Category: Adult Anxiety - Social


Fear of Positive Evaluation and Mindfulness-Based Interventions for SAD

Saturday, November 18
2:00 PM - 3:30 PM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Social Anxiety | Mindfulness | Compassion / Empathy
Presentation Type: Symposium

Self-compassion pertains to an accepting and caring attitude towards oneself, and is an adaptive coping response to social anxiety (Leary et al., 2007). Werner et al. (2011) found that two core cognitive features of social anxiety, fear of positive evaluation (FPE) and fear of negative evaluation (FNE), related to lower self-compassion in patients with social anxiety disorder (SAD). With regard to distinct facets of mindfulness (Neff, 2003), both FPE and FNE were associated with increased self-judgment, perceived isolation, and feeling overwhelmed with negative emotion. Interestingly, however, FPE alone (not FNE or social anxiety in general) related inversely to self-kindness and mindfulness. Given that lower FPE related more strongly to global self-compassion than either FNE or social anxiety, the findings of Werner et al. highlighted a novel utility of mindfulness-based interventions for SAD—namely, for improving self-compassion while reducing clinically severe FPE. However, this utility had yet to be formally tested, despite recent calls to examine self-compassion (e.g., Werner et al.) and FPE (e.g., Weeks & Howell, 2014) as treatment targets for SAD.

56 adult patients with generalized SAD were randomized to complete either a Mindfulness-Based Stress Reduction (MBSR) or a comparison aerobic exercise (AE) program. A univariate analysis of variance (ANOVA) was tested, with changes in FPE and FNE from pre- to post-treatment included as continuously-distributed independent variables, treatment group (MBSR vs. AE) included as a fixed factor, and change (pre- to post-) in self-compassion as the dependent variable. Consistent with our hypothesis, FPE emerged as a significant unique predictor of changes in self-compassion, F = 7.11, p = .018, whereas FNE did not, p = .09. As expected, greater reductions in FPE were linked to greater increases in self-compassion, r = -.43, p = .04.

Consistent with prior findings (Werner et al., 2011), improvements in FPE (but not FNE) were meaningfully linked to improvements in mindfulness. Theoretical and clinical implications regarding the links between FPE, FNE, and mindfulness-based interventions for SAD will be discussed. 

Justin Weeks

Nebraska Medicine Psychology Department


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Fear of Positive Evaluation and Mindfulness-Based Interventions for SAD

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