Cognitive Therapy of Anxiety Disorders

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Social Phobia 335


by acting or appearing foolish, less intelligent, or visibly anxious (Beidel & Turner,
2007). There is considerable empirical evidence that fear of negative evaluation is a core
feature of social phobia (e.g., Ball et al., 1995; Hackmann et al., 1998; Hirsch & Clark,
2004; Mansell & Clark, 1999; Voncken, et al., 2003). However, individuals with social
phobia may fear any social evaluation, either positive or negative, that involves feelings
of conspicuousness or self- consciousness (Weeks, Heimberg, Rodebaugh, & Norton,
2008). Moreover, the negative evaluation feared by those with social phobia is not sim-
ply some mildly negative impression on others but a much more extreme experience of
dreaded humiliation or shame (Beck et al., 1985, 2005). Shame is a painful affect in
which personal attributes, characteristics, or behavior are perceived as causing a loss
of social standing or attractiveness to others, or even worse, their outright criticism or
rejection (Gilbert, 2000).


Social Situations


The majority of individuals with social phobia experience marked anxiety in a variety
of social situations (Rapee, Sanderson, & Barlow, 1988; Turner, Beidel, Dancu, & Keys,
1986). Rachman (2004) noted that the most common situations feared in social pho-
bia are public speaking, attendance at parties or meetings, and speaking to authority
figures. Beidel and Turner (2007) reported that formal speaking (the most distressing
situation), parties, initiating and maintaining conversations, and informal speaking and
meetings were rated as distressing and avoided by more than 75% of patients with social
phobia. Dating was rated as distressing and something avoided by half of the sample,
whereas eating and drinking in public, using public washrooms, and writing in public
was feared by 25% or less of social phobic individuals. The anxiety- provoking situa-
tions in social phobia have been categorized as those dealing with social interaction
versus those concerned with performance (Rapee, 1995b). Table 9.2 presents a list of
interpersonal and performance situations from Antony and Swinson (2000b) that are
rated for level of fear and avoidance when assessing social phobia.


table 9.2. Common interpersonal and performance situations feared in social phobia


Interpersonal situations Performance situations


••Initiating a date or appointment with someone
••Being introduced to unfamiliar person
••Attending a party or social gathering
••Having friend for dinner
••Starting a conversation
••Talking on phone to a familiar person
••Talking on phone to an unfamiliar person
••Expressing your personal opinion to others
••Having job interview
••Being assertive with others
••Returning a purchased item
••Making eye contact
••Expressing dissatisfaction with restaurant food
••Talking to authority figures

••Making a toast or speech
••Speaking in meetings
••Playing sports in front of an audience
••Participating in a wedding party or public
ceremony
••Singing/performing to an audience
••Eating/drinking in a public setting
••Using public washrooms
••Writing in front of others
••Making a mistake in public (e.g.,
mispronouncing a word)
••Walking/running in busy public place
••Introducing yourself to others
••Shopping in a busy store
••Walking in front of a large group of people (e.g.,
walking up aisle of church, theater)

Note. Based on Antony and Swinson (2000b).

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