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Gavric D, Cameron D, Waechter S, Moscovitch DA, McCabe RE, Rowa K. Just do something: An experimental investigation of brief interventions for reducing the negative impact of post-event processing in social anxiety disorder. J Anxiety Disord 2023; 98:102744. [PMID: 37478698 DOI: 10.1016/j.janxdis.2023.102744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/02/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
Post-Event Processing (PEP) is prevalent and problematic in Social Anxiety Disorder (SAD) but is typically not a direct target in evidence-based treatments such as cognitive behavioural therapy (CBT) for SAD. The primary aim of the current study was to examine the impact of several theoretically and empirically derived interventions for PEP in SAD, including concrete thinking, abstract thinking, and distraction in comparison to a control (i.e., do nothing) condition. Based on prior research, we hypothesized that the concrete and distract conditions would be associated with positive benefits, including reductions in PEP and improvements in self-perception, whereas the abstract and control conditions would not. The second aim of the study was to identify baseline variables that predict the trajectory of change in PEP over time. Participants (N=92) with a principal diagnosis of SAD completed a social stress task and were randomly assigned to one of four conditions. Participants completed measures at baseline, post-intervention/control, and at 1-week, and 1-month follow-up. Contrary to hypotheses, all three active conditions were similarly effective at reducing PEP and improving self-perceptions relative to the control condition. In the absence of an intervention, engagement in PEP remained high up to a month following the social stress task. Higher levels of baseline state anxiety, intolerance of uncertainty, and use of safety behaviours predicted greater PEP, even in the presence of an intervention. These results highlight the benefits of relatively brief interventions that disrupt the course of PEP for people with SAD. Such interventions can be easily incorporated into CBT protocols for SAD to enhance their effects.
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Affiliation(s)
- Dubravka Gavric
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - Duncan Cameron
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
| | - Stephanie Waechter
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - David A Moscovitch
- Department of Psychology and Centre for Mental Health Research and Treatment, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
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Moran T, Eyal T. Emotion Regulation by Psychological Distance and Level of Abstraction: Two Meta-Analyses. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2022; 26:112-159. [PMID: 35100904 DOI: 10.1177/10888683211069025] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Self-reflection is suggested to attenuate feelings, yet researchers disagree on whether adopting a distant or near perspective, or processing the experience abstractly or concretely, is more effective. Given the relationship between psychological distance and level of abstraction, we suggest the "construal-matching hypothesis": Psychological distance and abstraction differently influence emotion intensity, depending on whether the emotion's appraisal involves low-level or high-level construal. Two meta-analyses tested the effects of psychological distance (k = 230) and level-of-abstraction (k = 98) manipulations on emotional experience. A distant perspective attenuated emotional experience (g = 0.52) but with weaker effects for high-level (g = 0.29; for example, self-conscious emotions) than low-level emotions (g= 0.64; for example, basic emotions). Level of abstraction only attenuated the experience of low-level emotions (g = 0.2) and showed a reverse (nonsignificant) effect for high-level emotions (g = -0.13). These results highlight differences between distancing and level-of-abstraction manipulations and the importance of considering the type of emotion experienced in emotion regulation.
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Affiliation(s)
- Tal Moran
- The Open University of Israel, Ra'anana, Israel.,Ghent University, Belgium
| | - Tal Eyal
- Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Kim H, Kim BH, Kim MK, Eom H, Kim JJ. Alteration of resting-state functional connectivity network properties in patients with social anxiety disorder after virtual reality-based self-training. Front Psychiatry 2022; 13:959696. [PMID: 36203841 PMCID: PMC9530634 DOI: 10.3389/fpsyt.2022.959696] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
Social anxiety disorder (SAD) is a mental disorder characterized by excessive anxiety in social situations. This study aimed to examine the alteration of resting-state functional connectivity in SAD patients related to the virtual reality-based self-training (VRS) which enables exposure to social situations in a controlled environment. Fifty-two SAD patients were randomly assigned to the experimental group who received the VRS, or the control group who did not. Self-report questionnaires and resting-state functional magnetic resonance imaging (fMRI) were performed to assess clinical symptoms and analyze the resting-state network properties, respectively. Significant decrease in social anxiety and an increase in self-esteem was found in the experimental group. From the resting-state fMRI analysis, alteration of local network properties in the left dorsolateral prefrontal gyrus (-10.0%, p = 0.025), left inferior frontal gyrus (-32.3%, p = 0.044), left insula (-17.2%, p = 0.046), left Heschl's gyrus (-21.2%, p = 0.011), bilateral inferior temporal gyrus (right: +122.6%, p = 0.045; left:-46.7%, p = 0.015), and right calcarine sulcus (+17.0%, p = 0.010) were found in the experimental group. Average shortest path length (+8.3%, p = 0.008) and network efficiency (-7.6%, p = 0.011) are found to be altered from the global network property analysis. In addition, the experimental group displayed more positive and more negative changes in the correlation trend of average shortest path length (p = 0.004) and global network efficiency (p = 0.014) with the severity of social anxiety, respectively. These results suggest potential effectiveness of the VRS, which is possibly related to the change of aberrant processing and control of visual and auditory linguistic stimuli and the adaptive change in rumination pattern.
