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

Abstract

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.

Fear of positive evaluation in borderline personality disorder

“…Until now, fear of positive evaluation in clinical samples seemed to be highest in SAD [25]. For example, fear of positive evaluation was higher in individuals with SAD compared to individuals with other anxiety disorders [46].…”

“…Fear of positive evaluation has rarely been studied in other mental disorders than SAD and, to our knowledge, has not been studied in BPD. Reichenberger and Bleichert [25] asked for studies on fear of positive evaluation in BPD. They argued that fear of positive evaluation in BPD might be relevant, because high fear of positive evaluation [25] as well as BPD symptoms (e.g., [26]) are associated with social impairments.…”

“…What are the implications of high fear of positive evaluation in BPD? High fear of positive evaluation has been associated with social impairments and less quality of life (see [25] for a review). Fear of positive evaluation might contribute to the well described long term impaired psychosocial functioning in BPD [26].…”

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

“…Nevertheless, our brief, FPE-specific CBT protocol, informed by a growing body of empirical evidence (Reichenberger and Blechert, 2018), demonstrated considerable promise. The current Figure 1.…”

“…c Elizabeth M. Waldron is now at Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL 60611, USA. cognitive feature of SAD (for a review, see Reichenberger and Blechert, 2018). Specifically, FPE begets direct social comparison of the self with others and therefore causes the recipient to feel highly conspicuous (e.g.…”