The Disqualification of Positive Social Outcomes Scale: a novel assessment of a long-recognized cognitive tendency in social anxiety disorder

Fear of Positive Evaluation and Loneliness: Mediating Role of Social Anxiety and Suppression

Loneliness is a commonly observed problem that is associated with several mental and physical health outcomes. Although research shows that fear of negative evaluation is related to loneliness, no study has examined the role of fear of positive evaluation (FPE) on loneliness. This study investigated the mediator role of social anxiety and suppression in the relationship between FPE and loneliness using an undergraduate sample (N = 467). The results show that FPE is positively associated with loneliness and that this relationship is mediated by social anxiety and suppression. This study highlights the importance of the FPE in understanding loneliness and can guide intervention programs for loneliness.

The Shared and Distinct Mechanisms Underlying Fear of Evaluation in Social Anxiety: The Roles of Negative and Positive Evaluation

Social anxiety disorder (SAD) is associated with persistent fear of negative evaluation (FNE) and fear of positive evaluation (FPE), which play critical roles in the development and maintenance of anxiety symptoms. However, it remains unclear how FNE and FPE contribute to the common and different symptoms of social anxiety. In this review, we tried to elucidate the shared and distinct mechanisms underlying fear of evaluation and clarify the impact of FNE and FPE on social anxiety by integrating the theories, external expressions, and internal mechanisms. First, FNE and FPE share evolutionary functions but have distinct motivations for maintaining social role stability. Second, FNE and FPE share similar emotions and avoidance behaviors but contribute to distinct comorbid symptoms in SAD, including eating disorders and alcohol abuse. Third, FNE and FPE share emotional and social pain circuits but have different dysfunctions in the prefrontal, cingulate, and reward brain regions, which are associated with rejection sensitivity and anhedonia features. Overall, this review sheds light on the cognitive and neural mechanisms of SAD based on fear of evaluation, highlighting both the shared and distinctive aspects of FNE and FPE. These insights have important implications for the development of effective interventions for social anxiety.

Bivalent Fears of Evaluation in Social Anxiety: Evaluation of an Extended Psychoevolutionary Model

Fears of negative evaluation (FNEs) and fears of positive evaluation (FPEs) comprise a bivalent model of evaluation that can explain the aetiology and maintenance of Social Anxiety Disorder (SAD). In this study, we examined an extended version of this model which incorporates two related cognitive processes (concerns about reprisal and discounting of positive outcomes) as partial mediators of the effects of FNEs and FPEs. We built on earlier work by including a broader measure of social anxiety across different social situations and comparing models for groups of participants with and without probable SAD. Structural equation modelling was utilised to test the model in a sample of 890 university students (74.8% female, mean age 29.49). We replicated the findings of Cook et al. in the overall sample and in the group with probable SAD. FNEs and FPEs predicted social anxiety directly and were serially mediated by concerns about reprisal and discounting positive outcomes. The model was also a good fit for those without SAD; however, in the model, FNEs were no longer a direct predictor of social anxiety. The findings confirm the utility of the extended bivalent model and have implications for psychoevolutionary accounts of social anxiety.

Development and validation of the positive evaluation core beliefs scale for social anxiety

Fear of positive evaluation (FPE) is becoming recognised as an important component of social anxiety that is distinct from fear of negative evaluation (FNE). While core belief scales exist for fear of negative evaluation (FNE), none has been developed for FPE. Therefore, this paper describes the development and validation of a measure of core beliefs that is specific to FPE. An exploratory factor analysis was performed on 60 initial items with an Australian undergraduate sample, in which a confirmatory factor analysis was performed with an independent Australian general population sample. A series of further analyses were performed to test convergent and divergent validity. The Positive Evaluation Core Beliefs Scale (PECS) emerged as a 17-item two-factor psychometrically valid measure that correlates more strongly with measurement of FPE than FNE. The PECS measure offers a new opportunity for researchers and clinicians to better explore cognitions associated with social anxiety.

