Adaptive and maladaptive emotion regulation strategies: Interactive effects during CBT for social anxiety disorder
Section snippets
Background
In the past decade, there has been growing interest in understanding emotion regulation difficulties in social anxiety disorder (SAD; e.g., Hofmann, 2010, Hofmann et al., 2012, Kashdan et al., 2014, Kashdan and Steger, 2006, Moscovitch et al., 2010, Turk et al., 2005). In non-clinical samples, symptoms of social anxiety have been associated with the use of the putatively maladaptive strategies of suppression (e.g., Kashdan and Breen, 2008, McLean et al., 2007, Perini et al., 2006), experiential
Participants
As part of a larger neuroimaging study examining CBT for SAD, participants were recruited through referrals, community flyers, and web listings advertising a free treatment at Stanford University (see Goldin et al., 2014) for detailed methods. We screened 436 individuals over the telephone to obtain preliminary eligibility information based upon the study inclusion/exclusion criteria (described in detail in the next section). Individuals who met these criteria (N = 110) were invited to
Preliminary analyses
Before conducting our main analyses, we examined how the measures of interest changed over time by running 3 GEE models, predicting weekly changes in social anxiety symptoms, use of maladaptive avoidance strategies, or use of adaptive engagement strategies by treatment study phase (N = 71 participants, n = 1088 observations). We found a significant two-way interaction between study phase and weekly changes in social anxiety symptoms, Wald's χ2 = 9.11, p < .001, b = .39, SE (.13), CI (.14; .65), the use
Discussion
In this study, we sought to expand upon the growing literature on emotion regulation deficits in SAD by adopting a contextual framework emphasizing the examination of interactions among strategies in the repertoire (e.g., Aldao & Nolen-Hoeksema, 2012). First, we found support for the presence of an asymmetry in the relationship between social anxiety symptoms and the use of adaptive engagement/maladaptive avoidance strategies, whereby the use of adaptive engagement strategies had a weaker
Authorship note
A. A., H. J., and J.G. developed the study concept. H. J., P. G., and J. G. contributed to the study design and data collection. A. A. conducted data analysis. All four authors wrote the manuscript and approved the final version for submission.
Funding
This research was supported by a National Institute of Mental Health Grant R01 MH076074 awarded to James J. Gross.
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