Cognitive-evaluative features of childhood social anxiety in a performance task

Testing theoretical processes that maintain paediatric social anxiety: A comparison between children and adolescents with social anxiety disorder, other mental disorders, and non-clinical controls

BACKGROUND

Paediatric social anxiety disorder (SoAD) responds poorly to treatment. Improved understanding of potential psychological maintaining processes may indicate fruitful directions to improve treatment outcomes. The current study compared self-reported psychological processes and state anxiety in response to two social tasks experienced by children and adolescents with SoAD against comparison samples.

METHODS

641 children and adolescents aged 6-17 years (Mage = 9.45 yr; 47.6% girls) engaged in a brief, impromptu speech and a social discussion with a confederate. Participants included 307 with SoAD, 285 with other mental disorders, and 49 non-clinical controls. Participants who completed each task self-reported their anticipated probability and cost of negative evaluation, self-focused attention, personal evaluation of social performance, and engagement in post-event rumination (assessed 1 h later). Independent raters also scored their social performance. Relationships between the variables were tested through path analysis.

RESULTS

Participants with SoAD were more likely to avoid and reported significantly greater state anxiety than both comparison groups. They also reported higher levels of each of the putative maintaining processes than either comparison group. In contrast, independent observers did not discriminate between groups on their overt social performance. Path analyses demonstrated good fit of a priori models to the data for both social tasks.

CONCLUSIONS

Paediatric SoAD is associated with strong expectation of the probability and cost of negative evaluation, excess self-focused attention, and more negative evaluation of one's own social performance. In turn, these putative processes are strong predictors of state anxiety and post-event processing in response to both a speech and social interaction.

Social skills deficits and self-appraisal biases in children with social anxiety disorder

Social Anxiety Disorder is highly prevalent among children and leads to poor long-term outcomes if left untreated. Theoretical models of anxiety differ in whether children with Social Anxiety Disorder experience objective social skills deficits, negative self-interpretation biases, or some combination of the two. This pilot study evaluated evidence in support of the "deficit" and "bias" models. Approval was obtained from the ethics committee of a large private university in Cambridge, MA, USA, and data collection was completed in 2015. We recruited 68 parent-child dyads for a study in which anxious children (with Social Anxiety Disorder) and non-anxious children underwent a child-adapted version of the Trier Social Stress Test. Children were aged 8-14, 67.6% male, and self-identified as 54.4% White, 7.4% Black, 4.4% Latinx, 13.2% Asian, 14.7% multiethnic, and 5.9% "other" or no response. Performance ratings were obtained from children, their parents, and external observers. We found evidence of both specific social skills deficits and self-appraisal biases in anxious children. Anxious children struggled with signs of physical discomfort but not with actual speech content. Although children were generally able to accurately evaluate their social performance, older anxious children were most self-critical. Parents were similarly accurate in appraisals of their children's social performance. Anxious children responded favorably to positive feedback with improved self-evaluations of performance and decreased anxiety. Findings suggest that a comprehensive "integrated" theoretical model of Social Anxiety Disorder should include both skills deficits and self-appraisal biases.

In the moment social experiences and perceptions of children with social anxiety disorder: A qualitative study

OBJECTIVES

Childhood social anxiety disorder (SAD) is a common and disabling condition. General forms of cognitive behavioural treatments have demonstrated poorer efficacy for childhood SAD when compared to other childhood anxiety disorders and further understanding of the psychological factors that contribute to the maintenance of childhood SAD is warranted. Examining the social experiences of children with SAD may help to identify relevant psychological factors and increase our understanding of what keeps childhood SAD going.

METHODS

The current study used reflexive thematic analysis to analyse the transcripts of interviews with 12 children aged 8-12 years with SAD who had been interviewed about their 'in the moment' social experiences during a social stress induction task. The interview topic guide included factors hypothesized to maintain SAD in adult cognitive models of the disorder.

