People with social phobia dread social situations and live in fear of public embarrassment. Their anxiety often permeates all public activities, including eating out, or visiting a public lavatory. Research shows they catastrophise about social situations, what people think about them, and what negative social events say about the kind of person they are. By correcting these biases, cognitive behavioural therapy (CBT) can be an effective treatment. However, it's not known whether all of these biases need to be addressed for long term recovery, or if instead the correction of one particular bias is crucial. Judith Wilson and Ronald Rapee (Macquarie University, Sydney) investigated.
Thirty-six people undergoing a 12-week CBT programme for social phobia completed questionnaires before and after their treatment. Their long-term recovery was assessed three months later.
After CBT, the participants were less likely to believe a hypothetical social situation would cause others to think ill of them; were less likely to think it reflected badly on the kind of person they are; and less likely to think it would have long-term negative implications for their relationships and/or career. Of these, only reductions in the participants' belief that negative social events revealed bad things about them, independently predicted reduced social phobia at three months.
Whereas previous research has suggested social phobics are overly concerned by what others think of them, this research highlights the importance of how they view themselves. "It is ultimately the negative inferences they draw with regard to the self that may be important for maintaining the disorder", the authors said.
Wilson, J.K. & Rapee, R.M. (2005). The interpretation of negative social events in social phobia: changes during treatment and relationship to outcome. Behaviour Research and Therapy, 43, 373-389.