Public and private self-consciousness and social phobia

Social Elite in Imperial China: Their Destinies as Documented by the Historical Literature and Their Personality as Defined by the Contemporary Five-Factor Model

Background: The association between personality and life outcome has been widely studied in Western countries, and one might question whether the association exists in China. The official documentation from the Twenty-Six Histories of Imperial China, which presents life-long data on the social elite, may offer a convenient way to realize this effort. Meanwhile, a possible association might help identify competent personalities and offer treatment hints for personality disorders or other psychiatric deviations worldwide. Methods: Based on these historical records (about 618–1911 AD) on 18 social elite groups with long longevity (Macrobian group) and 30 with normal lifespans (Control group), we assessed personality traits/facets using the revised NEO Personality Inventory (NEO-PI-R) and destiny using the Destiny Evaluation Questionnaire (DEQ). Results: Compared to the Controls, the Macrobian group scored higher on the DEQ’s Health and Destiny in General and lower on the NEO-PI-R traits Openness to Experience and Extraversion and facets such as Openness to Fantasy, Openness to Aesthetics, Openness to Feelings, Excitement-Seeking, and Self-Consciousness. In the Macrobian group, the Trust and Compliance facets predicted the DEQ’s Family and Marriage and Social Relationships aspects, respectively; Conscientiousness and its facets Dutifulness, Self-Discipline, and Competence predicted Family and Marriage, Career Achievement, and Destiny in General, respectively; and the Self-Consciousness facet predicted worse performance in Career Achievement, Family and Marriage, and Social Relationships and the Depression facet of Destiny in General. In the Control group, Openness to Feelings positively and Anxiety negatively predicted Health. Conclusions: Less self-focused attention and more interdependence between individuals were beneficial to several aspects of individual destiny in Imperial China, which might be profound for the individual career development and clinical treatment of personality disorders in contemporary society.

Perception of eye contact, self-referential thinking and age

Increased thinking about one's self has been proposed to widen the gaze cone, that is, the range of gaze deviations that an observer judges as looking directly at them (eye contact). This study investigated the effects of a self-referential thinking manipulation and demographic factors on the gaze cone. In a preregistered experiment (N = 200), the self-referential thinking manipulation, as compared to a control manipulation, did not influence the gaze cone, or the use of first-person pronouns in a manipulation check measuring self-referential processing. This may indicate a failure of the manipulation and participants' lack of effort. However, participants' age was significantly correlated with both measures: older people had wider gaze cones and used more self-referring pronouns. A second experiment (N = 300) further examined the effect of the manipulation and demographic factors on self-referential processing, and the results were replicated. These findings may reflect age-related self-reference and positivity effects.

Self-Consciousness, Self-Objectification, and Social Anxiety as Predictors of Photo Editing Behavior among Emerging Adults

This study aims to assess the impact of self-consciousness, self-objectification, and social anxiety on photo editing behavior among emerging adults. Correlational research strategy was used for the present quantitative research, and convenient sampling strategy was used to collect data of 444 university students (135 males and 309 females) with the age range of 18-25 years. The self-consciousness scale, objectified body consciousness scale, photo manipulation scale, and social anxiety scale were used as assessment tools for this study. For data analysis, $t$ -test for independent samples, correlation, and regression analysis were implied. The results revealed that women had higher self-consciousness and social anxiety in contrast to men. Moreover, self-objectification and evaluation anxiety were positively correlated with photo editing behavior. Lastly, overall self-objectification and body shame, one of the three aspects of self-objectification resulted as significant predictors of photo manipulation behavior among emerging adults. This study contributes to the indigenous literature of clinical and social psychology.

Hospitalization, interpersonal and personal factors of social anxiety among COVID-19 survivors at the six-month follow-up after hospital treatment: the minority stress model

BACKGROUND

As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety.

OBJECTIVES

This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors.

METHODS

A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan); adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety.

RESULTS

The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ²(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety.

CONCLUSIONS

The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion.

