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Negative schemas lie at the core of many common and debilitating mental disorders. Thus, intervention scientists and clinicians have long recognized the importance of designing effective interventions that target schema change. Here, we suggest that the optimal development and administration of such interventions can benefit from a framework outlining how schema change occurs in the brain. Guided by basic neuroscientific findings, we provide a memory-based neurocognitive framework for conceptualizing how schemas emerge and change over time and how they can be modified during psychological treatment of clinical disorders. We highlight the critical roles of the hippocampus, ventromedial prefrontal cortex, amygdala, and posterior neocortex in directing schema-congruent and -incongruent learning (SCIL) in the interactive neural network that comprises the autobiographical memory system. We then use this framework, which we call the SCIL model, to derive new insights about the optimal design features of clinical interventions that aim to strengthen or weaken schema-based knowledge through the core processes of episodic mental simulation and prediction error. Finally, we examine clinical applications of the SCIL model to schema-change interventions in psychotherapy and provide cognitive-behavior therapy for social anxiety disorder as an illustrative example. [ABSTRACT FROM AUTHOR]

Background: Safety behaviours are hypothesized to play a vital role in maintaining social anxiety disorder (SAD), in part by orienting socially anxious individuals to adopt an avoidance-based mindset focused on self-protection and self-concealment. Evidence suggests an association between safety behaviour use and negative social outcomes for individuals with SAD. However, research has largely focused on the broad group of safety behaviours, whereas specific subtypes have received less attention. Aim: The present study aimed to further our understanding of the negative interpersonal consequences of specific types of safety behaviours for individuals with SAD by examining whether active, inhibiting/restricting, or physical symptom management safety behaviour use affects perceived likeability and authenticity during a conversation with a stranger. Method: Individuals with SAD (n = 29; mean age 35.5 years) and healthy control (non-SAD) participants (n = 40; mean age 18.6 years) engaged in a semi-structured social interaction with trained confederates. Results: Participants with SAD were perceived as significantly less likeable and authentic by the confederates, and rated themselves as significantly less authentic compared with those without SAD. The association between group status and likeability was mediated by the use of inhibiting/restricting safety behaviours and the association between group status and participant-rated authenticity was mediated by the use of both inhibiting/restricting and active safety behaviours, but not physical symptom management strategies. Conclusions: These results contribute to a growing literature suggesting that some, but not all, safety behaviours may play an important role in creating the negative social outcomes that individuals with SAD experience. [ABSTRACT FROM AUTHOR]

Background: Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes. Methods: A randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up. Results: Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up). Conclusions: Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment. [ABSTRACT FROM AUTHOR]

Individuals with social anxiety (SA) have well-established fears of being negatively evaluated and exposing self-perceived flaws to others. However, the unique impacts of pre-existing SA on well-being and interpersonal outcomes within the stressful context of the pandemic are currently unknown. In a study that took place in May 2020, we surveyed 488 North American community participants online. We used multiple linear regression to analyze whether retrospective reports of pre-pandemic SA symptoms predicted current coronavirus anxiety, loneliness, fears of negative evaluation, use of preventive measures, and affiliative outcomes, and whether pre-pandemic functional impairment and recent COVID-related stressors moderated these relations. Results highlighted the negative effects of pre-pandemic SA on current mental health functioning, especially for participants with higher pre-pandemic functional impairment and greater exposure to COVID-related stressors. Although participants with higher pre-pandemic SA reported currently feeling lonelier and more fearful of negative evaluation, they also endorsed greater efforts to affiliate with others. High SA individuals may have heightened desire for social support within the isolating context of the pandemic, in which COVID-related social restrictions enable greater avoidance of social evaluation but may also mask the enduring impairment associated with pre-pandemic SA. [ABSTRACT FROM AUTHOR]

Background: Imagery rescripting (IR) is an effective intervention for social anxiety disorder (SAD) that targets autobiographical memories of painful past events. IR is thought to promote needs fulfillment and memory updating by guiding patients to change unhelpful schema through addressing the needs of the younger self within the memory. Methods: Qualitative coding was used to examine the features of clinically relevant strategies enacted during IR to fulfill needs and update memories in 14 individuals with SAD. Results: Participants typically enacted multiple strategies to address the needs of the younger self during rescripting, with compassionate and assertive strategies used more frequently than avoidance. Most strategies were practically feasible and enacted by the imagined self rather than imagined others, with the majority of patients achieving a strong degree of needs fulfillment, especially when strategies were consistent with identified needs. Participants' reflections on how their memories have changed are provided from follow-up data collected 6 months post-intervention. Themes of self-reappraisal, self-compassion, and self-distancing are highlighted as potentially important for facilitating needs fulfilment and memory updating. Conclusions: Findings illuminate the clinical processes through which socially traumatic memories in SAD may be updated in IR by guiding patients to fulfill their needs and promote improved emotional health. [ABSTRACT FROM AUTHOR]

