Differences in the relative use of global and local information (seeing the forest vs. the trees) may explain why people with social anxiety often do not benefit from corrective feedback, even though they pay close attention to details in social situations. In the current study, participants high (n=43) or low (n=47) in social anxiety symptoms gave a series of brief speeches, and then self-rated their speaking performance on items reflecting global and local performance indicators (self-assessment) and also received standardized performance feedback from an experimenter. Participants then completed a questionnaire asking how they thought the experimenter would rate their performance based on the feedback provided (experimenter assessment). Participants completed the self- and experimenter assessments again after 3 days, in addition to a measure of postevent processing (repetitive negative thinking) about their speech performance. Results showed that, as hypothesized, the High SA group rated their performance more negatively than the Low SA group. Moreover, the High SA group's ratings of global aspects of their performance became relatively more negative over time, compared to their ratings of local aspects and the Low SA group's ratings. As expected, postevent processing mediated the relationship between social anxiety group status and worsening global performance evaluations. These findings point to a pattern of progressively more negative global evaluations over time for persons high in social anxiety.

Working memory capacity in generalized social phobia

Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with generalized social phobia. Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with generalized social phobia and nonanxious controls using an operation span task with threat-relevant and neutral stimuli. Results revealed that nonanxious individuals demonstrated better WMC than individuals with generalized social phobia for neutral words but not for social threat words. Individuals with generalized social phobia demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with generalized social phobia may have relatively enhanced working memory performance for salient, socially relevant information. This enhanced working memory capacity for threat-relevant information may be the result of practice with this information in generalized social phobia.

Negative post-event processing and decreased self-appraisals of performance following social stress in childhood social anxiety: an experimental study

Cognitive models of social phobia (SP) assume that following social evaluative stress, individuals with SP engage into dysfunctional post-event processing (PEP), a detailed negative review of the past event. While previous research has already shown, that children with high levels of social fears suffer from more frequent negative PEP, it remains unclear how stable PEP is across time in this age group and whether it leads to degraded self-appraisals of performance. Therefore in the present study we exposed a group of high (HSA) and low socially anxious children (LSA; both n = 20), aged 10-12 years, to a social evaluative situation and assessed negative and positive PEP as well as self-rated performance at 2.5 h and one week after the task. Our results revealed that HSA children reported more negative PEP than LSA children, independent of levels of depression. Moreover, negative PEP was related to measures of social anxiety and performance ratings within the tasks. Only the performance ratings in HSA children worsened over the course of the following week and were related to more negative PEP. Thus, these results speak for the high clinical relevance dysfunctional PEP may have for the maintenance of social fears already in childhood.

The relationship of post-event processing to self-evaluation of performance in social anxiety

Socially anxious and control participants engaged in a social interaction with a confederate and then wrote about themselves or the other person (i.e., self-focused post-event processing [SF-PEP] vs. other-focused post-event processing [OF-PEP]) and completed several questionnaires. One week later, participants completed measures concerning their evaluation of their performance in the social interaction and the degree to which they engaged in post-event processing (PEP) during the week. Socially anxious individuals evaluated their performance in the social interaction more poorly than control participants, both immediately after and 1 week later. Socially anxious individuals assigned to the SF-PEP condition displayed fewer positive feelings about their performance compared to the socially anxious individuals in the OF-PEP condition as well as controls in either condition. Also, the trait tendency to engage in PEP moderated the effect of social anxiety on participants' evaluation of their performance in the interaction, such that high socially anxious individuals with high trait PEP scores evaluated themselves in the interaction more negatively at the later assessment. These results suggest that PEP and other self-evaluative processes may perpetuate the cycle of social anxiety.

The relationship between the maladaptive self-beliefs characteristic of social anxiety and avoidance

The Clark and Wells (1995) model of social phobia proposes that there are three types of maladaptive self-beliefs responsible for persistent social anxiety (high standard, conditional, and unconditional beliefs). Another prominent feature of social phobia is the avoidance of social-evaluative situations. To our knowledge, there have been no studies that have examined the relationship between these specific maladaptive self-belief types and avoidance. We hypothesised that while accounting for potential confounding variables (i.e., fear of negative evaluation and general symptomology), each of the three maladaptive self-belief types would be significantly and positively associated with cognitive and behavioural avoidance in the social domain, but not these forms of avoidance in the non-social domain. In a sample of undergraduates (N = 361), we found only partial support for our hypotheses. In the social domain, stronger high standard beliefs predicted less behavioural avoidance, stronger unconditional beliefs predicted more behavioural avoidance, and stronger conditional beliefs predicted more cognitive avoidance. In the non-social domain, stronger unconditional beliefs predicted more cognitive avoidance. These relationships were obtained at all levels of social anxiety. Additionally, the unconditional beliefs partially mediated the relationship between social anxiety and behavioural avoidance in the social domain, and the conditional beliefs fully mediated the relationship between social anxiety and cognitive avoidance in the social domain. These results emphasise the distinct nature of each of the maladaptive self-belief types and the need to elucidate their relationship with other components in theoretical models of social phobia.