Remediation Strategies for Performance Anxiety across Sex, Sport and Stage: Identifying Common Approaches and a Unified Cognitive Model

Strategies for addressing anxiety-related decrements in performance have been implemented across a variety of domains, including Sex, Sport, and Stage. In this review, we (1) iterate the dominant anxiety-related remediation strategies within each of these domains; (2) identify over-lapping and domain-specific strategies; and (3) attempt to unify the conceptualization of performance-related anxiety across these three areas under the information-processing framework of the Reflective/deliberative-Impulsive/automatic Model (RIM). Despite both diversity and similarity in remediation approaches across domains, we found that many strategies appear to share the common goal of maintaining a dominant automatic style of information processing in high performance demand situations. We then describe how various remediation strategies might hypothetically fit within the RIM framework and its subcomponents, identifying each intervention as falling into one or more broad categories related to achieving and/or maintaining dominance in automatic information processing. We conclude by affirming the benefit of adopting a unifying information-processing framework for the conceptualization of performance-related anxiety, as a way of both guiding future cross- and inter- disciplinary research and elucidating effective remediation models that share common pathways/mechanisms to improved performance.

Visual attention patterns during online video-mediated interaction in socially anxious individuals

BACKGROUND AND OBJECTIVES

These days, a growing number of social interactions occur through video-mediated communication (VMC). However, little is known about how socially anxious individuals use this technology. Here, we examined the visual attention patterns of high and low socially anxious individuals during a live interaction with a study confederate using a typical online VMC setup.

METHODS

High (n = 30) and low (n = 30) socially anxious participants completed a VMC-based social interaction task comprised of two parts: A one-on-one acquaintance interview followed by a one-on-one short presentation assignment. State anxiety was measured before and after the task, and gaze data was collected throughout.

RESULTS

High socially anxious participants experienced elevated anxiety following the interaction task, whereas no elevation was observed for low socially anxious participants. Gaze data revealed that high socially anxious participants dwelled longer on the confederate's image during the acquaintance interview compared with the presentation task, and dwelled longer on non-face areas during the presentation relative to during the acquaintance interview. This task-related gaze pattern was not observed among low socially anxious participants.

LIMITATIONS

An analog sample was used in this study and future research should replicate its findings in a clinical sample. Future studies may also wish to counterbalance confederate's gender and task order across participants.

CONCLUSIONS

The results suggest that during VMC, socially anxious individuals observe their environment differently than non-socially anxious individuals, depending on the context of the interaction. This context-dependency might help explain mixed findings in previous studies. Further theoretical implications of these findings are discussed.

Anxiety and Performance in Sex, Sport, and Stage: Identifying Common Ground

Anxiety has long been associated with diminished performance within a number of domains involving evaluative interpersonal interactions, including Sex, Sport, and Stage. Here, we pose three questions: (1) how do these disparate fields approach and understand anxiety and performance; (2) how does the understanding of the issue within one field offer insight to another field; and (3) how could each field benefit from the ideas and strategies used by the others. We begin with a short review of models of anxiety/arousal and performance and then explore definitions, models, presumed underlying physiological processes, and characterizing and influencing factors within each domain separately in a narrative review. This discussion is followed by a synthesis that identifies elements specific to and common across the various domains, with the latter captured in a model of essential characteristics. Concluding remarks note the potential value of promoting increased cross-disciplinary conversation and research, with each domain likely benefiting from the conceptualizations and expert knowledge of the others.

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.

Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

Social anxiety disorder (SAD) is associated with aberrant self-referential processing (SRP) such as increased self-focused attention. Aberrant SRP is one of the core features of SAD and is also related to therapeutic interventions. Understanding of the underlying neural correlates of SRP in SAD is important for identifying specific brain regions as treatment targets. We reviewed functional magnetic resonance imaging (fMRI) studies to clarify the neural correlates of SRP and their clinical implications for SAD. Task-based and resting fMRI studies have reported the cortical midline structures including the default mode network, theory of mind-related regions of the temporo-parietal junction and temporal pole, and the insula as significant neural correlates of aberrant SRP in SAD patients. Also, these neural correlates are related to clinical improvement on pharmacological and cognitive-behavioral treatments. Furthermore, these could be candidates for the development of novel SAD treatments. This review supports that neural correlates of SAD may be significant biomarkers for future pathophysiology based treatment.

The mediation roles of discrepancy stress and self-esteem between masculine role discrepancy and mental health problems

INTRODUCTION

Masculine role discrepancy and discrepancy stress occur when men perceive that they fail to live up to the ideal manhood derived from societal prescriptions. The present study examined the associations between masculine role discrepancy and two emotional and mental health problems (social anxiety and depressive symptoms), and potential mediation effects through discrepancy stress and self-esteem in a male general population.