A unique feature of the global coronavirus pandemic has been the widespread adoption of mask-wearing as a public health measure to minimize the risk of contagion. Little is known about the effects of increased mask-wearing on social interactions, social anxiety, or overall mental health. Explore the potential effects of mask-wearing on social anxiety. We review existing literatures to highlight three preselected sets of factors that may be important in shaping the effects of mask-wearing on social anxiety. These are: (a) people's perceptions of the social norms associated with wearing masks; (b) people's experiences of the degree to which masks prevent accurate interpretation of social and emotional cues; and (c) people's use of masks as a type of safety behavior that enables self-concealment. APA PsycNet and PubMed were searched principally between September and November 2020 for articles describing the relationship between social anxiety, intolerance of uncertainty, ambiguous feedback, and safety behavior use and for research on the relationship between mask-wearing and social norms and social interactions. Information identified as relevant from articles of interest was extracted and included in our review. The effects of mask-wearing on social anxiety are likely to be substantial and clinically relevant. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusion Social anxiety is characterized by maladaptive self‐schemas about being socially undesirable. Self‐schemas are deeply held beliefs which are derived from negative autobiographical memories of painful social experiences. In contrast to the plethora of past research on negative memories in social anxiety, almost no research has investigated objectively positive social autobiographical memories. In this preregistered study, we examined the effects of social anxiety and self‐schemas on the appraised impact and meaningfulness of retrieved positive versus negative social autobiographical memories.Participants recruited via Prolific (final n = 343) were randomized to one of two conditions in which they were instructed to retrieve, orally narrate, and appraise a positive or negative social autobiographical memory of a specific experience from their personal past where they felt either valued or unvalued, respectively.Results demonstrated that participants rated their positive memories as more impactful and meaningful than negative memories overall, but this effect was reversed for participants who endorsed having either stronger negative self‐schemas or greater social anxiety symptoms, for whom negative memories were more impactful. Additionally, participants who endorsed having stronger positive self‐schemas rated their negative memories as significantly less impactful and their positive memories as nearly more impactful.Together, these results elucidate how self‐schemas and social anxiety are related to autobiographical memory appraisals, paving the way for future research on memory‐based therapeutic interventions for social anxiety disorder. [ABSTRACT FROM AUTHOR]

Cognitive models of social anxiety disorder suggest that memory biases for negative social information contribute to symptoms of social anxiety (SA). However, it remains unclear whether memory biases in SA are related to social information, specifically, and if so, whether the valence of such information would moderate memory performance. In the present study, 197 community participants were randomised to imagine themselves as the central character in either 10 social or 10 non-social scenarios. In both conditions, half of the scenarios ended with objectively positive outcomes and half ended with objectively negative outcomes. Results demonstrated that higher trait SA was related to memory performance for social scenarios only, and in particular to poorer memory for social scenarios that ended positively. Thus, the impact of SA on memory performance depended on how social information was framed, with higher SA related to poorer memory for positive social experiences. These context-specific effects contribute to the growing literature on positivity deficits in SA. [ABSTRACT FROM AUTHOR]

Negative mental imagery contributes to symptom maintenance in social anxiety disorder (SAD). Here, we investigated the effects of image morphing, a brief mental strategy designed to facilitate access to positive images. Participants with SAD and healthy control (HC) participants were randomly assigned to receive either image morphing or supportive counseling. Although initial training and 1-week daily practice were successful in equipping morphing participants across groups with the required skill, those assigned to morphing failed to demonstrate differential improvements in positive affect, negative affect, or self- perception relative to control participants during a subsequent social stress task. Ancillary analyses revealed that the number of positive details contained in retrieved or morphed images prior to the task significantly predicted the level of positive affect reported after the task, but this effect was observed only for HC participants. We discuss the need for future research to refine innovative imagery-based psychotherapeutic strategies for social anxiety. [ABSTRACT FROM AUTHOR]

