Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T19:10:49.319Z Has data issue: false hasContentIssue false
  • English
  • Français

Positive Beliefs about Post-Event Processing in Social Anxiety Disorder

Published online by Cambridge University Press:  01 December 2021

Ariella P. Lenton-Brym ,
Olivia Provost-Walker ,
Virginia Tsekova ,
Randi E. McCabe  and
Karen Rowa
Ariella P. Lenton-Brym*
Affiliation:
Department of Psychology, Ryerson University, Toronto, Ontario, Canada
Olivia Provost-Walker
Affiliation:
Department of Psychology, Ryerson University, Toronto, Ontario, Canada
Virginia Tsekova
Affiliation:
Department of Psychology, Ryerson University, Toronto, Ontario, Canada
Randi E. McCabe
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
Karen Rowa
Affiliation:
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
*
*Corresponding author: Ariella P. Lenton-Brym, Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, Canada M5B 2K3. Email: [email protected]
Get access

Abstract

Background: Post-event processing (PEP) is an important maintenance factor of social anxiety disorder (SAD). This study examined psychometric properties of the Positive Beliefs about Post-Event Processing Questionnaire (PB-PEPQ; Fisak & Hammond, 2013), which measures metacognitive beliefs about PEP. Method: Participants receiving treatment for SAD (n = 71) and other anxiety and related disorders (n = 266) completed self-report questionnaires at several timepoints. Results: Confirmatory factor analysis did not support the PB-PEPQ's proposed unidimensional model. Subsequent exploratory factor analysis yielded a three-factor structure consisting of engaging in PEP to (1) review negative events (Negative scale), (2) review positive events (Positive scale), and (3) better understand one's social anxiety (Understand scale). Within the SAD subsample, PB-PEPQ scales demonstrated good internal consistency (α = 0.83–0.85) and test–retest reliability (r = 0.65–0.78). Convergent and criterion validity of the PB-PEPQ Negative scale were supported. PB-PEPQ scale scores were significantly higher within the SAD group, as compared with the other groups (generalised anxiety disorder, panic disorder and agoraphobia, posttraumatic stress disorder, and obsessive-compulsive disorder), supporting the scales’ discriminative validity. Conclusion: Findings support the reliability and validity of the PB-PEPQ in a clinical sample and reveal the measure's multifactorial structure.

Keywords

post-event processingmetacognitionsocial anxietyscale validationfactor structure
Type
Standard Paper
Information
Behaviour Change , Volume 39 , Issue 4 , December 2022 , pp. 247 - 262
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Australian Association for Cognitive and Behaviour Therapy

