Search

Although cognitive behavioral group therapy (CBGT) is an effective treatment for social anxiety disorder, many socially anxious patients are still symptomatic after treatment. A possible improvement for CBGT could come from the more experiential group psychotherapy, psychodrama (PD). The integration of CBGT and PD (labeled CBPT) might offer an even more effective treatment than CBGT or PD alone. With the present study, we investigated first whether three kinds of group therapy (CBGT, PD, and CBPT) are superior to a waitlist (WL). Second, we investigated whether CBPT is more effective than CBGT or PD alone. One hundred and forty-four social anxiety patients were randomly assigned to three active conditions or a WL. After wait, WL-participants were randomized over the active treatment conditions. The results of a multilevel analysis showed that all treatments were superior to WL in reducing social anxiety complaints. Only CBGT and CBPT differed significantly from WL in reducing fear of negative evaluations. There were no significant differences between active conditions in any of the variables after treatment and after six-month follow up, neither were there significant differences in treatment dropout. First there is the lack of a long-term follow-up. Second, because of loss of participants, we did not reach the planned numbers in the active treatment groups in comparison to WL. Moreover, this study was not designed as a non-inferiority or equivalence trial. Although the integrative CBPT showed good results, it was not more effective than the other treatments. • All treatments were superior to the waiting list group in reducing social anxiety. • Compared to WL, CBGT and CBPT but not PD decreased fear of negative evaluation. • Comparing only active treatments, no treatment was superior to another treatment. [ABSTRACT FROM AUTHOR]

Research has shown that patients with a social anxiety disorder (SAD) show social performance deficits. These deficits are a maintaining factor in SAD, as mending social behavior improves interpersonal judgments and reduces social anxiety. Thus finding ways to enhance social behavior is evidently of importance in the treatment of SAD. This double-blind, placebo-controlled study investigated the effect of an intranasal administration of the hormone oxytocin (24 IU) on social behavior and anxious appearance in SAD patients (N = 40) and healthy controls (N = 39). Forty minutes after oxytocin administration participants were submitted to two live social situations (i.e., a waiting room situation and a getting acquainted task). The participants ('self-rated') and observers ('observer-rated') scored participants' social behavior and anxious appearance. Participants also rated their positive and negative affect. Confirming the social performance deficits in SAD, observers regarded SAD patients as more anxious and less socially skilled than healthy controls. Results indicated oxytocin-induced improvement of observer-rated social behavior in SAD patients compared to placebo but only in the getting acquainted task. This effect was not perceived as such by patients themselves and did not improve their affect ratings. In conclusion, this study found support for the idea that oxytocin helps SAD patients to perform better in social interactions, although this improvement seemed context-dependent (i.e., only present in the getting-acquainted task) and 'not perceived by the patient. [ABSTRACT FROM AUTHOR]

From a biopsychological perspective, social anxiety can be seen as a proneness to act submissively in order to reduce conflict and avoid rejection by others. Research into this framework so far specifically focused on the self-perceived social world. Less is known about the relation between social anxiety and one's actual position within a group, as perceived by group members. In addition, research to date showed that social anxiety seems related to social rejection after short interactions, but it is not known if social anxiety affects affiliation ratings after more prolonged interactions. Therefore, the current study tested if social anxiety is related to lower dominance and affiliation ratings by self and others in groups that exist for longer periods of time. Seventy-six participants from eight groups rated themselves and their group members on the dimensions of dominance and affiliation. The results showed that social anxiety was negatively related to dominance but not to affiliation. These results indicate that it is necessary to investigate social evaluations of individuals with social anxiety in more naturalistic and less structured settings. Also, the results hint that it might be worthwhile to investigate if specific safety behaviors are related to lower dominance ratings by others. [ABSTRACT FROM AUTHOR]

