The relation between anxiety and skill in performance-based anxiety disorders: A behavioral formulation of social phobia

doi:10.1016/S0005-7894(01)80052-6

Behavior Therapy

Volume 32, Issue 1, Winter 2001, Pages 185-207

https://doi.org/10.1016/S0005-7894(01)80052-6 Get rights and content

Anxiety-related responding and skill deficits have historically been associated with performance-based anxiety disorders such as social phobia. Prominent cognitive-behavioral models of social phobia have typically deemphasized skill deficits and focused more on the effects of negative cognition on social performance. Considering that empirical accounts of the relation between social skill and social performance are generally modest, the impact of skill deficits on the development and maintenance of performance inadequacies may be relatively neglected in theoretical paradigms in this area. A second problem that has plagued social skill research is the misuse of the term skill deficit as a synonym for performance deficit. In response to these issues, we utilize the multilevel framework of psychological behaviorism to offer a more parsimonious account of the relation between anxiety and skill in social phobia. We argue that this integrated model assimilates contemporary accounts of social phobia and uniquely expands upon them by delineating the unique and cumulative effects of skill and anxiety on social performance. We further suggest that this model resolves existing theoretical incompatibilities, facilitates improved patient-treatment matching, and shows promise as a guiding framework for empirical research.

References (119)

AldenL.E. et al.
Social phobia and social appraisal in successful and unsuccessful social interactions
Behaviour Research and Therapy
(1995)
BeidelD.C. et al.
Physiological, cognitive, and behavioral aspects of social anxiety
Behaviour Research and Therapy
(1985)
BooneM.L. et al.
Multimodal comparisons of social phobia subtypes and avoidant personality disorder
Journal of Anxiety Disorders
(1999)
DalgleishT. et al.
Biases of attention and memory in disorders of anxiety and depression
Clinical Psychology Review
(1990)
EifertG.H.
Cardiophobia: A paradigmatic behavioral model of heart-focused anxiety and non-anginal chest pain
Behaviour Research and Therapy
(1992)
EifertG.H.
More theory-driven and less diagnosis-based behavior therapy
Journal of Behavior Therapy and Experimental Psychiatry
(1996)
EifertG.H. et al.
Unifying the field: Developing an integrative paradigm for behavior therapy
Journal of Behavior Therapy and Experimental Psychiatry
(1993)
EifertG.H. et al.
The triple response approach to assessment: A conceptual and methodological reappraisal
Behaviour Research and Therapy
(1991)
GlasgowR.E. et al.
The behavioral assessment of male and female social competence in dyadic interactions
Behavior Therapy
(1975)
HofmannS.G. et al.
Speech disturbances and gaze behavior during public speaking in subtypes of social phobia
Journal of Anxiety Disorders
(1997)

KelloggJ.S. et al.

The effects of time pressure on arithmetic performance

Journal of Anxiety Disorders

(1999)

LearyM.R. et al.

Self-presentational concerns and social anxiety: The role of generalized impression expectancies

Journal of Research in Personality

(1988)

LoweM.R. et al.

A self-report measure of social skill

Behavior Therapy

(1978)

LucockM.P. et al.

Cognitive factors in social anxiety and its treatment

Behavior Research and Therapy

(1988)

MontiP.M. et al.

Midi-level measurement of social anxiety in psychiatric and non-psychiatric samples

Behaviour Research and Therapy

(1984)

MorrisonR.L. et al.

The role of social perception in social skill

Behavior Therapy

(1981)

NewmanM.G. et al.

Does behavioral treatment of social phobia lead to cognitive changes?

Behavior Therapy

(1994)

RapeeR.M. et al.

A cognitive-behavioral model of anxiety in social phobia

Behavior Research and Therapy

(1997)

RiesB.J. et al.

Assessment of contemporary social phobia verbal report instruments

Behavior Research and Therapy

(1998)

SchneiderF. et al.

Subcortical correlates of differential classical conditioning of aversive emotional reactions in social phobia

Biological Psychiatry

(1999)

StaatsA.W.

Valuable, but not maximal: It's time behavior therapy attended to its behaviorism

Behaviour Research and Therapy

(1999)

StaatsA.W. et al.

The paradigmatic behaviorism theory of emotions: Basis for unification

Clinical Psychology Review

(1990)

StopaL. et al.

Cognitive processes in social phobia

Behaviour Research and Therapy

(1993)

American Heritage Dictionary. (2nd ed.). (1985). Boston: Houghton Mifflin...

Diagnostic and statistical manual of mental disorders

(1994)

AmiesP.L. et al.

