Measuring state pre-event and post-event rumination in Social Anxiety Disorder: Psychometric properties of the Socially Anxious Rumination Questionnaire (SARQ)

Post-event rumination and social anxiety: a systematic review and meta-analysis

Post-event rumination, the extent to which one engages in persistent, detailed, and negative thinking following social situations, serves as a risk process in the pathophysiology of social anxiety. Although a substantial body of research has assessed post-event rumination and social anxiety, this literature has produced inconsistent results. We conducted a systematic review and meta-analysis to examine whether the magnitude of the association between post-event rumination and social anxiety varied as a function of questionnaire and/or task utilized. We included all studies reporting a correlation between post-event rumination and social anxiety symptomatology. Fisher's z correlation coefficients were calculated through random-effect meta-analyses. Results indicated a moderate association between post-event rumination and social anxiety symptomatology (r = 0.45, p < 0.001, 95%CI [0.40-0.50]). Subgroup meta-analyses indicated that the type of questionnaire used to assess post-event rumination (Q = 44.36, df = 3, p < 0.001) and social anxiety (Q = 26.44, df = 8, p < 0.001), as well as the task conducted prior to assessing post-event rumination (Q = 14.31, df = 2, p < 0.001), influenced the effect size. This study demonstrates a moderate relation between post-event rumination and social anxiety across the anxiety spectrum, illustrating the importance of treatments specifically targeting post-event rumination. Moreover, we highlight the importance of taking care when designing studies to explore relations between post-event rumination and social anxiety.

Psychological interventions for pre-event and post-event rumination in social anxiety: A systematic review and meta-analysis

Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.

Development and initial validation of the Visual Social Anxiety Scale (VSAS): Could a picture be worth a thousand words?

Accurate assessment is crucial for determining appropriate therapeutic interventions for social anxiety and conducting sound clinical research. While self-report measures of social anxiety are widely used in both research and clinical settings, they have several drawbacks inherent to their textual nature. Here, we describe the development and initial validation of the Visual Social Anxiety Scale (VSAS), a novel picture-based self-report measure of social anxiety, based on the well-established widely-used Liebowitz Social Anxiety Scale (LSAS). Specifically, the 24 items of the LSAS were used as the basis for social situations to be included in the VSAS. First, pictures to serve as VSAS items were selected using a rigorous two-phase process (four pilot studies; n = 225). Next, reliability (internal consistency, test-retest) and validity (convergent, discriminant) were explored with new participants (n = 304) who completed the VSAS and a battery of additional self-report questionnaires, delivered in a random order. The VSAS was completed again a month later (n = 260/304). The VSAS showed high internal consistency and test-retest reliability, and good convergent and discriminant validities. VSAS correlations with convergent measures were significantly greater than its correlations with discriminant measures. Thus, the VSAS shows initial promise as a novel picture-based self-report measure of social anxiety.