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Interpretations and judgments regarding positive and negative social scenarios in childhood social anxiety

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Abstract

The present study extended our understanding of cognitive biases in childhood social anxiety. A non-clinical sample of 11–13-year olds completed social anxiety and depression scales and were presented with scenarios depicting positive and mildly negative social events. Social anxiety was associated with tendencies to interpret positive social events in a discounting fashion, to catastrophize in response to mildly negative social events, and to anticipate more negative emotional reactions to the negative events. Implications for understanding and treating social anxiety are discussed.

Introduction

Theoretical models of social phobia suggest that biased information processing contributes to the aetiology and maintenance of social anxiety (Clark & Wells, 1995; Rapee & Heimberg, 1997). Clark and Wells (1995) argued that socially anxious individuals are inclined to draw negative inferences about ambiguous social events, resulting in increased anxiety and subsequent avoidance. In line with this prediction, the studies reported by Amir, Foa, and Coles (1998), Constans, Penn, Ihen, and Hope (1999) and Stopa and Clark (2000) all demonstrated that social phobic and socially anxious adults exhibit interpretation biases for ambiguous social events. Similar negative biases have been found when asking clinically anxious or non-referred children high in social anxiety to interpret ambiguous, threat-neutral social scenarios (Barrett, Rapee, Dadds, & Ryan, 1996; Chorpita, Albano, & Barlow, 1996; Muris, Merckelbach, & Damsma, 2000; Warren, Emde, & Sroufe, 2000).

In a similar way, Beck, Emery, and Greenberg (1985) suggested that social phobic individuals have a tendency to interpret mildly negative social events (e.g., mild criticism from an acquaintance) in a catastrophic fashion (e.g., he/she dislikes me). To date, two studies have investigated the role of catastrophization in maintaining social anxiety (Stopa & Clark, 2000; Vassilopoulos, 2006). In the study by Stopa and Clark (2000) patients with generalized social phobia, equally anxious participants with another anxiety disorder and non-patient controls were asked to describe how they would respond if faced with a mildly negative social event. Such events included making a mistake at work and being called in to see the boss, and discovering that a new acquaintance disliked you. Response formats included both answers to open-ended questions and likelihood rankings and belief ratings for experimenter-provided interpretations. The results indicated that patients with social phobia have a specific tendency to interpret mildly negative social events in a catastrophic fashion. This finding has been replicated with non-clinical adults who are high in social anxiety (Vassilopoulos, 2006). However, to date, no study has investigated the role of catastrophization in children high in social anxiety. The present study addresses this issue by comparing the interpretations endorsed by children with varying levels of socially anxious symptoms. Given the existing evidence of biases in the interpretation of threat-neutral ambiguous situations among socially anxious children, a similar tendency to catastrophize in response to mildly negative events seems plausible.

The tendency to interpret social events in a more negative way may be relevant not just to threat-neutral or mildly negative events, but also to positive events. The importance of processing positive social information in social anxiety has only recently been started to be investigated adequately in the current literature. Specifically, high socially anxious individuals may tend to systematically discount positive events, i.e., to see them as having less positive or even negative implications for one's view of the self and/or one's future. Consistent with this view, Voncken, Bögels, and de Vries (2003) presented participants with brief scripts of social events (ranging from positive to extremely negative), and found preliminary evidence suggesting that social phobic adults tend to interpret positive social events (e.g., “Someone makes a compliment about your looks”) as more negative. Also, Vassilopoulos (2006) conducted a similar study with high and low socially anxious volunteers and arrived at similar results. Finally, Alden, Taylor, Mellings, and Laposa (2008) developed a scale that measures the tendency to engage in threat-maintaining interpretations of positive social events and demonstrated that negative interpretation of positive events was significantly greater in a clinical sample of patients with generalized social anxiety disorder than a group of non-anxious controls. These findings appear to indicate the discounting of positive social interactions as part of the socially anxious adults’ interpretation bias. However, to our knowledge no study has investigated whether children high in social anxiety also tend to interpret positive social events in a discounting manner. Therefore, a more complete understanding of the scope and specificity of interpretation processes in childhood social anxiety requires the inclusion of both mildly negative and positive social events.

