Ecological momentary assessment of post-event processing in between two speech tasks: Relationships with cognitive and affective factors involved in the maintenance of social anxiety

Attention mechanisms of social anxiety in daily life: Unique effects of negative self-focused attention on post-event processing

Social anxiety disorder (SAD) is characterized by biased patterns of attention that are theorized to play a key role in maintaining symptoms. SAD has been linked to externally oriented attentional biases (i.e., towards social-evaluative threats) and internally oriented attentional biases (i.e., towards anxiety-laden thoughts and sensations), both of which might increase proneness for post-event processing (PEP), a form of rumination about the negative aspects of past social events. However, prior research examining attentional biases in SAD has primarily been conducted in laboratory settings, leaving unanswered questions about the naturalistic patterns of attention and cognition that most strongly characterize and maintain social anxiety. The present study applied ecological momentary assessment (EMA) to examine attentional biases during real-world social interactions and their effects on subsequent PEP in a sample of adults with high (n = 108) and low (n = 94) levels of social anxiety. Three times per day for one week, participants reported their attention orientation (i.e., internal versus external), the valence of their attentional foci (i.e., negative versus positive), and their degree of PEP following salient social events. Results revealed that high (vs. low) levels of social anxiety were associated with relatively more internally oriented and negatively valenced attention during social interactions, which in turn predicted increases in subsequent PEP. Findings highlight the salience of negative self-focused attention and ruminative thinking as maintenance factors in social anxiety, and suggest that interventions targeting these mechanisms could show promise in future research.

Post-event processing in social anxiety: A scoping review

Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referential thinking that occurs following a social-evaluative event, may partly explain inhibited desensitization to social fears. Post-event processing has been studied extensively since its first description by Clark and Wells (1995) and previously reviewed (e.g., Brozovich & Heimberg, 2008; Wong, 2016). However, these reviews are now dated or limited in scope. In the present scoping review, we pay particular attention to contemporary research that addresses unanswered questions raised in past reviews (e.g., Brozovich & Heimberg, 2008), synthesizing existing knowledge. Specifically, we discuss post-event processing's evolving role in cognitive models of social anxiety disorder, its core features, its eliciting situations (e.g., performance vs. social interactions), its relation to other cognitive and affective constructs (e.g., memory, performance appraisal, self-focused attention), and its assessment. Our findings indicate that post-event processing is more frequent after performance situations than social interactions, is related to negative memory biases, is bi-directionally related to worsening performance appraisals, and may be precipitated by self-focused attention. Future research directions include elucidating post-event processing's course, clarifying post-event processing's potential causal role in the development of social anxiety disorder, and identifying factors that underlie post-event processing's deleterious nature.

Studies of Social Anxiety Using Ambulatory Assessment: Systematic Review

BACKGROUND

There has been an increased interest in understanding social anxiety (SA) and SA disorder (SAD) antecedents and consequences as they occur in real time, resulting in a proliferation of studies using ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet.

OBJECTIVE

This review aimed to identify and describe the latest advances in the understanding of SA and SAD through the use of AA.

METHODS

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search was conducted in Scopus, PubMed, and Web of Science.

RESULTS

A total of 70 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive, and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use, and interactional patterns were the principal topics of the included studies. In addition, the incorporation of AA to study psychological interventions, multimodal assessment using sensors and biosensors, and transcultural differences were some of the identified emerging topics.

CONCLUSIONS

AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light on the cognitive, emotional, and behavioral antecedents and consequences of SA and the development and maintenance of SAD as a mental disorder.

A retrospective study of negative and positive post-event processing following stressful and pleasant social interactions

BACKGROUND AND OBJECTIVES

Negative post-event processing (PEP) is a key maintenance factor of social anxiety, but little is known about the role positive PEP, particularly in relation to situations that are not perceived as stressful. The objective was to examine negative and positive PEP following stressful and pleasant social interactions. We were also interested in how participants remembered and described the interactions.

METHODS

Young adults (n = 411) recalled a recent pleasant or stressful social interaction and indicated how much negative and positive PEP they engaged in since the interaction. They also completed questionnaires measuring social anxiety and the memory's phenomenological qualities and wrote a description of the interaction.

RESULTS

Higher social anxiety was linked with more negative and less positive PEP, regardless of whether the interaction was perceived as stressful or pleasant. Participants reporting more negative PEP used more negative words in describing the interaction and their memory was more negative and emotionally intense. Those reporting more positive PEP used more positive and less negative words in their descriptions. For stressful interactions, positive PEP was related to a more positive memory; for pleasant ones, it was related to increased emotional intensity.

LIMITATIONS

Limitations included the sample type (restricted age range, non-clinical) and the retrospective, cross-sectional nature of the study.

CONCLUSIONS

Results provide insight into PEP following stressful and pleasant social interactions. We also found preliminary evidence that positive PEP may be helpful and protective. Future studies may benefit from longitudinal and mixed methods designs.