RESULTS

The interviews revealed both variety and commonalities in the experiences and interpretations of social events in children with SAD, captured in three related main themes: (i) Discomfort being the centre of attention, (ii) (Lack of) awareness of cognitions and (iii) Managing social fears. Findings indicated likely developmental influences on which maintenance mechanisms apply at which point in time.

CONCLUSIONS

There is variation in the psychological mechanisms that children with SAD endorse and developmental factors are likely to influence when specific mechanisms are relevant. We now need further studies that take a developmentally informed approach to understand the nature of the association between the factors identified in this study and social anxiety in childhood to inform the development of more effective interventions for childhood SAD.

Taking a Closer Look at Social Performance in Childhood Social Anxiety Disorder: Biopsychosocial Context Considerations and Effects of Cognitive Behavior Therapy

Models of social anxiety disorder (SAD) describe shortfalls in child social performance, whereas empirically, children often show a deficit only in subjective and not objective performance. We examined social performance in relation to possible changes (before and after cognitive behavior therapy [CBT] including social skills training) and to an objective parameter (vocal arousal). Children with SAD were expected to subjectively judge their behavior as less competent than healthy control (HC) children despite a lack of objective differences. Children receiving CBT were expected to show a change in subjective and objective social performance in comparison to children waiting for treatment. Exploratory correlation analyses were used to disentangle the relation between social performance and vocal arousal. One hundred and nineteen children (64 with and 55 without SAD; aged 9-13 years) completed a Trier Social Stress Test (TSST). Children with SAD participated in a second TSST after CBT or waiting. Performance was assessed by self-report and by blinded observers. Vocal arousal was analyzed by audio recording. Children with SAD were objectively assessed as more socially competent than HC children; subjectively, children with SAD showed lower social performance. CBT showed no effect on subjective or objective performance ratings. Vocal arousal did not correlate with social performance. Results need to be considered carefully, as psychometric problems appeared that had not been considered in previous studies. The surprising lack of CBT effects suggests a need to focus on cognitions surrounding social performance. Further, social skills training should not be a standard SAD treatment component but used only if necessary.

Early physiological indicators of narcissism and self-esteem in children

A common belief is that narcissism is a manifestation of high self‐esteem. Here, we argue that self‐esteem and narcissism are fundamentally distinct and have unique early physiological indicators. We hypothesized that children predisposed to narcissism would show elevated, whereas children predisposed to high self‐esteem would show lowered, physiological arousal in social‐evaluative contexts. We tested this in a prospective study including 113 children, who were first assessed at age 4.5, a critical age when children begin evaluating themselves through others' eyes. At age 4.5, children sang a song in front of an audience while being videotaped. Children's physiological arousal (skin conductance, heart rate, and heart rate variability) was assessed while children anticipated, performed, and recovered from the singing task. At age 7.5, children's narcissism and self‐esteem levels were assessed. Consistent with our predictions, children predisposed to higher narcissism levels showed elevated skin conductance levels during anticipation. Their skin conductance levels further rose during performance (but less so than for other children) and failed to return to baseline during recovery. By contrast, children predisposed to higher self‐esteem levels showed lowered skin conductance levels throughout the procedure. The effects emerged for skin conductance but not heart rate or heart rate variability, suggesting that arousal was sympathetically driven. Effects were larger and more robust for self‐esteem than for narcissism. Together, these findings uncover distinct physiological indicators of narcissism and self‐esteem: Narcissism is predicted by indicators reflecting early social‐evaluative concerns, whereas self‐esteem is predicted by indicators reflecting an early sense of comfort in social‐evaluative contexts.

Some experts fear that self‐esteem can develop into narcissism. Challenging this view, we show that self‐esteem and narcissism (at age 7.5) have distinct early physiological indicators (at age 4.5). In our prospective study, narcissism was predicted by elevated, whereas self‐esteem was predicted by lowered, physiological arousal in a social‐evaluative context.

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.

