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01-04-2015 | Original Article

What If I Appear Boring, Anxious, or Unattractive? Validation and Treatment Sensitivity of the Negative Self Portrayal Scale in Clinical Samples

Auteurs: David A. Moscovitch, Karen Rowa, Jeffrey R. Paulitzki, Martin M. Antony, Randi E. McCabe

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2015

Abstract

A recently developed self-report questionnaire, the Negative Self Portrayal Scale (NSPS; Moscovitch and Huyder in Behav Ther 42:183–196. doi:10.1016/j.beth.2010.04.007, 2011) assesses concerns about appearing socially incompetent, physically unattractive, and/or visibly anxious to evaluative others. Initial validation studies of the NSPS yielded promising results but were conducted exclusively on samples of undergraduate students. Here, we aimed to replicate and extend those initial studies by examining the factor structure, construct validity, and treatment sensitivity of the NSPS in samples of community-based participants with a principal diagnosis of social anxiety disorder (SAD), a principal anxiety disorder diagnosis other than SAD, or no history of psychological problems. Results provided support for the construct validity of the NSPS within clinical samples and suggested that the types of concerns assessed by the NSPS and its subscales may be useful for predicting individual differences in emotional and behavioral symptoms of social anxiety (SA) and for conceptualizing change processes during cognitive behavioral therapy for SAD. Confirmatory factor analyses indicated that while the hypothesized three-factor model fit significantly better than an alternative one-factor model, the fit indices associated with the three-factor model were below satisfactory cutoffs, thus tempering conclusions that the best fitting structure was found and highlighting the need for additional research. Implications of these findings are discussed vis-à-vis Moscovitch’s (Cogn Behav Pract 16:123–134. doi:10.1016/j.cbpra.2008.04.002, 2009) theoretical model of SA and the potential utility of the NSPS for both clinical research and practice.

vorige artikel The Impact of Perceived Standards on State Anxiety, Appraisal Processes, and Negative Pre- and Post-event Rumination in Social Anxiety Disorder

volgende artikel The Cognitive Behavioural Processes Questionnaire: A Preliminary Analysis within Student, Mixed Clinical and Community Samples and the Identification of a Core Transdiagnostic Process

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The disorder-specific treatment manuals used for the present study consisted of evidence-based CBT interventions adapted from several published CBT manuals and the scientific literature. More information about the specific treatment manuals is available upon request from the second author.

For the purposes of examining the factor structure of the NSPS, sample size constraints prohibited us from conducting a multiple group CFA. Prior to conducting the CFA on the pooled data, preliminary tests revealed that NSPS scores were not significantly associated with any of the demographic variables which may have differed across the subgroups. For example, the zero-order correlation between participant age and NSPS total scores was nonsignificant, r = .10, p = .19. Univariate ANOVAs further demonstrated that neither marital status, F(5,163) = .97, p = .44, nor ethnicity, F(5,167) = 1.0, p = .42, were predictive of NSPS total scores.

Equivalent results were found when the two CFA models were compared using only clinical participants (i.e., excluding the healthy controls).

Given that CBT for SA is geared toward addressing the types of concerns most typical of SA (and that this is not the focus of treatment for CBT for other AC conditions), it is reasonable to expect the Time × Treatment Focus interaction to be in only one direction (and not the opposite direction). Therefore, a one-tailed test of significance was used.

Examining each of the NSPS subscales separately in 2 (Time) × 2 (Treatment Focus) mixed ANOVAs revealed, interestingly, that there was a significant interaction for signs of anxiety, F(1,89) = 6.0, p = .01, η _p ² = .07 (SA group: Pretreatment Mean = 22.5; SD = 7.8; Posttreatment Mean = 17.2; SD = 7.4; AC group: Pretreatment Mean = 15.9; SD = 6.0; Posttreatment Mean = 13.5; SD = 5.6), but not for social competence [F(1,89) = 1.7, p = .19, η _p ² = .02], or for physical appearance [F(1,89) = 1.6, p = .20, η _p ² = .02]. However, the pattern of differences between group means over time for each of these subscales was consistent with expectations, such that patients who received CBT for SAD reported greater changes in NSPS concerns about social competence (SA group: Pretreatment Mean = 35.5; SD = 11.1; Posttreatment Mean = 29.9; SD = 12.8; AC group: Pretreatment Mean = 22.3; SD = 9.6; Posttreatment Mean = 19.1; SD = 9.6) and physical appearance (SA group: Pretreatment Mean = 25.0; SD = 8.8; Posttreatment Mean = 21.8; SD = 8.9; AC group: Pretreatment Mean = 16.1; SD = 7.5; Posttreatment Mean = 14.4; SD = 7.7) from pre- to post-treatment than those who received CBT for other anxiety disorders.

For this reason, the items that comprise the physical appearance subscale of the NSPS were worded specifically to capture these more general SAD-relevant physical appearance concerns rather than the more focused concerns about particular physical body parts, attributes, or weight and shape, which might be more applicable to BDD and the eating disorders.

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Titel: What If I Appear Boring, Anxious, or Unattractive? Validation and Treatment Sensitivity of the Negative Self Portrayal Scale in Clinical Samples
Auteurs: David A. Moscovitch
Karen Rowa
Jeffrey R. Paulitzki
Martin M. Antony
Randi E. McCabe
Publicatiedatum: 01-04-2015
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 2/2015
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-014-9645-5

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