Background/objectives: Research has demonstrated an association between social anxiety and impaired Theory of Mind (ToM). We assess whether ToM deficits occur even at a subclinical level of social anxiety and whether group differences in ToM performance are consistent with interpretation bias. We also explore potential reasons as to why socially anxious individuals may perform differently on ToM tasks.Methods/design: Undergraduate participants high (HSA; n = 78) and low (LSA; n = 35) in social anxiety completed a task of ToM decoding, the Reading the Mind in the Eyes (MIE), a task of ToM reasoning, the Movie for the Assessment of Social Cognition (MASC), and a post-task questionnaire about their experience completing the MASC.Results: HSAs performed marginally worse than LSAs on the MIE on neutrally valenced trials, and their pattern of errors may be consistent with a negative interpretation bias. HSAs and LSAs did not differ overall in performance on the MASC, though HSAs reported experiencing more confusion and distress than LSAs during the task, and this distress was associated with more MASC errors for HSA participants only. These results provide insight into the nature of ToM ability in socially anxious individuals and highlight important avenues for future research. [ABSTRACT FROM AUTHOR]

Individuals with social anxiety disorder (SADs; n  = 41) and healthy controls (HCs; n  = 40) were administered the Waterloo Images and Memories Interview , in which they described mental images that they tend to experience in both anxiety-provoking and non-anxiety-provoking social situations. Participants then recalled, in as much detail as possible, specific autobiographical memories of salient aversive and non-aversive social experiences that they believed led to the formation of these images. Audio-recorded memory narratives were transcribed and coded based on the procedure of the Autobiographical Interview , which provides a precise measure of the degree of episodic detail contained within each memory. Participants also rated the subjective properties of their recalled memories. Results revealed that participants across the two groups retrieved equivalent rates of both aversive and non-aversive social memories. However, SAD participants' memories of aversive events contained significantly more episodic detail than those of HCs, suggesting that they may be more highly accessible. Moreover, participants with SAD appraised their memories of aversive experiences as more distressing and intrusive than HCs, and perceived them as having a significantly greater influence on their self-perception. In contrast, no group differences were observed for memories of non-aversive events. Findings have the potential to shed new light on autobiographical memory in SAD, with implications for psychotherapeutic intervention. [ABSTRACT FROM AUTHOR]

Forty participants with social anxiety disorder (SAD) and 42 healthy controls (HCs) were randomized to watch a confederate deliver a speech in either a visibly anxious or confident manner. Participants rated their perception of the presenter’s desirability across five attributes and compared themselves to the presenter along these same dimensions. Participants then delivered their own speeches, and were rated in a similar manner by trained research assistants who were naïve to participants’ group status and study objectives. Results demonstrated that all participants, irrespective of group status, judged the visibly anxious presenter as being less desirable and the confident presenter as more desirable. Socially anxious participants tended to view themselves as inferior to confident others. Coders also rated participants with SAD, based on their speeches, as being less interpersonally desirable than HCs. These results suggest that individuals who appear visibly anxious may be objectively disadvantaged in their ability to make a positive first impression on others. We discuss these findings in relation to theoretical models of social anxiety and explore how to address such interpersonal factors in psychological interventions for SAD. [ABSTRACT FROM AUTHOR]

Background Post-event processing (PEP) is defined as repetitive negative thinking following anxiety provoking social events. PEP is thought to maintain anxiety symptoms in Social Anxiety Disorder (SAD) but little is known about the specific factors that contribute to the maintenance of PEP. Aims The current study investigated how perceptions of performance and positive metacognitive beliefs might contribute to the persistence of PEP. Method Participants with SAD ( n = 24) as well as anxious ( n = 24) and healthy ( n = 25) control participants completed a standardized social performance task in the lab. Their engagement in PEP and perceptions of performance were assessed in the week that followed. Results Immediately following the social task, individuals with SAD rated their performance more negatively and endorsed a greater number of positive metacognitive beliefs about PEP than did participants in both control groups. Importantly, both metacognitive beliefs and initial negative self-ratings of performance mediated the relationship between group status and PEP in the days following the event. Conclusions These results are consistent with cognitive and metacognitive models of SAD and enhance our understanding of the cognitive processes which may function to initiate and maintain negative thinking patterns in SAD. [ABSTRACT FROM AUTHOR]

