May 26, 2020

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment. This month’s summary focuses on self-imagery in those with social anxiety.

Leigh, Chiu, and Clark (2020) recently conducted an experiment manipulating self-imagery in socially anxious adolescents. The study (n=34) included two groups of adolescents, ages 11-14. Anxiety ratings were captured using Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA).

The experiment included asking socially anxious participants to generate and maintain a specific image prior to and during a conversation with a stranger. In the negative image condition, the person imagined a situation in which they were previously socially anxious. In the neutral self-image condition, the participant recalled a situation in which they were relaxed. After eliciting the specific self-image, participants engaged in conversations with psychology students. Following the conversations, participants rated how anxious they felt, how anxious they thought they appeared, how well they thought the conversation went, and a brief assessment of safety behaviors. Conversations partners were asked to rate how anxious the participant appeared, how enjoyable the conversation was, how likeable they found the participant, and the conversation partner’s own anxiety. An independent observer also rated specific aspects of the conversation.

Results showed participants were equally successful in maintaining images in both conditions (negative and neutral). Maintaining a negative self-image was correlated with participants feeling more anxious, estimating they appeared more anxious, perceiving the conversation as less successful, and engaging in more safety behaviors. Ratings of conversation partners and independent observers matched these lower ratings for the negative self-image condition. In contrast, participants had lower anxiety ratings and perceived better social interaction in the neutral image condition. In summary, a negative self-image led to less desirable outcomes across self-reports, conversation partners, and independent assessor ratings. These results are consistent with similar findings in adult populations.

What role does a negative self-image play in maintaining symptoms for your socially anxious clients? What ways you help clients modify these self-images?

Eleanor Leigh, Kenny Chiu, David M. Clark. The effects of modifying mental imagery in adolescent social anxiety, PLOS ONE, April 6, 2020.

Michelle Dexter, Ph.D., A-CBT
Representative of NSAC Los Angeles
(Behavioral Associates, Los Angeles)