Abstract
Background
Social anxiety disorder (SAD) is often conceptualized as arising from maladaptive cognitions. One cognitive domain that has received relatively little attention, despite endorsement from people struggling with social anxiety, is the belief that they may lose control over their speech/behaviour and/or their physical symptoms of anxiety. The present study aimed to evaluate the causal role of these beliefs on social anxiety symptoms in an analogue sample.
Methods
Beliefs were manipulated using false feedback in undergraduate psychology students (N = 130) to induce either high or low levels of beliefs about losing control. Participants then engaged in a social interaction task with a confederate.
Results
The high beliefs about losing control (HLC) condition reported greater anxiety just before meeting the confederate than the low loss of control (LLC) condition. Further, HLC participants reported worse social performance and greater perceived failures of control than did those in the LLC condition during their interaction with a confederate.
Conclusion
Results suggest beliefs about losing control are producing cognitive and behavioural changes which may in part explain differences in performance in social interactions. Beliefs about losing control appear to be relevant to the cognitive model of social anxiety. Future studies should consider whether these beliefs are malleable among individuals with SAD.
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Notes
Though both sex and gender were included in demographics, all participants reported their gender as matching their sex assigned at birth.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Alcolado, G. M., & Radomsky, A. S. (2011). Believe in yourself: Manipulating beliefs about memory causes checking. Behaviour Research and Therapy,49(1), 42–49. https://doi.org/10.1016/j.brat.2010.10.001.
Alden, L. E., & Wallace, S. T. (1995). Social phobia and social appraisal in successful and unsuccessful social interactions. Behaviour Research and Therapy,33(5), 497–505. https://doi.org/10.1016/0005-7967(94)00088-2.
Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., et al. (2004). Disability and quality of life impact of mental disorders in Europe: Results from the european study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica,109(s420), 38–46. https://doi.org/10.1111/j.1600-0047.2004.00329.x.
Brody, L. R., & Hall, J. A. (2008). Gender and emotion in context. In M. Lewis, J. M. Haviland-Jones, & L. F. Barrett (Eds.), Handbook of emotions (3rd ed., pp. 395–408). New York: Guilford Press.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy,24(4), 461–470. https://doi.org/10.1016/0005-7967(86)90011-2.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. Heimberg, M. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp. 69–93). New York: Guilford Press.
Clark, D. A., & Purdon, C. (1993). New perspectives for a cognitive theory of obsessions. Australian Psychologist,28(3), 161–167. https://doi.org/10.1080/00050069308258896.
Cloitre, M., Heimberg, R. G., Liebowitz, M. R., & Gitow, A. (1992). Perceptions of control in panic disorder and social phobia. Cognitive Therapy and Research,16(5), 569–577. https://doi.org/10.1007/BF01175142.
Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Foa, E., & Weisler, R. H. (2000). Psychometric properties of the social phobia inventory (SPIN): New self-rating scale. The British Journal of Psychiatry,176, 379–386. https://doi.org/10.1192/bjp.176.4.379.
De Castella, K., Goldin, P., Jazaieri, H., Ziv, M., Heimberg, R. G., & Gross, J. J. (2014). Emotion beliefs in social anxiety disorder: Associations with stress, anxiety, and well-being. Australian Journal of Psychology,66(2), 139–148. https://doi.org/10.1111/ajpy.12053.
Gagné, J., & Radomsky, A. S. (2017). Manipulating beliefs about losing control causes checking behaviour. Journal of Obsessive-Compulsive and Related Disorders,15, 34–42. https://doi.org/10.1016/j.jocrd.2017.08.013.
Hackmann, A., Surawy, C., & Clark, D. M. (1998). Seeing yourself through others’ eyes: A study of spontaneously occurring images in social phobia. Behavioural and Cognitive Psychotherapy,26(1), 3–12. https://doi.org/10.1017/S1352465898000022.
Herres, J., Shearer, A., Kodish, T., Kim, B., Wang, S. B., & Diamond, G. S. (2019). Differences in suicide risk severity among suicidal youth with anxiety disorders. Crisis. https://doi.org/10.1027/0227-5910/a000571.
