Category: Adult Anxiety - Social
Social anxiety disorder (SAD) is associated with a distorted negative view of the self as fundamentally undesirable or defective (Moscovitch, 2009), and a related tendency to experience shame (Michail & Birchwood, 2013). It is posited that negative self-identity and proneness to shame contribute to fear of negative evaluation by others, a core characteristic of SAD. Negative evaluation by others may precipitate negative evaluation of the self, contributing to shame (Tangney, 2001). It is plausible that a fear of negative evaluation may persist via the conditioned association between negative evaluation and painful experience of shame.
Shame may drive a desire to hide the self (Barrett, 1995) and self-concealment efforts may be demonstrated via associated safety behaviours (e.g., excessive self-control), which in turn can exacerbate and maintain social anxiety symptoms (Moscovitch et al., 2013). Accordingly, self-concealment has been found to mediate the relationship between shame-proneness and psychological symptoms (Pineles, Street, & Koenen, 2006), and the belief that one must hide one’s true self to avoid rejection increases the severity of social interaction fears (Levinson, Rodebaugh, Lim, & Fernandez, 2015). Treatment may reduce the perceived need to hide oneself by reducing cognitions contributing to shame (Michail & Birchwood, 2013). By addressing acceptability of the self, it may also reduce fear of negative evaluation and social anxiety symptoms (Mills, 2005).
We hypothesised that treatment targeting social anxiety symptoms will result in a decrease in shame-proneness, belief in the need to hide the true self, and fear of negative evaluation. These relationships were examined within the context of a 12-week cognitive-behavioural therapy group program targeting social anxiety. We recruited 40 individuals diagnosed with SAD, aged between 19 and 58 years old. As hypothesised, pre- to post-treatment levels of shame-proneness decreased (d = .94), along with belief in the need to hide the true self (d = .60), fear of negative evaluation (d = 1.2) and social anxiety (d = 1.29), all ps< .05. Additionally, pre- to post-treatment reductions in shame-proneness were strongly associated with decreased belief in the need to hide the true self, r(18) = .50, p = .036, lower fear of negative evaluation, r(18) = .76, p < .001, and lower social anxiety symptoms, r(18) = .65, p = .004.
Our results indicate that a reduction in shame-proneness is associated with reduced belief in the need to hide the self, and decreased fear of negative evaluation and social anxiety symptoms. These findings contribute to recent research on shame as a vulnerability factor for psychopathology (Levinson, Byrne, & Rodebaugh, 2016) by highlighting the potential contribution of associated self-concealment beliefs.
Christopher Jillard– Ph.D. Student, Swinburne University of Technology, Melbourne, Victoria, Australia
Michelle Lim– Lecturer in Clinical Psychology, Swinburne University of Technology
Glen Bates– Pro-Vice Chancellor (Student Engagement), Swinburne University of Technology
Swinburne University of Technology
Melbourne, Victoria, Australia