Cognitive Variables in Social Anxiety Disorder in Children and Adolescents: A Network Analysis

Clark and Wells' prominent model of social anxiety disorder (SAD) assumes that cognitive variables such as negative expectations or dysfunctional cognitions play a central role in the symptomatology of SAD. In contrast to adults, it is less clear how well the cognitive model can be applied to children and adolescents. A network analysis with seven nodes was conducted to explore the importance of cognitive variables and their interaction with symptoms of SAD based on N = 205 children and adolescents (8-18 years, M = 11.54 years). Cognitive variables had a high but differential impact within the positively connected network of SAD. Dysfunctional cognitions were most strongly connected within the network. Dysfunctional cognitions, as predicted by Clark and Wells' model, seem to act as a hub affecting several symptoms. The association between negative expectations and avoidance indicates that negative expectations may particularly contribute to the maintenance of SAD.

Research Review: The relationship between social anxiety and social cognition in children and adolescents: a systematic review and meta-analysis

BACKGROUND

Childhood Social Anxiety Disorder (SAD) is common and impairing. The recommended treatment is a disorder specific form of cognitive behavioural therapy (CBT) that includes social skills training and, whilst they appear to be more effective than more general treatments, it is not clear whether social skills training is the critical component involved in improved outcomes, particularly given that evidence for the relationship between social anxiety and social skills deficits in children is inconsistent. This may be partly due to an overlap in their observable features, and because the nature of the association may vary in different contexts (e.g. according to child age). An alternative approach is to examine the association between social anxiety and the social cognitive capacities that underpin social skills. This paper aims to examine the association between social anxiety and social cognition in children and adolescents, and examine conceptual and methodological moderators of this relationship.

METHODS

Papers published between 1980 and 2019 were screened systematically. Fifty studies were identified from which an effect size could be calculated for the relationship between social anxiety and social cognition, including 15,411 children and adolescents.

RESULTS

An overall significant, but moderate effect (r = -.15) was identified, where increased social anxiety was associated with lower social cognitive ability. Moderation analyses revealed specific associations within studies examining social anxiety among participants with and without ASD who were older than 7 years old, and studies assessing the relationship between social anxiety and specific aspects of Theory of Mind (ToM). No significant association was identified between social anxiety and emotion recognition.

CONCLUSIONS

Significant associations between social anxiety and social cognitive abilities appear to be accounted for by elevated social anxiety among children with ASD, and those with difficulties in specific aspects of ToM but not broader social skills, such as emotion recognition. This reinforces the importance of accurately identifying and treating social anxiety within ASD populations. In addition, treatments for social anxiety among neurotypical populations may benefit from targeting particular aspects of ToM rather than emotion recognition and other broad social skills.

[Cognition in children with social anxiety disorder experiencing stress]

Cognition in children with social anxiety disorder experiencing stress Abstract. Empirical data on cognitions of children with social anxiety disorder (SAD) are inconclusive. Objective: The present study examines the significance of cognition in children with SAD. Method: Thirty children suffering from SAD and 30 control children free of diagnosis (HC) aged between 9 and 15 years took part in an experiment. Their cognition was assessed before, during, and after a stress-inducing social situation. The assessment method was a self-report measurement. Coping perception was also assessed. Results: Children with SAD did not report a higher level of negative or coping cognition than those in the HC group. An interaction was apparent on the positive cognition scale: Older children (11-12 or 13-15 years) with SAD reported less positive cognition than those in the HC group, and younger children with SAD (9-10 years) reported more than those in the HC group. No group differences were found for perceived coping. Conclusions: The findings are important to the cognitive model and for the psychological treatment of SAD in children.

Examining the Relation Between Adolescent Social Anxiety and Positive Affect Regulation: Self-Report vs. Observation

Social anxiety symptomatology is associated with disruptions in positive affect, though no study has examined deficits in responses to positive affect related to adolescent social anxiety symptoms. The present study tested whether adolescents' self-reported and observed social anxiety symptoms were uniquely associated with specific responses to positive affect. Moreover, we examined whether adolescent gender moderated these relations. Ninety adolescents (ages 11 to 18, M_age = 14.26, SD = 2.03; girls = 62%; white = 79%) completed self-report measures, participated in a social stressor task, and engaged in two positively-valenced interaction tasks with their female caregivers. Adolescent self-reported social anxiety symptoms were not uniquely associated with responses to positive affect. However, observed social anxiety symptoms were uniquely related to greater self-reported inhibiting positive affect responses and fewer observed positive affect maximizing behaviors. These findings highlight the need to examine self-reported and observed social anxiety symptoms in understanding associated disruptions in positive affect regulation.

