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Pre- and post-event rumination have been proposed to be key processes involved in the maintenance of social anxiety disorder. While the importance of addressing rumination in treatment is becoming increasingly clear, factors that mediate the relationship between changes in social anxiety and changes in rumination have yet to be investigated. Individuals with social anxiety disorder (N = 82) completed measures that assessed key cognitive and attentional processes of social anxiety, including pre- and post-event rumination, before and after cognitive behavioural treatment. Following treatment there were significant reductions in pre- and post-event rumination in addition to other cognitive and attentional aspects of social anxiety. Mediation analyses revealed that changes in state anxiety and performance and threat appraisals mediated the relationship between changes in social anxiety and pre-event rumination, while only changes in threat appraisals mediated the relationship between changes in social anxiety and post-event rumination. It appears that key cognitive and attentional processes have differing importance when anticipating feared social situations and when reflecting on it afterwards. This suggests that treatment that aims to reduce the role of pre-event rumination needs to consider multiple factors, while threat appraisals particularly need to be addressed when addressing post-event rumination.

While cognitive behavioral therapy (CBT) is considered an evidence based treatment for a range of disorders, individuals differ in their response to treatment. Research investigating the pre-treatment factors that can predict better response to CBT is important because it allows identified factors to be addressed prior to commencing standard CBT protocols, enables modifications to be made to standard CBT protocols, or provides information about suitability for CBT. Pre-treatment attitudes aligned with therapy is a potential predictor of outcome, yet no self-report measure exists. This three-study paper reports on the development of a short self-report measure of attitudes aligned with CBT, named the CBT Suitability Scale (CBT-SUITS). Items were developed rationally based on theoretical models of CBT. Results in community and treatment seeking samples show that the instrument has a clear factor structure and adequate reliability. Results in community samples show that the instrument measures attitudes distinct from symptom severity and predicts CBT credibility. While further research in clinical settings is needed, the CBT-SUITS is an important measure of attitudes aligned with CBT for use in research and clinical practice.

This study compared a single-session intervention of positive reappraisal to cognitive restructuring and supportive counselling to examine whether a brief positive reappraisal intervention could significantly increase positive reappraisal coping and positive emotion and lead to reductions in anxiety and depression. Inclusion criteria were: aged 60 years or older, diagnosed with type 2 diabetes, cognitively intact, and English language proficiency. 81 participants were randomly allocated to a condition and self-report measures of positive reappraisal, emotion, anxiety and depression were compared pre-intervention and at 1-week follow-up. The positive reappraisal intervention led to significantly increased positive reappraisal coping compared to the other two conditions, and significantly higher positive but not negative emotion compared to the control condition. No group differences in anxiety and depression were found. The results indicate that the single-session intervention may be effective for increasing older adults’ positive reappraisal coping and specifically their positive emotion when compared to supportive counselling.

The present study examined the reciprocal relationships between probability estimates, cost estimates, and social anxiety during a 12-week course of cognitive-behaviour therapy (CBT) for social anxiety disorder (SAD). One hundred and sixty-three individuals with a principal diagnosis of SAD completed a weekly tracking measure that included questions about probability and cost estimates for negative consequences and current levels of social anxiety relating to a hypothetical speech task. Paired-samples t tests revealed that these variables changed from pre-to-post treatment. Cross-lagged path analyses revealed that cost estimates predicted subsequent changes in social anxiety levels early in treatment, over and above previous anxiety ratings, while probability estimates predicted subsequent levels of social anxiety at the final stages of treatment, over and above previous anxiety ratings. Overall, the results indicated that (1) cost bias early in treatment predicts subsequent social anxiety levels, and (2) both probability and cost estimates seem to play important, but seemingly independent, roles as mechanisms of change in CBT for SAD.

Negative interpretation biases have been associated with clinical depression and anxiety. However, ageing is associated with a positivity effect, in which older adults have a positive interpretation bias compared to younger adults. Few studies have compared interpretation biases in younger and older adults and fewer have made this comparison in clinical samples with anxiety and depression. This study conducted a signal detection analysis to assess differences in interpretation biases to ambiguous sentences in a control and a depressed and anxious sample of younger (18–30 years) and older (60+ years) adults. Participants completed an interpretation bias task in which they were presented with unambiguous neutral sentences and ambiguous sentences related to threat. In addition, participants completed a recognition memory task to assess sensitivity and response biases to threat. Clinical anxiety and depression was associated with a negative interpretation bias; however, there were no significant differences in sensitivity or response bias on the recognition memory task. Older age was associated with a positive interpretation bias. Compared to younger adults, older adults showed a positive interpretation bias for ambiguous sentences, and greater sensitivity towards neutral sentences. In contrast, younger adults showed a negative interpretation bias, as well as a response bias towards threatening sentences.

The present studies examined attentional bias for photographed faces and household objects among individuals diagnosed with generalised social phobia using a letter-probe computer task. Study 1 was conducted to replicate previous findings showing evidence of avoidance for faces among individuals diagnosed with generalised social phobia using a similar methodology as Mansell, W., Clark, D., Ehlers, A., and Chen, Y. P. (1999, Cognition and Emotion, 13(6), 673–690) on a clinical sample. Thirty-one clinical participants and 32 matched controls received identical threat instructions regarding an upcoming speech-task following the computer task. Contrary to previous findings, clinical participants demonstrated a preference for attending toward faces than household objects, regardless of facial expression and more so than controls. Study 2 was conducted on a different clinical sample in an attempt to replicate the findings of Study 1 with clearer instructions regarding the upcoming speech task. Thirty-one clinical participants and 32 matched controls were administered the same speech threat and task instructions as those used by Mansell, W., Clark, D., Ehlers, A., and Chen, Y. P. (1999, Cognition and Emotion, 13(6), 673–690). Findings revealed the same pattern found in Study 1. Hence, in contrast to previous findings, both studies demonstrated that under conditions of social threat individuals diagnosed with generalised social phobia are more vigilant of pictorial faces generally than non-anxious individuals. The current findings lend support to cognitive models predicting that anxious individuals prefer to attend more to social cues of threat, in this case, faces. Explanations for these contradictory findings on attentional processing in social phobia are discussed with reference to the possible impact of perceived social threat and altered levels of state anxiety. Suggestion is also made for clearer research to reconcile these seemingly opposing results.

