Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-24T00:14:13.890Z Has data issue: false hasContentIssue false
  • English
  • Français

Physical Appearance Anxiety Impedes the Therapeutic Effects of Video Feedback in High Socially Anxious Individuals

Published online by Cambridge University Press:  15 January 2013

Elizabeth M. J. Orr  and
David A. Moscovitch
Elizabeth M. J. Orr*
Affiliation:
University of Waterloo, Ontario, Canada
David A. Moscovitch
Affiliation:
University of Waterloo, Ontario, Canada
*
Reprint requests to Elizabeth Orr, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, CanadaN2L 3G1. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Video feedback (VF) interventions effectively reduce social anxiety symptoms and negative self-perception, particularly when they are preceded by cognitive preparation (CP) and followed by cognitive review. Aims: In the current study, we re-examined data from a study on the efficacy of a novel VF intervention for individuals high in social anxiety to test the hypothesis that physical appearance anxiety would moderate the effects of VF. Method: Data were analyzed from 68 socially anxious participants who performed an initial public speech, and were randomly assigned to an Elaborated VF condition (VF plus cognitive preparation and cognitive review), a Standard VF condition (VF plus cognitive preparation) or a No VF condition (exposure alone), and then performed a second speech. Results: As hypothesized, when appearance concerns were low, both participants who received Elaborated and Standard VF were significantly less anxious during speech 2 than those in the No VF condition. However, when levels of appearance concern were high, neither Elaborated nor Standard VF reduced anxiety levels during speech 2 beyond the No VF condition. Conclusions: Results from our analog sample suggest the importance of tailoring treatment protocols to accommodate the idiosyncratic concerns of socially anxious patients.

Keywords

Social anxietyself-perceptionvideo feedbackphysical appearancecognitive behavioral therapy
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 42 , Issue 1 , January 2014 , pp. 92 - 104
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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