METHODS

Based on random population-based sampling, 2000 male residents in Hong Kong were interviewed. Levels of masculine role discrepancy, discrepancy stress, self-esteem, social anxiety, and depressive symptoms were assessed by using validated scales.

RESULTS

Results of structural equation modeling analysis indicated that the proposed model fit the sample well. (χ²(118) = 832.34, p < .05, CFI = 0.94, NNFI = 0.91, RMSEA = 0.06). Those who were young, single and less educated were vulnerable to masculine role discrepancy, discrepancy stress, and emotional/mental health problems. We found that discrepancy stress significantly mediated the association between masculine role discrepancy and social anxiety, while self-esteem significantly mediated the associations between masculine role discrepancy and both social anxiety and depression.

LIMITATIONS

Study limitations mainly included the cross-sectional design and reliance on self-reported questionnaires.

CONCLUSIONS

The associations between masculine discrepancy and social anxiety/depressive symptoms among men may be explained by the increase in discrepancy stress and decrease in self-esteem. The findings suggest needs and directions for future research for the relationship between masculine role discrepancy and men's mental health, mechanisms involved, and interventions for improvement.

Social Anxiety and the Cued Activation of Relational Knowledge

A cued activation procedure was used to examine the hypothesis that social anxiety involves an expectation of being rejected or evaluated negatively by others, combined with a concern about impression management. Participants underwent a conditioning procedure in which distinctive computer tones were paired with thoughts of social rejection and acceptance, respectively. In a pilot study, a lexical decision task established that when these tone cues were played later, they differentially activated expectations of rejection. In the main study, female participants interacted with a male confederate while one of the tones, or a control tone, sounded repeatedly in the background. Several indicators of social anxiety showed an interaction between level of public self-consciousness and the nature of the tone played. High-self-conscious individuals tended to be affected by the cues, whereas low-self-conscious people were not affected.

Self-Focused Cognition in Social Anxiety: A Review of the Theoretical and Empirical Literature

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social or performance situations. Cognitive models suggest that self-focused cognitive processes play a crucial role in generating and maintaining social anxiety, and that self-focused cognition occurs prior to, during, and following social situations (Clark & Wells, 1995; Rapee & Heimberg, 1997). There is a substantial body of empirical evidence demonstrating that socially anxious individuals engage in self-focused cognition during and following a social or performance situation. A smaller but growing body literature suggests that a similar process occurs prior to such situations, and that these three processes are interdependent. Furthermore, the vast majority of research to date indicates that self-focused cognitive processes are detrimental, and that they generate and maintain social anxiety in a variety of ways. However, there remains considerable scope for research to further explicate the role of these processes in the maintenance of SAD, and to enhance interventions designed to ameliorate their negative effects.

Social anxiety disorder and the psychobiology of self-consciousness

Individuals with social anxiety disorder (SAD) are characterized by fear or anxiety about social situations, but also by important alterations in self-referential processing. Given advances in our understanding of the neurocircuitry and neurochemistry of SAD, the question arises of the relationship between this research and an emergent literature on the psychobiology of self and self-consciousness. A number of investigations of SAD have highlighted altered activity in the medial prefrontal cortex (mPFC; involved in self-representation), insula (involved in interoceptive processing), and other structures that play a role in bodily self-consciousness, as well as the potential value of interventions such as selective serotonin reuptake inhibitors (SSRI) and self-focused reappraisal in normalizing such changes. Future studies to more closely investigate associations between psychobiological alterations and changes in self-related processing in SAD, may be useful in shedding additional light on both SAD and self-consciousness.

Psychophysiological responses to eye contact in adolescents with social anxiety disorder

We investigated whether eye contact is aversive and negatively arousing for adolescents with social anxiety disorder (SAD). Participants were 17 adolescents with clinically diagnosed SAD and 17 age- and sex-matched controls. While participants viewed the stimuli, a real person with either direct gaze (eye contact), averted gaze, or closed eyes, we measured autonomic arousal (skin conductance responses) and electroencephalographic indices of approach-avoidance-motivation. Additionally, preferred viewing times, self-assessed arousal, valence, and situational self-awareness were measured. We found indications of enhanced autonomic and self-evaluated arousal, attenuated relative left-sided frontal cortical activity (associated with approach-motivation), and more negatively valenced self-evaluated feelings in adolescents with SAD compared to controls when viewing a face making eye contact. The behavioral measures and self-assessments were consistent with the physiological results. The results provide multifaceted evidence that eye contact with another person is an aversive and highly arousing situation for adolescents with SAD.