CyberStatus: Responses to status manipulation and fears of positive and negative evaluations

Fear of positive evaluation (FPE) and fear of negative evaluation (FNE), which play distinct and central roles in social anxiety (SA), are postulated to reflect conflicting forces in hierarchal group contexts. Yet, experimental studies testing these assumptions are scarce. We examined the impact of status positions on FPE, FNE, and SA using a novel manipulation, CyberStatus. Participants (N = 557) provided self-descriptive statements before being randomly assigned to high, intermediate, or low-status conditions. Next, they reported their emotions, status, and belongingness-related cognitions and adjusted their self-presentation. FPE was more strongly linked to self-presentation modifications in the high- compared to intermediate-status conditions and positively associated with perceived status in the low vs. intermediate conditions. Furthermore, FPE and SA were more linked to belongingness in low vs. intermediate status conditions while FNE demonstrated the reversed pattern. These findings support and expand the evolutionary perspective on evaluation fears and emphasize the importance of assessing the linkage between status and belongingness systems in SA.

Long-Term Outcomes and Cost-Effectiveness of an Internet-Based Self-Help Intervention for Social Anxiety Disorder in University Students: Results of a Randomized Controlled Trial

Social anxiety disorder (SAD) is widespread among university students and is associated with high costs for the society. While unguided internet- and mobile-based interventions (IMIs) may have short-term effects in reducing SAD symptoms, evidence for their long-term efficacy and cost-effectiveness is still limited. The aim of this study is to examine the 6-month outcomes of an IMI for university students with SAD. Participants were recruited via mass mails sent to enrolled students and included if they were at least 18 years old, met the diagnostic criteria of SAD in a structured clinical interview for DSM-IV axis I disorders (SCID-I), and provided written informed consent. In a prospective study designed as a two-armed randomized-controlled trial, 200 students (mean age 26.7 years) diagnosed with SAD were randomly assigned to an IMI or a waitlist control (WLC) condition. The IMI consisted of nine weekly sessions based on the cognitive-behavioral treatment model for social phobia by Clark and Wells. The primary outcome was SAD symptom severity assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). A health economic evaluation from a societal and healthcare perspective examined the costs related to the symptom-free status and quality-adjusted life years (QALYs) gained. Statistically significant differences in SAD symptom severity previously found at posttreatment favoring the IMI were maintained at a 6-month follow-up [SIAS (Cohen's d = 0.59; 95% CI, 0.30, 0.87) and SPS (Cohen's d = 0.83; 95% CI, 0.54, 1.1)]. From a societal perspective, at a willingness to pay (WTP) of €0, the intervention was found to have a 92% and 93% probability of cost-effectiveness compared with the WLC per symptom-free status and QALY gained, respectively. From a healthcare perspective, the likelihood of cost-effectiveness of the intervention was 97% per symptom-free status at a WTP of €1000 (US$1326) and 96% per QALY gained at a WTP of €6000 (US$7956). This IMI is effective in treating university students with SAD and has an acceptable likelihood of cost-effectiveness compared with WLC from a societal perspective. This intervention can be integrated into university healthcare to reach students with SAD as it is scalable, shows a high probability of cost-effectiveness, and overcomes known treatment barriers. This trial is registered with DRKS00011424.

Fear of positive evaluation mediates the relationship between self-efficacy and fear of negative evaluation in nursing students: A cross-sectional study

BACKGROUND

Fear of evaluation (including the negative and positive ones) has been the focus of scholarly attention as one of the core components of social anxiety. However, most existing research has focused on participants with social anxiety. Previous research has suggested that self-efficacy and fear of positive evaluation are associated with fear of negative evaluation. Still, it remains unknown whether there is an association between the three. For undergraduate nursing students in complex social environments, understanding the association between self-efficacy and fear of positive and negative evaluation is essential to facilitate the high-quality development of nursing talent.

OBJECTIVE

We aimed to explore the mediating role of fear of positive evaluation in the relationship between self-efficacy and fear of negative evaluation.

METHODS

A cross-sectional survey was conducted on 824 undergraduate nursing students using the Brief Fear of Negative Evaluation Scale-Straightforward Items, the Fear of Positive Evaluation Scale, and the General Self-Efficacy Scale. Pearson correlation analysis was used to explore the correlation of the variables. t-test or ANOVA was used as a univariate analysis. A bootstrap test was conducted to verify the mediating effect through the SPSS macro plugin PROCESS v3.3, with P < 0.05 indicating a statistically significant difference.