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, MJ and Rapee, RM (2004). Post-event rumination and negative self-appraisal in social phobia before and after treatment. Journal of Abnormal Psychology, 113, 136–144. doi:10.1037/0021-843X.113.1.136.CrossRefGoogle ScholarPubMed
Aderka, IM, Hofmann, SG, Nickerson, A, Hermesh, H, Gilboa-Schechtman, E and Marom, S (2012). Functional impairment in social anxiety disorder. Journal of Anxiety Disorders, 26, 393–400. doi:10.1016/j.janxdis.2012.01.003.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org.10.1176/appi.books.9780890425596.Google Scholar
Antony, MM, Bieling, PJ, Cox, BJ, Enns, MW and Swinson, RP (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10, 176–181. doi:10.1037/1040-3590.10.2.176.CrossRefGoogle Scholar
Antony, MM, Coons, MJ, McCabe, RE, Ashbaugh, A and Swinson, RP (2006). Psychometric properties of the social phobia inventory: Further evaluation. Behaviour Research and Therapy, 44, 1177–1185. doi:10.1016/j.brat.2005.08.013.CrossRefGoogle ScholarPubMed
Arditte, KA, Shaw, AM and Timpano, KR (2016). Repetitive negative thinking: A transdiagnostic correlate of affective disorders. Journal of Social and Clinical Psychology, 35, 181–201. doi:10.1521/jscp.2016.35.3.181.CrossRefGoogle Scholar
Bentler, PM (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246. doi:10.1037/0033-2909.107.2.238.CrossRefGoogle ScholarPubMed
Borkovec, TD, Hazlett-Stevens, H and Diaz, ML (1999). The role of positive beliefs about worry in generalized anxiety disorder and its treatment. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 6, 126–138.3.0.CO;2-M>CrossRefGoogle Scholar
Brozovich, F and Heimberg, RG (2008). An analysis of post-event processing in social anxiety disorder. Clinical Psychology Review, 28, 891–903. doi:10.1016/j.cpr.2008.01.002.CrossRefGoogle ScholarPubMed
Clark, DM (2001). A cognitive perspective on social phobia. In Crozier, WR and Alden, LE (eds), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 405–430). New York, NY: John Wiley & Sons.Google Scholar
Clark, DM and Wells, A (1995). A cognitive model of social phobia. In Heimberg, RG, Liebowitz, MR, Hope, DA and Schneier, FR (eds), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York, NY: Guilford Press.Google Scholar
Connor, KM, Davidson, JR, Churchill, LE, Sherwood, A, Weisler, RH and Foa, E (2000). Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale. British Journal of Psychiatry, 176, 379–386.CrossRefGoogle ScholarPubMed
Dannahy, L and Stopa, L (2007). Post-event processing in social anxiety. Behaviour Research and Therapy, 45, 1207–1219. doi:10.1016/j.brat.2006.08.017.CrossRefGoogle ScholarPubMed
Edwards, SL, Rapee, RM and Franklin, J (2003). Post-event rumination and recall bias for a social performance event in high and low socially anxious individuals. Cognitive Therapy and Research, 27, 603–617. doi:10.1023/A:1026395526858.CrossRefGoogle Scholar
Eng, W, Coles, ME, Heimberg, RG and Safren, SA (2005). Domains of life satisfaction in social anxiety disorder: Relation to symptoms and response to cognitive-behavioural therapy. Journal of Anxiety Disorders, 19, 143–156. doi:10.1016/j.janxdis.2004.01.007.CrossRefGoogle Scholar
Fehm, L, Schneider, G and Hoyer, J (2007). Is post-event processing specific for social anxiety? Journal of Behavior Therapy and Experimental Psychiatry, 38, 11–22. doi:10.1016/j.jbtep.2006.02.004.CrossRefGoogle ScholarPubMed
Fisak, B Jr and Hammond, AN (2013). Are positive beliefs about post-event processing related to social anxiety? Behaviour Change, 30, 36–47. doi:10.1017/bec.2013.4.CrossRefGoogle Scholar
Gavric, D, Moscovitch, DA, Rowa, K and Mccabe, RE (2017). Post-event processing in social anxiety disorder: Examining the mediating roles of positive metacognitive beliefs and perceptions of performance. Behaviour Research and Therapy 91, 1–12. doi: https://doi.org/10.1016/j.brat.2017.01.002CrossRefGoogle Scholar
Gkika, S, Wittkowski, A and Wells, A (2017). Social cognition and metacognition in social anxiety: A systematic review. Clinical Psychology & Psychotherapy, 25, 10–30. doi:10.1002/cpp.2127.CrossRefGoogle ScholarPubMed