Socially anxiety may be related to a different pattern of facial mimicry and contagion of others’ emotions. We report two studies in which participants with different levels of social anxiety reacted to others’ emotional displays, either shown on a computer screen (Study 1) or in an actual social interaction (Study 2). Study 1 examined facial mimicry and emotional contagion in response to displays of happiness, anger, fear, and contempt. Participants mimicked negative and positive emotions to some extent, but we found no relation between mimicry and the social anxiety level of the participants. Furthermore, socially anxious individuals were more prone to experience negative emotions and felt more irritated in response to negative emotion displays. In Study 2, we found that social anxiety was related to enhanced mimicry of smiling, but this was only the case for polite smiles and not for enjoyment smiles. These results suggest that socially anxious individuals tend to catch negative emotions from others, but suppress their expression by mimicking positive displays. This may be explained by the tendency of socially anxious individuals to avoid conflict or rejection. [ABSTRACT FROM AUTHOR]

Blushing-fearful individuals often expect that others will judge them negatively. In two studies, we tested if this could be explained by having relatively strict beliefs about what is appropriate social behaviour. Study 1 used a student sample ( n = 74), whereas study 2 compared a clinical treatment-seeking sample of blushing-fearful individuals ( n = 33) with a non-anxious control group ( n = 31). In both studies, participants were asked to read descriptions of common behaviours that could be considered as breaching the prevailing social norms but not necessarily so. Participants indicated (i) to what extent they considered these behaviours as violating the prevailing norm and (ii) their expectation of observers' judgments. Study 1 showed that strict norms were indeed related to fear of blushing and that the tendency of fearful participants to expect negative judgments could at least partly explain this relationship. Study 2 showed that high-fearful and low-fearful individuals do indeed differ in the strictness of their norms and that especially the norms that individuals apply to themselves might be relevant. These findings may provide fresh clues for improving available treatment options. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Blushing-fearful individuals attribute relatively strict social norms to other people about which behaviours are appropriate and which are not and have stricter personal norms as well., Blushing-fearful individuals' tendency to expect overly negative judgments in ambivalent social situations can partly be explained by their relatively strict social norms., Having relatively strict social norms may (also) explain why blushing-fearful individuals report to blush often and intensely., It may be worthwhile to address strict social norms in therapy for fear of blushing. [ABSTRACT FROM AUTHOR]

The article discusses the social effects of facial blushing. It notes on the occurrence of blushing in several situations such as after a mishap and after being complimented. It states that blush response occur in visible parts of the body. The sympathetic branch of the autonomic nervous system controls blushing.

Blushing is restricted to the facial area that is uncovered and in the center of social attention. Together with the observation that blushing typically occurs in interpersonal situations, it has been proposed that the blush might have acquired signaling properties with relevant social implications. Following such a functional perspective, this article evaluates the signal value and social effects of the blush. First, it is argued that the blush fulfils all criteria for being a reliable social signal. It seems impossible to fake or to suppress, and it seems to co-occur with a specific mental state: The acute awareness that one's goal of esteem before others is at stake. Second, it is illustrated that the social effects of the blush may greatly vary as a function of context. In contexts that clearly imply some kind of misbehavior, the blush has face-saving properties. Yet, in many other contexts, such as merely being the center of attention or situations that are ambiguous with regard to the blushing actors' antecedent behaviors, the blush may have undesirable effects. Third, it is illustrated that the signal value of the blush not only affects the observers but also the blushing actors. It is shown that the anticipated influence of one's blushing on other people's judgments may help explain why actors often consider blushing as a highly undesirable response, and why some people may even develop a phobic fear of blushing. [ABSTRACT FROM AUTHOR]

The clinical impression is that people who fear blushing do not easily seek psychological help for their complaints. Therefore, we designed a low-threshold psychoeducational group intervention to reduce fear of blushing. The intervention followed a cognitive-behavioural approach, but in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The effectiveness of the course in reducing fear of blushing and social anxiety was tested in a group of blushing-fearful individuals ( n = 47) by using an uncontrolled study design. The course consisted of six weekly sessions and one booster session 3 months after the last regular session. Assessments took place upon application, immediately before the intervention, after the sixth session, before the booster session, and at 1-year follow-up. Results showed that the course was effective in reducing fear of blushing as well as symptoms of social anxiety. The positive effect of the course on anxiety measures suggests that it might be a promising approach for treating fear of blushing. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message The course 'dealing with fear of blushing' is a cognitive-behavioural group intervention in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'., The course was effective in reducing anxiety complaints. An effect size of 1.4 and a reduction of approximately 30 points on this Blushing, Trembling and Sweating Questionnaire are comparable with what was reported for individual cognitive-behavioural treatments., Participants evaluated the course positively. [ABSTRACT FROM AUTHOR]

