اضطراب اجتماعی و خودتمرکز فکری

Studies of rumination have supported the differentiation of self-focus into distinct modes of self-attention with distinct functional effects. Given that self-focused attention and rumination have been implicated in the maintenance of social anxiety, the present study investigated the effects of these two distinct forms of self-focused attention on mood and cognition in social anxiety. High and low socially anxious individuals (n = 29 in each group) either thought analytically about, or focused on their momentary experience of, identical symptom-focused induction items from [Nolen-Hoeksema, S., & Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7, 561–570] rumination task. As predicted, in high socially anxious individuals, the experiential (low analysis) self-focus condition decreased ratings of anxious mood pre- to post-manipulation and was associated with more positive thoughts on a thought-listing exercise, whereas the analytical (high analysis) self-focus condition resulted in no significant effects on mood and cognition. Theoretical and clinical implications of these findings are discussed.

Self-focused attention is an awareness of self-referent information and is a common process among different forms of psychopathology (Ingram, 1990 and Harvey et al., 2004). Several authors have pointed to the importance of self-focus in social anxiety (e.g., Clark & Wells, 1995; Ingram, 1990; Rapee & Heimberg, 1997). According to Wells and Clark, when socially anxious individuals enter a feared situation, they are already in a “pre-activated self-focused processing mode” (1997, p.15) and tend to use internal sources of information (e.g., thoughts, feelings, somatic sensations, etc.) to construct a distorted image of themselves. Although not clearly spelled out by the Clark and Wells’ model, individuals become self-focused both prior to a feared social situation (anticipatory rumination) and after leaving the situation (post-event rumination). A range of studies supports the contention that self-focused attention is associated with increases in social anxiety, poor performance and negative self-judgments (for a review see Spurr & Stopa, 2002). More specifically, there is extensive evidence indicating that individuals with elevated social anxiety engage in elevated levels of post-event rumination (Abbott & Rapee, 2004; Edwards, Rapee, & Franklin, 2003; Kocovski, Endler, Rector, & Flett, 2005; Mellings & Alden, 2000; Perini, Abbot, & Rapee, 2006; Rachman, Gruter-Andrew, & Shafran, 2000; Rapee & Heimberg, 1997) or anticipatory rumination (Hinrichsen & Clark, 2003; Vassilopoulos, 2004 and Vassilopoulos, in press). However, although self-focus and rumination have been implicated in social anxiety (Clark & Wells, 1995; Rapee & Heimberg, 1997), there is limited research into the mechanisms underlying these processes. In addition, recent experimental evidence suggests that there may be a number of distinct modes of self-focused attention within ruminative self-focus, each of which has distinct functional properties, some adaptive and others maladaptive (Joormann, Dkane, & Gotlib, 2006; Teasdale, 1999; Treynor, Gonzalez, & Nolen-Hoeksema, 2003; Watkins, 2004; Watkins & Moulds, 2005; Watkins and Teasdale, 2001 and Watkins and Teasdale, 2004). These findings raise the possibility that there may also be different forms of rumination within social anxiety, which would have considerable implications for cognitive models of social anxiety, since they currently propose that ruminative self-focus is exclusively maladaptive (e.g., Clark & Wells, 1995). More specifically, it has been proposed that self-focused cognitions typically associated with rumination can occur within an analytical, evaluative mode versus an experiential, concrete mode. According to the Watkins and Teasdale account, analytical self-focus, defined as thinking analytically “about” the meanings, causes and implications of one's feelings, symptoms and experiences, is characterized by abstract, conceptual and evaluative overprocessing and perpetuates depressive symptomatology. In contrast, experiential self-focus, defined as focusing on the direct experience of one's feelings, symptoms and experiences, is an adaptive process characterized by more concrete and direct processing of experiences in the present moment. By instructing participants to engage in either analytical or experiential cognitions, Watkins and Teasdale, 2001 and Watkins and Teasdale, 2004 found evidence in depressed patients that experiential self-focus significantly reduces overgeneral memory (i.e., recall of categoric memories summarising repeated events such as “I am always making mistakes”), whilst analytical self-focus maintains overgeneral memory. Similarly, Rimes and Watkins (2005) found that in depressed participants, the analytical self-focus condition increased global negative self-judgments (ratings of the self as worthless and incompetent) pre- to post-manipulation, whereas the experiential self-focus condition resulted in no significant change in such global negative self-judgments. Finally, Vassilopoulos and Watkins (submitted for publication) extended the Rimes and Watkins’ (2005) study to social anxiety. The current study also investigated the effects of different modes of ruminative self-focus on high and low socially anxious individuals’ cognitions using a thought-listing technique instead of the endorsement method used in the previous studies (Rimes & Watkins, 2005; Vassilopoulos & Watkins, submitted for publication). The thought-listing procedure was selected on the basis of the suggestion that item endorsement may lead to a more general self-evaluation, steering away from the “current internal dialogue” (Myszka, Galassi, & Ware, 1986). The present study thus was an extension of the Watkins and Teasdale account of self-focused rumination to social anxiety. Given that rumination has been implicated in social anxiety, I investigated whether the mode of processing during ruminative self-focus influences cognitions in social anxiety. Consistent with Watkins and Teasdale's (2004) hypothesis that experiential self-focus is adaptive, whilst analytical self-focus is maladaptive, I predicted that socially anxious participants instructed to experience their symptoms in a non-analytical way would report less negative and more positive thoughts than instructed to think in an analytical and evaluative way about their symptoms. I also investigated the effects of analytical and experiential forms of self-focus on mood. Competing predictions can be deduced from the literature. Watkins and Teasdale, 2001 and Watkins and Teasdale, 2004 found equivalent short-term effects of processing style on mood, whereas Rimes and Watkins (2005) found that the analytical form of self-focus condition increased participants’ ratings of depressed mood. Finally, as previous studies have found that these manipulations only have differential effects in vulnerable groups (Rimes & Watkins, 2005; Watkins & Moulds, 2005; Watkins & Teasdale, 2004) I expected no differential effect of processing style on mood and cognition in low socially anxious participants.