Childhood Maltreatment, Shame-Proneness and Self-Criticism in Social Anxiety Disorder: A Sequential Mediational Model

2014 ◽  
Vol 22 (6) ◽  
pp. 570-579 ◽  
Author(s):  
Ben Shahar ◽  
Guy Doron ◽  
Ohad Szepsenwol
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Mediational Model ◽  
Shame Proneness

scholarly journals Social anxiety disorder and shame cognitions in psychosis

2012 ◽  
Vol 43 (1) ◽  
pp. 133-142 ◽  
Author(s):  
M. Michail ◽  
M. Birchwood
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Status ◽  
Social Anxiety Disorder ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Shame Proneness ◽  
Perceived Social Status ◽  
The Relationship

BackgroundSocial anxiety disorder (SAD) is surprisingly prevalent among people with psychosis and exerts significant impact on social disability. The processes that underlie its development remain unclear. The aim of this study was to investigate the relationship between shame cognitions arising from a stigmatizing psychosis illness and perceived loss of social status in co-morbid SAD in psychosis.MethodThis was a cross-sectional study. A sample of individuals with SAD (with or without psychosis) was compared with a sample with psychosis only and healthy controls on shame proneness, shame cognitions linked to psychosis and perceived social status.ResultsShame proneness (p < 0.01) and loss of social status (p < 0.01) were significantly elevated in those with SAD (with or without psychosis) compared to those with psychosis only and healthy controls. Individuals with psychosis and social anxiety expressed significantly greater levels of shame (p < 0.05), rejection (p < 0.01) and appraisals of entrapment (p < 0.01) linked to their diagnosis and associated stigma, compared to those without social anxiety.ConclusionsThese findings suggest that shame cognitions arising from a stigmatizing illness play a significant role in social anxiety in psychosis. Psychological interventions could be enhanced by taking into consideration these idiosyncratic shame appraisals when addressing symptoms of social anxiety and associated distress in psychosis. Further investigation into the content of shame cognitions and their role in motivating concealment of the stigmatized identity of being ‘ill’ is needed.

scholarly journals The Role of Environmental Factors in the Aetiology of Social Anxiety Disorder: A Review of the Theoretical and Empirical Literature

2017 ◽  
Vol 34 (2) ◽  
pp. 76-97 ◽  
Author(s):  
Alice R. Norton ◽  
Maree J. Abbott
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Environmental Factors ◽  
Attachment Style ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Social Performance ◽  
Empirical Literature ◽  
Peer Experiences ◽  
Current Article

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social/performance situations, and a number of key environmental factors have been implicated in the aetiology of the disorder. Hence, the current article reviews theoretical and empirical evidence linking the development of SAD with parenting factors, traumatic life events, and aversive social experiences. Specifically, research suggests that the risk of developing SAD is increased by over-controlling, critical and cold parenting, an insecure attachment style, aversive social/peer experiences, emotional maltreatment, and to a lesser extent other forms of childhood maltreatment and adversity. Moreover, these factors may lead to posttraumatic reactions, distorted negative self-imagery, and internalised shame-based schemas that subsequently maintain SAD symptomatology. However, further research is necessary to clarify the nature, interactions, and relative contributions of these factors. It is likely that SAD develops via a complex interplay of biological and environmental factors, and that multiple aetiological pathways underlie the development of the disorder.

scholarly journals Childhood maltreatment linked to greater symptom severity and poorer quality of life and function in social anxiety disorder

2009 ◽  
Vol 26 (11) ◽  
pp. 1027-1032 ◽  
Author(s):  
Naomi M. Simon ◽  
Nannette N. Herlands ◽  
Elizabeth H. Marks ◽  
Catherine Mancini ◽  
Andrea Letamendi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Symptom Severity ◽  
And Function

scholarly journals Childhood maltreatment and social anxiety disorder: implications for symptom severity and response to pharmacotherapy

2011 ◽  
Vol 29 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Laura C. Bruce ◽  
Richard G. Heimberg ◽  
Carlos Blanco ◽  
Franklin R. Schneier ◽  
Michael R. Liebowitz
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Symptom Severity

scholarly journals The Effect of Shame on Patients With Social Anxiety Disorder in Internet-Based Cognitive Behavioral Therapy: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Haoyu Wang ◽  
Qingxue Zhao ◽  
Wenting Mu ◽  
Marcus Rodriguez ◽  
Mingyi Qian ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioral Therapy ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Anxiety Symptoms ◽  
Cognitive Behavioral ◽  
Mediation Effect ◽  
Self Help ◽  
Shame Proneness