FINDINGS

Self-efficacy, fear of positive evaluation, and fear of negative evaluation were significantly associated. Self-efficacy directly and negatively predicted fear of negative evaluation (B = -3.14, p < 0.001). Fear of positive evaluation partially mediated between self-efficacy and fear of negative evaluation, with a mediating effect size of 38.22 %.

DISCUSSION

Self-efficacy can directly and negatively influence fear of negative evaluation. Meanwhile, it can also indirectly reduce the fear of negative evaluation by reducing the fear of positive evaluation. Nursing educators can improve the fear of negative evaluation by increasing students' self-efficacy and encouraging them to view positive assessments correctly.

Mechanisms Linking Perfectionism and Social Anxiety: The Role of Hostility and Disqualification of Positive Social Outcomes

While considerable research has focused on maladaptive perfectionism as a risk factor for social anxiety, little attention has been given to the mechanisms that mediate the effects. We integrated perfectionism with the bivalent fear of evaluation model of social anxiety to investigate 2 hypothesized mechanisms: hostile attribution bias and disqualification of positive social outcomes (DPSO). Specifically, we hypothesized that individuals with maladaptive perfectionism develop hostile attribution biases which then lead to DPSO, which in turn predisposes them to social anxiety. Participants were 242 individuals from the general population who completed measures of perfectionism, hostile attribution bias, DPSO, and social anxiety. A test of multiple mediators using bootstrapping supported the hypothesized multiple mediator models. The results suggested that maladaptive perfectionism predisposes an individual to social anxiety through hostile attribution bias and DPSO. The results further suggested that DPSO but not hostile attribution bias operates as an individual mediator in the perfectionism-social anxiety relationship. The findings from this study provide support for the bivalent fear of evaluation model of social anxiety; however, the use of a cross-sectional design limited our ability to find true cause-and-effect relationships.

A corticostriatal pathway mediating self-efficacy enhancement

Forming positive beliefs about one's ability to perform challenging tasks, often termed self-efficacy, is fundamental to motivation and emotional well-being. Self-efficacy crucially depends on positive social feedback, yet people differ in the degree to which they integrate such feedback into self-beliefs (i.e., positive bias). While diminished positive bias of this sort is linked to mood and anxiety, the neural processes by which positive feedback on public performance enhances self-efficacy remain unclear. To address this, we conducted a behavioral and fMRI study wherein participants delivered a public speech and received fictitious positive and neutral feedback on their performance in the MRI scanner. Before and after receiving feedback, participants evaluated their actual and expected performance. We found that reduced positive bias in updating self-efficacy based on positive social feedback associated with a psychopathological dimension reflecting symptoms of anxiety, depression, and low self-esteem. Analysis of brain encoding of social feedback showed that a positive self-efficacy update bias associated with a stronger reward-related response in the ventral striatum (VS) and stronger coupling of the VS with a temporoparietal region involved in self-processing. Together, our findings demarcate a corticostriatal circuit that promotes positive bias in self-efficacy updating based on social feedback, and highlight the centrality of such bias to emotional well-being.

Anxiety- and Depression-Related Individual Differences in Affective and Cognitive Judgments of Self-Referential Praise and Criticism

Introduction: While praise is generally pleasant and criticism unpleasant, individual differences in response to social evaluations arise from distinct personal traits and states. Here, we investigate how processing of self-referential praise and criticism varies with personal attributes related to anxiety and depression, two highly prevalent and often chronic affective conditions. Methods: Ninety-three healthy participants first completed questionnaires for anxiety- and depression-related traits and states, and then they were scheduled to perform an evaluation task to rate praise and criticism for pleasantness and truthfulness. Results: Fear of negative evaluation positively correlated with unpleasantness of criticism. Trait- and state-anxiety and depression were positively associated with the truthfulness of criticism but negatively associated with that of praise. We further divided participants into high- and low-scoring groups based on the medians of their scores of each scale that displayed significant correlations with comment ratings and found group differences in their responses to praise and criticism. Discussion: The findings suggest that more highly anxious and depressed individuals may be subject to negatively-distorted self-representations in response to self-referential evaluations, thus exhibiting attenuated rejection for criticism or reduced acceptance for praise, which may have important implications not only for facilitating daily social interactions but also for subclinical and clinical diagnosis and treatment given that affective and cognitive processing of self-referential evaluations serves as a critical process exhibiting the sense of the self.

