Does anticipation help or hinder performance in a subsequent speech?

This study examined the effects of anticipatory processing on a subsequent speech in high and low socially anxious participants. Forty participants (n = 20 in each group) gave two speeches, one after no anticipatory processing and one after 10-minutes of anticipatory processing. In anticipatory processing, high socially anxious participants were more anxious, and experienced more negative and unhelpful self-images than low socially anxious participants did. However, both groups rated memories of past speeches as having a somewhat helpful effect on their speech preparation. High socially anxious participants tended to use the observer perspective more in the anticipated speech, while, in the unanticipated speech, they might have been switching between observer and field perspectives. Low socially anxious participants tended to use the field perspective in both speeches. High and low socially anxious participants reported better speech performances after the anticipated, compared to after the unanticipated speech. Results suggest that anticipatory processing may have both positive and negative effects on socially anxious individuals' cognitive processing and performance before and during a speech

A narrative identity perspective on mechanisms of change in imagery rescripting

Imagery rescripting (ImRs) is increasingly used in cognitive-behavioral therapy (CBT) to change beliefs and meanings about the self associated with negative and traumatic memories. It is quintessentially an imagery intervention that targets the self and autobiographical memory (AM); however, to date most of the research into its effectiveness has focused on symptom alleviation. The mechanisms of change remain unclear. In this article, we outline a narrative identity model of change in ImRs and note the value of the narrative identity literature in helping us understand memory-focused therapeutic interventions

The fear of others: a qualitative analysis of interpersonal threat in social phobia and paranoia

The cognitive models indicate that people with social phobia and paranoia share a common fear of others. While we recognize clinical differences, it is likely that some of the same psychological processes contribute to the maintenance of both presentations, yet the nature and extent of these similarities and differences are not yet clearly understood. This study explored threat experiences in people with social phobia and persecutory delusions in order to elucidate these aspects of the respective cognitive models. Accounts of interpersonal threat experiences were examined in nine people with social phobia and nine people with persecutory delusions. Verbatim transcripts were analyzed using thematic analysis. Three major themes emerged from the data: participants’ experience of threat, reactions while under threat, and subsequent reflections. Narrative coherence emerged as a superordinate theme. Typical fear responses were found in both groups, particularly in their reactions to threat. The key differences were in participants’ perceptual experiences, ability to stand back from the threat following the event, and narrative coherence. The findings are discussed in relation to current cognitive models of social phobia and paranoia. Theoretical and clinical implications are drawn out, and highlight the need to examine attentional and metacognitive processes more closely if we are to understand the maintenance of perceived threat in these groups, and means of alleviating associated distress

The spotlight effect and the illusion of transparency in social anxiety

[Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment, and treatment (pp. 69–93). New York: Guildford Press] cognitive model of social phobia suggests that both public and private sources of information contribute to the construction of the self as a social object, which is thought to maintain the disorder. This study used two concepts developed in social psychology that might help to explain the processes that contribute to the development of this constructed self. These two concepts are the spotlight effect [Gilovich, T., Medvec, V. H., & Savitsky, K. (2000). The spotlight effect in social judgment: an egocentric bias in estimates of the salience of one’s own actions and appearance. Journal of Personality and Social Psychology, 78(2), 211–222] and the illusion of transparency [Gilovich, T., Medvec, V. H., & Savitsky, K. (1998). The Illusion of transparency: biased assessments of others’ ability to read one’s own emotional states. Journal of personality and social psychology, 75(2), 332–346]. Participants performed a memory task under either a low or a high social-evaluative condition. In the high social-evaluative condition, participants reported higher levels of the spotlight effect and more negative evaluation of task performance, compared to participants in the low social-evaluative condition. There were no differences between the two conditions in levels of the illusion of transparency. Surprisingly, however, in the low socialevaluative condition, participants reported higher levels of the illusion of transparency than the spotlight effect, whereas, in the high social-evaluative condition, they reported the opposite. Results suggest that the spotlight effect may be specific to social-evaluative concerns, whereas, the illusion of transparency may represent more general features of social anxiety concerns. Implications of the results for Clark and Wells’ cognitive model of social phobia model are discussed

CBT for eating disorders: The impact of early changes in eating pathology on later changes in personality pathology, anxiety and depression.

