Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention
Introduction
Attention processes are assumed to play an important role in social anxiety and social phobia. In this article we will review existing evidence for a maintaining and causal role of these processes in social fears, review evidence for the effectiveness of attention training in social phobia, and discuss possible mechanisms that can explain the effectiveness of attention procedures in treating social phobia.
We have classified the studies according to two important theoretical approaches to attention in social phobia that will be described in more detail later; (I) hypervigilance and (II) self-focused attention. Within the area of anxiety, hypervigilance is typically used to refer to the selective attention for threat-related stimuli rather than neutral stimuli (e.g. Eysenck, 1992, Mogg & Bradley, 1998). It has been suggested that hypervigilance is soon followed by avoidance: a defense reaction to prevent or minimise danger (e.g. Mogg, Bradley, de Bono, & Painter, 1997). Self-focused attention refers to the bi-directionality of human social consciousness (Duval & Wicklund, 1972), which is focused on the self or the external environment. Self-focused attention in a social context can result in a state of objective self-awareness, a state in which the person takes himself to be an object.
We discuss the conducted experiments in these two areas relevant for our understanding of the role of attention processes in social anxiety and social phobia. The following questions will be addressed:
- (I)
What is the evidence for and against a possible maintaining role of attention processes in social anxiety?
- (II)
What is the evidence for and against a causal role of attention processes in social anxiety (or, are attention processes just a by-product of social anxiety)?
- (III)
Which attention processes are specific for social anxiety and not related to other types of anxiety and psychopathology?
- (IV)
How are attention processes related to change in social anxiety?
Section snippets
Evidence for an association between change in attention and in social phobia
From the previous sections it can be concluded that certain attention processes are strongly associated with social phobia, although the direction of the association is not fully clear, that is, hypervigilance, attention away from social cues, and self-focused attention may cause social fears or may result from (be a by-product of) social fears. Based on the association between the reviewed attention processes and social anxiety, it can be expected that (I) attention processes change as a
Conclusions
We first reviewed the evidence for the role of attention processes in social anxiety and social phobia. Across the wide range of experimental studies, there is reasonable evidence for a brief vigilance and prolonged avoidance of social threats in paradigms that are high in ecological validity. However, further studies are required to explore the contextual factors that determine which bias is observed in which contexts, especially within clinical populations. The evidence also suggests that
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2022, International Review of Research in Developmental DisabilitiesCitation Excerpt :The features described above relate to the cognitive component of social anxiety (e.g., negative social worries), and are implicated in some models of social anxiety in ASD, which will be explored later in the chapter. Escaping from a socially threatening situation is one of the most common avoidance behaviors in people who experience social anxiety (Bögels & Mansell, 2004). However, when these people with social anxiety do persist in social situations, they may engage in “safety behaviors” or “subtle avoidance” in order to prevent social distress (Clark & Wells, 1995).