The neuropsychology of self-reflection in psychiatric illness

The development of robust neuropsychological measures of social and affective function-which link critical dimensions of mental health to their underlying neural circuitry-could be a key step in achieving a more pathophysiologically-based approach to psychiatric medicine. In this article, we summarize research indicating that self-reflection (the inward attention to personal thoughts, memories, feelings, and actions) may be a useful model for developing such a paradigm, as there is evidence that self-reflection is (1) measurable with self-report scales and performance-based tests, (2) linked to the activity of a specific neural circuit, and (3) dimensionally related to mental health and various forms of psychopathology.

Do Higher Self-Reports of Social Anxiety Translate to Greater Occurrence of Social Anxiety Disorder in Asian Americans Compared to Caucasian Americans?

This study was designed to clarify the discrepancy between data showing higher self-reported levels of social anxiety in Asian Americans (Horng, 2004; Okazaki, 1997, 2000, 2002) but lower lifetime prevalence rates of social anxiety disorder (SAD) in Asian Americans compared to Caucasian Americans (Hwu, Yeh, & Chang, 1989; Lee et al., 1990b; Takeuchi et al., 1998). Results revealed that based on responses on the self-report Social Phobia Inventory (SPIN), Asian Americans endorsed higher levels of social anxiety symptoms and were more likely to meet a threshold for "high social anxiety," using the diagnostic cutoff score of 19 or higher on the SPIN. However, when clinician-formulated diagnoses were assigned, there was no evidence for significant differences in the prevalence of SAD in Asian Americans versus Caucasian Americans. Explanation of the results, their implications, limitations, and future directions are discussed.

Cognitive processes as mediators of the relation between mindfulness and change in social anxiety symptoms following cognitive behavioral treatment

The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias--even when the treatment does not target mindfulness.

Psychometric properties and clinical cut-off scores of the Spanish version of the Social Anxiety Scale for Adolescents

This study examined the reliability and validity evidence drawn from the scores of the Spanish version of the Slovenian-developed Social Anxiety Scale for Adolescents (SASA; Puklek, 1997; Puklek & Vidmar, 2000) using a community sample (Study 1) and a clinical sample (Study 2). Confirmatory factor analysis in Study 1 replicated the 2-factor structure found by the original authors in a sample of Slovenian adolescents. Test-retest reliability was adequate. Furthermore, the SASA correlated significantly with other social anxiety scales, supporting concurrent validity evidence in Spanish adolescents. The results of Study 2 confirmed the correlations between the SASA and other social anxiety measures in a clinical sample. In addition, findings revealed that the SASA can effectively discriminate between adolescents with a clinical diagnosis of social anxiety disorder (SAD) and those without this disorder. Finally, cut-off scores for the SASA are provided for Spanish adolescents.

The relations between social anxiety and social intelligence: a latent variable analysis

Social anxiety has been associated with biases in cognitive processing and deficits in social performances. Yet, it remains unclear if these variations may be partly attributable to deficits in fundamental social abilities: for example, social intelligence (SI). Using the Magdeburg Test of Social Intelligence (MTSI) as an objective and performance based SI measure, we examined the relationship between social anxiety and SI in a general population sample (N=110) using Structural Equation Modeling. Dimensions of social anxiety as postulated by Clark and Wells (1995) and facets of SI (social understanding, social memory, and social perception), were negatively correlated. Use of safety-behavior in particular was related to deficits in social understanding (r=-0.25; p<0.05) and social perception and memory (r=-0.24; p<0.05). Results suggest small to medium sized relationships between specific facets of social anxiety and certain domains of SI. Therapeutic implications for socially anxious individuals concerning SI are discussed.

