Transcript A Cognitive Perspective on Social Phobia

A Cognitive Perspective on
Social Phobia
Triple Threat
Sheila Krogh-Jespersen
Alicia Briganti
Victoria Cox
Outline
 The Cognitive Model
 Empirical Studies of the Cognitive Model
 A theory Derived Cognitive Treatment and
Effectiveness
The Cognitive Model
 Assumptions:
 Excessively high standards of social
performance
 Conditional beliefs concerning the
consequences of performing a certain way
 Unconditional negative beliefs about the
self
Self as a Social Object:
 Self-monitoring
 Feeling anxious is the same as looking
anxious
 Observer perspective imagining
 “Felt self”
Safety Behaviors:
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Many are internal mental processes
Variety of behaviors in one situation
Creation of symptoms
Increase in self-focus
Draw attention
Confirmation of fears
Before & After:
 Before:
 Thoughts focus on negative past
experiences
 After:
 Notice negative responses
 Associate with previous failures
Testable Hypotheses of the Cognitive
Model
1. Social phobics interpret external social
events in an excessively negative fashion.
e.g., Amir, Foa, & Coles, 1998
2. Social phobics show enhanced self-focused
attention and reduced processing of
external social cues when anxious in social
situations.
e.g., Bruch, Heimburg, Berger, & Collins, 1989; Mellings & Alden, 2000
Testable Hypotheses of the Cognitive
Model, cont.
3.
Social phobics generate distorted observerperspective images of how they think they appear
to others.
e.g., Hackman, Suraway, & Clark, 1998; Hackman, Clark, & McManus, 2000
4.
In-situation safety seeking behaviors and selffocused attention prevent disconfirmation of social
phobics’ negative beliefs and maintain social
phobia.
e.g., Morgan & Raffle, 1999
Testable Hypotheses of the Cognitive
Model, cont.
5.
In-situation safety behaviors and self-focused
attention contaminate social interactions by
making social phobics less appealing to others.
e.g., Alden & Bieling, 1998
6.
Social phobics (reduced) processing of external
social cues is biased in favor of detection and
recall of cues that could be interpreted as signs
of disapproval from others.
e.g., Veljaca & Rapee, 1998
Testable Hypotheses of the Cognitive
Model, cont.
7. Social phobics engage in negatively biased
anticipatory processing before entering
feared social situations and engage in
prolonged, negatively biased, post-event
processing.
e.g., Hinrichsen & Clark, 2000; Rachman, Gruter-Andrew, &Shafran,
2000
Attentional Biases in Anxiety
Patients
 Highly anxious people are more responsive &
attentive to cues of threat. Initial experiments show
high anxious Ss revealing greater --- In (T,NT pairs) of words or faces, detect dot faster when
located at T spot. See spider quicker in array.
 Emotional Stroop interference to T vs NT words
 Choosing T over NT meaning of ambiguous words whether
spoken (dye, die) or written (growth)
 But these are correlations, and perhaps not causal for
creating susceptibility to anxiety disorder.
Creating Anxiety by Creating an
Attentional Bias Towards Threats
 Give lots of training on: location of dot target is same
as preceding threat (or NT) word; or
 Ambiguous word always has the threatening
meaning, e.g, BATTER primes for As_ _ lt (Assault)
or Pa- ca_ke (Pancake).
 During a later randomized tests in a stressful task, Ss
showed the Threat bias AND a greater increase in
anxious mood (due to the stress task) following these
several methods of inducing bias.
 Note: Social phobics try to avoid their threatening
cues, e.g., not looking at faces of other people.
Stages of Treatment
 Therapeutic Relationship
 Idiosyncratic Model
An idiosyncratic model
Stages of Treatment
 Therapeutic Relationship
 Idiosyncratic Model
 Manipulate the Model
 Video Feedback
 Shift of Attention
Exposure Assignment Record
Sheet
Thoughts and Assumptions
 Pre and post event thinking
 Assumptions about behavior
Results
 Preliminary results promising
 Fear of Negative valuation Scale
 Post-treatment improvement mean of 11 points
 Follow-up improvement mean of 15 points