Processing of increased frequency of social interaction in social anxiety disorder and borderline personality disorder

We investigated how patients with social anxiety disorder (SAD) and patients with borderline personality disorder (BPD) process an increase in the frequency of social interaction. We used an EEG-compatible version of the online ball-tossing game Cyberball to induce an increase in the frequency of social interaction. In the first condition, each player received the ball equally often (inclusion: 33% ball reception). In the following condition, the frequency of the ball reception was increased (overinclusion: 45% ball reception). The main outcome variable was the event-related potential P2, an indicator for social reward processing. Moreover, positive emotions were assessed. Twenty-eight patients with SAD, 29 patients with BPD and 28 healthy controls (HCs) participated. As expected, HCs and patients with BPD, but not patients with SAD, showed an increase in the P2 amplitude from the inclusion to the overinclusion condition. Contrary to our expectations, positive emotions did not change from the inclusion to the overinclusion condition. EEG results provide preliminary evidence that patients with BPD and HCs, but not patients with SAD, process an increase in the frequency of social interaction as rewarding.

Targeting fear of positive evaluation in patients with social anxiety disorder via a brief cognitive behavioural therapy protocol: a proof-of-principle study

BACKGROUND

Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.

AIMS

To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.

METHOD

Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.

RESULTS

A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.

CONCLUSIONS

Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.

Fear of positive evaluation and social anxiety: A systematic review of trait-based findings

BACKGROUND

Although fear of negative evaluation (FNE) has long been recognized as a core cognitive bias in social anxiety, fear of positive evaluation (FPE) has received considerable attention over the past several years. The literature would benefit from a synthesis of the current state of the research in order to contribute to our understanding of FPE.

METHODS

A systematic review of the literature was conducted in order to address several questions: (a) Is self-reported FPE distinct from self-reported FNE? (b) Is self-reported FPE related to social anxiety symptomatology? and (c) Is self-reported FPE uniquely related to social anxiety symptomatology when accounting for self-reported FNE? Inclusion criteria included studies published in English, testing FPE and FNE with trait-based measures, and testing social anxiety with either self-report or diagnostic interviews.

RESULTS

There were 33 studies identified in this review that provided convincing empirical support for each of these questions across community and clinical samples of adolescents, undergraduates, and adults.

LIMITATIONS

The systematic review did not have access to null results, present meta-analytic results, or include studies that evaluated FPE or social anxiety with experimental designs.

CONCLUSIONS

The findings from the systematic review support updated theoritical models of social anxiety and highlight the importance of assessing and treating FPE in clinical interventions.

Efficacy and cost-effectiveness of an unguided, internet-based self-help intervention for social anxiety disorder in university students: protocol of a randomized controlled trial

BACKGROUND

Social anxiety disorder (SAD) is highly prevalent among university students, but the majority of affected students remain untreated. Internet- and mobile-based self-help interventions (IMIs) may be a promising strategy to address this unmet need. This study aims to investigate the efficacy and cost-effectiveness of an unguided internet-based treatment for SAD among university students. The intervention is optimized for the treatment of university students and includes one module targeting fear of positive evaluations that is a neglected aspect of SAD treatment.

METHODS

The study is a two arm randomized controlled trial in which 200 university students with a primary diagnosis of SAD will be assigned randomly to either a wait-list control group (WLC) or the intervention group (IG). The intervention consists of 9 sessions of an internet-based cognitive-behavioral treatment, which also includes a module on fear of positive evaluation (FPE). Guidance is delivered only on the basis of standardized automatic messages, consisting of positive reinforcements for session completion, reminders, and motivational messages in response to non-adherence. All participants will additionally have full access to treatment as usual. Diagnostic status will be assessed through Structured Clinical Interviews for DSM Disorders (SCID). Assessments will be completed at baseline, 10 weeks and 6-month follow-up. The primary outcome will be SAD symptoms at post-treatment, assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Secondary outcomes will include diagnostic status, depression, quality of life and fear of positive evaluation. Cost-effectiveness and cost-utility analyses will be evaluated from a societal and health provider perspective.

DISCUSSION

Results of this study will contribute to growing evidence for the efficacy and cost-effectiveness of unguided IMIs for the treatment of SAD in university students. Consequently, this trial may provide valuable information for policy makers and clinicians regarding the allocation of limited treatment resources to such interventions.

