Problem 4 2.6
Hell is other people
Source 1 – Cognitive-Behavioural Models of Social Anxiety Disorder (Wong,
Gordon, Heimberg)
A cognitive model of SAD – Clark and Wells
SAD develops as a result of an interaction between innate behavioural
predispositions and life experiences
- It leads individuals to perceive the social world as a dangerous one which they
have little ability to navigate
Key feature - a strong desire to convey a particular favourable impression of oneself
to others and marked insecurity about one’s ability to do so
- contributes to the sense that the person is at substantial risk of behaving in an
inept and unacceptable fashion and that such behaviour will have catastrophic
consequences involving loss of status, loss of value, or rejection.
Dysfunctional processes
the dysfunctional pattern of social anxiety is comprised of 4 interactive processes
1. One enters a feared situation and judges that they may be in danger of being
negatively evaluated.
- They turn their attention inward and use interoceptive information as the main
source of feedback about their performance.
- Often, their internal experiences are believed to be obvious to those around
them (e.g., “I feel nervous, therefore everyone must realize I am nervous”)
- processing of the self as a social object – the attentional inward bias and
distorted images which is the alleged reason why exposure alone to feared
situations is insufficient to reduce social anxiety
2. The behaviours that socially anxious individuals engage in to prevent negative
evaluation by others (safety behaviours)
- E.g., a person concerned with others noticing his profuse sweating may wear an
extra layer of dark clothing
- safety behaviours often make the feared behaviour or outcome more likely to
occur: the extra layer of clothing may cause the person to sweat more
- maintain anxiety because they prevent the person from experiencing
unambiguous, disconfirming evidence of their negative beliefs about feared
consequences
3. Overestimate how negatively others evaluate their performance and predict the
consequences of social failures to be far worse than is realistic
- As a result of these cognitive distortions, they are hypervigilant in monitoring
their behaviour and performance, which may further impair their ability to fully
engage in social interactions
- Real performance deficits may result, which could lead to others perceiving them
to be socially unskilled, aloof, or unfriendly
4. Either before or after a social situation is encountered, individuals frequently
experience a period of anticipatory anxiety in which previous negative
, experiences are recalled, and expectations of failure and images of oneself
performing poorly are evoked
- Can lead to complete avoidance of the situation
- If situation is not avoided, anticipatory anxiety can lead the person to enter the
situation with a self-focused processing mode and reduced capacity for noticing
positive reactions from others
- After a social interaction, they often review their performance in detail, recalling
events and their outcomes to have been more negative than they really were
- This maintains negative self-schemas and increases the likelihood that the person
will avoid feared situations in the future
A cognitive-behavioural model of SAD – Rapee and Heimberg
social anxiety exists along a continuum, with individuals with SAD representing the
higher end of the continuum.
- the degree of dysfunctional patterns can also be represented along a continuum
- The difference between those with SAD and those without is “the extent to
which [individuals with SAD] appraise cues as predictive of threat and the extent
of threat predicted by a given cue”
A genetic tendency toward preferential attention to threat may be one factor which
influences the development of dysfunctional processes
- this interacts with early childhood family environment and/or other experiences
(e.g., being teased or bullied) to create a perception of the social world as being
dangerous and unforgiving
defining characteristic - assumption that others are likely to evaluate them
negatively
- attach fundamental importance to being accepted by others
- Result = a set of expectations and goals that the person feels unable to reach +
predictions of very negative consequences of this failure.
- Discrepancy between the mental representations of the self as seen by others
and others’ perceived expectations, lies at the heart of SAD.
Dysfunctional processes of a cognitive behavioural model of SAD
The prospect of an audience activates a mental representation of the self as they
imagine they are perceived by that audience.
- This mental representation of the self is a distorted image that is shaped by a
number of inputs
individuals form a “baseline image” that may be derived from past experiences and
actual images of the self as seen by an audience (e.g., from mirrors or photographs)
and which is consistent with negative self-schemas and core beliefs.
- It is modified by internal (interoceptive) and external feedback. E.g., sensations
of warmth blushing noticeably
- individuals have a bias toward attending to external cues in the social
environment that signal threat or negative evaluation.