Interpretations of and memory for bodily sensations during public speaking

This study examined whether negative interpretations of bodily sensations result in a memory bias for such sensations under conditions of social evaluation. Undergraduate students (N=77) were connected to equipment which they were told would measure their physiology and were trained on how to monitor their physiology via computer feedback as they gave a video-taped speech. Approximately half of participants (n=41) were told that their physiological feedback provides important information about their performance, and those remaining (n=36) were told that their physiological feedback is unrelated to their performance. Participants were subsequently given free recall and recognition tests for the computer feedback. Results suggest that believing physiological feedback is related to quality of performance resulted in enhanced memory for all information about bodily sensations. Furthermore, heightened social anxiety was associated with enhanced processing of stimuli associated with increasing physiology whereas lower social anxiety was associated with enhanced processing of stimuli associated with stable physiology when the belief that physiological feedback provides important information about performance is activated. Results are discussed in relation to cognitive-behavioural models of social anxiety.

Self-consciousness, friendship quality, and adolescent internalizing problems

The correlates between public and private self-consciousness and internalizing difficulties were examined during early adolescence. Friendship quality was assessed as a possible moderator of the relation between self-consciousness and maladjustment. One hundred and thirty-seven young adolescents (N = 87girls; M age = 13.98 years) reported on their self-consciousness, internalizing problems, and the quality of their best friendship. Results indicated stronger associations between private self-consciousness and internalizing correlates than between public self-consciousness and internalizing problems, suggesting that private self-consciousness may be a stronger risk factor during adolescence. Contrary to expectations, evidence revealed that positive friendship quality may exacerbate some difficulties associated with self-consciousness. Results pertaining to friendship quality add to the growing literature on the ways in which friendships can contribute to adjustment difficulties.

The sexual self-consciousness scale: psychometric properties

An investigation of the Sexual Self-Consciousness Scale (SSCS) is reported that aims to measure individual variability with regard to the construct of self-consciousness as experienced in sexual situations. The construct relates to the attentional-capacity model of sexual arousal. Sexual self-consciousness may constitute a vulnerability factor for the development of sexual dysfunction. In the present study, men and women with sexual dysfunction and healthy control participants were investigated (N = 282). Principal component analysis and multitrait scaling analysis showed that a two-component, oblimin-rotated solution based on 12 items and explaining 53.7% of the total variance could be well interpreted. The Sexual Embarrassment subscale (Cronbach's alpha = .84), the Sexual Self-Focus subscale (alpha = .79), and the full scale (alpha = .85) were found to have satisfactory to good internal consistency. Test-retest reliability was satisfactory for the Sexual Embarrassment subscale (r = .84), the Sexual Self-Focus subscale (r = .79), and total score (r = .83). An effect of sex was found on the Sexual Embarrassment subscale, with female participants scoring higher than male participants. Compared with sexually functional participants, sexually dysfunctional participants scored higher on the Sexual Embarrassment and Sexual Self-Focus subscales. Convergent and divergent construct validity was investigated by comparing the associations of SSCS subscales with general self-consciousness and psychological distress scales. The pattern of correlations was interpreted as providing support for the instrument's construct validity. In conclusion, the SSCS was found to have satisfactory reliability and validity characteristics, and is expected to contribute to the field of sex research and clinical sexology.

Construction and reliability of the Japanese version of the Adolescent Egocentrism-Sociocentrism (AES) scale and its preliminary application in the Japanese university students

In recent years, the problem of interpersonal relationships has been reported to be associated with various adolescent psychiatric problems. Egocentrism is one factor related to the problem of interpersonal relationships. The Adolescent Egocentrism-Sociocentrism (AES) scale is used to assess egocentrism in Western countries, but no such scale has been developed in Japan. The purpose of our current study was to develop the Japanese version of the AES scale and investigate the relationship between the egocentrism assessed by the AES scale and the self-consciousness assessed by the Japanese version of the self-consciousness scale. The original version of the AES scale was first translated into Japanese using the forward-backward method and examined for factorial reliability and validity. The results demonstrated that the Japanese version of the AES scale shows adequate factorial reliability and validity, but different from the original version the "egocentrism personal fable" subscale which measures the feeling that oneself is special and unique was not extracted in the Japanese version. We found a moderate correlation between the non-social focuses of the AES scale and the public self-consciousness subscale of the self-consciousness scale. This correlation suggests that a strong attention of others' view on oneself results in the avoidance of others. The Japanese version of the AES scale can examine egocentrism adequately together with sociocentrism and non-social focuses. As this scale is self-reporting and easy to complete, it may have practical utility in a clinical setting.