Abstract: It has been proposed that blushing-fearful individuals overestimate both the probability and the interpersonal costs of blushing. To study these judgmental biases, we presented a treatment-seeking sample of blushing-fearful individuals a series of vignettes describing social events and tested whether this clinical sample would overestimate the costs and probability of blushing compared to non-fearful controls. To test if blushing-fearfuls overestimate and/or low-fearful individuals underestimate the cost of displaying a blush, a second experiment examined the effects of blushing in these situations on observers’ judgments. Experiment 1 showed that blushing-fearfuls indeed have judgmental biases for the probability and costs of blushing. Experiment 2 showed that the observers’ judgments were very similar to the judgments anticipated by the low-fear group in Experiment 1. Thus the judgmental biases that were evident in the high-fearfuls can be best interpreted as an overestimation of the social costs of displaying a blush. These findings help improving our understanding of the mechanisms that may drive blushing phobia and also point to the clinical implication that it might be worthwhile to challenge blushing-fearfuls’ judgmental biases. [Copyright &y& Elsevier]

Abstract: Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety–social rejection relationship. This study studied two pathways hypothesized to lead to poor social performance in social anxiety: increased self-focused attention and negative beliefs. State social anxiety was experimentally manipulated in high and low-blushing-fearful individuals by letting half of the participants believe that they blushed intensely during a 5 min getting-acquainted interaction with two confederates. Participants rated their state social anxiety, self-focused attention, and level of negative beliefs. Two confederates and two video-observers rated subsequently likeability (i.e., social rejection) and social performance of the participants. In both groups, the social anxiety–social rejection relationship was present. Although state social anxiety was related to heightened self-focused attention and negative beliefs, only negative beliefs were associated with relatively poor social performance. In contrast to current SAD models, self-focused attention did not play a key-role in poor social performance but seemed to function as a by-product of state social anxiety. Beliefs of being negatively evaluated seem to elicit changes in behavioral repertoire resulting in a poor social performance and subsequent rejection. [ABSTRACT FROM AUTHOR]

The present study examines two mechanisms that might explain why blushing-fearful individuals fear blushing: Judgmental biases for blushing in ordinary social situations that usually do not elicit a blush, and negative conditional cognitions about blushing irrespective of situation. A web-based self-report measure, linked to a German internet forum for people with fear of blushing, was completed by a group of high blushing-fearful participants ( n = 155) and a low fear group ( n = 61). Supporting the idea that cognitive biases are involved in fear of blushing, blushing-fearful participants showed inflated estimates of both the probability and the costs of blushing in these situations. In addition, blushing-fearful individuals were characterized by relatively negative conditional cognitions about blushing. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, we investigate whether people attribute costs to displaying a blush. Individuals with and without fear of blushing were invited to have a short conversation with two confederates. During the conversation, half of the individuals received the feedback that they were blushing intensely. The study tested whether the belief that one is blushing leads to the anticipation that one will be judged negatively. In addition, the set-up permitted the actual physiological blush response to be investigated. In line with the model that we propose for erythrophobia, participants in the feedback condition expected the confederates to judge them relatively negatively, independent of their fear of blushing. Furthermore, sustaining the idea that believing that one will blush can act as a self-fulfilling prophecy, high-fearfuls showed relatively intense facial coloration in both conditions, whereas low-fearfuls only showed enhanced blush responses following false blush feedback. [Copyright &y& Elsevier]

To explain blushing phobics’ fearful preoccupation with blushing, this study investigated the anticipated consequences of blushing when considering the interpersonal influences of displaying a blush. Using a vignette study approach, participants ( N = 48, mean age 20.47, and SD 4.44) with variable levels of fear of blushing were instructed to imagine that they did or did not blush in several situations, and were asked to indicate their expectations of an observer’s judgment. Irrespective of their fear of blushing, participants generally attributed negative effects to their blush in these situations. This finding sustains the idea that people dislike blushing due to the anticipated influence of the blush on other’s judgments about the self, but does not support the idea that fear of blushing is fueled by an overestimation of these negative effects of blushing. Meanwhile, high-fearfuls did report a relatively high-subjective probability of displaying a blush in these situations. Expecting to blush in situations in which people generally anticipate that blushing elicits a negative observer’s judgment, may well contribute to blushing fearfuls’ preoccupation with blushing. [ABSTRACT FROM AUTHOR]