Aiken, L. S. and West, S. G. (1991). Multiple Regression: testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Health Disorders (4th ed., text rev.). Washington, DC: APA.Google Scholar
Baker, S. R. and Edelmann, R. J. (2002). Is social phobia related to lack of social skills? Duration of skill-related behaviours and ratings of behavioural adequacy. British Journal of Clinical Psychology, 41, 243–257. doi:10.1348/014466502760379118 CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A. and Brown, G. K. (1996). Beck Depression Inventory: Manual (2nd ed). San Antonio: Psychological Corporation.Google Scholar
Brewin, C. R. (2006). Understanding cognitive behaviour therapy: a retrieval competition account. Behavior Research and Therapy, 44, 765–784. doi:10.1016/j.brat.2006.02.005 CrossRefGoogle ScholarPubMed
Clark, D. M., Ehlers, A., McManus, F., Hackman, A., Fennell, M., Campbell, H., et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology, 71, 1058–1067. doi:10.1037/0022-006X.71.6.1058 CrossRefGoogle ScholarPubMed
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R. G., Liebowitz, M. R., Hope, D. A. and Schneier, F. R. (Eds.), Social Phobia: diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford Press.Google Scholar
Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Foa, E. and Weisler, R. H. (2000). Psychometric properties of the Social Phobia Inventory (SPIN): new self-rating scale. British Journal of Psychiatry, 176, 379–386. doi:10.1192/bjp.176.4.379 CrossRefGoogle ScholarPubMed
Davidson, J. R. T., Foa, E. B, Huppert, J. D., Keefe, F. J., Franklin, M. E., Compton, J. S., et al. (2004). Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia. Archives of General Psychiatry, 61, 1005–1013. doi:10.1001/archpsyc.61.10.1005 CrossRefGoogle ScholarPubMed
Fang, A. and Hofmann, S. G. (2010). Relationship between social anxiety disorder and body dysmorphic disorder. Clinical Psychology Review, 30, 1040–1048. doi:10.1016/j.cpr.2010.08.001 CrossRefGoogle ScholarPubMed
Foa, E. B. and McNally, R. J. (1996). Mechanisms of change in exposure therapy. In Rapee, R. M. (Ed.), Current Controversies in the Anxiety Disorders (pp. 214–227). New York: Guilford Press.Google Scholar
Fydic, T., Chambless, D. L., Perry, K. J., Buergener, F. and Beazley, M. B. (1998). Behavioral assessment of social performance: a rating system for social phobia. Behaviour Research and Therapy, 36, 995–1010. doi:10.1016/S0005-7967(98)00069-2 Google Scholar
Hart, T. A., Flora, D. B., Palyo, S. A., Fresco, D. M., Holle, C. and Heimberg, R. G. (2008). Development and examination of the Social Appearance Anxiety Scale. Assessment, 15, 48–59. doi:10.1177/1073191107306673 CrossRefGoogle ScholarPubMed
Harvey, A. G., Clark, D. M., Ehlers, A. and Rapee, R. (2000). Social anxiety and self-impression: cognitive preparation enhances the effects of video feedback following a stressful social task. Behaviour Research and Therapy, 38, 1183–1192. doi:10.1016/S0005-7967(99)00148-5 CrossRefGoogle Scholar
Herbert, J. D., Gaudiano, B. A., Rheingold, A. A., Myers, V. H., Dalrymple, K. and Nolan, E. M. (2005). Social skills training augments the effectiveness of cognitive behavioral group therapy for social anxiety disorder. Behavior Therapy, 36, 125–138. doi:10.1016/S0005-7894(05)80061-9 CrossRefGoogle Scholar
Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36, 193–209. doi:10.1080/16506070701421313 CrossRefGoogle ScholarPubMed
Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and meditational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27, 87–96. doi:10.1093/jpepsy/27.1.87 CrossRefGoogle Scholar
Izgiç, F., Akyüz, G., Dogan, O. and Kugu, N. (2004). Social phobia among university students and its relation to self-esteem and body image. Canadian Journal of Psychiatry, 49, 630–634.CrossRefGoogle ScholarPubMed
Kim, H. Y., Lundh, L. G. and Harvey, A. G. (2002). The enhancement of video feedback by cognitive preparation in the treatment of social anxiety: a single session experiment. Journal of Behavior Therapy, 33, 19–37. doi:10.1016/S0005-7916(02)00010-1 Google ScholarPubMed
Kuyken, W., Padesky, C. A. and Dudley, R. (2009). Collaborative Case Conceptualization. New York: The Guilford Press.Google Scholar
Lutwak, N. and Ferrari, J. (1997). Shame-related social anxiety: replicating a link with various social interaction measures. Anxiety, Stress, and Coping: An International Journal, 10, 335–340. doi: 10.1080/10615809708249307 CrossRefGoogle Scholar
McCroskey, J. C. (1982). An Introduction to Rhetorical Communication (4th ed.). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Mortberg, E., Clark, D. M., Sundin, O. and Aberg Wistedt, A. (2007). Intensive group cognitive treatment and individual cognitive therapy vs. treatment as usual in social phobia: a randomized controlled trial. Acta Psychiatrica Scandinavica, 115, 142–154. doi: 10.1111/j.1600-0447.2006.00839.x CrossRefGoogle ScholarPubMed
Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 16, 123–134. doi:10.1016/j.cbpra.2008.04.002 CrossRefGoogle Scholar
Moscovitch, D. A. and Huyder, V. (2011). The negative self-portrayal scale: development, validation, and application to social anxiety. Behavior Therapy, 42, 183–196. doi: 10.1016/j.beth.2010.04.007 CrossRefGoogle ScholarPubMed
Mulkens, S. and Jansen, A. (2009). Mirror gazing increases attractiveness in satisfied, but not in dissatisfied women: a model for body dysmorphic disorder? Journal of Behavior Therapy and Experimental Psychiatry, 40, 211–218. doi: 10.1016/j.jbtep.2008.10.001 CrossRefGoogle ScholarPubMed