Exploring the relationship between fear of positive evaluation and social anxiety

Cognitive-behavioral theorists have proposed that fear of negative evaluation is the core feature of social anxiety [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69-93). New York: Guilford Press; Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behavior Research and Therapy, 35, 741-756]. However, we have previously hypothesized that fear of evaluation in general is important in social anxiety, including fears of positive as well as negative evaluation, and we developed the Fear of Positive Evaluation Scale (FPES; Weeks, J. W., Heimberg, R. G., & Rodebaugh, T. L. (2007). The Fear of Positive Evaluation Scale: Assessing a proposed cognitive component of social anxiety disorder. Manuscript submitted for review.) to test this hypothesis. The present paper reviews several studies conducted for the purpose of extending the empirical examination of the construct of fear of positive evaluation (FPE). Consistent with hypothesis, FPE was positively associated with discomfort in response to receipt of positive social feedback and negatively associated with perceived accuracy of the feedback received. Furthermore, the FPES correlated significantly with several measures related to social anxiety, and lower correlations with measures of other constructs provided evidence of discriminant validity. Thus, findings from the present series of studies add to the developing support for the hypothesis that fear of positive evaluation is important in social anxiety.

Die deutsche Version der Mindful Attention and Awareness Scale (MAAS) Psychometrische Befunde zu einem Achtsamkeitsfragebogen

Zusammenfassung. Theoretischer Hintergrund: Achtsamkeit ist eine bestimmte Form der Aufmerksamkeitslenkung, die durch drei Merkmale gekennzeichnet ist: (1) absichtsvoll (2), im gegenwärtigen Moment und (3) nicht wertend. Therapieansätze, in denen die Förderung von Achtsamkeit eine zentrale Rolle einnimmt, werden in letzter Zeit zunehmend eingesetzt. Fragestellung: Wie gut sind die Gütekriterien der deutschen Übersetzung der „Mindful Attention Awareness Scale” (MAAS)? Methode: Die 15 Items der MAAS wurden übersetzt. An einer Stichprobe von 469 studentischen Versuchspersonen wurden die dimensionale Struktur, Reliabilität und Validität der Skala überprüft. Ergebnisse: In Übereinstimmung mit den Ergebnissen zur amerikanischen Originalfassung zeigte die deutschsprachige Version der MAAS eine eindimensionale Struktur, eine interne Konsistenz von α = .83 und Zusammenhänge mit psychopathologischer Belastung und subjektivem Wohlbefinden. Schlussfolgerungen: Mit der deutschen Übersetzung der MAAS liegt ein Fragebogen vor, mit dem Achtsamkeit ökonomisch, reliabel und valide erfasst werden kann.

The Fear of Positive Evaluation Scale: assessing a proposed cognitive component of social anxiety

Cognitive-behavioral models propose that fear of negative evaluation is the core feature of social anxiety disorder. However, it may be that fear of evaluation in general is important in social anxiety, including fears of positive as well as negative evaluation. To test this hypothesis, we developed the Fear of Positive Evaluation Scale (FPES) and conducted analyses to examine the psychometric properties of the FPES, as well as test hypotheses regarding the construct of fear of positive evaluation (FPE). Responses from a large (n = 1711) undergraduate sample were utilized. The reliability, construct validity, and factorial validity of the FPES were examined; the distinction of FPE from fear of negative evaluation was evaluated utilizing confirmatory factor analysis; and the ability of FPE to predict social interaction anxiety above and beyond fear of negative evaluation was assessed. Results provide preliminary support for the psychometric properties of the FPES and the validity of the construct of FPE. The implications of FPE with respect to the study and treatment of social anxiety disorder are discussed.

Private and public self-awareness in social anxiety

Clark and Wells' [(1995). A cognitive model of social phobia. In R.G. Heimberg, M. Liebowitz, D.A. Hope, & F. Schneier (Eds.). Social phobia: Diagnosis, assessment and treatment. New York: Guildford Press] cognitive model of social phobia proposes that self-focused attention and construction of the self as a social object maintain anxiety. This study examines the effect of two different self-focus manipulations (mirror and video) on public and private self-awareness, perspective taking, anxiety, and attributions. Thirty one high socially anxious participants (26 female, 5 male) with a mean age of 19.58 (SD=1.89) and 32 low socially anxious participants (21 female, 11 male) with a mean age of 20.47 (SD=3.69) took part in a conversation with a stooge. Public self-awareness increased in both groups but was higher overall in the high socially anxious group. Private self-awareness decreased for the low socially anxious group, but did not change for the high socially anxious group. High socially anxious participants were also more aware of their surroundings than low socially anxious participants. High socially anxious participants used the field perspective less, and experienced more anxiety. High socially anxious participants also made fewer internal attributions for the conversation going well and more for the conversation going badly than low socially anxious participants who did the opposite. The implications of the results for the cognitive model are discussed.