Are Socially Anxious Children Poor or Advanced Mindreaders?

Why are some children more socially anxious than others? One theory holds that socially anxious children are poor mindreaders, which hampers their social interactions; another that socially anxious children are advanced mindreaders leading to heightened self-consciousness in social situations. To test these theories simultaneously, this study (N = 105, ages 8-12) assessed children's mindreading (accuracy in detecting mental states from the eye region), self-consciousness (indexed as physiological blushing during public performance), and social anxiety levels. Results support both theories, showing a quadratic relation between mindreading and social anxiety. Low mindreading was related to clinical levels of social anxiety. High mindreading was related to subclinical levels of social anxiety through blushing. Our findings suggest two social-cognitive pathways to heightened social anxiety.

Are children with social anxiety disorder more likely than children with other anxiety disorders to anticipate poor social performance and reflect negatively on their performance?

BACKGROUND

The cognitive theory of social anxiety disorder (SAD) suggests that adults with SAD have a tendency to anticipate poor social performance and reflect negatively on their performance following a social event. While a number of studies with socially anxious adults have supported the role of poor performance anticipation and post-event rumination in SAD, to date, only a few studies have addressed whether this also applies to children with SAD.

METHODS

Children (7-12 years) diagnosed with SAD (n = 40), other anxious children (n = 40) and non-anxious children (n = 34) were exposed to a social stressor speech task and their pre- and post-performance appraisals assessed, taking into account objective performance ratings.

RESULTS

Although observers rated some aspects of performance as significantly worse among children with SAD than children with other anxiety disorders, children with SAD were not more likely than their anxious or non-anxious peers to show a general bias in pre- or post-performance appraisals. Furthermore, children with SAD were just as likely as their anxious and non-anxious peers to recognize good performance but were more critical of themselves when their performance was poor.

LIMITATIONS

The speech task did not involve a same-age peer. Participants were relatively affluent group of predominantly non-minority status. Specificity for SAD in relation to other anxiety disorders remains unclear.

CONCLUSIONS

Focusing on counteracting pre- and post-event social performance appraisals may potentially be inappropriate for childhood SAD. Children with SAD might benefit from interventions that focus on helping them to become less critical of themselves after social interactions have not gone well.

Cognitive-behavioural outreach for an adolescent experiencing social anxiety, panic and agoraphobia: A single-case experimental design

PROBLEM

Previous research suggests that the adult-focussed Clark and Wells (1995) model of social anxiety disorder (SAD) can be used to guide clinic-based treatment for adolescents. This single-case study (N = 1) investigated whether this model could also guide community-based outreach work for a 16-year-old female who was unable to attend clinic-based appointments due to social anxiety comorbid with panic and agoraphobia.

METHODS

An experimental A-B-A design was used with three assessment-formulation sessions and 12 intervention sessions, focussing on exposure, cognitive restructuring, attention training, behavioural experiments and imagery rescripting. The Revised Child Anxiety and Depression Scale (RCADS), the Session Rating Scale (SRS) and the Goal Based Outcome form were administered at regular intervals.

FINDINGS AND CONCLUSIONS

Social anxiety and panic scores reduced below the clinical threshold and the young person was able to leave home, travel independently (short-term goal) and re-engage with her social-family life (medium-term goal). SRS scores suggest that the intervention was acceptable and the therapeutic alliance was maintained throughout. In summary, this case study suggests that the Clark and Wells (1995) model of SAD can be used to guide community-based outreach work with adolescents unable to leave their home. Limitations and ideas for future research are discussed.