This study tested D. M. Clark and A. Wells’ (1995) proposition that negative post-event rumination is produced by negative self perceptions formed by socially phobic individuals during anxiety-provoking events. A socially phobic group and a nonanxious control group performed an impromptu speech, and appraised their performance immediately afterwards. One week later, participants were assessed as to how frequently they had had negative thoughts about the speech, how much they engaged with these thoughts, how distressing these thoughts were, and how much control they felt they had over the thoughts. The socially phobic group engaged in more negative rumination than controls on each of these levels, and perceived their performance as worse than controls immediately after the speech. Perception of performance was found to mediate the relationship between social anxiety and post-event rumination, providing support for Clark and Wells’ model.

Recent evidence suggests that video feedback helps improve the accuracy of self-ratings of performance in speech-anxious participants (e.g., Rapee & Hayman, 1996. Behaviour Research and Therapy, 34, 315–322.). Evidence also suggests that this effect is stronger for participants who have a more negatively distorted impression of their performance (self-observer discrepancy; Rodebaugh & Chambless, 2002. Cognitive Therapy and Research, 26, 629–644.). Data collected in Rapee and Hayman’s study were analyzed to determine if similar results would be found in this independent sample. Evidence was found for moderating effects of self-observer discrepancy comparable to those shown in Rodebaugh and Chambless. The self-observer discrepancy itself showed relatively weak relationships with general indices of social anxiety, but a very strong relationship with initial self-rating of performance. The results suggest that self-observer discrepancy is a predictor of response to video feedback, and that clinicians may be able to estimate the discrepancy by examining self-rating in conjunction with behavior.

Maladaptive interpretations of negative social events are considered to be an important cognitive feature of social phobia. The present study sought to investigate the content-specificity of interpretative biases in social phobia, and to examine the influence of concurrent depressive symptoms on the interpretation of different types of events. Individuals with social phobia were compared with non-clinical controls in terms of the degree to which they believed different interpretations of hypothetical social or non-social situations with either positive or negative outcomes. The effect of including scores on a measure of depression as a covariate in analyses was also examined. The results showed that individuals with social phobia were more likely than controls to believe negative interpretations of negative social events, regardless of their level of concurrent depression. Negative interpretative biases were also evident for other types of events when depression was not included as a covariate, although the majority of these biases were no longer evident when depression was controlled. Results are discussed in terms of their implications regarding cognitive differences between social anxiety and depression.

This study investigated the role of control beliefs in childhood anxiety disorders. The sample comprised 117 youth aged 9–17 years (86 met diagnostic criteria for an anxiety disorder and the remaining 31 were nonreferred comparison participants). Participants' anxiety levels and their perceptions of control over anxiety-related events (e.g., “things that might be harmful,” “feeling shaky or nervous”) were assessed. Findings indicated that perceived control over anxiety-related events was significantly negatively correlated with self-reported anxiety levels. Moreover, youth with anxiety disorders reported significantly lower perceived control about anxiety than the nonreferred participants. Findings were consistent with theory and suggest that anxiety disorders in youth are associated with beliefs that anxiety is uncontrollable.

Current theories predict that following a social–evaluative performance, people high in social anxiety will ruminate about the negative features of the event and, in turn, will show a bias toward recalling the negative aspects of the event. In this study participants presented an impromptu speech and were then provided with half positive and half negative feedback on their performance. A free-recall task was used to test immediate recall for the feedback. Participants returned 1 week later and were again tested on recall for the feedback as well as completing a questionnaire indicating the extent to which they engaged in both positive and negative rumination regarding the speech task during the preceding week. Evidence for a negative memory bias in the high socially anxious group (HI) was found at both times, however this negative bias did not increase over time. The hypothesis that the HI group would spend more time than the low socially anxious group ruminating over perceived negative aspects of the speech task was also supported. Social anxiety and depression scores were both uniquely associated with negative rumination, however when controlling for depression the Group × Rumination–Valence interaction became nonsignificant. The HI group did engage in greater levels of overall rumination however, even when depression scores were statistically controlled. There was no significant relationship shown between negative recall bias and negative rumination.

Conscious and preconscious processing of threatening information in posttraumatic stress disorder (PTSD) was studied using a masked modified Stroop paradigm. Twenty subjects who had been in motor vehicle accidents (MVAs) and met criteria for PTSD were compared with 20 MVA non-PTSD and 20 non-MVA subjects. PTSD subjects, but not MVA or non-MVA subjects, demonstrated greater interference on threat words in both the masked and unmasked conditions. The results suggest that preferential processing of threat-related information in PTSD occurs at a preconscious stage of processing.

A revised Stroop color-naming task was used to test hypotheses derived from Beck's cognitive theory of anxiety disorders which proposes that social phobics are hypervigilant to social-evaluative threat cues. Color-naming latencies for social and physical threat words were compared to matched neutral words for both social phobics and individuals with panic disorder. As predicted, social phobics showed longer latencies for social threat words, and panickers had longer latencies for physical threat words. Latency for color-naming social threat words correlated with self-reported avoidance among social phobics. These results are consistent with Beck's notion of self-schemata which facilitate the processing of threat cues. Methodological issues and clinical implications are discussed.