A cognitive-behavioral model of anxiety in social phobia

Rapee, Ronald M.; Heimberg, Richard G.

doi:10.1016/s0005-7967(97)00022-3

Cited by 2,422 publications

(2,376 citation statements)

References 89 publications

Supporting

189

Mentioning

2,021

Contrasting

Unclassified

Order By: Relevance

“…First, we sought to examine how social anxiety is associated with different appraisals for various social interaction and risk-taking behaviors. Many of the results fit with dominant cognitive-behavioral models (Clark & Wells, 1995;Rapee & Heimberg, 1997); social anxiety was associated with greater threat appraisals for each domain of social and risk-taking behaviors. However, appraisals were not solely focused on threat, as socially anxious people reported frequent approach-avoidance conflicts.…”

supporting

confidence: 53%

“…People with excessive social anxiety vary in the amount of energy devoted to inhibiting and controlling their natural emotional reactions (Kashdan & Steger, 2006) and therefore, only a subset may regularly expend themselves to the point of being more impulsive, fickle, and quick-tempered than their more inhibited peers (Kashdan & Hofmann, in press). Since emotional well-being and self-regulation are significant contributors to success, being socially anxious and riskprone is expected to characterize a particularly impaired subgroup of people.Although the extant data are limited to date, existing theoretical models (Clark & Wells, 1995;Gilbert, 2001;Leary, 2001;Rapee & Heimberg, 1997) suggest conditions linking social anxiety to increased risk-prone activity. We present several speculations based on these theories.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Social anxiety and disinhibition: An analysis of curiosity and social rank appraisals, approach–avoidance conflicts, and disruptive risk-taking behavior

Kashdan

Elhai

Breen

2008

Journal of Anxiety Disorders

109

View full text Add to dashboard Cite

We examined how social anxiety is related to appraisals for various disinhibited behaviors and sought to identify potential subgroups of socially anxious people. College students completed trait measures and appraised disinhibited behaviors on their potential for threat, opportunity to satisfy curiosity, and ability to enhance social status. Three months later, participants were asked to report on their frequency of disinhibited behaviors since the initial assessment. People with greater social anxiety demonstrated frequent approach-avoidance conflicts -co-existing recognition of threats and rewards -about social interactions and disinhibited behaviors. Even when asked about the activity most likely to be avoided, participants with greater social anxiety evaluated these as having potential to satisfy curiosity and advance their social status. Three qualitatively different groups of people were identified based on social anxiety tendencies and approach-avoidance appraisal patterns. Groups differed on the degree of approach-avoidance conflicts, measures of psychological and social wellbeing, and frequency of social interactions and disinhibited behaviors. Moderately socially anxious people who were approach oriented reported the most difficulties. Results suggest that social anxiety is associated with tension between competing desires to avoid anxiety and explore. However, there appears to be important variability in the regulatory orientation, behavior, and well-being of socially anxious people. Conclusions about the nature of social anxiety may be compromised by not attending to existing differences in self-regulatory orientation and strategies.Keywords social anxiety; emotion regulation; curiosity; social rank; sexual activity; aggression; substance abuse One of the core components of social anxiety is an approach-avoidance conflict between wanting to make a good impression and form relationships with other people yet wanting to avoid exposure to negative evaluation (Clark & Wells, 1995;Gilbert, 2001;Kashdan, 2007; Contact Author: Todd B. Kashdan, Department of Psychology, MS 3F5, George Mason University, Fairfax, VA 22030, Email: E-mail: tkashdan@gmu.edu, Office Phone : 703-993-9486, Fax: 703-993-1359, website: http://mason.gmu.edu/∼tkashdan. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptRapee & . The motivation to avoid negative evaluation leads many socially anxious people to avoid or escape social situations. Most work on social anxiety has focused on over-regula...

show abstract

supporting

confidence: 53%

mentioning

confidence: 99%

Social anxiety and disinhibition: An analysis of curiosity and social rank appraisals, approach–avoidance conflicts, and disruptive risk-taking behavior

Kashdan

Elhai

Breen

2008

Journal of Anxiety Disorders

109

View full text Add to dashboard Cite

show abstract

“…Such images are usually associated with explicit fearful memories of past phobic experiences. The fearful memories then reinforce negative beliefs and strengthen the phobic response (Rapee and Heimberg 1997; Fehm and Margraf 2002). The anticipation and avoidance of potential future harm, and the retrieval of fearful memories, both seem to play a crucial role in the symptomatology and maintenance of specific phobias.…”