A prospective examination of predictors of post-event processing following videotaped exposures in group cognitive behavioural therapy for individuals with social phobia

Following social events, individuals with social phobia engage in post-event processing (PEP), namely a post-mortem detailed analysis of a social situation. This study aimed to examine cognitive and symptom correlates of PEP, as well as stability of PEP, in the context of videotaped exposures that occurred during treatment at sessions four and eight. Before treatment, 75 individuals with DSM-IV diagnosed social phobia completed measures of social anxiety, anxious rumination, fear of causing discomfort to others, and negative interpretation of positive social events. They rated their peak anxiety during the taped exposure. Then, they completed a measure of PEP one week after each videotaped exposure exercise. Results revealed that baseline social anxiety symptoms, state anxiety during the videotaping, anxious rumination, fear of causing discomfort to others, and negative interpretation of positive social events were all positively associated with PEP for the first taped exposure. Regression analyses demonstrated that unique predictors of PEP over and above baseline social anxiety were state social anxiety during the exposure, and anxious coping-focused rumination. This was largely replicated in the second taped exposure. In addition, PEP following two videotaped exposures separated by four weeks showed a moderate-to-large positive correlation. These findings highlight symptom and cognitive correlates of PEP, and underscore importance of state anxiety in social situations, as well as general anxiety focused rumination in social phobia.

The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder

Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment.

Constructing a self: the role of self-structure and self-certainty in social anxiety

Current cognitive models stress the importance of negative self-perceptions in maintaining social anxiety, but focus predominantly on content rather than structure. Two studies examine the role of self-structure (self-organisation, self-complexity, and self-concept clarity) in social anxiety. In study one, self-organisation and self-concept clarity were correlated with social anxiety, and a step-wise multiple regression showed that after controlling for depression and self-esteem, which explained 35% of the variance in social anxiety scores, self-concept clarity uniquely predicted social anxiety and accounted for an additional 7% of the variance in social anxiety scores in an undergraduate sample (N=95) and the interaction between self-concept clarity and compartmentalisation (an aspect of evaluative self-organisation) at step 3 of the multiple regression accounted for a further 3% of the variance in social anxiety scores. In study two, high (n=26) socially anxious participants demonstrated less self-concept clarity than low socially anxious participants (n=26) on both self-report (used in study one) and on computerised measures of self-consistency and confidence in self-related judgments. The high socially anxious group had more compartmentalised self-organisation than the low anxious group, but there were no differences between the two groups on any of the other measures of self-organisation. Self-complexity did not contribute to social anxiety in either study, although this may have been due to the absence of a stressor. Overall, the results suggest that self-structure has a potentially important role in understanding social anxiety and that self-concept clarity and other aspects of self-structure such as compartmentalisation interact with each other and could be potential maintaining factors in social anxiety. Cognitive therapy for social phobia might influence self-structure, and understanding the role of structural variables in maintenance and treatment could eventually help to improve treatment outcome.

What predicts the trajectory of rumination?: A prospective evaluation

The current report aimed to document individual differences that predict the trajectory of post-event rumination following an evaluative event. In this study, 127 undergraduate students were assessed over a 5-day period preceding and following a mid-term exam. Participants completed measures of anticipatory processing, trait test anxiety, trait tendency to ruminate, negative affect, and post-event rumination. Hierarchical linear modeling was used to examine predictors of post-evaluative rumination. Results suggested that individuals who reported high levels of anticipatory processing and trait test anxiety tended to experience prolonged amounts of rumination following the exam, even when controlling for negative affect, relative to those who scored low on these measures. These results suggest that specific individual difference factors impact the amount and trajectory of rumination beyond levels of general negative affect. Implications for understanding risk factors for heightened rumination are discussed, with particular attention to the larger rumination literature.