Individuals preferentially allocate attentional resources to monitoring and adjusting
the mental representation of the self as perceived by the audience
- This is in addition to the attentional resources needed to engage in the social task
at hand
, - social performance suffers as attentional resources are taxed, and the poor
performance only serves to confirm negative mental representations of the self
key dysfunctional process - comparison of the mental representation of the self with
the perceived expectations of the audience
- believe that others hold extremely high standards for their performance - the
greater the perceived failure to live up to this standard, the greater the likelihood
of negative evaluation, and the greater the anxiety.
- often engage in avoidance or escape from feared situations, as it seemingly
provides respite from the cycle.
- avoidance becomes another source of shame and frustration and contributes to
an increasingly negative mental representation of the self as seen by the
audience.
research has shown that individuals with SAD frequently engage in negative self-
imagery
- the images of socially anxious individuals are often from the observer’s
perspective
- consistent with the theory that those with SAD formulate a mental
representation of the self as seen by the audience
recent research suggests that socially anxious individuals fear any evaluation,
whether it is negative or positive
- Fear of positive evaluation (FPE) may arise when successful social performance
activates the belief that others will expect continued success in future social
interactions, but the person may doubt his or her ability to meet these increased
expectations.
- those with SAD fear and attend to cues of evaluation, regardless of valence
- sele
Comparison between the models
Both models highlight the application of attentional resources to identifying threat
cues, maladaptive avoidance behaviours, and the dysfunctional cognitions held by
socially anxious individuals
- social skills may be intact, but anxiety, negative cognitions, or avoidance/safety
behaviours may impede social interaction and give the appearance of social skill
deficits
nature of attentional focus that occurs among individuals with SAD
- Clark and Wells - the core attentional bias is the person’s shift to monitoring
internal cues, which prevents them from attending to the actual reactions from
others
processing of external social cues does occur—and is negatively biased—but
this processing is reduced due to the direction of the person’s attention
toward internal cues
- Rapee and Heimberg - although there is an increase in self-focused attention
with increased anxiety, attention is directed externally in search of threat cues
interactive relationship between self-monitoring of internal cues and
monitoring of the environment for external threat
Hell is other people
Source 1 – Cognitive-Behavioural Models of Social Anxiety Disorder (Wong,
Gordon, Heimberg)
A cognitive model of SAD – Clark and Wells
SAD develops as a result of an interaction between innate behavioural
predispositions and life experiences
- It leads individuals to perceive the social world as a dangerous one which they
have little ability to navigate
Key feature - a strong desire to convey a particular favourable impression of oneself
to others and marked insecurity about one’s ability to do so
- contributes to the sense that the person is at substantial risk of behaving in an
inept and unacceptable fashion and that such behaviour will have catastrophic
consequences involving loss of status, loss of value, or rejection.
Dysfunctional processes
the dysfunctional pattern of social anxiety is comprised of 4 interactive processes
1. One enters a feared situation and judges that they may be in danger of being
negatively evaluated.
- They turn their attention inward and use interoceptive information as the main
source of feedback about their performance.
- Often, their internal experiences are believed to be obvious to those around
them (e.g., “I feel nervous, therefore everyone must realize I am nervous”)
- processing of the self as a social object – the attentional inward bias and
distorted images which is the alleged reason why exposure alone to feared
situations is insufficient to reduce social anxiety
2. The behaviours that socially anxious individuals engage in to prevent negative
evaluation by others (safety behaviours)
- E.g., a person concerned with others noticing his profuse sweating may wear an
extra layer of dark clothing
- safety behaviours often make the feared behaviour or outcome more likely to
occur: the extra layer of clothing may cause the person to sweat more
- maintain anxiety because they prevent the person from experiencing
unambiguous, disconfirming evidence of their negative beliefs about feared
consequences
3. Overestimate how negatively others evaluate their performance and predict the
consequences of social failures to be far worse than is realistic
- As a result of these cognitive distortions, they are hypervigilant in monitoring
their behaviour and performance, which may further impair their ability to fully
engage in social interactions
- Real performance deficits may result, which could lead to others perceiving them
to be socially unskilled, aloof, or unfriendly
4. Either before or after a social situation is encountered, individuals frequently
experience a period of anticipatory anxiety in which previous negative
, experiences are recalled, and expectations of failure and images of oneself
performing poorly are evoked
- Can lead to complete avoidance of the situation
- If situation is not avoided, anticipatory anxiety can lead the person to enter the
situation with a self-focused processing mode and reduced capacity for noticing
positive reactions from others
- After a social interaction, they often review their performance in detail, recalling
events and their outcomes to have been more negative than they really were
- This maintains negative self-schemas and increases the likelihood that the person
will avoid feared situations in the future
A cognitive-behavioural model of SAD – Rapee and Heimberg
social anxiety exists along a continuum, with individuals with SAD representing the
higher end of the continuum.