Hofmann, S. G. (2005). Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia. Behaviour Research and Therapy,43(7), 885–895. https://doi.org/10.1016/j.brat.2004.07.002.
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy,36(4), 193–209. https://doi.org/10.1080/16506070701421313.
Hofmann, S. G., Ehlers, A., & Roth, W. T. (1995). Conditioning theory: A model for the etiology of public speaking anxiety? Behaviour Research and Therapy,33(5), 567–571. https://doi.org/10.1016/0005-7967(94)00072-R.
Johns, A., & Peters, L. (2012). Self-discrepancies and the situational domains of social phobia. Behaviour Change,29(2), 109–125. https://doi.org/10.1017/bec.2012.1.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry,62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research,21(3), 169–184. https://doi.org/10.1002/mpr.1359.
Kline, R. B. (2009). Becoming a behavioral science researcher: A guide to producing research that matters. New York: Guilford Press.
Koyuncu, A., Ertekin, E., Binbay, Z., Özyıldırım, İ., Yüksel, Ç., & Tükel, R. (2014). The clinical impact of mood disorder comorbidity on social anxiety disorder. Comprehensive Psychiatry,55, 363–369. https://doi.org/10.1016/j.comppsych.2013.08.016.
Kushner, M. G., Sher, K. J., & Beitman, B. D. (1990). The relation between alcohol problems and the anxiety disorders. The American Journal of Psychiatry,147(6), 685–695. https://doi.org/10.1176/ajp.147.6.685.
Leung, A. W., & Heimberg, R. G. (1996). Homework compliance, perceptions of control, and outcome of cognitive-behavioral treatment of social phobia. Behaviour Research and Therapy,34(5), 423–432. https://doi.org/10.1016/0005-7967(96)00014-9.
Levenson, H. (1973). Multidimensional locus of control in psychiatric patients. Journal of Consulting and Clinical Psychology,41(3), 397–404. https://doi.org/10.1037/h0035357.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy,33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U.
Mansell, W., & Clark, D. M. (1999). How do I appear to others? Social anxiety and processing of the observable self. Behaviour Research and Therapy,37(5), 419–434. https://doi.org/10.1016/S0005-7967(98)00148-X.
Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice,16(2), 123–134. https://doi.org/10.1016/j.cbpra.2008.04.002.
Moscovitch, D. A., & Hofmann, S. G. (2007). When ambiguity hurts: Social standards moderate self-appraisals in generalized social phobia. Behaviour Research and Therapy,45(5), 1039–1052. https://doi.org/10.1016/j.brat.2006.07.008.
Osborne, J. W., & Overbay, A. (2004). The power of outliers (and why researchers should always check for them). Practical Assessment, Research & Evaluation,9(6), 1–12.
Ottaviani, R., & Beck, A. T. (1987). Cognitive aspects of panic disorders. Journal of Anxiety Disorders,1(1), 15–28. https://doi.org/10.1016/0887-6185(87)90019-3.
Papageorgiou, C., & Wells, A. (2002). Effects of heart rate information on anxiety, perspective taking, and performance in high and low social-evaluative anxiety. Behavior Therapy,33(2), 181–199. https://doi.org/10.1016/S0005-7894(02)80024-7.
Plasencia, M. L., Alden, L. E., & Taylor, C. T. (2011). Differential effects of safety behaviour subtypes in social anxiety disorder. Behaviour Research and Therapy,49(10), 665–675. https://doi.org/10.1016/j.brat.2011.07.005.
Radomsky, A. S., & Gagné, J. P. (2019). The development and validation of the beliefs about losing control inventory (BALCI). Cognitive Behaviour Therapy. https://doi.org/10.1080/16506073.2019.1614978.
Rapee, R. M. (1997). Perceived threat and perceived control as predictors of the degree of fear in physical and social situations. Journal of Anxiety Disorders,11(5), 455–461. https://doi.org/10.1016/S0887-6185(97)00022-4.
Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy,35(8), 741–756. https://doi.org/10.1016/S0005-7967(97)00022-3.
