Cognitive Constructs and Social Anxiety Disorder: Beyond Fearing Negative Evaluation

Abstract

Pioneering models of social anxiety disorder (SAD) underscored fear of negative evaluation (FNE) as central in the disorder's development. Additional cognitive predictors have since been identified, including fear of positive evaluation (FPE), anxiety sensitivity, and intolerance of uncertainty (IU), but rarely have these constructs been examined together. The present study concurrently examined the variance accounted for in SAD symptoms by these constructs. Participants meeting criteria for SAD (n = 197; 65% women) completed self-report measures online. FNE, FPE, anxiety sensitivity, and IU all accounted for unique variance in SAD symptoms. FPE accounted for variance comparable to FNE, and the cognitive dimension of anxiety sensitivity and the prospective dimension of IU accounted for comparable variance, though slightly less than that accounted for by FNE and FPE. The results support the theorized roles that these constructs play in the etiology of SAD and highlight both FNE and FPE as central foci in SAD treatment.

Social anxiety is characterized by biased learning about performance and the self.

“…This finding is consistent with growing evidence that SAD is characterized by diminished positive affect in addition to greater negative affect (Amir, Prouvost, & Kuckertz, 2012; Gilboa-Schechtman, Shachar, & Sahar, 2014; Kashdan, 2007). It is also in line with previous findings suggesting that SAD is associated with fear of positive , in addition to fear of negative social evaluation (Alden, Taylor, Mellings, & Laposa, 2008; Arkin & Appelman, 1983; Sapach, Carleton, Mulvogue, Weeks, & Heimberg, 2015; Wallace & Alden, 1997; Weeks, 2015; Weeks & Howell, 2012). …”

Intolerance of uncertainty moderates the relations among religiosity and motives for religion, depression, and social evaluation fears

“…IU and depression may be positively related, because IU serves as a key underlying vulnerability factor for psychopathology and because uncertainty is inescapable (Carleton, , ), potentiating hopelessness and helplessness (e.g., Dugas et al, ; Nelson et al, ). IU is also generally related to higher fear of negative evaluation (FNE; e.g., Carleton, Collimore, & Asmundson, ) and fear of positive evaluation (FPE; Teale Sapach, Carleton, Mulvogue, Weeks, & Heimberg, ), which is defined as the fear of social reprisal that may result from being publically and positively evaluated (e.g., Weeks & Howell, , ). Both FNE and FPE also relate to depression (e.g., Collins, Westra, Dozois, & Stewart, ; Weeks, Heimberg, & Rodebaugh, ; Reichenberger, Wiggert, Agroskin, Wilhelm, & Blechert, ), social anxiety (Boelen & Reijntjes, ; Boelen, Vrinssen, & van Tulder, ; Weeks & Howell, ), and eating pathology (Gilbert, & Meyer, ; Levinson & Rodebaugh, ; Menatti, Deboer, Weeks, & Heimberg, ).…”

“…Both FNE and FPE also relate to depression (e.g., Collins, Westra, Dozois, & Stewart, ; Weeks, Heimberg, & Rodebaugh, ; Reichenberger, Wiggert, Agroskin, Wilhelm, & Blechert, ), social anxiety (Boelen & Reijntjes, ; Boelen, Vrinssen, & van Tulder, ; Weeks & Howell, ), and eating pathology (Gilbert, & Meyer, ; Levinson & Rodebaugh, ; Menatti, Deboer, Weeks, & Heimberg, ). Although evaluative feedback can often seem ambiguous, individuals with persistent evaluative fears have difficulty tolerating this ambiguity, tend to fear that they are being evaluated (e.g., Teale Sapach et al, ), and may engage in maladaptive coping behaviors to alleviate these fears, such as social avoidance (e.g., Carleton et al, ; Heimberg, Brozovich, & Rapee, ) and disordered eating to achieve control and desired body shape (e.g., McFillin et al, ).…”

Latent dimensions of social anxiety disorder: A re-evaluation of the Social Phobia Inventory (SPIN)

“…This third latent variable may relate to the well-established construct Intolerance of Uncertainty (IU), which has been conceptualized as a trans-diagnostic risk factor for anxiety disorders (Carleton, 2012) and incorporated into recent theoretical accounts of SAD (Teale Sapach, Carleton, Mulvogue, Weeks, & Heimberg, 2015). Notably, IU has been shown to predict social anxiety severity even after controlling for fear of negative evaluation (Boelen & Reijntjes, 2009; Carleton, Collimore, & Asmundson, 2010; Teale Sapach et al, 2015).…”

“…Notably, IU has been shown to predict social anxiety severity even after controlling for fear of negative evaluation (Boelen & Reijntjes, 2009; Carleton, Collimore, & Asmundson, 2010; Teale Sapach et al, 2015). In the current study, Fear of Uncertainty in Social Situations displayed a stronger relationship than the other SPIN factors to GAD severity, a domain that has a long-established association with IU (Dugas et al, 2005).…”