Finally, it has been suggested that elevated probability estimates of harm and inflated perceived costs of harm play an important role in the maintenance of anxiety disorders (Beck et al., 1985; Foa & Kozak, 1986). Consistent with this hypothesis are the findings that socially phobic and socially anxious adults estimated the probability of hypothetical negative events as higher or the probability of mild positive events as lower than did nonanxious controls (Butler & Mathews, 1983; Gilboa-Schechtman, Franklin, & Foa, 2000; Lucock & Salkovskis, 1988; Vassilopoulos, 2006). However, the evidence for anxiety-related patterns of probability estimates in children and adolescence is mixed. On the one hand, studies of clinically referred anxious children and adolescents have not provided support for a distinct pattern of probability estimates (Dalgleish et al. (2000), Dalgleish et al. (1997); Spence, Donocan, & Brechman-Toussaint, 1999). That is, anxiety-disordered youth do not give higher probability estimates for negative events, and do not indicate that such events are more likely to occur to themselves as compared to youth without anxiety problems. On the other hand, studies that have examined probability estimates in non-clinical children and adolescents appear to provide some support for the presence of this cognitive pattern in youths (Canterbury et al., 2004; Muris & Van der Heiden, 2006).

Preliminary evidence suggests that more negative judgments about the affective impact of social scenarios are made by socially anxious individuals. In research with adults, patients with generalized social phobia and high socially anxious individuals assign higher emotional impact to mildly negative events than do nonanxious individuals (Foa, Franklin, Perry, & Herbert, 1996; Vassilopoulos, 2006). In correspondence with this, two studies examined threat perception abnormalities and judgmental biases in socially anxious children (Muris, Luermans, Merckelbach, & Mayer, 2000; Muris et al., 2000). Results suggested that socially anxious children displayed higher levels of negative feelings in response to non-threatening stories where social situations were described. However, no positive or negative social events were included, and thus little is known about socially anxious children's judgments about clearly valenced event descriptions. We might expect a greater estimation of negative emotional reactions when presented with negative scenarios, in line with the general tendency to over-perceive threat, as described above. Identifying any such patterns in socially anxious children's judgements about affective responses to social scenarios therefore can potentially help us clarify the emergence of distinctive information-processing patterns in social anxiety.

Careful attention must be paid to methods for accessing children's interpretations and judgment tendencies. One approach is to ask participants to rank order the two or three alternative interpretations of social events according to their perceived likelihood or the extent to which they would be endorsed. However, this method produces dependency between rankings as the first ranking limits the freedom of ranking the remaining two choices, and the second ranking determines the third. Therefore, the three types of interpretations (negative, positive and neutral) cannot be compared directly and the possibility of two interpretations (e.g., positive and neutral) coming concurrently to participant's mind is excluded. To correct for such dependency, the participants in the present study rated each possible explanation with respect to its likelihood of coming to mind, using a five-point scale ranging from 1 (I would not think of it at all) to 5 (I would think of it immediately).

To summarize then, the main aims of the current study are

  • 1.

    To establish whether socially anxious children interpret mildly negative social events in a catastrophic fashion.

  • 2.

    To investigate whether socially anxious children interpret positive social events in a discounting fashion.

  • 3.

    To investigate whether socially anxious children are likely to (a) report more negative affect in response to negative events or less positive affect in response to positive events; and (b) estimate the probabilities of negative events as higher or estimate the probabilities of positive events as lower.

  • 4.

    It should be noted that because of expected comorbidity of depressive and socially anxious symptoms (Schneier, Johnson, Hornig, Liebowitz, & Weissman, 1992), we measured the level of depressive symptoms in order to control for this variable in analysis. This is important since several studies have shown that depressive symptoms are associated with interpretation and judgmental biases (e.g., Voncken, Bögels, & Peeters, 2007).

Section snippets

Participants

The sample consisted of 109 children (61 boys and 48 girls) who were recruited from five regular primary schools in the south west of Greece. The mean age of the children was 11.3 years (SD=0.5, range 11–13 years). All children were White Europeans. No exact information was obtained on the socioeconomic background of each individual child, but it should be noted that three schools were located in a rural area and were predominantly visited by children with a low to middle socioeconomic

Results

To examine relations between social anxiety and children's interpretations, emotional reaction judgments and probability judgments, Pearson product-moment correlations were computed between SASC-R, NSECQ and PSEDQ scores. As can be seen in Table 1, significant correlations were found between social anxiety and children's interpretations as well as estimations of probability and emotional reaction on the positive and mildly negative social events (with r's varying between 0.19 and 0.52, all p

Discussion

The present study confirms the value of asking children to make judgements about clearly valenced social situations. Greater social anxiety was linked to more catastrophic interpretations of mildly negative events, and was also associated with an increased tendency to discount positive experiences. Furthermore, anticipated negative emotional reactions to mildly negative events rose with increasing social anxiety. All of these patterns were present even after controlling for depressive symptoms,

Acknowledgements

We would like to thank Georgio Konstantinidi, Sophia Karela, Aggeliki Menegi, Ioanna Koutsopoulou, Dionysia Regli and Anastasia Kotsia for their help with data collection. We also thank the anonymous reviewers for their valuable suggestions.

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