TRIAL REGISTRATION

DRKS00011424 (German Clinical Trials Register (DRKS)) Registered 14/12/2016.

Efficacy of an unguided internet-based self-help intervention for social anxiety disorder in university students: A randomized controlled trial

OBJECTIVES

Internet- and mobile-based interventions (IMIs) offer the opportunity to deliver mental health treatments on a large scale. This randomized controlled trial evaluated the efficacy of an unguided IMI (StudiCare SAD) for university students with social anxiety disorder (SAD).

METHODS

University students (N = 200) diagnosed with SAD were randomly assigned to an IMI or a waitlist control group (WLC) with full access to treatment as usual. StudiCare SAD consists of nine sessions. The primary outcome was SAD symptoms at posttreatment (10 weeks), assessed via the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Secondary outcomes included depression, quality of life, fear of positive evaluation, general psychopathology, and interpersonal problems.

RESULTS

Results indicated moderate to large effect sizes in favor of StudiCare SAD compared with WLC for SAD at posttest for the primary outcomes (SPS: d = 0.76; SIAS: d = 0.55, p < 0.001). Effects on all secondary outcomes were significant and in favor of the intervention group.

CONCLUSION

StudiCare SAD has proven effective in reducing SAD symptoms in university students. Providing IMIs may be a promising way to reach university students with SAD at an early stage with an effective treatment.

Malaise with praise: A narrative review of 10 years of research on the concept of Fear of Positive Evaluation in social anxiety

Social anxiety is characterized by a fear of being negatively evaluated by others (i.e., Fear of Negative Evaluation [FNE]). In 2008, Weeks, Heimberg, and Rodebaugh proposed Fear of Positive Evaluation (FPE) as a second cognitive component in social anxiety. The article presents an overview of FPE, its psycho-evolutionary theoretical foundation and assessment by the Fear of Positive Evaluation Scale as well as relevant psychometric research on demographic characteristics. The relationship of FPE with a wide range of established dimensions from clinical, personality, and social psychology (i.e., self-esteem, perfectionism, or quality of life) will be reviewed. The role of FPE for psychological comorbidities such as other anxiety disorders, depression, eating, and substance use disorders as well as for treatment of social anxiety will be discussed. Future research might address questions of causality of FPE relative to related constructs, further data on psychometric properties, as well as on its independence from FNE in longitudinal studies. In sum, FPE seems to be a valid and reliable construct that explains cognitions, emotions, and behavior related to social anxiety at subclinical and clinical levels and therefore enriches the psychometric repertoire in the fields of social psychology, personality, and clinical psychology.

Partners' Support During Good Times: Associations With Fears of Positive and Negative Evaluation

Capitalization interactions within romantic couples, in which they share positive events with each other, are significantly tied to their satisfaction and overall wellbeing. Recent work suggests that social anxiety is negatively associated with beneficial capitalization interactions (i.e., making capitalization bids and responding with active and constructive responses). To further investigate this understanding, we offer a deeper and differentiating look at two core components of social anxiety: fears of positive and negative evaluation. In addition, we offer an innovative look at the varying self-disclosures of capitalization recipients, by using a novel index—Relevant Talking Time (RTT) which examines the duration of relevantly disclosing and discussing one's own good event. We reasoned that the two types of evaluative fears might have different connections to capitalization processes, considering provision, receipt, and self-disclosure. Our findings (N = 74; 37 community couples in a lab-videotaped‘ interaction) suggest that high fear of positive evaluation is associated with poorer provision of active-constructive capitalization, whereas high fear of negative evaluation is associated with a reduced disclosers' RTT. In addition, our results interestingly demonstrate that disclosers' RTT is tied to their partners' anxiety characteristics as well. We discuss the possible implications and explanations of our findings.

Examination of the Brief Fear of Negative Evaluation Scale–Version 2 and the Brief Fear of Negative Evaluation Scale–Straightforward Items Factor Structure in a Sample of U.S. College Students

The current study examined the factor structure of the Brief Fear of Negative Evaluation–Straightforward Items (BFNE-S) and the Brief Fear of Negative Evaluation–Version 2 (BFNE-II) among 151 college students from the United States. Results indicated that the BFNE-S and the BFNE-II scores demonstrated excellent internal consistency reliability. Single-group confirmatory factor analyses found that compared with the BFNE-II, the BFNE-S demonstrated a superior fit for the unitary theoretical model. Together, these findings suggest that the BFNE-S appears to be a better measure for assessing fear of negative evaluation in U.S. college students.

