Cognitive Therapy of Anxiety Disorders

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Social Phobia 357


failed to find a significant effect for angry faces. Based on the face-in-the-crowd identi-
fication task, Gilboa- Schechtman et al. (1999) also found that individuals with GSP had
an attentional bias for angry faces. Other studies using a modified visual dot probe task
in which pairs of faces are shown found that high social anxiety is associated with atten-
tion away from emotional faces (Chen et al., 2002; Mansell et al., 1999). Furthermore,
Vassilopoulos (2005) found a vigilance- avoidance pattern with high social anxiety asso-
ciated with an initial attentional preference for social threat words at 200 milliseconds
exposure, followed by attentional bias away from the same stimulus word type at 500
milliseconds (see Amir et al., 1998a, for similar results). Recently Schmidt et al. (2009)
reported that training individuals with GSP to attend to neutral rather than disgusted
faces on a modified dot probe task results in significant reduction in social anxiety. This
suggests that attentional threat may have a causal role in social phobia.
In summary, there is strong support that socially anxious individuals exhibit an
automatic attentional bias for social threat. Recent studies indicate that attentional
bias for threat may be particularly evident when socially phobic individuals process
angry faces, a stimulus highly salient for individuals with fear of negative evaluation
(Stein, Goldin, Sareen, Eyler Zorrilla, & Brown, 2002). However, a more complex
vigilance- avoidance pattern may best characterize the attentional bias for threat in
social phobia (Heimberg & Becker, 2002). Moreover, it is still unclear whether indi-
viduals with social phobia are hypervigilant for external social threat cues or instead
direct their attention away from external social stimuli in favor of heightened self-
focused attention.


Clinician Guideline 9.9
In cognitive therapy of social phobia deliberate and effortful processing of positive social
cues is encouraged to correct the negative effects of the client’s automatic attentional bias for
social threat.

Hypothesis 4


For social phobia exposure to social situations is associated with a heightened self- focused
attention on internal cues of anxiety and its adverse effects on performance and the
perceived negative impression of others.


According to the cognitive model (see Figure 9.1), a heightened focus on one’s
thoughts, images, physiological responses, behaviors, and feelings will occur during
situational exposure because of activation of the maladaptive social self- schemas.
There is now consistent empirical support for this hypothesis. Individuals with social
phobia attend less to the external environment and more to their negative, self- focused
cognitions when confronting a social- evaluative experience (e.g., Daly et al., 1989;
Mansell & Clark, 1999). Other studies have reported an information- processing bias
for internal physiological cues rather than external social threat stimuli (Mansell et
al., 2003; Pineles & Mineka, 2005). When giving an impromptu speech, high socially
anxious individuals reported significantly greater perceived physiological activity than
low anxious individuals, even though the groups did not differ significantly in level of

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