Social phobia: A comparative clinical study

British Journal of Psychiatry

(1983)

AmmermanR.T. et al.

Effects of scene manipulation on role-play test behavior

Journal of Psychopathology and Behavioral Assessment

(1986)

ArkowitzH.

Assessment of social skills

AshcraftM.H. et al.

Mathematics anxiety and mental arithmetic performance: An exploratory investigation

Cognition and Emotion

(1994)

BanduraA.

Social learning theory

(1977)

BarlowD.H.

Anxiety and its disorders: The nature and treatment of anxiety and panic

(1988)

BarlowD.H. et al.

Fear, panic, anxiety, and disorders of emotion

BeckA.T. et al.

Anxiety disorders and phobias: A cognitive perspective

(1985)

BeckA.T. et al.

Cognitive therapy for evaluation anxieties

BeckerR.E. et al.

Assessment of social skills

ButcherJ.N. et al.

Understanding abnormal behavior in cultural context

CarverC.S. et al.

A control-process perspective on anxiety

Anxiety Research

(1988)

CaseyM.B. et al.

Mediators of gender differences in mathematics college entrance test scores: A comparison of spatial skills with internalized beliefs and anxieties

Developmental Psychology

(1997)

ClarkD.M. et al.

A cognitive model of social phobia

ClarkJ.V. et al.

Social anxiety and self-evaluation of interpersonal performance

Psychological Reports

(1975)

CookM. et al.

Selective associations in the origins of phobic fears and their implications for behavior therapy

CurranJ.P.

Pandora's box reopened?: The assessment of social skills

Journal of Behavioral Assessment

(1979)

CurranJ.P.

A procedure for the assessment of social skills: The simulated social interaction test

CurranJ.P. et al.

The assessment of social inadequacy

EdelmannR.J.

Dealing with embarrassing events: Socially anxious and non-socially anxious groups compared

British Journal of Clinical Psychology

(1985)

EifertG.H.

Language conditioning: Clinical issues and applications in behavior therapy

EifertG.H.

The acquisition and treatment of phobic anxiety: A paradigmatic behavioral perspective

EifertG.H. et al.

Depression: Behavioral principles and implications for treatment and relapse prevention

EysenckM.W.

Anxiety: The cognitive perspective

(1992)

EysenckM.W. et al.

Anxiety and performance: The processing efficiency theory

Cognition and Emotion

(1992)

Cited by (62)