Social anxiety (SA) and online privacy concerns (OPCs) are conceptually distinct fears, but both may be activated by Internet-based social contexts. Whereas SA is focused on being the object of interpersonal evaluation, OPC is focused on preventing others from gaining unauthorized access to private personal information. No research to date has investigated how SA and OPCs may uniquely or interactively predict individual differences in online interaction anxiety or attitudes and preferences about online communication. Participants ( N = 374) completed the Social Phobia Inventory and measures of OPCs, online interaction anxiety, and attitudes related to online communication. The results revealed that SA and OPCs were not correlated with one another; however, they each uniquely predicted significant variance in particular outcomes, with no interactive effects. Findings help to illuminate the ways in which online communication preferences may be differentially shaped by people's levels of SA and OPCs, respectively. Theoretical implications and applications are discussed. [ABSTRACT FROM AUTHOR]

The pain of social exclusion can motivate people to capitalize on opportunities to reconnect with others and repair their self-esteem and feelings of belongingness. This effect is often diminished for those with high social anxiety (HSA). Prior research suggests this may be due to their diminished capacity for recognizing and emotionally responding to relational reward cues. We investigated whether non-relational success experiences in the aftermath of exclusion may be an alternative means of repairing threatened self-esteem and belongingness in HSA individuals. In a preregistered, online study, we threatened belongingness and self-esteem in 422 participants by excluding them in a Cyberball game and then assigned them to one of three conditions: Relational Repair, Non-Relational Repair, or a No-Repair control condition. Results showed that both repair contexts facilitated needs repair relative to the no-repair control condition, and mediation analyses suggested this effect was driven by increased positive affect (PA). HSA individuals were less likely to restore needs regardless of condition and this effect appeared to be driven by low PA. Findings emphasize the critical role of PA for restoring threatened needs in the aftermath of exclusion and suggest that HSA inhibits needs repair processes across both relational and non-relational reward contexts. • Social exclusion motivates people to repair their self-esteem and need for belonging. • Those with high social anxiety (HSA) struggle to repair these social wounds. • Dampened reward responsivity in social contexts may disrupt repair processes for HSAs. • HSA individuals were less likely to experience positive affect and restore needs. • This effect was consistent across rewarding social and non-social contexts. [ABSTRACT FROM AUTHOR]

We present a study designed to investigate fear of positive vs. negative evaluation within the context of a laboratory-based paradigm designed to evoke social threat. Eighty-nine undergraduates with high (n = 43) or low (n = 46) levels of trait social anxiety took part in a "getting acquainted" task. Participants rated their anxiety about receiving prospective positive vs. negative evaluation in anticipation of receiving public feedback on a filmed introduction of themselves that they had made for an unknown social partner whom they expected they would later meet. Results demonstrated, in contrast to extant theories of fear of positive evaluation in social anxiety, that all participants, including those with high levels of social anxiety, rated the prospect of positive evaluation as anxiety reducing. This finding raises important questions about the construct of fear of positive evaluation and how to measure it "in vivo" in an ecologically valid manner. [ABSTRACT FROM AUTHOR]

In this short paper in honour of my father's Festschrift, I describe a recent collaboration with him in which we joined forces to investigate the nature of autobiographical images and memories in social anxiety. I outline our work together and the unique insights that were gleaned from our interactive contributions. Then, I reflect on how this collaboration has helped to lay the foundation for subsequent work in my lab and illuminate new directions in my program of research, enhance my career as a scientist-practitioner, and ultimately, enrich both my personal and professional identities. In so doing, I aim to highlight one of the most important and enduring aspects of my father's legacy: the profound positive impact he has on the people with whom he has worked. [ABSTRACT FROM AUTHOR]

The current study examined whether high socially anxious individuals overestimate the cost of committing social blunders due to the mental heuristic known as the focusing illusion, specifically that they may focus on salient blunder-related information without considering other inconspicuous blunder-unrelated information. Two hundred and fifty-nine undergraduate participants across the social anxiety spectrum imagined and estimated costs associated with committing hypothetical blunders. Participants were randomly assigned to one of four conditions: (1) No defocusing; (2) indirect defocusing; (3) direct defocusing; and (4) indirect plus direct defocusing. Indirect defocusing involved participants generating factors that they thought would influence how they would be judged such that they could potentially consider the impact of blunder-unrelated information on others' judgments. Direct defocusing involved participants being directly provided with blunder-unrelated information as part of the hypothetical blunder descriptions. Results revealed that direct defocusing lowered perceived costs across social anxiety levels, whereas indirect defocusing did not induce participants to consider blunder-unrelated information and did not reduce perceived costs. Novel treatment approaches to reduce cost estimates of blunders for social anxiety disorder are discussed. [ABSTRACT FROM AUTHOR]

