Negative self-focused cognitions mediate the effect of trait social anxiety on state anxiety
Introduction
The cognitive model of social anxiety (Clark & Wells, 1995; Hofmann, 2007; Rapee & Heimberg, 1997) predicts that, when confronted with social threat, socially anxious individuals shift their attention focus inward onto negative self-focused cognitions, leading to heightened social anxiety and subsequent avoidance behaviors. There is evidence for the notion that socially anxious individuals have more negative and self-deprecating cognitions in socially threatening situations than healthy individuals (Clark & Wells, 1995; Hackmann, Clark, & McManus, 2000; Hackmann, Surawy, & Clark, 1998; Stopa & Clark, 1993). Socially anxious individuals typically monitor their internal state in the face of social threat, leading to increased self-reported anxiety (Hofmann & Barlow, 2002; Spurr & Stopa, 2002; Woody, 1996). Successful treatment is associated with decreased self-focused attention (Hofmann, 2000; Wells & Papageorgiou, 1998; Woody, Chambless, & Glass, 1997), which is correlated with changes in social anxiety, especially among individuals who receive cognitive behavioral interventions (Hofmann, Moscovitch, Kim, & Taylor, 2004). When healthy individuals anticipate a public-speaking task with a thought protocol imitating the cognitive style of socially anxious individuals, the participants’ self-reported anxiety is comparable to that of high socially anxious individuals (Hinrichsen & Clark, 2003; Vassilopoulos, 2005). It has further been shown that the estimated cost of social mishaps partially mediates therapy success (Hofmann, 2004). This is consistent with cross-sectional studies suggesting that cognitive variables, such as self-focused attention (Kashdan & Roberts, 2004), perception of emotional control (Hofmann, 2005), and evaluation of one's own performance (Perini, Abbott, & Rapee, 2006), are causally related to social anxiety. Nevertheless, no study has demonstrated experimentally that anxiety in anticipation of a socially threatening situation is cognitively mediated—one of the core assumptions of the cognitive model. As a result, some authors have recently questioned the cognitive mediation model of social anxiety (e.g. Longmore & Worrell, 2007).
To examine whether cognitions mediate social anxiety, which is an important prediction of the cognitive model, we assessed anxious responding during anticipation of public speaking, the most commonly feared social situation by socially anxious individuals and the general population (Mannuzza, Schneier, Chapman, & Liebowitz, 1995; Pollard & Henderson, 1988). We expected that trait social anxiety would predict increases of acute social anxiety in response to this situation. To examine the role of cognitions as a mediator, we induced negative self-focused cognitions with a script developed by Hinrichsen and Clark (2003) and compared this to relaxation instructions that encourage participants to focus their attention away from negative cognitions (Hudetz, Hudetz, & Reddy, 2004).1 Therefore, we expected greater anxiety and negative cognitions during negative anticipation than during baseline and relaxed anticipation. Moreover, we expected that task-induced changes would be mediated by corresponding differences in the amount of negative cognitions.
In addition to self-report measures, we examined physiological correlates of trait social anxiety (Dewar & Stravynski, 2001; Hofmann, Heinrichs, & Moscovitch, 2004). Heart rate variability in the high-frequency spectrum (HRV-HF, Camm et al., 1996) is a commonly used index of respiratory sinus arrhythmia and primarily reflects parasympathetic influence on heart rate (see Grossman & Taylor, 2007, for a discussion of interpretative issues and further influencing factors). Between-subjects differences have been associated with emotional reactivity (Beauchaine, 2001; Thayer & Brosschot, 2005) and acute shifts of HRV-HF have been linked to self-regulatory efforts of emotional responding (Beauchaine, 2001; Porges, 1995; Thayer & Lane, 2000). Therefore, we expected an inverse relationship of between-subjects’ levels of HRV-HF, and the level of anxiety as well as the amount of negative cognitions while anticipating public speaking. Furthermore, we expected that higher levels of trait social anxiety would predict stronger task-induced within-individual decrease of HRV-HF. Moreover, we expected that this contingency would be mediated by negative cognitions. In addition, we used the startle paradigm to probe the activation of avoidance tendencies by affective information processing (Bradley, Codispoti, & Lang, 2006; Vrana, Spence, & Lang, 1988), assessed skin conductance level (SCL) as an index of distress-related sympathetic arousal (e.g. Boucsein, 1992), and heart rate as a general indicator of physiological activation (e.g. Alpers, Wilhelm, & Roth, 2005). In line with previous reports (e.g. Mauss, Wilhelm, & Gross, 2004), we expected general stress-related activation in SCL and HR in anticipation of public speaking, but no association with trait social anxiety. For startle amplitude, we expected similar effects as for self-reported anxiety.