- the degree of dysfunctional patterns can also be represented along a continuum
- The difference between those with SAD and those without is “the extent to
which [individuals with SAD] appraise cues as predictive of threat and the extent
of threat predicted by a given cue”
A genetic tendency toward preferential attention to threat may be one factor which
influences the development of dysfunctional processes
- this interacts with early childhood family environment and/or other experiences
(e.g., being teased or bullied) to create a perception of the social world as being
dangerous and unforgiving
defining characteristic - assumption that others are likely to evaluate them
negatively
- attach fundamental importance to being accepted by others
- Result = a set of expectations and goals that the person feels unable to reach +
predictions of very negative consequences of this failure.
- Discrepancy between the mental representations of the self as seen by others
and others’ perceived expectations, lies at the heart of SAD.
Dysfunctional processes of a cognitive behavioural model of SAD
The prospect of an audience activates a mental representation of the self as they
imagine they are perceived by that audience.
- This mental representation of the self is a distorted image that is shaped by a
number of inputs
individuals form a “baseline image” that may be derived from past experiences and
actual images of the self as seen by an audience (e.g., from mirrors or photographs)
and which is consistent with negative self-schemas and core beliefs.
- It is modified by internal (interoceptive) and external feedback. E.g., sensations
of warmth blushing noticeably
- individuals have a bias toward attending to external cues in the social
environment that signal threat or negative evaluation.
Individuals preferentially allocate attentional resources to monitoring and adjusting
the mental representation of the self as perceived by the audience
- This is in addition to the attentional resources needed to engage in the social task
at hand
, - social performance suffers as attentional resources are taxed, and the poor
performance only serves to confirm negative mental representations of the self
key dysfunctional process - comparison of the mental representation of the self with
the perceived expectations of the audience
- believe that others hold extremely high standards for their performance - the
greater the perceived failure to live up to this standard, the greater the likelihood
of negative evaluation, and the greater the anxiety.
- often engage in avoidance or escape from feared situations, as it seemingly
provides respite from the cycle.
- avoidance becomes another source of shame and frustration and contributes to
an increasingly negative mental representation of the self as seen by the
audience.
research has shown that individuals with SAD frequently engage in negative self-
imagery
- the images of socially anxious individuals are often from the observer’s
perspective
- consistent with the theory that those with SAD formulate a mental
representation of the self as seen by the audience
recent research suggests that socially anxious individuals fear any evaluation,
whether it is negative or positive
- Fear of positive evaluation (FPE) may arise when successful social performance
activates the belief that others will expect continued success in future social
interactions, but the person may doubt his or her ability to meet these increased
expectations.
- those with SAD fear and attend to cues of evaluation, regardless of valence
- sele
Comparison between the models
Both models highlight the application of attentional resources to identifying threat
cues, maladaptive avoidance behaviours, and the dysfunctional cognitions held by
socially anxious individuals
- social skills may be intact, but anxiety, negative cognitions, or avoidance/safety
behaviours may impede social interaction and give the appearance of social skill
deficits
nature of attentional focus that occurs among individuals with SAD
- Clark and Wells - the core attentional bias is the person’s shift to monitoring
internal cues, which prevents them from attending to the actual reactions from
others
processing of external social cues does occur—and is negatively biased—but
this processing is reduced due to the direction of the person’s attention
toward internal cues
- Rapee and Heimberg - although there is an increase in self-focused attention
with increased anxiety, attention is directed externally in search of threat cues
interactive relationship between self-monitoring of internal cues and
monitoring of the environment for external threat
