360 TREATMENT OF SPECIFIC ANXIETY DISORDERS
al., 2005). In response to vignettes depicting an embarrassing social event, high socially
anxious students had more thoughts about the negative aspects of the situation than
low anxious individuals, a finding that is consistent with a postevent, ruminative coping
style (Kocovski, Endler, Rector, & Flett, 2005). In another study, high socially anxious
students tended to recall more negative and shameful memories when asked to recall
a past ambiguous social event (Field, Psychol, & Morgan, 2004; see also Morgan &
Banerjee, 2008).
Although still preliminary, it is apparent that postevent processing is an important
contributing factor to social anxiety. In their review Brozovich and Heimberg (2008)
concluded that self- report, diary, and experimental studies indicate that postevent pro-
cessing is a prominent cognitive process that contributes to social anxiety by reinforcing
negative impressions of oneself (i.e., mental representation of self from the assumed per-
spective of the audience), negative memories of social situations, and negative assump-
tions about future social encounters (see also Abbott & Rapee, 2004). Moreover, auto-
biographical memory recall bias for the negative aspects of past social events may be a
pivotal cognitive feature of postevent processing that accounts for its effects on anxiety.
Overall, there is some empirical support for Hypothesis 6, although a number of issues
remain such as whether postevent processing is more likely in performance than social
interaction situations, whether it becomes more negative and less positive over time, and
the role played by imagery (Brozovich & Heimberg, 2008).
Clinician Guideline 9.12
The cognitive therapist must also target change in postevent processing when treating
social anxiety. This is accomplished by reducing negative rumination about past perfor-
mance and encouraging a more positive reappraisal of past social performance and its con-
sequence.Anticipatory Phase
Although we have not generated a specific hypothesis about the anticipatory period of
social anxiety, this is not to minimize the importance of this phase in the pathogen-
esis of social phobia. Even though only a few studies have investigated anticipatory
pro cessing in social phobia, the preliminary findings are supportive of the cognitive
model.
Mellings and Alden (2000) found that only a high social anxiety group became
more apprehensive about participating in a second standard social interaction 1 day
after completing an initial unstructured 10-minute conversation with a confederate.
Based on a semistructured interview that assessed periods of anticipation before social
interactions, Hinrichsen and Clark (2003) reported that the high socially anxious group
(1) recalled more past perceived social failures; (2) were more aware of negative bodily
sensations, thoughts and images; and (3) relied more on problematic cognitive strategies
to manage their anticipatory anxiety. In a subsequent study both high and low socially
anxious students who were given anticipatory anxiety compared to distraction instruc-
tions during 20 minutes of preparation for a speech exhibited significantly higher anxi-
ety ratings (Hinrichsen & Clark, 2003; see also Vassilopoulos, 2008).