Fear of evaluation in social anxiety: Mediation of attentional bias to human faces

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Highlights

  • Fear of negative evaluation (FNE) and fear of positive evaluation are implicated in social anxiety.

  • Levels of FPE (but not FNE) predicted attention bias to a social threat stimulus.

  • FPE fully mediated the relationship between social anxiety symptoms and attention.

Abstract

Social anxiety disorder (SAD) is a debilitating psychological disorder characterised by excessive fears of one or more social or performance situations, where there is potential for evaluation by others. A recently expanded cognitive-behavioural model of SAD emphasizes that both the fear of negative evaluation (FNE) and the fear of positive evaluation (FPE) contribute to enduring symptoms of SAD. Research also suggests that socially anxious individuals may show biases toward threat relevant stimuli, such as angry faces. The current study utilised a modified version of the pictorial dot-probe task in order to examine whether FNE and FPE mediate the relationship between social anxiety and an attentional bias. A group of 38 participants with moderate to high levels of self-reported social anxiety were tested in groups of two to four people and were advised that they would be required to deliver an impromptu speech. All participants then completed an assessment of attentional bias using angry-neutral, happy-neutral, and angry-happy face pairs. Conditions were satisfied for only one mediation model, indicating that the relationship between social anxiety and attentional avoidance of angry faces was mediated by FPE. These findings have important clinical implications for types of treatment concerning cognitive symptoms of SAD, along with advancing models of social anxiety. Limitations and ideas for future research from the current study were also discussed.

Section snippets

Fear of evaluation in social anxiety: mediation of attentional biases to human faces

Social anxiety disorder (SAD) is a debilitating psychological disorder characterised by persistent and excessive fears of one or more social or performance situations, where there is potential of evaluation by others (American Psychiatric Association, 2013, Rapee and Heimberg, 1997). Epidemiological data suggests 12 month prevalence rates of 4.5% for SAD (males 3.0%, females 4.6%; Somers, Goldner, Waraich, & Hsu, 2006). The disorder can be severely incapacitating with significant impairment in

Cognitive theories of social anxiety

Cognitive-behavioural models attempt to explain the processes that shape and maintain social anxiety, with emphasis on the preferential allocation of attentional resources to threat, and excessive self-focused attention due to fears of negative evaluation from others (Clark and Wells, 1995, Hirsch and Clark, 2004, Rapee and Heimberg, 1997). Fear of negative evaluation (FNE) is a core component of cognitive-behavioural models of social anxiety with extensive empirical support (Clark and Wells,

Fear of evaluation

Consistent with psycho-evolutionary models of social anxiety, it has been suggested that FPE and FNE may serve separate and distinct adaptive goals (Gilbert, 2001, Weeks and Howell, 2012). For example, those who view themselves as socially inferior to others may avoid giving a positive impression that could be regarded as a threat by other group members (FPE), whilst also motivated not to appear so socially unfavourable as to be excluded from the social group (FNE; Weeks, Rodebaugh, Heimberg,

Attentional bias

In an effort to measure attentional bias, many researchers have employed well established research paradigms such as the emotional Stroop task and the dot-probe task. These techniques are the most frequently used paradigms for studying attentional bias in social anxiety (Lee & Telch, 2008), resulting in accumulated evidence for attentional vigilance toward negative stimuli with socially anxious individuals (Mogg & Bradley, 2002).

Aims, overview and hypotheses

While there is a body of literature investigating attentional biases, and research that supports the prominence of FNE as a core cognitive component of social anxiety, FPE is a relatively novel construct with limited knowledge on the importance of this construct. Furthermore, it remains unknown whether fear of evaluation mediates the relationship between social anxiety and attentional bias. Therefore, the current study aimed to replicate and extend earlier work on attentional biases more

Participants

A total of 81 undergraduate students volunteered in exchange for partial course credit. Students with social/performance anxiety experiences were strongly encouraged to participate in order to yield a sample of individuals scoring higher than non-anxious samples on mean levels of social anxiety. Only those scoring in the middle and upper quartile ranges (a total score of >27) on the Social Interaction Anxiety Scale (SIAS; Mattick & Clarke, 1998) were used in the analysis (n = 40). The SIAS was

Results

The means, standard deviations and ranges of all the measures used and attentional bias scores are presented in Table 1. A paired samples t-test revealed a statistically significant difference between STAI-S baseline and post-induction scores (t(37) = 9.35, p < .001), with higher anxiety scores after induction, indicating that the social threat induction increased participant's state anxiety.

Discussion

Cognitive-behavioural theories of social anxiety place emphasis on the preferential allocation of attentional resources to threat, and excessive self-focused attention due to fears of evaluation (Clark and Wells, 1995, Hirsch and Clark, 2004, Rapee and Heimberg, 1997). However, when socially anxious participants are tested under conditions of social-evaluative threat, the bias pattern found is avoidance of angry faces relative to neutral faces and avoidance of happy faces compared to neutral

Conclusion

In conclusion, the current findings are encouraging given that they are the first to address the unique contribution of FPE in explaining the relationship between social anxiety and an avoidance of angry faces under conditions of concurrent social-evaluative threat. Such findings provide added insight with respect to the underlying aetiology and maintenance of SAD and add to the nascent literature which promotes the importance of FPE to conceptualisations of social anxiety. In this manner,

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