Section snippets
Participants
We recruited 36 undergraduate students at Boston University with a wide range of trait social anxiety (M=54.48, SD=23.79, Min=8.80, Max=99.32) as measured with the social phobia subscale of the Social Phobia and Anxiety Inventory (SPAI: Turner, Beidel, Dancu, & Stanley, 1989), a well-established self-report measure of trait social anxiety with excellent psychometric properties (Turner, Stanley, Beidel, & Bond, 1989). The internal consistency of the SPAI social phobia subscale in the current
Manipulation check
After the experiment, relaxed anticipation was rated as moderately pleasant, M=4.17, SD=1.20, while negative anticipation was rated as moderately unpleasant, M=3.31, SD=1.49, t(34)=3.51, p<.001, d=.78. In addition, negative cognitions (SSPS-N) were significantly enhanced during negative anticipation in comparison to relaxed anticipation, as indicated by a significant main effect Task, F(1,33)=10.54, p<.01, partial-η2=.24 (Table 1). There was no main effect Task-Order, differentiating the two
Discussion
In the present study, we investigated a core assumption of the cognitive model of social anxiety (Clark & Wells, 1995; Rapee & Heimberg, 1997), namely, that negative self-focused cognitions mediate the relationship between trait social anxiety and anxious responding during anticipation of a socially threatening situation (i.e. public speaking). Our results support our main hypothesis. Consistent with previous reports (Hinrichsen & Clark, 2003; Vassilopoulos, 2005), self-reported anxiety
Acknowledgments
This work was funded in part by NIMH Grant MHMH075889 (Stefan G. Hofmann), and a scholarship by the Gottlieb Daimler- and Karl Benz-Foundation, Germany (Stefan M. Schulz), and by the Research Group Emotion and Behavior which is sponsored by the German Research Society (DFG) (Georg W. Alpers). It was conducted as part of S.M. Schulz's doctoral dissertation at the Department of Psychology, University of Würzburg. Dr. Hofmann is a paid consultant by Organon (Schering-Plough) for issues and
References (52)
- et al.
Anticipation of public speaking in virtual reality reveals a relationship between trait social anxiety and startle reactivity
Biological Psychiatry
(2006) - et al.
Toward understanding respiratory sinus arrhythmia: Relations to cardiac vagal tone, evolution and biobehavioral functions
Biological Psychology
(2007) - et al.
Recurrent images and early memories in social phobia
Behaviour Research and Therapy
(2000) - et al.
Linking self-reported childhood behavioral inhibition to adolescent social phobia
Journal of the American Academy of Child and Adolescent Psychiatry
(1998) - et al.
Anticipatory processing in social anxiety: Two pilot studies
Journal of Behavior Therapy and Experimental Psychiatry
(2003) Self-focused attention before and after treatment of social phobia
Behaviour Research and Therapy
(2000)Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia
Behaviour Research and Therapy
(2005)- et al.
An instrument to assess self-statements during public speaking: Scale development and preliminary psychometric properties
Behavior Therapy
(2000) - et al.
The nature and expression of social phobia: Toward a new classification
Clinical Psychology Review
(2004) - et al.
Do we need to challenge thoughts in cognitive behavior therapy?
Clinical Psychology Review
(2007)
A cognitive-behavioral model of anxiety in social phobia
Behaviour Research and Therapy
Self-focused attention in social phobia and social anxiety
Clinical Psychology Review
Cognitive processes in social phobia
Behaviour Research and Therapy
Psychosomatics and psychopathology: Looking up and down from the brain
Psychoneuroendocrinology
A model of neurovisceral integration in emotion regulation and dysregulation
Journal of Affective Disorders
Social phobia: Effects of external attention on anxiety, negative beliefs, and perspective taking
Behavior Therapy
Self-focused attention in the treatment of social phobia
Behaviour Research and Therapy
Psychophysiological assessment during exposure in driving phobic patients
Journal of Abnormal Psychology
DSM-IV-TR, Diagnostic and statistical manual of mental disorders-text revision
The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
Vagal tone, development, and Gray's motivational theory: Toward an integrated model of autonomic nervous system functioning in psychopathology
Development and Psychopathology
Committee report: Guidelines for human startle eyeblink electromyographic studies
Psychophysiology
Electrodermal activity
A multi-process account of startle modulation during affective perception
Psychophysiology
Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal
Journal of Abnormal Psychology
Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use
Circulation
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