Background and Objectives: Negative beliefs about other's judgments play an important role in the development and maintenance of social anxiety disorder. The present experiment examined the effects of role-playing followed by role reversal compared to role-playing twice on altering these negative cognitions.Methods: Thirty-six adult social anxiety patients were randomized into two conditions: a role-playing condition in which 18 participants role-played an anxiety-provoking social situation twice, or a role reversal condition in which 18 participants role-played an anxiety-provoking social situation followed by enacting the same situation using role reversal. Before the start of the experiment, patients were asked to report their negative cognitions about the other's judgments. Next, they were asked to rate the believability of these negative cognitions, as well as the probability and cost estimates of negative judgments by the other person, at three time-points: before the first block of role-playing, after the first block of role-playing, and after the second block of the experiment.Results: Results demonstrated that role-playing followed by role reversal had a stronger effect on the most negative cognitions than role-playing twice.Limitations: The most important limitation of the present study is that there was no control group to assess the effects of role-playing alone. Moreover, the second block of the experiment was repetitive in role-playing, however, it was a new task in role reversal.Conclusions: The results support the hypothesis that role reversal is an effective technique that can be used to correct negative cognitions about other's judgments in SAD. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to unravel the relationship between socially anxious individuals' expectation of being (dis)liked and actual likeability by looking at the mediating role of both strategic and automatic social behavior: Self-disclosure as well as mimicry were examined.Method: Female participants (N = 91) with various levels of social anxiety participated in a social task with a confederate. Before the task, participants indicated their expectation of being liked by the confederate. Afterwards, objective video-observers rated the likeability of the participants before and after the social task as well as their level of self-disclosure and mimicry.Results: Social anxiety correlated negatively with the expectation to be liked but was not related to observer ratings of likeability, self-disclosure or mimicry. However, degree of social anxiety moderated the relation between expectations and self-disclosure. As expected, participants with low levels of social anxiety disclosed more if they expected to be liked. A reversed pattern was found for the high socially anxious participants: Here, higher expectations of being liked were related to less self-disclosure.Limitations: The study used an analogue female sample. Our social interaction task was highly structured and does not reflect informal day-to-day conversations.Conclusion: Socially anxious individuals function rather well in highly structured social tasks. No support was found for declined likeability or disrupted mimicry. Nevertheless, high socially anxious individuals did have a cognitive bias and show a self-protective strategy: when expecting a neutral judgment they reduce their level of self-disclosure. This pattern probably adds to their feelings of social disconnectedness. [ABSTRACT FROM AUTHOR]

A letter to the editor concerning the article "Blushing: An Embarrassing Condition, But Treatable," published in the April 22, 2006 issue is presented.

To explain blushing phobics’ fearful preoccupation with blushing, this study investigated the anticipated consequences of displaying a blush on others’ judgements of the self and of the incident. We tested whether especially in the context of ambiguous situations that may be interpreted as a transgression, individuals would expect negative consequences of their blushing, and whether this effect is most pronounced in relatively high blushing fearful individuals. Using a vignette approach, participants ( N = 36) with variable levels of blushing fear were instructed to imagine that they did or did not started blushing (i) after a mishap and (ii) in situations that are more ambiguous in their meaning. Independent of situation, participants indicated to expect a positive rather than a negative influence of blushing on others’ judgements of the self and of the incident. Unexpectedly, this pattern was even most pronounced in relatively fearful individuals. The results are in conflict with the idea that fear of blushing is fuelled by overestimating the undesirable communicative effects of blushing in ambiguous situations. In addition, the results seem to imply that different processes are involved in judging blushing others and judging other’s views of themselves when displaying a blush. [ABSTRACT FROM AUTHOR]