Disrupted joint action accounts for reduced likability of socially anxious individuals
2020, Journal of Behavior Therapy and Experimental Psychiatry
Motivated by their fear of disapproval, individuals with social anxiety continually monitor their own behaviour during social interactions hoping to prevent dreaded negative outcomes. Ironically, they do evoke less positive reactions from others. This study investigated whether lower engagement in the interpersonal process of joint action by socially anxious individuals leads them to attract less positive ratings by their conversation partners.
High socially anxious (HSA; N = 36) and low socially anxious individuals (LSA; N = 36) had separate conversations with a naïve conversation partner (N = 36). Conversations were filmed and analysed for joint action using the conventional manual way and a more exploratory automated way. Conversation partners rated the quality of the interaction and the person they talked to.
Conversation partners rated HSA participants less positively than LSA participants. The conventional manual method showed less joint action in conversations with LSA participants and crucially, joint action served as mediator between social anxiety status and general impression, quality of interaction and desire to meet again. These results were not replicated with the automated method.
The study used an analogue sample and future research should investigate whether these findings also apply to a clinical sample. Future studies should further explore the utility of automated techniques to measure joint action.
Reduced joint action may explain why socially anxious individuals tend to be perceived less positively by others. The findings emphasise the importance of taking an interpersonal and holistic approach to understanding aspects of social anxiety disorder.
Intervening with adults
2020, Social Skills Across the Life Span: Theory, Assessment, and Intervention
Social skills facilitate meaningful and rewarding interactions with others. Functional impairments in social skills place individuals at risk for adverse social, occupational, mental, and physical health outcomes. In this chapter, we provide an overview on social skills training (SST) programs that can help adults acquire and implement effective social skills. We identify key principles underlying social learning theory and review implementation and service delivery considerations among adult populations. Extant programs serve a variety of presenting concerns, including but not limited to adults with neurodevelopmental disorders, mood and depressive disorders, serious mental illness such as schizophrenia, and problems such as traumatic brain injury and couple distress. Intervention targets with adults often include enhancing communication, relationship, social cognitive, and independent living/vocational skills. We review exemplar programs that have supportive research evidence and discuss future directions for SST programs for adults.
Do implicitly measured math–anxiety associations play a role in math behavior?
2019, Journal of Experimental Child Psychology
Citation Excerpt :
However, this conclusion might be too premature given the line of evidence for threat-associative processing in schema-based information processing in other domains of anxiety (Ouimet et al., 2009; see also Beck & Clark, 1997; Mathews & MacLeod, 2005). In addition, although math anxiety concerns learned anxiety without direct evolutionary benefits, it does share cognitive, affective, and behavioral components as well as general anxiety vulnerability with other domains of anxiety (see Dowker, Sarkar, & Looi, 2016; Hopko, McNeil, Zvolensky, & Eifert, 2001). Moreover, positive results have also been found, and several other explanations for the current lack of findings are also possible.
The current study examined the role of implicitly measured associations (henceforth referred to as associations) between math and anxiety in adolescents’ math anxiety. Previous research has shown that associations predicted behavior independent of explicit measures. In this study, it was investigated whether math–anxiety associations would be related to math anxiety and whether they predicted math behavior as well as state math anxiety independent of explicitly measured math anxiety. In addition, the domain specificity of math–anxiety associations for predicting math behavior was investigated. Adolescents’ anxiety associations and self-reported anxiety were assessed for three domains: math anxiety, foreign language (English) anxiety, and trait anxiety. A sample of 189 secondary school students performed three single-target implicit association tests, performed a math problem solving task, and filled out questionnaires. Overall, adolescents showed stronger math–anxiety associations in comparison with math–calmness associations. In contrast to our hypotheses, math–anxiety associations were not related and did not uniquely or specifically predict math behavior and state math anxiety. Explicit anxiety measures demonstrated specificity in predicting math and English grades as well as state math anxiety. The innovative aspects of this study are the investigation of implicitly measured math–anxiety associations and the relation to math anxiety and math behavior. Further research is needed to develop tasks that are better able to capture the most relevant math–threat associations and to investigate which math behavior might be most strongly influenced by these associations.
Sensitivity shift theory: A developmental model of positive affect and motivational deficits in social anxiety disorder
2019, Clinical Psychology Review
Citation Excerpt :
Our prediction that social skills deficits are a consequence of diminished social motivation must be considered in light of previous work illustrating that adults with SAD do not necessarily demonstrate poor social skills (Angelico, De Sousa Crippa, & Loureiro, 2013), as well as evidence that treating social skills deficits may enhance treatment outcomes in SAD (Beidel et al., 2014; Herbert et al., 2005). Moreover, some conceptualizations of SAD also argue that these individuals have adequate social skills, but excessive anxiety during social interaction consumes limited attentional resources, leaving comparatively less cognitive capacity left over to devote to skillful social interaction (Hopko, McNeil, Zvolensky, & Eifert, 2001). Thus, some have argued that social skills deficits in this population may be better conceptualized as a performance deficit due to situationally-specific anxiety.
Social anxiety disorder (SAD) is a common and impairing condition that emerges in early adolescence, confers significant interpersonal disability and often persists into adulthood. Prevailing interventions for socially anxious youth are largely based on cognitive-behavioral models originally developed in adult samples, but produce only modest rates of remission in adolescents. The purposes of this review are to examine plausible explanations for these modest rates of treatment response and to critically evaluate the relevance of developmental mechanisms related to reward circuitry function. In doing so, we propose Sensitivity Shift Theory (SST), an integrated theoretical model addressing the development of social anhedonia in a meaningful subset of adolescents and adults with SAD. The central prediction of SST involves a shift, or developmental transition from social sensitivity during the late childhood/early adolescent period into later-emerging social anhedonia that includes reductions in positive affect, infrequent social approach behaviors and social skills deficits. We further provide a complementary mechanistic account by which these newly identified processes may be addressed using available evidence-based treatments that influence positive affect, including mindfulness-based interventions (MBIs). Collectively, SST provides a mechanisms-focused framework for explaining relatively modest rates of response to current front-line treatments in socially anxious youth, as well as discrepant observations in SAD samples of both high- and low- levels of social motivation depending on developmental factors and learning history.
Are children with social anxiety disorder more likely than children with other anxiety disorders to anticipate poor social performance and reflect negatively on their performance?
2019, Journal of Affective Disorders
The cognitive theory of social anxiety disorder (SAD) suggests that adults with SAD have a tendency to anticipate poor social performance and reflect negatively on their performance following a social event. While a number of studies with socially anxious adults have supported the role of poor performance anticipation and post-event rumination in SAD, to date, only a few studies have addressed whether this also applies to children with SAD.
Children (7–12 years) diagnosed with SAD (n = 40), other anxious children (n = 40) and non-anxious children (n = 34) were exposed to a social stressor speech task and their pre- and post-performance appraisals assessed, taking into account objective performance ratings.
Although observers rated some aspects of performance as significantly worse among children with SAD than children with other anxiety disorders, children with SAD were not more likely than their anxious or non-anxious peers to show a general bias in pre- or post-performance appraisals. Furthermore, children with SAD were just as likely as their anxious and non-anxious peers to recognize good performance but were more critical of themselves when their performance was poor.
The speech task did not involve a same-age peer. Participants were relatively affluent group of predominantly non-minority status. Specificity for SAD in relation to other anxiety disorders remains unclear.
Focusing on counteracting pre- and post-event social performance appraisals may potentially be inappropriate for childhood SAD. Children with SAD might benefit from interventions that focus on helping them to become less critical of themselves after social interactions have not gone well.
High risk, high reward: Daily perceptions of social challenge and performance in social anxiety disorder
2018, Journal of Anxiety Disorders
Individuals with Social Anxiety Disorder (SAD) have difficulty engaging in social situations because their actions are predicated on minimizing the subjectively biased high potential for rejection. That is, individuals with SAD frequently perceive social situations as challenging, and their performance as subpar. Yet when individuals perceive themselves as succeeding in challenging situations, they typically report these situations as enjoyable and rewarding. This subjective experience of succeeding in a challenging situation has been studied as flow (Csikszentmihalyi, 1975; 2000). Thirty-three adults with SAD and 34 matched healthy controls completed a baseline assessment, along with daily and experience sampling entries for 14 days. Results were analyzed using three-level generalized linear mixed effects models, with observations nested within days, nested within participants. Although individuals with and without SAD experienced the same frequency of flow in daily life, social situations led to proportionally more flow in participants with SAD than healthy controls. Both results were unexpected, and reasons for them are explored at length. Several experiential variables (positive emotions during and importance ascribed to the event) predicted the probability of flow during each situation. These results offer intervention-relevant suggestions for how individuals may benefit from seeking out challenging situations that offer maximal rewards.