The spotlight effect and the illusion of transparency in social anxiety

[Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment, and treatment (pp. 69-93). New York: Guildford Press] cognitive model of social phobia suggests that both public and private sources of information contribute to the construction of the self as a social object, which is thought to maintain the disorder. This study used two concepts developed in social psychology that might help to explain the processes that contribute to the development of this constructed self. These two concepts are the spotlight effect [Gilovich, T., Medvec, V. H., & Savitsky, K. (2000). The spotlight effect in social judgment: an egocentric bias in estimates of the salience of one's own actions and appearance. Journal of Personality and Social Psychology, 78(2), 211-222] and the illusion of transparency [Gilovich, T., Medvec, V. H., & Savitsky, K. (1998). The Illusion of transparency: biased assessments of others' ability to read one's own emotional states. Journal of personality and social psychology, 75(2), 332-346]. Participants performed a memory task under either a low or a high social-evaluative condition. In the high social-evaluative condition, participants reported higher levels of the spotlight effect and more negative evaluation of task performance, compared to participants in the low social-evaluative condition. There were no differences between the two conditions in levels of the illusion of transparency. Surprisingly, however, in the low social-evaluative condition, participants reported higher levels of the illusion of transparency than the spotlight effect, whereas, in the high social-evaluative condition, they reported the opposite. Results suggest that the spotlight effect may be specific to social-evaluative concerns, whereas, the illusion of transparency may represent more general features of social anxiety concerns. Implications of the results for Clark and Wells' cognitive model of social phobia model are discussed.

Social anxiety in young gay men

Based on the assumption that sexual minority individuals are particularly sensitive to the possible rejection of others, the present study examined the occurrence and correlates of social anxiety symptomatology in gay and heterosexual men. Eighty-seven heterosexual and 87 gay undergraduate men between the ages of 18 and 24 completed common measures of social anxiety, self-esteem, boyhood gender conformity, and a modified S-R Inventory of Anxiousness. Results reveal that gay men reported greater fear of negative evaluation and social interaction anxiety and lower self-esteem than heterosexual men. Gay men who are less open about their sexual orientation and those who are less comfortable with being gay were more likely to experience anxiety in social interactions. The modified S-R Inventory of Anxiousness was useful in revealing that relatively innocuous situations for heterosexual men can be anxiety-provoking for gay men. The hypothesis that gay men who were gender nonconforming as children would report a higher degree of social interaction anxiety was not supported. Results are discussed in terms of the socialization experiences of gay men and are explicated using a minority stress framework. Implications are offered for the treatment of social anxiety in this population.

Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention

Four domains of evidence regarding the relationship between attention and social phobia are reviewed: (1) possible maintaining factor, (2) causal relationship, (3) specific relationship and (4) mediator of change during treatment. Two areas of research are covered and integrated: vigilance-avoidance of social threat stimuli and self-focused attention. There is empirical support for these processes as possible maintaining factors that are specific to patients and non-clinical samples with high levels of social anxiety. There is reasonable evidence to promote the use of attentional strategies in the treatment of social phobia, although better controlled studies are required. We propose six overlapping mechanisms that could be responsible for change: reduced vigilance; reduced avoidance; reduced self-focused attention; mindfulness; increased attentional control; increased self-esteem.

The nature and expression of social phobia: Toward a new classification

Social phobia (social anxiety disorder) was officially recognized as a distinct clinical entity only with the publication of the DSM-III in 1980. Research on the psychopathology of this disorder has revealed a great degree of heterogeneity in its symptomatology. In order to acknowledge this heterogeneity, later versions of the nosological system introduced the generalized subtype of social phobia to describe individuals who fear most or all social situations. The empirical literature on the differences between the diagnostic subtypes has yielded inconsistent findings. Based on the recent emotion literature and concepts from evolutionary psychology, we discuss fearfulness, anxiousness, shyness, self-consciousness, submissiveness, and anger as dimensions of social phobia. The empirical evidence for this classification system and its relationship to the diagnostic subtypes will be discussed.

Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model

Theories of medically unexplained illness based on the concepts of dissociation, conversion, and somatization are summarized. Evidence cited in support of these theories is described and the conceptual strengths and shortcomings of each approach are considered. It is argued that each of these approaches adds to the understanding of unexplained illness but that none is able to provide a comprehensive explanation of the phenomenon. An integrative conceptual model of unexplained illness based on cognitive psychological principles is then presented. This model attempts to combine existing theoretical approaches within a single explanatory framework, extending previous theory by explaining how compelling symptoms can exist in the absence of organic pathology. The clinical and empirical implications of the model are then considered.

Changes in self-perception during treatment of social phobia

Ninety individuals with social phobia were randomly assigned to a waitlist control group, a cognitive-behavioral therapy group, or an exposure therapy group without explicit cognitive intervention. Two independent raters classified more than 2,000 thoughts that were reported by participants while anticipating socially stressful situations at pretest and posttest. Each thought was classified on the basis of its valence (positive, negative, or neutral) and attentional focus (self or other). The 2 treatments demonstrated a greater reduction in the frequency of negative self-focused thoughts than the control group. Changes in negative self-focused thoughts and changes in social anxiety were significantly correlated only in the cognitive-behavioral therapy group. The implications of these findings for the cognitive model of social phobia are discussed.

The observer perspective: effects on social anxiety and performance

The cognitive model of social phobia by Clark and Wells (Social phobia : Diagnosis, Assessment and treatment (1995)) proposes that individuals with social phobia generate a negative impression of how they appear to others, constructed from their own thoughts, feelings and internal sensations. This impression can occur in the form of a visual image from an external, or "observer", perspective. Although social phobics use this perspective more than controls, the impact of the observer perspective has not been tested experimentally. This study investigated the effects of taking the observer perspective on thinking, anxiety, behaviour and social performance in high and low socially anxious participants. Forty-four participants (N=22 in each group) gave two speeches, one in the observer and one in the field perspective. Use of the observer perspective produced more frequent negative thoughts, more safety behaviours, and worse self-evaluation of performance in both groups. There were also clear trends demonstrating increases in anxiety and in thought belief ratings in the observer perspective compared to the field perspective. Results are consistent with the Clark and Wells model of social phobia. This study also suggests that in low socially anxious individuals, the observer perspective may contain positive information.

Internal versus external attention in social anxiety: an investigation using a novel paradigm

Several cognitive models propose that social anxiety is associated with increased self-focused attention. Indirect evidence for this hypothesis has been provided by questionnaire studies, and by cognitive psychology paradigms that have demonstrated reduced processing of external information during feared social-evaluative situations. However, no studies have simultaneously measured on-line attention to internal and external events. A probe detection task that aimed to measure the balance of attention between internal and external stimuli was developed. High and low socially anxious individuals were instructed to detect two probes. The external probe was superimposed on pictures of faces (happy, neutral, angry) or household objects that were presented on a VDU. The 'internal' probe was a pulse to the finger which participants were led to believe represented significant changes in their physiology. Compared to low speech anxious individuals, high speech anxious individuals showed an internal attentional bias, that was specific to conditions of social-evaluative threat.

Self-focused attention in social phobia and social anxiety

Self-focused attention is an awareness of self-referent information and is present in many emotional disorders. This review concentrates on the role of self-focused attention in social anxiety with particular reference to the Clark and Wells [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. R. G. Heimberg, M. Liebowitz, D. A. Hope, & S. Scheier (Eds.), Social phobia: diagnosis, assessment and treatment. New York: Guilford.] model of social phobia. According to Clark and Wells, self-focused attention is an important maintaining factor in the disorder because it increases access to negative thoughts and feelings, can interfere with performance, and prevents the individual from observing external information that might disconfirm his or her fears. Clark and Wells also propose that socially phobic individuals construct a distorted impression of themselves, based on internally generated information, that takes the form of a visual image (often seen from the perspective of an observer) or felt sense. This paper describes the model and then reviews other theories of self-focused attention, and empirical evidence on self-focused attention. Two types of evidence are reviewed: one, studies that have been conducted from a variety of theoretical perspectives that have relevance either to social anxiety in general or to the Clark and Wells model in particular; two, studies that were designed as a direct test of Clark and Wells' predictions. The final section of the review summarizes the conclusions and suggests areas for future examination.