Negative mental images in social anxiety disorder (SAD) are often rooted in autobiographical memories of formative, distressing life events. In the present study, 25 participants with SAD retrieved an idiosyncratic negative mental image and associated autobiographical memory. Participants were then randomly assigned either to a single-session of imagery rescripting (IR) targeting the retrieved autobiographical memory or to a non-intervention control condition (no-IR). Outcomes were assessed one week later. Compared to control participants, those who received IR experienced substantial reduction in SAD symptoms accompanied by more positive and less negative appraisals of their autobiographical memories. Moreover, IR relative to no-IR participants reported marked shifts in the content, validity, and accuracy of their memory-derived negative core beliefs about self and others, but not about the world. Results support the promise of IR as a stand-alone intervention for SAD and suggest important directions for future research to enhance our understanding of the cognitive mechanisms that underlie its effects. [ABSTRACT FROM AUTHOR]

It has been demonstrated that verbal context information alters the neural processing of ambiguous faces such as faces with no apparent facial expression. In social anxiety, neutral faces may be implicitly threatening for socially anxious individuals due to their ambiguous nature, but even more so if these neutral faces are put in self-referential negative contexts. Therefore, we measured event-related brain potentials (ERPs) in response to neutral faces which were preceded by affective verbal information (negative, neutral, positive). Participants with low social anxiety (LSA; n = 23) and high social anxiety (HSA; n = 21) were asked to watch and rate valence and arousal of the respective faces while continuous EEG was recorded. ERP analysis revealed that HSA showed elevated P100 amplitudes in response to faces, but reduced structural encoding of faces as indexed by reduced N170 amplitudes. In general, affective context led to an enhanced early posterior negativity (EPN) for negative compared to neutral facial expressions. Moreover, HSA compared to LSA showed enhanced late positive potentials (LPP) to negatively contextualized faces, whereas in LSA this effect was found for faces in positive contexts. Also, HSA rated faces in negative contexts as more negative compared to LSA. These results point at enhanced vigilance for neutral faces regardless of context in HSA, while structural encoding seems to be diminished (avoidance). Interestingly, later components of sustained processing (LPP) indicate that LSA show enhanced visuocortical processing for faces in positive contexts (happy bias), whereas this seems to be the case for negatively contextualized faces in HSA (threat bias). Finally, our results add further new evidence that top-down information in interaction with individual anxiety levels can influence early-stage aspects of visual perception. [ABSTRACT FROM AUTHOR]

In a study designed to clarify and extend previous research on social blunders in social anxiety, 32 participants with social anxiety disorder (SAD), 25 anxious control (AC) participants with anxiety disorders other than SAD, and 25 healthy control (HC) participants with no history of anxiety problems estimated the costs of hypothetical blunders committed by either themselves or by others. Participants with SAD rated the costs of their own imagined blunders as highly inflated relative to both AC and HC participants. In contrast, for blunders participants imagined others committing, only SAD and healthy control participants’ cost estimates differed from one another. Moreover, concerns about revealing self-flaws – and, in particular, about appearing socially incompetent – accounted for significant, unique variance in SAD participants’ exaggerated cost estimates of self blunders, over and above symptoms of social anxiety and depression. These results enhance our understanding of how and why socially anxious individuals negatively appraise social blunders and help to clarify the potential function and role of social mishap exposures in the treatment of SAD. [ABSTRACT FROM AUTHOR]

Background: Video feedback (VF) interventions effectively reduce social anxiety symptoms and negative self-perception, particularly when they are preceded by cognitive preparation (CP) and followed by cognitive review. Aims: In the current study, we re-examined data from a study on the efficacy of a novel VF intervention for individuals high in social anxiety to test the hypothesis that physical appearance anxiety would moderate the effects of VF. Method: Data were analyzed from 68 socially anxious participants who performed an initial public speech, and were randomly assigned to an Elaborated VF condition (VF plus cognitive preparation and cognitive review), a Standard VF condition (VF plus cognitive preparation) or a No VF condition (exposure alone), and then performed a second speech. Results: As hypothesized, when appearance concerns were low, both participants who received Elaborated and Standard VF were significantly less anxious during speech 2 than those in the No VF condition. However, when levels of appearance concern were high, neither Elaborated nor Standard VF reduced anxiety levels during speech 2 beyond the No VF condition. Conclusions: Results from our analog sample suggest the importance of tailoring treatment protocols to accommodate the idiosyncratic concerns of socially anxious patients. [ABSTRACT FROM AUTHOR]