View all citing articles on Scopus

View full text

Review ArticleThe relation between anxiety and skill in performance-based anxiety disorders: A behavioral formulation of social phobia

Behaviour Research and Therapy

Behaviour Research and Therapy

Journal of Anxiety Disorders

Clinical Psychology Review

Behaviour Research and Therapy

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Behavior Therapy and Experimental Psychiatry

Behaviour Research and Therapy

Behavior Therapy

Journal of Anxiety Disorders

Journal of Anxiety Disorders

Journal of Research in Personality

Behavior Therapy

Behavior Research and Therapy

Behaviour Research and Therapy

Behavior Therapy

Behavior Therapy

Behavior Research and Therapy

Behavior Research and Therapy

Biological Psychiatry

Behaviour Research and Therapy

Clinical Psychology Review

Behaviour Research and Therapy

Diagnostic and statistical manual of mental disorders

Social phobia: A comparative clinical study

British Journal of Psychiatry

Effects of scene manipulation on role-play test behavior

Journal of Psychopathology and Behavioral Assessment

Assessment of social skills

Mathematics anxiety and mental arithmetic performance: An exploratory investigation

Cognition and Emotion

Social learning theory

Anxiety and its disorders: The nature and treatment of anxiety and panic

Fear, panic, anxiety, and disorders of emotion

Anxiety disorders and phobias: A cognitive perspective

Cognitive therapy for evaluation anxieties

Assessment of social skills

Understanding abnormal behavior in cultural context

A control-process perspective on anxiety

Anxiety Research

Mediators of gender differences in mathematics college entrance test scores: A comparison of spatial skills with internalized beliefs and anxieties

Developmental Psychology

A cognitive model of social phobia

Social anxiety and self-evaluation of interpersonal performance

Psychological Reports

Selective associations in the origins of phobic fears and their implications for behavior therapy

Pandora's box reopened?: The assessment of social skills

Journal of Behavioral Assessment

A procedure for the assessment of social skills: The simulated social interaction test

The assessment of social inadequacy

Dealing with embarrassing events: Socially anxious and non-socially anxious groups compared

British Journal of Clinical Psychology

Language conditioning: Clinical issues and applications in behavior therapy

The acquisition and treatment of phobic anxiety: A paradigmatic behavioral perspective

Depression: Behavioral principles and implications for treatment and relapse prevention

Anxiety: The cognitive perspective

Anxiety and performance: The processing efficiency theory

Cognition and Emotion

Review Article
The relation between anxiety and skill in performance-based anxiety disorders: A behavioral formulation of social phobia