خودنمایانگری در اختلال اضطراب اجتماعی: تجزیه و تحلیل زبانی روایت شرح حال

Abstract Cognitive models of social anxiety disorder (SAD) posit aberrant beliefs about the social self as a key psychological mechanism that maintains fear of negative evaluation in social and performance situations. Consequently, a distorted self-view should be evident when recalling painful autobiographical social memories, as reflected in linguistic expression, negative self-beliefs, and emotion and avoidance. To test this hypothesis, 42 adults diagnosed with SAD and 27 non-psychiatric healthy controls (HC) composed autobiographical narratives of distinct social anxiety related situations, generated negative self-beliefs (NSB), and provided emotion and avoidance ratings. Although narratives were matched for initial emotional intensity and present vividness, linguistic analyses demonstrated that, compared to HC, SAD employed more self-referential, anxiety, and sensory words, and made fewer references to other people. There were no differences in the number of self-referential NSB identified by SAD and HC. Social anxiety symptom severity, however, was associated with greater self-referential NSB in SAD only. SAD reported greater current self-conscious emotions when recalling autobiographical social situations, and greater active avoidance of similar situations than did HC. These findings support cognitive models of SAD, and suggest that autobiographical memory of social situations in SAD may influence current and future thinking, emotion, and behavioral avoidance.

Results Demographic, clinical, and control measures Between-group t-tests showed that SAD and HC did not differ on age, gender, education or ethnicity (all ps < .05). Compared to HC, SAD reported greater social anxiety symptom severity (LSAS), fear of negative evaluation (BFNE), and depressive symptoms (BDI-II) ( Table 1). There were no between-group differences in Age at Time of Event (p > .92), Time since Event (p > .88), Words per Narrative (p > .65), or Words per Sentence (p > .35), Vividness of Memory (p > .71) or Emotion THEN (p > .22). Linguistic analysis of autobiographical narratives Multivariate analyses of variance demonstrated that, compared to HC, SAD used significantly more first-person singular (SAD: M = 11.8, SD = 2.3, HC: M = 9.3, SD = 2.4, t(67) = 4.39, p < .005, partial eta2View the MathML source(ηp2)=.22), and anxiety/fear (SAD: M = 1.2, SD = 0.9, HC: M = 0.5, SD = 0.4, t(67) = 4.02, p < .005, View the MathML source(ηp2)=.19) words, made fewer references to other people (SAD: M = 3.1, SD = 1.8, HC: M = 4.7, SD = 2.4, t(67) = 4.39, p < .01, View the MathML source(ηp2)=.12), and used more sensory/perceptual processes(SAD: M = 4.1, SD = 1.7, HC: M = 2.9, SD = 1.2, t(67) = 4.39, p < .005, View the MathML source(ηp2)=.13), and physical touch (sensation) (SAD: M = 1.4, SD = 1.1, HC: M = 0.8, SD = 0.6, t(67) = 4.39, p < .01, View the MathML source(ηp2)=.10) words ( Fig. 2). Linguistic variables in SAD and HC. *p<.01, **p<.005. Error bars display ... Fig. 2. Linguistic variables in SAD and HC. *p < .01, **p < .005. Error bars display standard error of the mean. Figure options To determine whether words used in recall were influenced by current levels of anxiety, current self-conscious emotion was added as a covariate. Current self-conscious emotion could reflect anxiety induced by both the experimental situation and the autobiographical memory itself. This addition resulted in no changes in significance in the linguistic analysis, first-person singular (t(66) = 4.24, p < .001, View the MathML source(ηp2)=.21), anxiety/fear (t(66) = 4.58, p < .001, View the MathML source(ηp2)=.24), sensory/perceptual processes (t(66) = 4.40, p < .005, View the MathML source(ηp2)=.15), physical touch (sensation) (t(66) = 2.73, p < .01, View the MathML source(ηp2)=.10) words, references to other people (t(66) = 3.00, p < .005, View the MathML source(ηp2)=.12). Negative self-beliefs A between-group t-test resulted in no difference in the percentage of Self-referential NSBs (SAD: M = 57.0%, SD = 18.9% vs. HC: M = 64.0%, SD = 18.5; t(64) = 1.48, p > .14), and Self plus Other-referential NSBs (SAD: M = 42.8%, SD = 19.1% vs. HC: M = 36.1%, SD = 18.5%; t(64) = 1.43, p > .16). A paired t-test indicated that across all participants more Self-referential NSBs (M = 59.7%, SD = 18.9%) were generated, compared to Self plus Other-referential NSBs (M = 40.2%, SD = 19.0%), t(65) = 4.19, p < .001. Social anxiety symptom severity (LSAS) was associated with more Self-referential NSBs in SAD (r = .34, p < .05), but fewer Self-referential NSBs in HC (r = −.41, p < .05). Emotion and avoidance Between-group t-tests showed that, compared to HC, SAD experienced greater current self-conscious emotions (Emotion NOW) when recalling a painful social autobiographical memory (SAD: M = 5.1, SD = 1.8 vs. HC: M = 4.0, SD = 1.5; t(67) = 2.9, p < .01, View the MathML source(ηp2)=.09), and more active avoidance of similar situations (SAD: M = 5.9, SD = 1.8 vs. HC: M = 4.6, SD = 2.0; t(67) = 2.9, p < .01, View the MathML source(ηp2)=.12) ( Table 2). Social anxiety symptom severity was associated with greater current self-conscious emotion (BFNE: r = .43, p < .05) and active avoidance of similar situations (BFNE: r = .37, p < .05; LSAS: r = .35, p < .05) in SAD, and with greater current self-conscious emotion (LSAS: r = .58, p < .01) in HC. Table 2. Autobiographical narrative variables by group Variable SAD: mean ± SD HC: mean ± SD t, p-value Age at time of event (years) 20.5 ± 5.6 20.3 ± 6.5 0.11 Time since event (years) 13.6 ± 10.1 13.2 ± 8.4 0.01 Words per narrative 114.9 ± 49.2 120.0 ± 40.9 0.45 Words per sentence 23.3 ± 13.6 20.8 ± 6.0 0.94 Vividness of memory 7.3 ± 1.3 7.2 ± 1.6 0.38 Emotion THEN 8.2 ± 0.7 8.0 ± 0.1 1.23 Emotion NOW 5.1 ± 1.8 4.0 ± 1.5 2.91** Active avoidance 5.9 ± 1.8 4.6 ± 2.0 2.92**