Abstract: Background and objectives: The link between social anxiety (SA) and maladaptive emotion regulation has been clearly established, but little is known about the spontaneous regulation strategies that may be activated during social stress by negative involuntary mental images and whether the nature of such strategies might distinguish individuals with high vs. low trait SA. Methods: Participants with high (n = 33) or low (n = 33) trait SA performed an evaluative speech and reported whether they experienced an involuntary negative mental image during the task. They also rated their negative affect (NA) and positive affect (PA) and the extent to which they viewed their image as being controllable and malleable. Finally, they described the types of strategies they spontaneously used to try to control or change their image intrusions. Reported strategies were then subjected to a content analysis and categorized by blinded coders. Results: Among high SA participants, image controllability was both diminished overall and positively correlated with PA. Whereas 90% of low SA individuals reported that they spontaneously self-regulated by altering the content or perceptual features of their images, only about half of the high SA participants used this strategy, with the other 50% reporting that they either suppressed their images or succumbed passively to them in whatever form they took. Limitations and conclusions: Although these initial findings require replication in future experimental studies on clinical samples, they also help to enrich our understanding of the strategies that are commonly used by high and low SA individuals to manage their image intrusions during in-vivo stress and suggest potential avenues for future research on the role of imagery in adaptive and maladaptive emotion regulation. [Copyright &y& Elsevier]

Abstract: It has been proposed that self-portrayal concerns – fundamental worries that particular negative self-attributes will become exposed during social encounters and criticized by others – underlie the experience of social anxiety (SA) and drive associated avoidance and safety behaviors (Moscovitch, 2009). The development of the Negative Self Portrayal Scale (NSPS) to assess such concerns across the dimensions of social competence, signs of anxiety, and physical appearance has helped yield promising initial findings that support the basic tenets of Moscovitch's (2009) theoretical model in samples of undergraduate students (Moscovitch & Huyder, 2011). The present study investigated the nature of self-portrayal concerns and their relation to affect and behavior in a sample of 194 community-based participants consisting of (a) 62 individuals with a principal diagnosis of generalized SAD, either with (n = 35) or without (n = 27) an additional depressive disorder diagnosis, (b) 51 individuals with another principal anxiety disorder diagnosis, either with (n = 22) or without (n = 29) an additional diagnosis of SAD, and (c) 81 healthy controls. Participants completed trait questionnaires, daily diaries of naturalistic social encounters, and a laboratory-based speech task. Results demonstrated (a) that a diagnosis of SAD confers unique risk for elevated self-portrayal concerns, (b) that such concerns predict significant variance in safety behavior use across diverse contexts, and (c) that the use of safety behaviors mediates the relation between such concerns and the experience of heightened negative affect. Implications for case conceptualization and treatment of SAD are discussed. [Copyright &y& Elsevier]

The features of negative mental images and associated autobiographical memories were compared in high ( n = 39) versus low ( n = 46) socially anxious (HSA and LSA) participants using a modified version of the Waterloo Images and Memories Interview (WIMI; Moscovitch, Gavric, Bielak, Merrifield, & Moscovitch, 2011) either in anticipation of a videotaped speech or during post-event processing. Results indicated that negative images and memories were endorsed more frequently by HSA (vs. LSA) participants, and by those in the Anticipation ( vs. Post-Event Processing) condition. Moreover, HSA relative to LSA participants reported more negative emotional consequences associated with bringing their images and memories to mind. Finally, post-event relative to anticipatory images and memories were associated with greater reported negative impact on participants' perceptions of self and others. Results and their potential theoretical and clinical implications are discussed in relation to contemporary cognitive-behavioral models of social anxiety. [ABSTRACT FROM AUTHOR]

Abstract: Seventy high socially anxious (HSA) and 74 low socially anxious (LSA) participants rated perceived interpersonal and emotional consequences of both (a) autobiographical social blunders recalled from their own lives and (b) imagined blunders presented in standardized hypothetical social scenarios. Ratings of participants’ autobiographical blunders were also provided by research assistants who were blind to hypotheses. Results indicated that HSA participants overestimated the negative consequences of their own autobiographical blunders. These negative perceptions among HSA participants extended to imagined blunders, even when participants were instructed to imagine a third party other than themselves as the person committing the blunder. This pattern of results suggests the conclusion that the perceived consequences of social blunders among HSA individuals are driven by the belief that social standards are high, inflexible, or both. [Copyright &y& Elsevier]

