Cognitive Therapy of Anxiety Disorders

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Social Phobia 359


elicited more negative reactions from others. In a more recent study individuals with
social phobia reported greater use of safety behaviors and exhibited larger performance
deficits in standard conversation and speech tasks than individuals with other anxiety
disorders or nonclinical controls (Stangier et al., 2006). A subsequent path analysis
revealed that safety behaviors partially mediated group differences in social perfor-
mance. In a series of single-case studies, Wells et al. (1995) found that a single session
of exposure plus decreased use of safety behaviors was significantly more effective than
a single session of exposure alone in reducing within- situation anxiety and catastrophic
beliefs. At this point, only a few studies have investigated the role of safety behaviors
in social phobia but these initial findings suggest that maladaptive safety seeking may
play a role in the persistence of social anxiety. More research is needed, especially on
the relation between involuntary inhibitory behavior and production of safety- seeking
coping responses.


Clinician Guideline 9.11
Target cognitive and behavioral safety or concealment responses in cognitive therapy of
social phobia.

Hypothesis 6


Postevent processing of social situations is characterized by an explicit autobiographical
memory bias for past negative social experiences in those with social phobia.


Unlike other disorders in which anxiety declines or ceases after escape from a
threatening situation, individuals with social phobia will experience recurrence of anxi-
ety as they recall past social incidents that were embarrassing and associated with per-
ceived negative evaluation. Postevent processing involving repeated biased recall and
rumination about past threatening social events will increase anticipatory anxiety for
future social situations by providing schema- congruent evidence of social threat and
ineptitude.
Researchers have only recently begun to investigate the role of postevent processing
in social phobia. In a study by Mellings and Alden (2000), high and low socially anxious
students, who participated in a standard social interaction, were assessed for rumina-
tion and recall of the interaction 1 day later. The highly anxious group reported signifi-
cantly more rumination and there was a tendency for postevent rumination to predict
recall of negative self- related information about the previous day’s interaction with the
laboratory confederate (see also Kocovski & Rector, 2008). Abbott and Rapee (2004)
found that socially phobic individuals engaged in significantly more negative rumina-
tion about a 3-minute impromptu speech given 1 week earlier and this was related to
how negatively they appraised their speech performance. In addition 12 weeks of CBT
led to a significant reduction in negative postevent rumination.
A questionnaire study of past learning experiences found that individuals with
social phobia indicated that they ruminated about their poor performance in past
embarrassing social situations significantly more than nonclinical controls (Harvey et

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