Hayes, AF. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from: http://www.afhayes.com/public/process2012.pdfGoogle Scholar
Hedman, E, Mörtberg, E, Hesser, H, Clark, DM, Lekander, M, Andersson, E and Ljótsson, B (2013). Mediators in psychological treatment of social anxiety disorder: Individual cognitive therapy compared to cognitive behavioral group therapy. Behaviour Research and Therapy, 51, 696–705. doi:10.1016/j.brat.2013.07.006.CrossRefGoogle ScholarPubMed
Heimberg, RG (2002). Cognitive-behavioral therapy for social anxiety disorder: Current status and future directions. Biological Psychiatry, 51, 101–108. doi:10.1016/S0006-3223(01)01183-0.CrossRefGoogle ScholarPubMed
Henry, JD and Crawford, JR (2005). The short-form version of the depression anxiety stress scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227–239. doi:10.1348/014466505X29657.CrossRefGoogle Scholar
Hofmann, SG and Otto, MW (2017). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder-specific treatment techniques. Routledge.CrossRefGoogle Scholar
Hofmann, S and Otto, M (2018). Cognitive behavioral therapy for social anxiety disorder. Routledge. doi:10.4324/9781315617039Google Scholar
Hooper, D, Coughlan, J and Mullen, M. (2008). Evaluating model fit: A synthesis of the structural equation modelling literature. In 7th European Conference on Research Methodology for Business and Management Studies (pp. 195–200).Google Scholar
Katz, DE, Cassin, S, Weerasinghe, R and Rector, NA (2019). Changes in post-event processing during cognitive behavioural therapy for social anxiety disorder: A longitudinal analysis using post-session measurement and experience sampling methodology. Journal of Anxiety Disorders, 66, 6. doi:10.1016/j.janxdis.2019.102107.CrossRefGoogle ScholarPubMed
Keller, MB (2003). The lifelong course of social anxiety disorder: A clinical perspective. Acta Psychiatrica Scandinavica, 108, 85–94. doi:10.1034/j.1600-0447.108.s417.6.x.CrossRefGoogle Scholar
Kline, RB (2016). Principles and practice of structural equation modeling (4th ed. New York, NY: Guilford Publications.Google Scholar
Kocovski, NL and Rector, NA (2007). Predictors of post-event rumination related to social anxiety. Cognitive Behaviour Therapy, 36, 112–122. doi:10.1080/16506070701232090.CrossRefGoogle ScholarPubMed
Kocovski, NL, Endler, NS, Rector, NA and Flett, GL (2005). Ruminative coping and post-event processing in social anxiety. Behaviour Research and Therapy, 43, 971–984. doi:10.1016/j.brat.2004.06.015.CrossRefGoogle ScholarPubMed
Laposa, JM, Collimore, KC and Rector, NA (2014). Is post-event processing a social anxiety specific or transdiagnostic cognitive process in the anxiety spectrum? Behavioural and Cognitive Psychotherapy, 42, 706–717. doi:10.1017/s135246581300074x.CrossRefGoogle ScholarPubMed
Lovibond, PF and Lovibond, SH (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343. doi:10.1016/0005-7967(94)00075-U.CrossRefGoogle ScholarPubMed
McCabe, RE, Milosevic, I, Rowa, K, Shnaider, P, Key, B, Antony, MM and the DART Working Group (2017). Diagnostic Assessment Research Tool (DART). Unpublished Instrument.Google Scholar
McDonald, RP and Marsh, HW (1990). Choosing a multivariate model: Noncentrality and goodness of fit. Psychological Bulletin, 107, 247–255. doi:10.1037/0033-2909.107.2.247.CrossRefGoogle Scholar
McEvoy, PM and Kingsep, P (2006). The post-event processing questionnaire in a clinical sample with social phobia. Behaviour Research and Therapy, 44, 1689–1697. doi:10.1016/j.brat.2005.12.005.CrossRefGoogle Scholar
McEvoy, PM, Mahoney, A, Perini, SJ and Kingsep, P (2009). Changes in post-event processing and metacognitions during cognitive behavioral group therapy for social phobia. Journal of Anxiety Disorders, 23, 617–623. doi:10.1016/j.janxdis.2009.01.011.CrossRefGoogle ScholarPubMed
McEvoy, PM, Mahoney, AEJ and Moulds, ML (2010). Are worry, rumination, and post-event processing one and the same?: Development of the repetitive thinking questionnaire. Journal of Anxiety Disorders, 24, 509–519. doi:10.1016/j.janxdis.2010.03.008.CrossRefGoogle ScholarPubMed