Whilst studies have consistently identified early symptom reduction as an important predictor of treatment outcome, the impact of early change on common comorbid features has not been investigated. This study of CBT for eating disorders explored patterns of early change in eating pathology and longer-term change in personality pathology, anxiety and depression. It also explored the impact of early change in eating pathology on overall change in personality pathology, anxiety and depression. Participants were 179 adults diagnosed with eating disorders who were offered a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment and following the 6th session. They also completed measures of personality disorder cognitions, anxiety and depression at the start and end of treatment. There were significant changes in eating pathology over the first six sessions of treatment. Significant improvements were also seen in personality disorder pathology, anxiety and depression by the end of therapy. Effect sizes were medium to large for both completer and intention to treat analyses. Early changes in eating pathology were associated with later changes in common comorbid features, with early reduction in restraint being a key predictor. These findings demonstrate that early symptom change can be achieved in CBT for eating disorders when delivered in routine clinical practice. Such change has long-term benefits that go beyond the domain of eating pathology, enhancing change in personality pathology, anxiety and depression

"The Lights of the world have gone out": a study of death in Virginia Woolf's fiction

Bibliography: p. 169-177

Special series: Imagery Rescripting Across Disorders: a Practical Guide

Intrusive images occur in many disorders and, as well as causing distress, they frequently represent important negative meanings about the self, other people, or the world. Imagery rescripting describes a set of therapeutic techniques that are aimed at changing these negative meanings. This special series focuses on when and how to do imagery rescripting in posttraumatic stress disorder, social phobia, depression, eating disorders, and personality disorders. These five articles contain a detailed guide on how to use imagery rescripting in the respective disorders and advice on how to tackle problems that can arise. The sixth and final article describes a qualitative research study on patients’ experiences of imagery in the early parts of a schema-focused therapy trial

Reconceptualizing the self

This article is an invited commentary on Moscovitch’s (2009) paper “What Is the Core Fear in Social Phobia? A New Model to 6 Facilitate Individualized Case Conceptualization and Treatment.” The crux of Moscovitch’s argument is that current models of social 7 phobia fail to conceptualize the nature of social fears correctly. Moscovitch proposes that the self is the phobic stimulus and should be the 8 target of exposure treatment, rather than social situations. This commentary evaluates Moscovitch’s claim and agrees that distorted 9 views of self are at the heart of the disorder, but contests the idea that the self can be conceptualized as a phobic stimulus. Instead, we need 10 to recognize that all individuals have multiple self-representations and that access to a current working self depends on a set of retrieval 11 mechanisms that involve both the contents of self-knowledge and the way that this information is stored. The application of these ideas to 12 social phobia is discussed. In the final section of the commentary, I discuss Moscovitch’s contributions to treatment derived from his new 13 model and outline some additional methods of working with the self, including imagery rescripting

Why is the self important in understanding and treating social phobia?

Current cognitive models of social phobia (Clark & Wells, 1995; Hofmann, 2007; Moscovitch, 2008; Rapee & Heimberg, 1997) all agree that the self plays a key maintaining role in the disorder. However, all of these models use a relatively limited conceptualisation of the self. The author proposes a tripartite approach in which theories of the self are grouped into three broad categories: content, structure, and process. Content refers to knowledge and information about the self, structure to the way that information is organised, and process to the ways in which individuals attend to and regulate the self. Structure has been largely neglected to date, and the author outlines ways in which the structural organisation of self-knowledge could contribute to social anxiety. High social anxiety is associated with low clarity about the self and with more uncertainty about selfjudgments. Structure interacts with content, and in the final part of the article potential interactions among imagery, self-concept, and self-structure are discussed