Post-event processing and memory bias for performance feedback in social anxiety

Despite predictions following from cognitive theories of anxiety, evidence for memory biases in social anxiety has been mixed. This study extends previous research by using stimuli relevant to participants' concerns and allowing time for post-event processing. Participants high (n=42) or low (n=39) in social anxiety symptoms gave speeches and received standardized feedback on their and a confederate's performance. Participants then took recognition and recall tests for the feedback immediately after it was given and after a two-day delay. Results showed no recall biases. However, the hypothesized recognition biases were found: the high social anxiety group remembered the confederate's feedback more positively than their own, remembered their negative feedback as worse than the low group, and diminished positive feedback over time. Moreover, post-event processing mediated the relationship between social anxiety and memory for negative feedback. Results suggest that biased recognition of social feedback is linked to social anxiety.

Are worry, rumination, and post-event processing one and the same? Development of the repetitive thinking questionnaire

Accumulating evidence suggests that repetitive negative thinking (RNT) is a transdiagnostic phenomenon. However, various forms of RNT such as worry, rumination, and post-event processing have been assessed using separate measures and have almost exclusively been examined within the anxiety, depression, and social phobia literatures, respectively. A single transdiagnostic measure of RNT would facilitate the identification of transdiagnostic maintaining factors of RNT, and would be more efficient than administering separate measures for each disorder. Items from three existing measures of RNT were modified to remove diagnosis-specific content and administered to a sample of undergraduate students (N=284). Exploratory factor analysis yielded two factors labeled Repetitive Negative Thinking and Absence of Repetitive Thinking (ART). The RNT scale demonstrated high internal reliability and was associated with anxiety, depression, anger, shame, and general distress. Moreover, the RNT scale was associated with constructs that are theoretically related to engagement in RNT, including positive and negative metacognitions, cognitive avoidance, thought suppression, and thought control strategies. The ART scale had little predictive utility. Theoretical and clinical implications are discussed.

Changes in post-event processing and metacognitions during cognitive behavioral group therapy for social phobia

This study examined changes in post-event processing (PEP), metacognitions, and symptoms of social anxiety and depression following cognitive behavioral group therapy for social phobia (N=61). Social anxiety, depression symptoms and PEP all significantly reduced following treatment. Reductions in PEP were associated with reductions in symptoms of social anxiety, but not depression. Metacognitions were also less strongly endorsed following treatment, with the exception of positive metacognitions. Interestingly, however, changes in metacognitions were generally associated with reductions in depression and not social anxiety. Theoretical and clinical implications as well as future research directions are discussed.

Adaptive and maladaptive self-focus: a pilot extension study with individuals high and low in fear of negative evaluation

Previous research in depressed participants has supported the differentiation of self-focus into distinct modes of self-attention with distinct functional effects. In particular, Rimes and Watkins (2005) investigated the effects of self-focused rumination on overgeneral thinking and found that analytical, evaluative self-focus increased global negative self-judgments, whereas self-focus low in analytical thinking decreased such judgments in depressed participants. Given that self-focused attention and rumination have been implicated in the maintenance of social anxiety, the present study investigated the effects of these two distinct forms of self-focused attention on global negative self-judgments in an analogue sample for social anxiety (high and low fear of negative evaluation, FNE). Individuals high and low in FNE (n=41 per group) were randomly allocated to analytic (abstract, evaluative) or experiential (concrete, process-focused) self-focused manipulations. As predicted, in high FNE individuals, the experiential self-focus condition decreased ratings of the self as worthless and incompetent pre- to post-manipulation, whereas the analytical self-focus condition maintained such negative self-judgments. Analytical and experiential self-focus did not differ in their effects on mood. The results suggest that an experiential mode of self-focused rumination may be adaptive in social anxiety.

A roadmap to rumination: a review of the definition, assessment, and conceptualization of this multifaceted construct

Rumination has been widely studied and is a crucial component in the study of cognitive vulnerabilities to depression. However, rumination means different things in the context of different theories, and has not been uniformly defined or measured. This article aims to review models of rumination, as well as the various ways in which it is assessed. The models are compared and contrasted with respect to several important dimensions of rumination. Guidelines to consider in the selection of a model and measure of rumination are presented, and suggestions for the conceptualization of rumination are offered. In addition, rumination's relation to other similar constructs is evaluated. Finally, future directions for the study of ruminative phenomena are presented. It is hoped that this article will be a useful guide to those interested in studying the multi-faceted construct of rumination.