Mellings, TMB and Alden, LE (2000). Cognitive processes in social anxiety: The effects of self-focus, rumination and anticipatory processing. Behaviour Research and Therapy, 38, 243–257. doi:10.1016/S0005-7967(99)00040-6.CrossRefGoogle ScholarPubMed
Mendlowicz, MV and Stein, MB (2000). Quality of life in individuals with anxiety disorders. The American Journal of Psychiatry, 157, 669–682. doi:10.1176/appi.ajp.157.5.669.CrossRefGoogle ScholarPubMed
Narr, RK and Teachman, BA (2017). Using advances from cognitive behavioral models of anxiety to guide treatment for social anxiety disorder. Journal of Clinical Psychology, 73, 524–535. doi:10.1002/jclp.22450.CrossRefGoogle ScholarPubMed
Patel, A, Knapp, M, Henderson, J and Baldwin, D (2002). The economic consequences of social phobia. Journal of Affective Disorders, 68, 221–233. doi:10.1016/S0165-0327(00)00323-2.CrossRefGoogle ScholarPubMed
Pawluk, EJ, Schneider, L, Milosevic, I, Shnaider, P, Rowa, K, Antony, MM, … McCabe, RE (in press). Psychometric properties of the Diagnostic Assessment Research Tool (DART) Self-Report Screener for DSM-5 mental disorders. Journal of Psychopathology and Behavioural Assessment. Journal of Psychopathology and Behavioral Assessment.Google Scholar
Perera, S, Rowa, K and McCabe, RE (2015). Post-event processing across multiple anxiety presentations: Is it specific to social anxiety disorder? Behavioural and Cognitive Psychotherapy, 44, 568–579. doi:10.1017/s1352465815000697.CrossRefGoogle ScholarPubMed
Price, M and Anderson, PL (2011). The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder. Behaviour Research and Therapy, 49, 132–137. doi:10.1016/j.brat.2010.11.006.CrossRefGoogle ScholarPubMed
Rachman, S, Grüter-Andrew, J and Shafran, R (2000). Post-event processing in social anxiety. Behaviour Research and Therapy, 38, 611–617. doi:10.1016/S0005-7967(99)00089-3.CrossRefGoogle ScholarPubMed
Raykov, T (1998). On the use of confirmatory factor analysis in personality research. Personality and Individual Differences, 24, 291–293.CrossRefGoogle Scholar
Rodebaugh, TL, Holaway, RM and Heimberg, RG (2004). The treatment of social anxiety disorder. Clinical Psychology Review, 24, 883–908. doi:10.1016/j.cpr.2004.07.007.CrossRefGoogle ScholarPubMed
Rodriguez, H, Kissell, K, Lucas, L and Fisak, B (2017). The development and evaluation of the psychometric properties of the negative beliefs about post-event processing scale. Behavioural and Cognitive Psychotherapy, 45, 590–599. doi:10.1017/s1352465817000340.CrossRefGoogle ScholarPubMed
Schneider, LH, Pawluk, EJ, Milosevic, I, Shnaider, P, Rowa, K, Antony, MM, … McCabe, RE. (in press). The Diagnostic Assessment Research Tool (DART) in action: A preliminary evaluation of a semistructured diagnostic interview for DSM-5 disorders. Psychological Assessment.Google Scholar
Stein, MB and Kean, YM (2000). Disability and quality of life in social phobia: Epidemiologic findings. The American Journal of Psychiatry, 157, 1606–1613. doi:10.1176/appi.ajp.157.10.1606.CrossRefGoogle ScholarPubMed
Vassilopoulos, SP, Brouzos, A and Moberly, NJ (2015). The relationships between metacognition, anticipatory processing, and social anxiety. Behaviour Change, 32, 114–126. doi:10.1017/bec.2015.4.CrossRefGoogle Scholar
Wells, A (1995). Meta-cognition and worry: A cognitive model of generalised anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320. doi:10.1017/S1352465800015897.CrossRefGoogle Scholar
Wong, QJJ and Moulds, ML (2009). Impact of rumination versus distraction on anxiety and maladaptive self-beliefs in socially anxious individuals. Behaviour Research and Therapy, 47, 861–867. doi:10.1016/j.brat.2009.06.014.CrossRefGoogle ScholarPubMed
Wong, QJJ and Moulds, ML (2010). Do socially anxious individuals hold positive metacognitive beliefs about rumination? Behaviour Change, 27, 69–83. doi:10.1375/bech.27.2.69.CrossRefGoogle Scholar
Yoshinaga, N, Takaoka, K and Kobori, O (2019). It hurts but I still need it: A qualitative investigation of post-event processing in social anxiety disorder. Behavioural and Cognitive Psychotherapy, 48, 364–369. doi:10.1017/s1352465819000651.CrossRefGoogle ScholarPubMed