Rapee, R. M., Craske, M. G., Brown, T. A., & Barlow, D. H. (1996). Measurement of perceived control over anxiety-related events. Behavior Therapy,27(2), 279–293. https://doi.org/10.1016/S0005-7894(96)80018-9.
Reuven-Magril, O., Dar, R., & Liberman, N. (2008). Illusion of control and behavioral control attempts in obsessive-compulsive disorder. Journal of Abnormal Psychology,117(2), 334–341. https://doi.org/10.1037/0021-843X.117.2.334.
Rowa, K., Paulitzki, J. R., Ierullo, M. D., Chiang, B., Antony, M. M., McCabe, R. E., et al. (2015). A false sense of security: Safety behaviors erode objective speech performance in individuals with social anxiety disorder. Behavior Therapy,46(3), 304–314. https://doi.org/10.1016/j.beth.2014.11.004.
Sanavio, E. (1988). Obsessions and compulsions: The padua inventory. Behaviour Research and Therapy,26(2), 169–177. https://doi.org/10.1016/0005-7967(88)90116-7.
Schlenker, B. R., & Leary, M. R. (1982). Social anxiety and self-presentation: A conceptualization model. Psychological Bulletin,92(3), 641–669. https://doi.org/10.1037/0033-2909.92.3.641.
Spokas, M., Luterek, J. A., & Heimberg, R. G. (2009). Social anxiety and emotional suppression: The mediating role of beliefs. Journal of Behavior Therapy and Experimental Psychiatry,40(2), 283–291. https://doi.org/10.1016/j.jbtep.2008.12.004.
Stein, M. B., & Kean, Y. M. (2000). Disability and quality of life in social phobia: Epidemiologic findings. American Journal of Psychiatry,157(10), 1606–1613. https://doi.org/10.1176/appi.ajp.157.10.1606.
Stevens, S., Gerlach, A. L., Cludius, B., Silkens, A., Craske, M. G., & Hermann, C. (2011). Heartbeat perception in social anxiety before and during speech anticipation. Behaviour Research and Therapy,49(2), 138–143. https://doi.org/10.1016/j.brat.2010.11.009.
Stopa, L., & Clark, D. M. (1993). Cognitive processes in social phobia. Behaviour Research and Therapy,31(3), 255–267. https://doi.org/10.1016/0005-7967(93)90024-O.
Stopa, L., & Clark, D. M. (2001). Social phobia: Comments on the viability and validity of an analogue research strategy and British norms for the fear of negative evaluation questionnaire. Behavioural and Cognitive Psychotherapy,29(4), 423–430. https://doi.org/10.1017/S1352465801004039.
Thompson, S., & Rapee, R. M. (2002). The effect of situational structure on the social performance of socially anxious and non-anxious participants. Journal of Behavior Therapy and Experimental Psychiatry,33(2), 91–102. https://doi.org/10.1016/S0005-7916(02)00021-6.
Voncken, M. J., & Bögels, S. M. (2008). Social performance deficits in social anxiety disorder: Reality during conversation and biased perception during speech. Journal of Anxiety Disorders,22(8), 1384–1392. https://doi.org/10.1016/j.janxdis.2008.02.001.
Weilage, M., & Hope, D. A. (1999). Self-discrepancy in social phobia and dysthymia. Cognitive Therapy & Research,23(6), 637. https://doi.org/10.1023/A:1018788925223.
Wolpe, J. (1969). The practice of behavior therapy (1st ed.). New York: Pergamon Press.
Wolpe, J. (1988). Subjective anxiety scale. In M. Hersen & A. S. Bellack (Eds.), Dictionary of behavioral assessment techniques (pp. 455–457). New York: Pergamon.
Acknowledgements
This study was funded by Social Sciences and Humanities Research Council of Canada (Grant Number 435-2017-0922).
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Kenneth Kelly-Turner and Adam S. Radomsky declared that they have no conflict of interest.
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Kelly-Turner, K., Radomsky, A.S. The Fear of Losing Control in Social Anxiety: An Experimental Approach. Cogn Ther Res 44, 834–845 (2020). https://doi.org/10.1007/s10608-020-10104-5
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DOI: https://doi.org/10.1007/s10608-020-10104-5