"Having the heart to be evaluated": The differential effects of fears of positive and negative evaluation on emotional and cardiovascular responses to social threat

Accumulating evidence supports fear of evaluation in general as important in social anxiety, including fear of positive evaluation (FPE) and fear of negative evaluation (FNE). The present study examined state responses to an impromptu speech task with a sample of 81 undergraduates. This study is the first to compare and contrast physiological responses associated with FPE and FNE, and to examine both FPE- and FNE-related changes in state anxiety/affect in response to perceived social evaluation during a speech. FPE uniquely predicted (relative to FNE/depression) increases in mean heart rate during the speech; in contrast, neither FNE nor depression related to changes in heart rate. Both FPE and FNE related uniquely to increases in negative affect and state anxiety during the speech. Furthermore, pre-speech state anxiety mediated the relationship between trait FPE and diminished positive affect during the speech. Implications for the theoretical conceptualization and treatment of social anxiety are discussed.

Psychometric evaluation of the Concerns of Social Reprisal Scale: Further explicating the roots of fear of positive evaluation

Fear of positive evaluation (FPE) has been proposed to be an important feature of social anxiety disorder (SAD) and to be rooted, at least partly, in concerns of social reprisal due to positive impressions. In order to formally test this hypothesis, the Concerns of Social Reprisal Scale (CSRS) was developed. The purpose of the present series of studies was to examine the psychometric profile of the CSRS across several independent samples including: a large (n=981) undergraduate sample; a clinical sample of individuals diagnosed with social anxiety disorder (n=27), and a demographically-matched subsample of healthy control participants (n=24). The factorial validity, internal consistency, and construct validity of the CSRS were examined. Results across both studies provided support for the psychometric profile of the CSRS. The implications of concerns of social reprisal for the assessment of social anxiety symptoms, theoretical models of fear of evaluation and SAD, and their potential clinical utility with regard to treating SAD are discussed.

Replication and extension of a hierarchical model of social anxiety and depression: fear of positive evaluation as a key unique factor in social anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215-224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.

Being "in" or "out" of the game: subjective and acoustic reactions to exclusion and popularity in social anxiety

Social Anxiety (SA) has been shown to be associated with compensatory deficits in pro-social behavior following exclusion and with failure to capitalize on social success. We assessed the subjective and expressive responses of high (n = 48) and low (n = 56) socially anxious individuals to exclusion, acceptance, and popularity induced by a participation in an online ball-tossing game. Before the manipulation, participants read aloud neutral and command utterances. Following the manipulation, participants rated their mood and cognitions and re-read the utterances. Acoustic properties (fundamental frequency-mF0, vocal intensity) of these utterances were analyzed. We found greater differences in self-esteem between high and low socially anxious individuals following the exclusion condition, as compared to the acceptance condition. Among low socially anxious individuals, exclusion promoted increased vocal confidence, as indicated by decreased mF0 and increased vocal intensity in uttering commands; High socially anxious individuals exhibited an opposite reaction, responding to exclusion by decreased vocal confidence. Following popularity, high SA was associated with decreased enhancement in mood and self-esteem in women but not in men. Consistent with evolutionary and interpersonal accounts of SA, we highlight the importance of examining the effects of SA and gender on events indicating unambiguous and unanimous social acceptance. Examining reactivity to changes in belongingness may have important implications for understanding the core mechanisms of SA.

Gaze avoidance in social anxiety disorder

BACKGROUND

The relationship between gaze avoidance and social anxiety has been examined previously using eye-tracking and static social images. Overall, findings to date highlight increased gaze avoidance as a behavioral marker of social anxiety. The purpose of the present study was to better elucidate the relationship between gaze avoidance and social anxiety disorder (SAD) symptoms via covert eye tracking of gaze tendencies in response to a dynamic computerized social interaction simulation. On the basis of the bivalent fear of evaluation (BFOE) model of social anxiety,([1]) it was expected that participants with SAD, compared to nonsocially anxious control (NSAC) participants, would exhibit gaze avoidance in response to both positive and negative social feedback.

