May 1, 2018

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment.

While facilitating a recent CBT group therapy session for Social Anxiety Disorder (SAD), a group member provided critical feedback to another member that focused on the other member’s “performance” and display of physiological signs of anxiety during an exposure task. While one pathway of cognitive restructuring focuses on individuals with SAD over-estimating the likelihood of negative criticism / judgment, I’m curious how you would approach a group situation when the criticism is actually present?

A recent related article by Koban et al. (below) further demonstrated a biased social learning in SAD. In the study it was found that a negative bias was present in adults with SAD, in that the impact of critical feedback was far greater on their self-image and self-esteem than non-socially anxious adults, who actually showed a positive bias (greater recall and impact of positive feedback).

Given this propensity towards a negative bias and attribution when critical feedback is present, what might be the most important therapeutic group factors (trust, commonality), or specific interventions most helpful in preventing further negative attribution?

Koban, L., Schneider, R., Ashar, Y. K., Andrews-Hanna, J. R., Landy, L., Moscovitch, D. A., Arch, J. J. (2017). Social anxiety is characterized by biased learning about performance and the self. Emotion, 17(8), 1144-1155. Link to abstract.

Robert Yeilding, Psy.D.
Clinical Psychologist

Representative of NSAC Newport Beach / Orange County (Anxiety and Depression Center)