Social anxiety and interpretation bias: examining clinical and subclinical components in adolescents

BACKGROUND

This study aimed to examine whether different components of interpretation bias are clinical or dimensional features of adolescent social anxiety. The study analyzed the components of this bias at a subclinical level of Social Anxiety Disorder (SAD) and compared these with a clinical sample of adolescents with SAD.

METHOD

Adolescents in the age range 13-17 years participated. A group with SAD (n = 30) was compared with a group with subclinical SAD (n = 60), and a non-socially anxious group (n = 95).

RESULTS

Negative interpretation bias for social situations was found to be a dimensional aspect of social anxiety. In contrast, belief in negative interpretations of social situations appears to be a clinical feature. Contrary to expectations, endorsement of positive interpretations did not differ between the three groups.

CONCLUSIONS

The results suggest that a screening instrument based on negative interpretations of social situations could be useful to detect adolescents at-risk of developing SAD. In a clinical setting, the belief in negative interpretations and the presence of the bias in nonsocial situations should also be considered.

Social anxiety in pre-adolescent children: What do we know about maintenance?

The cognitive theory of social anxiety disorder (SAD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, yet it remains unknown if, or to what extent, the same cognitive and behavioral maintenance mechanisms that occur in adult SAD also apply to SAD among pre-adolescent children. In contrast to the adult literature, current models of SAD in children mostly account for etiology and maintenance processes are given limited attention. Consequently, their clinical utility for the treatment of SAD in children may be limited. This narrative review, first, critically examines the different theoretical conceptualizations of the maintenance of social anxiety in the child and adult literature and illustrates how these have resulted in different treatment approaches and clinical understanding. Second, it reviews the available evidence relating to hypotheses about the maintenance of SAD in children as derived from adult cognitive and etiological models. Third, it highlights the need to attend directly to child specific maintenance mechanisms in SAD, to draw on cognitive theory, and to account for the influence of childhood-specific contextual (e.g. family and school-based interactions) and developmental factors on children's social experiences.

Erfassung störungsaufrechterhaltender Komponenten sozialer Angst bei Kindern und Jugendlichen im Eltern- und Selbsturteil

Zusammenfassung. Theoretischer Hintergrund: Der Fragebogen zur Erfassung störungsaufrechterhaltender Komponenten sozialer Angst bei Kindern und Jugendlichen (FESKA) erhebt kognitive, behaviorale und interaktionelle Komponenten sozialer Angststörungen von Kindern und Jugendlichen zwischen 4 und 14 Jahren. Fragestellung: Der FESKA wird im Eltern- (N = 259) und Selbsturteil (N = 159) an einer kombinierten Feld- und klinischen Stichprobe untersucht. Methode: Überprüft werden faktorielle Validität, Reliabilität und Aspekte divergenter und konvergenter Validität. Ergebnisse: Konfirmatorische Faktorenanalysen bestätigen das zugrundeliegende dreifaktorielle Bedingungsmodell. Interne Konsistenzen der Gesamtskalen und der Komponentenskalen sind zufriedenstellend, ihre Wiederholungszuverlässigkeiten sind für das Selbsturteil bedingt und für das Elternurteil nicht zufriedenstellend. Die Korrelationen der Skalen zwischen den Beurteilern fallen geringer als erwartet aus. Die konvergente Validität kann bestätigt werden. Schlussfolgerungen: Unter Berücksichtigung verschiedener Limitationen bestätigen die Befunde die Verwendung des FESKA in Klinik und Forschung.

The Role of Cognitive Factors in Childhood Social Anxiety: Social Threat Thoughts and Social Skills Perception

Models of cognitive processing in anxiety disorders state that socially anxious children display several distorted cognitive processes that maintain their anxiety. The present study investigated the role of social threat thoughts and social skills perception in relation to childhood trait and state social anxiety. In total, 141 children varying in their levels of social anxiety performed a short speech task in front of a camera and filled out self-reports about their trait social anxiety, state anxiety, social skills perception and social threat thoughts. Results showed that social threat thoughts mediated the relationship between trait social anxiety and state anxiety after the speech task, even when controlling for baseline state anxiety. Furthermore, we found that children with higher trait anxiety and more social threat thoughts had a lower perception of their social skills, but did not display a social skills deficit. These results provide evidence for the applicability of the cognitive social anxiety model to children.