METHODS

Participants with SAD (n = 20), and a sample of demographically equivalent NSAC (n = 19), were administered clinical diagnostic interviews and a computerized social simulation task. The simulation task consisted of viewing 26 dynamic videos (13 positive and 13 negative), each 12 s in duration. All participants were covertly eye tracked during the simulation.

RESULTS

SAD participants exhibited greater global gaze avoidance in response to both the positive and negative video clips in comparison to the controls. Moreover, the SAD group exhibited equivalent gaze avoidance in response to stimuli of both emotional valences.

CONCLUSIONS

These results provide additional support for gaze avoidance as a behavioral marker of SAD, as well as additional support for the BFOE model. Implications for the assessment of SAD are discussed.

Failure to capitalize on sharing good news with romantic partners: Exploring positivity deficits of socially anxious people with self-reports, partner-reports, and behavioral observations

Extending prior work on social anxiety and positivity deficits, we examined whether individual differences in social anxiety alter the ability to share and respond to the good news of romantic partners (i.e., capitalization support) and how this influences romantic relationship satisfaction and commitment. In this study of 174 heterosexual couples (average age of 21.5 with 58.3% identifying as Caucasian), greater social anxiety was associated with the provision and receipt of less supportive responses to shared positive events as measured by trait questionnaires, partner reports, and behavioral observations in the laboratory. In longitudinal analyses, individuals in romantic relationships with socially anxious partners who experienced inadequate capitalization support were more likely to terminate their relationship and report a decline in relationship quality six months later. As evidence of construct specificity, social anxiety effects were independent of depressive symptoms. Taken together, social anxiety influenced a person's ability to receive and provide support for shared positive events; these deficits had adverse romantic consequences. Researchers and clinicians may better understand social anxiety by exploring a wider range of interpersonal contexts and positive constructs. The addition of capitalization support to the social anxiety literature offers new insights into interpersonal approaches and treatments.

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With romantic partners, socially anxious people provided and received less supportive responses to shared positive events.

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Independent observers viewed socially anxious individuals as unenthusiastic and non-expressive of positive emotions.

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Over 6-months, social anxiety moderated the influence of capitalization support on relationship stability and quality.

Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder

The Fear of Positive Evaluation Scale (FPES; J. W. Weeks, R. G. Heimberg, & T. L. Rodebaugh, 2008) was designed to assess fear of positive evaluation, a proposed cognitive component of social anxiety. Although previous findings on the psychometric properties of the FPES have been highly encouraging, only 1 previous study has examined the psychometric profile of the FPES in a sample of patients with social anxiety disorder (T. A. Fergus et al., 2009). The primary purpose of the present study was to conduct a large multisite examination of the psychometric profile of the FPES among patients with a principal diagnosis of social anxiety disorder (n = 226; generalized subtype = 97.8%). Responses of nonanxious control participants (n = 42) were also examined. The factorial validity, internal consistency, test-retest reliability, construct validity, and treatment sensitivity of the FPES were strongly supported by our findings. Furthermore, an FPES cutoff score was identified for distinguishing levels of fear of positive evaluation characteristic of patients with social anxiety disorder from those characteristic of the control group. Results provide additional support for the psychometric properties of the FPES in clinical samples.

The hierarchical model of social interaction anxiety and depression: the critical roles of fears of evaluation

In this paper, we articulate a hierarchical model of social interaction anxiety (SIA) and depression to account for their comorbidity and the uniqueness of SIA. First, negative affect (NA) and positive affect (PA) are conceptualized as general factors shared by SIA and depression; the fear of negative evaluation (FNE) is operationalized as the specific factor, which accounts for more of the variance in SIA than in depression, and the fear of positive evaluation (FPE) is operationalized as the factor unique to SIA. FPE is the key feature that differentiates SIA from depression. Second, the proposed hierarchical model describes structural relationships among these factors, in which the higher-level factors (i.e., high NA and low PA) represent the vulnerability markers of both SIA and depression and the lower-level factors (i.e., FNE and FPE) are the dimensions of specific cognitive features. In addition, an alternative model, in which all of the relationships are the same, except that FPE is operationalized as a specific factor, is proposed to clarify the role of FPE. The results from the hierarchical regression and the structural equation modeling support the hypothesized hierarchical model. Further theoretical and practical implications for FPE and the multilevel model are discussed.