Abstract: High (n =41) and low (n =39) socially anxious (SA) participants completed the Waterloo Images and Memories Interview (WIMI), a new assessment tool that measures the accessibility and properties of mental images and associated autobiographical memories that individuals may experience across both anxiety-provoking (negative) and non-anxiety-provoking (positive) social situations. Results indicated that both high and low SA individuals experience negative images and associated autobiographical memories in anxiety-provoking social situations, but the rates of endorsement of such images and memories among high SA participants were substantially lower than those reported in recent studies. Moreover, whereas low SA individuals were capable of accessing a relatively balanced array of both negative and positive self-representations that were rich in episodic detail, high SA individuals retrieved a higher, more unbalanced ratio of negative-to-positive images and memories, as well as impoverished positive images that were significantly degraded in episodic detail. Finally, negative images influenced the two groups differently, with high SA individuals experiencing more negative emotional and cognitive consequences associated with bringing such images to mind. These results are discussed in relation to theoretical models of learning and memory within the context of contemporary cognitive behavioral models of social anxiety. [Copyright &y& Elsevier]

Abstract: Although previous studies have shown that socially anxious individuals exhibit greater relative right frontal electroencephalogram (EEG) activity at rest, no studies have investigated whether improvements in symptoms as a result of treatment are associated with concomitant changes in resting brain activity. Regional EEG activity was measured at rest in 23 patients with social anxiety disorder (SAD) before and after cognitive behavioral therapy (CBT). Results indicated that patients shifted significantly from greater relative right to greater relative left resting frontal brain activity from pre- to posttreatment. Greater left frontal EEG activity at pretreatment predicted greater reduction in social anxiety from pre- to posttreatment and lower posttreatment social anxiety after accounting for pretreatment symptoms. These relations were specific to the frontal alpha EEG asymmetry metric. These preliminary findings suggest that resting frontal EEG asymmetry may be a predictor of symptom change and endstate functioning in SAD patients who undergo efficacious psychological treatment. [Copyright &y& Elsevier]

Abstract: The Negative Self-Portrayal Scale (NSPS) is a new questionnaire designed to assess the extent to which individuals are concerned that specific self-attributes they view as being deficient will be exposed to scrutiny and evaluation by critical others in social situations. These concerns have been proposed to drive symptoms of social anxiety and account for individual differences in social fears and avoidance behaviors (). Here, we introduce the NSPS and examine its factor structure and psychometric properties across two large samples of North American undergraduate students with normally distributed symptoms of social anxiety. Exploratory and confirmatory factor analyses supported a 3-factor solution representing concerns about (a) social competence; (b) physical appearance; and (c) signs of anxiety. The NSPS was found to have good internal consistency and test-retest reliability, strong convergent validity, and adequate discriminant validity. In addition, NSPS total scores accounted for a significant proportion of unique variance in self-concealment (i.e., safety) behaviors over and above established symptom measures of social interaction anxiety, social performance anxiety, and depression. Results are discussed in relation to theoretical models of social anxiety and the potential utility of the NSPS for both clinical research and practice. [Copyright &y& Elsevier]

Coupling between EEG delta and beta oscillations is enhanced among anxious and healthy individuals during anticipatory anxiety. EEG coupling patterns associated with psychotherapy have not yet been quantified in socially anxious individuals. In this study, we used a double baseline, repeated measures design, in which 25 adults with a principal diagnosis of social anxiety disorder completed 12 weekly sessions of standardized group cognitive behavioral therapy and four EEG assessments: two at pretreatment, one at midtreatment, and one at posttreatment. Treatment was associated with reductions in symptom severity across multiple measures and informants, as well as reductions in delta-beta coupling at rest and during speech anticipation. Moreover, the clinical group exhibited greater coupling at pretreatment than did post hoc control participants with low social anxiety. The EEG cross-frequency profiles in the clinical group normalized by the posttreatment assessment. These findings provide evidence of concomitant improvement in neural and behavioral functioning among socially anxious adults undergoing psychotherapy. [ABSTRACT FROM PUBLISHER]