Der Einfluss von situativer Angst auf die soziale Performanz und Selbstbewertung von Kindern mit sozialen Ängsten

Theoretischer Hintergrund: Studien zu sozialen Fertigkeiten und der Selbstbewertung von Kindern mit sozialen Ängsten zeigen ein heterogenes Bild. Fragestellung: Als ein möglicherweise wichtiger, jedoch bisher unbeachteter Einflussfaktor für die Erklärung dieser inkonsistenten Befunde wird die situative Angst während sozialer Situationen untersucht. Methode: Kinder mit hoher/niedriger sozialer Angst (HSA/NSA, je n=20) absolvierten zwei sozial-evaluative Aufgaben. Soziale Performanz, Selbsteinschätzungen sowie situative Angst wurden erfasst. Ergebnisse: HSA-Kinder zeigten eine verminderte soziale Performanz im Vergleich zur NSA-Gruppe in beiden Aufgaben (ηp2=.234). In beiden Gruppen verringerte sich die situative Angst über die Aufgaben hinweg (ηp2=.143), während sich die Selbstbewertungen parallel verbesserten (ηp2=.376) und einen hohen Zusammenhang zur situativen Angst zeigten. Schlussfolgerungen: Angstexposition und -habituation haben somit möglicherweise einen direkten positiven Einfluss auf die Selbstbewertungen von HSA Kindern. Für den Aufbau sozialer Fertigkeiten bei HSA-Kindern sind wahrscheinlich gezielte Interventionen nötig.

Taking a closer look: autonomic dysregulation in socially anxious children

Previous research on autonomic characteristics of social anxiety in children and adolescents has produced highly inconsistent results which may partially be due to task differences and a limited breadth of autonomic measurement. Here we investigated a sample of high (HSA) and low socially anxious (LSA) children, aged 10-12 years before, during and after a standardized evaluated speech task while acquiring a broad set of autonomic and experiential measures. During baseline, we found evidence for tonically higher sympathetic autonomic activity in HSA children, indicated by higher low frequency heart rate variability (LF) and a trend for higher LF to high frequency heart rate variability ratios (LF/HF). In response to the speech task, HSA children showed blunted cardiac responding evidenced by slower increase and delayed recovery of heart rate and a similar significant trend on LF/HF values. Self-reported anxiety, by contrast, showed enhanced reactivity from baseline to anticipation in the HSA compared to the LSA group. The results suggest a restricted cardiac flexibility in HSA children and illustrate that broad autonomic assessment during a well-structured, naturalistic task may improve our understanding of the autonomic physiology of socially anxious children. The results have implications for current theories of social anxiety.

Hat das kognitive Modell von Clark und Wells zur sozialen Phobie Erklärungskraft für das Kindesalter?

Zusammenfassung. Das kognitive Modell von Clark und Wells (1995) zur sozialen Phobie hat in der empirischen Forschung der letzten Jahre viel Beachtung gefunden. Bisher bleibt jedoch unklar, ob das für das Erwachsenenalter konzipierte und evaluierte Modell auch Erklärungskraft für das Kindesalter hat. In unserem Literaturüberblick fanden wir Hinweise darauf, dass einige Aspekte des Modells schon im Kindesalter eine Rolle für die Aufrechterhaltung der Störung spielen, wie dysfunktionale antizipatorische Bewertungen, Aufmerksamkeits-, Interpretations- und Grübelprozesse. Empirische Studien zu anderen Komponenten des Modells liefern dagegen widersprüchliche Ergebnisse, oder können aufgrund nicht ausreichender Studienzahl nicht abschließend beurteilt werden. Insgesamt ergeben sich Hinweise darauf, dass das Modell zumindest zum Teil Erklärungskraft für die soziale Phobie des Kindes- und Jugendalters besitzt.

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.