Section: Introductionmentioning

confidence: 99%

CBT reduces CBF: cognitive‐behavioral therapy reduces cerebral blood flow in fear‐relevant brain regions in spider phobia

et al. 2016

View full text Add to dashboard Cite

BackgroundImaging studies have provided evidence that cognitive‐behavioral therapy (CBT) is able to change brain activation in phobic patients in response to threatening stimuli. The changes occurred in both emotion‐generating and modulatory regions. In this study, we use a data‐driven approach to explore resting state cerebral blood flow (CBF) measured by arterial spin labeling (ASL), before and after CBT.MethodsEight female patients with spider phobia were scanned before and 1 month after an exposure‐based group therapy for spider phobia. Each MRI session consisted of an ASL resting state measurement acquired before and after a symptom provocation task involving the showing of spider pictures in the scanner. The first ASL acquisition measured anticipatory anxiety and the second measured postprocessing of phobia‐relevant stimuli.ResultsCognitive‐behavioral therapy significantly reduced spider phobic symptoms in all patients. Symptom reduction during anticipatory anxiety was accompanied by reduced bilateral CBF in the parahippocampal gyrus, ventral anterior thalamus, Brodmann area 8, and the anterior cingulate cortex. During postprocessing of phobia‐relevant stimuli, patients showed reduced CBF in the bilateral insula, components of the motor cortex, and areas associated with language functions.ConclusionsLongitudinal CBF dynamics following CBT were in concordance with results from several studies using BOLD fMRI to investigate the effects of psychotherapy on brain activity. CBF can be quantified by ASL, with the principal advantage of sensitivity to slow variations in neural activity and task independence. Therefore, ASL may be a suitable method for monitoring and evaluating the efficacy of psychotherapy or pharmacotherapy approaches.

show abstract

“…Current treatments for public speaking anxiety combine traditional exposure (e.g., repeated trials of public speaking) with cognitive restructuring in which patients are taught to think about the feared situation neutrally or positively rather than negatively (Heimberg, 2002;Hofmann & Smits, 2008;Hope, Heimberg, Juster, & Turk, 2000;Rapee & Heimberg, 1997). Such treatments aim to reduce anticipatory anxiety, anxiety during speaking, and rumination about the speech after it is over (Clark & Wells, 1995).…”

mentioning

confidence: 99%

Affect labeling enhances exposure effectiveness for public speaking anxiety

Niles

Craske

Lieberman

et al. 2015

Behaviour Research and Therapy

View full text Add to dashboard Cite

a b s t r a c tExposure is an effective treatment for anxiety but many patients do not respond fully. Affect labeling (labeling emotional experience) attenuates emotional responding. The current project examined whether affect labeling enhances exposure effectiveness in participants with public speaking anxiety. Participants were randomized to exposure with or without affect labeling. Physiological arousal and selfreported fear were assessed before and after exposure and compared between groups. Consistent with hypotheses, participants assigned to Affect Labeling, especially those who used more labels during exposure, showed greater reduction in physiological activation than Control participants. No effect was found for self-report measures. Also, greater emotion regulation deficits at baseline predicted more benefit in physiological arousal from exposure combined with affect labeling than exposure alone. The current research provides evidence that behavioral strategies that target prefrontal-amygdala circuitry can improve treatment effectiveness for anxiety and these effects are particularly pronounced for patients with the greatest deficits in emotion regulation.

show abstract

A cognitive-behavioral model of anxiety in social phobia

Cited by 2,422 publications

References 89 publications

Social anxiety and disinhibition: An analysis of curiosity and social rank appraisals, approach–avoidance conflicts, and disruptive risk-taking behavior

Social anxiety and disinhibition: An analysis of curiosity and social rank appraisals, approach–avoidance conflicts, and disruptive risk-taking behavior

CBT reduces CBF: cognitive‐behavioral therapy reduces cerebral blood flow in fear‐relevant brain regions in spider phobia

Affect labeling enhances exposure effectiveness for public speaking anxiety

Contact Info

Product

Resources

About