Neziroglu, F., Hickey, M. and McKay, D. (2010). Psychophysiological and self-report components of disgust in body dysmorphic disorder: the effects of repeated exposure. International Journal of Cognitive Therapy, 3, 40–51. doi: 10.1521/ijct.2010.3.1.40 CrossRefGoogle Scholar
Neziroglu, F., McKay, D., Todaro, J. and Yaryura-Tobias, J. A. (1996). Effect of cognitive behavior therapy on persons with body dysmorphic disorder and comorbid axis II diagnoses. Behavior Therapy, 27, 67–77. doi:10.1016/S0005-7894(96)80036-0 CrossRefGoogle Scholar
Norton, P. J. and Hope, D. A. (2001). Kernels of truth or distorted perceptions: self and observer ratings of social anxiety and performance. Behavior Therapy, 32, 765–786. doi:10.1016/S0005-7894(01)80020-4 CrossRefGoogle Scholar
Orr, E. M. and Moscovitch, D. A. (2010). Learning to re-appraise the self during video feedback for social anxiety: does depth of processing matter? Behaviour Research and Therapy, 48, 728–737. doi:10.1016/j.brat.2010.04.004 CrossRefGoogle ScholarPubMed
Otto, M. W., Pollack, M. H., Gould, R. A., Worthington, J. J. 3rd, McArdle, E. T. and Rosenbaum, J. F. (2000). A comparison of the efficacy of clonazepam and cognitive-behavioral group therapy for the treatment of social phobia. Journal of Anxiety Disorders, 14, 345–358. doi:10.1016/S0887-6185(00)00027-X CrossRefGoogle ScholarPubMed
Parr, C. J. and Cartwright-Hatton, S. (2009). Social anxiety in adolescents: the effect of video feedback on anxiety and the self-evaluation of performance. Clinical Psychology and Psychotherapy, 16, 46–54. doi:10.1002/cpp.599 CrossRefGoogle ScholarPubMed
Phillips, K. (2005). The Broken Mirror: understanding and treating body dysmorphic disorder. New York: Oxford University Press.Google Scholar
Rapee, R. M. and Abbott, M. J. (2006). Mental representation of observable attributes in people with social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 37, 113–126. doi:10.1016/j.jbtep.2005.01.001 CrossRefGoogle ScholarPubMed
Rapee, R. M. and Abbott, M. J. (2007). Modelling relationships between cognitive variables during and following public speaking in participants with social phobia. Behaviour Research and Therapy, 45, 2977–2989. doi:10.1016/j.brat.2007.08.008 CrossRefGoogle ScholarPubMed
Rapee, R. M. and Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35, 741–756. doi:10.1016/S0005-7967(97)00022-3 CrossRefGoogle ScholarPubMed
Rapee, R. M. and Lim, L. (1992). Discrepancy between self- and observer ratings of performance in social phobics. Journal of Abnormal Psychology, 101, 728–731. doi:10.1037//0021-843X.101.4.728 CrossRefGoogle ScholarPubMed
Reed, D. L., Thompson, J. K., Brannick, M. T. and Sacco, W. P. (1991). Development and validation of the Physical Appearance State and Trait Anxiety Scale (PASTAS). Journal of Anxiety Disorders, 5, 323–332. doi:10.1016/0887-6185(91)90032-O CrossRefGoogle Scholar
Rodebaugh, T. L. (2004). I might look OK, but I'm still doubtful, anxious, and avoidant: the mixed effects of enhanced video feedback on social anxiety symptoms. Behaviour Research and Therapy, 42, 1435–1451. doi:10.1016/j.brat.2003.10.004 CrossRefGoogle ScholarPubMed
Rodebaugh, T. L. and Chambless, D. L. (2002). The effects of video feedback on self-perception of performance: a replication and extension. Cognitive Therapy and Research, 26, 629–644. doi:10.1023/A:1020357210137 CrossRefGoogle Scholar
Rodebaugh, T. L., Heimberg, R. G., Schultz, L. T. and Blackmore, M. (2010). The moderated effects of video feedback for social anxiety disorder. Journal of Anxiety Disorders, 24, 663–671. doi:10.1016/j.janxdis.2010.04.007 CrossRefGoogle ScholarPubMed
Rodebaugh, T. L. and Rapee, R. M. (2006). Those who think they look worst respond best: self-observer discrepancy predicts response to video feedback following a speech task. Cognitive Therapy and Research, 29, 705–715. doi:10.1007/s10608-005-9634-9 CrossRefGoogle Scholar
Segrin, C. and Kinney, T. (1995). Social skills deficits among the socially anxious: rejection from others and loneliness. Motivation and Emotion, 19, 1–24. doi:10.1007/BF02260670 CrossRefGoogle Scholar
Strahan, E. and Conger, A. J. (1998). Social anxiety and its effects on performance and perception. Journal of Anxiety Disorders, 12, 293–305. doi:10.1016/S0887-6185(98)00016-4 CrossRefGoogle ScholarPubMed
Trower, P., Bryant, B. and Argyle, M. (1978). Social Skills and Mental Health. Philadelphia: University of Pennsylvania Press.Google Scholar
Veale, D., Kinderman, P., Riley, S. and Lambrou, C. (2003). Self-discrepancy in body dysmorphic disorder. British Journal of Clinical Psychology, 42, 157–169. doi:10.1348/014466503321903571 CrossRefGoogle ScholarPubMed
Veale, D. and Neziroglu, F. (2010). Body Dysmorphic Disorder: a treatment manual. Chichester, UK: Wiley-Blackwell.CrossRefGoogle Scholar
Veale, D. and Riley, S. (2001). Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder. Behaviour Research and Therapy, 39, 1381–1393. doi:10.1016/S0005-7967(00)00102-9 CrossRefGoogle ScholarPubMed
Wlazlo, Z., Schroeder-Hartwig, K., Hand, I., Kaiser, G. and Munchau, N. (1990). Exposure in-vivo vs. social skills training for social phobia: long-term outcome and differential effects. Behaviour, Research and Therapy, 28, 181–193. doi:10.1016/0005-7967(90)90001-Y CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.