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Affiliation(s)
- Hun Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Byung-Hoon Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Min-Kyeong Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyojung Eom
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae-Jin Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
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Kambara K, Kira Y, Ogata A. Impact of repetitive thought and processing mode on goal striving. J Behav Ther Exp Psychiatry 2019; 65:101481. [PMID: 31112830 DOI: 10.1016/j.jbtep.2019.101481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/14/2019] [Accepted: 05/08/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Striving to attain personal goals is important for maintaining well-being. Previous research indicates that repetitive thoughts can influence the affect and cognition associated with personal goal strivings. Repetitive thought in the concrete-experiential processing mode improves affect and cognition after a negative event more than does repetitive thought in the abstract-analytic processing mode. We extend this prior work by examining whether repetitive thought directly influences the maintenance of personal goal strivings through a longitudinal survey. METHODS In Study 1, we examined the daily maintenance effect of repetitive thought on personal goal strivings using a multilevel analysis of 29 participants who reported their thoughts and goal strivings daily for one week. In Study 2, participants (N = 131) reported their thoughts and goal strivings over 10 weeks, and we examined the maintenance effect of repetitive thought on personal goal strivings every two weeks. RESULTS Highly repetitive thought in the abstract-analytic processing mode decreased the maintenance of short-term personal goal strivings in individuals with difficult goals. However, highly repetitive thought in the concrete-experiential processing mode increased the maintenance of long-term personal goal strivings in individuals with difficult goals. LIMITATIONS The study participants were university students; therefore, we cannot generalize the results to clinical populations or other age groups. CONCLUSION Interventions that increase repetitive thought in the concrete-experiential processing mode may be effective in facilitating long-term goal strivings in individuals attempting to overcome difficult situations and achieve important personal goals.
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Affiliation(s)
- Kohei Kambara
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan; Research Fellow of the Japan Society for the Promotion of Science, Japan.
| | - Yugo Kira
- Graduate School of Education, Hiroshima University, Japan
| | - Akiko Ogata
- Graduate School of Education, Hiroshima University, Japan
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Norton AR, Abbott MJ. Experiential Self-Focus in Social Anxiety Disorder: Is it Beneficial? J Clin Psychol 2017; 74:480-488. [DOI: 10.1002/jclp.22503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/31/2017] [Accepted: 05/04/2017] [Indexed: 11/11/2022]
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Nilsson JEC, Lundh LG. Audio Feedback with Reduced Self-focus as an Intervention for Social Anxiety: An Experimental Study. Cogn Behav Ther 2016; 45:150-62. [PMID: 26935474 DOI: 10.1080/16506073.2015.1126633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Socially anxious individuals tend to underestimate their performance largely due to attentional bias. Video and audio feedback (AF) with cognitive preparation (CP) have shown to improve socially anxious individuals' evaluation of their performance in previous studies. In the present study, it was hypothesized that one of the three steps in CP, reduced self-focus (RS), is sufficient to cause an improved voice evaluation after AF. This was tested in a single-session randomized controlled experiment. METHOD Forty-one socially anxious participants were asked to give a speech, then to listen to and evaluate a taped recording of their performance. Half of the sample were instructed to reduce their self-focus prior to AF, the rest received AF only. RS involved asking participants to listen to the audio recording as though they were listening to a stranger. Generalization effects were assessed by a second speech. RESULTS AF with RS led to more improved voice evaluations than AF-only after the first speech, and the effects remained in the evaluation of the second speech. More positive speech evaluations were associated with corresponding reductions of performance anxiety. LIMITATIONS small sample, analogue study. CONCLUSION One component of cognitive preparation-(RS)-appears to be sufficient to cause significant effects on voice evaluation in socially anxious individuals. If the results are replicated in clinical samples, AF with RS may be a promising intervention in the treatment of social anxiety.
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Hedman E, Mörtberg E, Hesser H, Clark DM, Lekander M, Andersson E, Ljótsson B. Mediators in psychological treatment of social anxiety disorder: individual cognitive therapy compared to cognitive behavioral group therapy. Behav Res Ther 2013; 51:696-705. [PMID: 23954724 DOI: 10.1016/j.brat.2013.07.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/28/2013] [Accepted: 07/08/2013] [Indexed: 11/28/2022]
Abstract
According to cognitive-behavioral models of social anxiety disorder (SAD), four of the important maintaining mechanisms are avoidance, self-focused attention, anticipatory processing and post-event cognitive processing. Individual cognitive therapy (ICT) and cognitive behavioral group therapy (CBGT) both have substantial empirical support. However, it is unclear whether they achieve their effects by similar or different mechanisms. The aim of this study was to investigate whether changes in the four maintenance processes mediate clinical improvement in ICT and CBGT for SAD. We analyzed data from participants (N = 94) who received either ICT or CBGT in two separate RCTs. The results showed that ICT had larger effects than CBGT on social anxiety and each of the four potential mediators. More pertinently, moderated mediation analyses revealed significant between-treatment differences. Whereas improvement in ICT was mainly mediated by reductions in avoidance and self-focused attention, improvement in CBGT was mediated by changes in self-focused attention and in anticipatory and post-event processing. These results support the importance of the putative mediators, but suggest that their relative weights are moderated by treatment type.
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Affiliation(s)
- Erik Hedman
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
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