Abstract: Patterns of synchrony in repeated measures of heart rate, skin conductance levels, negative affect, and positive affect were investigated in patients with social anxiety disorder and non-anxious controls during a speech task. Despite expected low levels of absolute concordance between measures of affect and arousal overall, results revealed clearly defined and specific patterns of emotional response coherence that distinguished between the two groups and depended on the types of measures used. Specifically, findings demonstrated that (a) for both patients and controls, increased heart rate was significantly synchronized with increased negative affect, with patients showing overall stronger levels of synchrony between these two measures than controls; (b) for controls only, increased heart rate was significantly synchronized with increased positive affect; and (c) for patients only, increased skin conductance was significantly synchronized with both increased negative affect and decreased positive affect. These findings are discussed in relation to current conceptualizations of the construct of emotion as well as directions for future research and potential implications for clinical practice. [ABSTRACT FROM AUTHOR]

Abstract: Video feedback (VF) with cognitive preparation (CP) has been widely integrated into cognitive-behavioral therapy (CBT) protocols for social anxiety disorder (SAD) due to its presumed efficacy in improving negative self-perception. However, previous experimental studies have demonstrated that improvements in negative self-perception via VF+CP do not typically facilitate anxiety reduction during subsequent social interactions – a troubling finding for proponents of cognitive models of social anxiety. We examined whether VF+CP could be optimized to enhance participants’ processing of corrective self-related information through the addition of a post-VF cognitive review (CR). Sixty-eight socially anxious individuals were randomly assigned to perform two public speeches in one of the following conditions: a) exposure alone (EXP); b) CP+VF; and c) CP+VF+CR. Those in the CP+VF+CR condition demonstrated marginally significant reductions in anxiety from speech 1 to speech 2 relative to those who received EXP – an improvement not shown for those in the CP+VF condition. Furthermore, only those who received CP+VF+CR demonstrated significant improvements in self-perception and performance expectations relative to EXP. Decreases in anxiety among participants who received CP+VF+CR relative to EXP were fully mediated by improvements in self-perception. Implications are discussed in the context of cognitive models of social anxiety and mechanisms of exposure-based learning. [ABSTRACT FROM AUTHOR]

Abstract: Sixty-seven individuals with social phobia (social anxiety disorder) and 60 healthy controls rated their perceived standing relative to others on 13 self-attribute dimensions, their level of certainty concerning those standings, and the importance of each dimension. As expected, individuals with social phobia provided self-ratings that were significantly more negative than controls across all dimensions. In addition, positive self-views were equated with higher levels of certainty and importance for controls, but not for individuals with social phobia. Thus, whereas reports of control participants reflected a healthy, positive framing of self-views, the ratings of clinical participants demonstrated an orientation toward self-framing that was neither positive nor negative. Together, these novel findings shed light on the nature of self-appraisals in social anxiety. Implications of these results are discussed in terms of contemporary cognitive-behavioral models of social phobia. [Copyright &y& Elsevier]

Abstract: Social anxiety and embarrassment are closely related constructs, both of which are relevant to the study of shyness. To examine the psychophysiological correlates of anxiety and embarrassment in relation to shyness, we measured autonomic arousal (heart rate, respiratory sinus arrhythmia, skin conductance level, and blushing response) in shy and non-shy female participants while they performed tasks designed to elicit either social anxiety or embarrassment. Results indicated that social anxiety and embarrassment are difficult to disentangle at the autonomic level. Blushing may be an important psychophysiological marker of shyness and social anxiety. [Copyright &y& Elsevier]

The present study investigated the phenomenon of sudden gains in 107 participants with social phobia (social anxiety disorder) who received either cognitive-behavioral group therapy or exposure group therapy without explicit cognitive interventions, which primarily used public speaking situations as exposure tasks. Twenty-two out of 967 session-to-session intervals met criteria for sudden gains, which most frequently occurred in Session 5. Individuals with sudden gains showed similar improvements in the 2 treatment groups. Although cognitive-behavioral therapy was associated with more cognitive changes than exposure therapy, cognitive changes did not precede sudden gains. In general, the results of this study question the clinical significance of sudden gains in social phobia treatment. [ABSTRACT FROM AUTHOR]

To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive-behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated 91% of the improvements in depression over time. Conversely, decreases in depression only accounted for 6% of the decreases in social anxiety over time. Changes in social anxiety fully mediated changes in depression during the course of treatment. The theoretical and clinical implications of these findings for the relationship between anxiety and depression are discussed. [ABSTRACT FROM AUTHOR]