BACKGROUND Prior research has demonstrated the efficacy of internet-based cognitive behavioral therapy (ICBT) for social anxiety disorder (SAD). However, it is unclear how shame influences the efficacy of this treatment. OBJECTIVE This study aimed to investigate the role shame played in the ICBT treatment process for participants with SAD. METHODS A total of 104 Chinese participants (73 females; age: mean 24.92, SD 4.59 years) were randomly assigned to self-help ICBT, guided ICBT, or wait list control groups. For the guided ICBT group, half of the participants were assigned to the group at a time due to resource constraints. This led to a time difference among the three groups. Participants were assessed before and immediately after the intervention using the Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), and Experience of Shame Scale (ESS). RESULTS Participants’ social anxiety symptoms (self-help: differences between pre- and posttreatment SIAS=−12.71; Cohen <i>d</i>=1.01; 95% CI 9.08 to 16.32; <i>P</i>&lt;.001 and differences between pre- and posttreatment SPS=11.13; Cohen <i>d</i>=0.89; 95% CI 6.98 to 15.28; <i>P</i>&lt;.001; guided: SIAS=19.45; Cohen <i>d</i>=1.20; 95% CI 14.67 to 24.24; <i>P</i>&lt;.001 and SPS=13.45; Cohen <i>d</i>=0.96; 95% CI 8.26 to 18.64; <i>P</i>&lt;.001) and shame proneness (self-help: differences between pre- and posttreatment ESS=7.34; Cohen <i>d</i>=0.75; 95% CI 3.99 to 10.69; <i>P</i>&lt;.001 and guided: differences between pre- and posttreatment ESS=9.97; Cohen <i>d</i>=0.88; 95% CI 5.36 to 14.57; <i>P</i>&lt;.001) in both the self-help and guided ICBT groups reduced significantly after treatment, with no significant differences between the two intervention groups. Across all the ICBT sessions, the only significant predictors of reductions in shame proneness were the average number of words participants wrote in the exposure module (β=.222; SE 0.175; t<sub>96</sub>=2.317; <i>P</i>=.02) and gender (β=−.33; SE 0.002; t<sub>77</sub>=−3.13; <i>P</i>=.002). We also found a mediation effect, wherein reductions in shame fully mediated the relationship between the average number of words participants wrote in the exposure module and reductions in social anxiety symptoms (SIAS: β=−.0049; SE 0.0016; 95% CI −0.0085 to −0.0019 and SPS: β=−.0039; SE 0.0015; 95% CI −0.0075 to −0.0012). CONCLUSIONS The findings of this study suggest that participants’ engagement in the exposure module in ICBT alleviates social anxiety symptoms by reducing the levels of shame proneness. Our study provides a new perspective for understanding the role of shame in the treatment of social anxiety. The possible mechanisms of the mediation effect and clinical implications are discussed.

scholarly journals Neurocognitive Heterogeneity in Social Anxiety Disorder: The Role of Self-Referential Processing and Childhood Maltreatment

2021 ◽  
pp. 216770262110044
Author(s):  
Anat Talmon ◽  
Matthew Luke Dixon ◽  
Philippe R. Goldin ◽  
Richard G. Heimberg ◽  
James J. Gross
Keyword(s):  
Emotion Regulation ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Well Being ◽  
Subjective Well Being ◽  
Emotional Maltreatment ◽  
Replication Sample ◽  
Discovery Sample

Social anxiety disorder (SAD) is characterized by negative self-beliefs and altered brain activation in the default-mode network (DMN). However, the extent to which there is neurocognitive heterogeneity in SAD remains unclear. We had two independent samples of patients perform a self-referential encoding task and complete self-reports of childhood maltreatment, subjective well-being, and emotion regulation. In the replication sample, we also measured DMN activation using functional MRI. We used k-means clustering, which revealed two distinct subgroups of patients with SAD in the discovery sample. Cluster 1 demonstrated higher levels of negative self-referential trait endorsement, lower levels of positive self-referential trait endorsement, and significantly higher levels of childhood emotional maltreatment, lower subjective well-being, and altered emotion-regulation-strategy use. A similar pattern was observed in the replication sample, which further demonstrated higher DMN activation during negative trait judgments in Cluster 1. Participants in the SAD clusters, from both the discovery and replication samples, were significantly distinct from samples of control participants. These findings reveal neurocognitive heterogeneity in SAD and its relationship to emotional maltreatment.

scholarly journals Neurocognitive Heterogeneity in Social Anxiety Disorder: The Role of Self-Referential Processing and Childhood Maltreatment

2020 ◽  
Author(s):  
Anat Talmon ◽  
Matthew Luke Dixon ◽  
Philippe R. Goldin ◽  
Richard G. Heimberg ◽  
James J. Gross
Keyword(s):  
Emotion Regulation ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Childhood Maltreatment ◽  
Well Being ◽  
Subjective Well Being ◽  
Emotional Maltreatment ◽  
Replication Sample ◽  
Discovery Sample

ABSTRACTSocial anxiety disorder (SAD) is characterized by negative self-beliefs and altered brain activation in the default mode network (DMN). However, the extent to which there is neurocognitive heterogeneity in SAD remains unclear. We had two independent samples of patients perform a self-referential encoding task, and complete self-reports of childhood maltreatment, subjective well-being, and emotion regulation. In the replication sample, we also measured DMN activation using functional magnetic resonance imaging. K-means clustering revealed two distinct sub-groups of SAD patients in the discovery sample. Cluster 1 demonstrated higher levels of negative and lower levels of positive self-referential trait endorsement, and significantly higher levels of childhood emotional maltreatment, lower subjective well-being, and altered emotion regulation strategy use. A similar pattern was observed in the replication sample, which further demonstrated higher DMN activation during negative trait judgments in cluster 1. These findings reveal neurocognitive heterogeneity in SAD and its relationship to emotional maltreatment.

scholarly journals The Effect of Shame on Patients With Social Anxiety Disorder in Internet-Based Cognitive Behavioral Therapy: Randomized Controlled Trial

10.2196/15797 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e15797 ◽  
Author(s):  
Haoyu Wang ◽  
Qingxue Zhao ◽  
Wenting Mu ◽  
Marcus Rodriguez ◽  
Mingyi Qian ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioral Therapy ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Anxiety Symptoms ◽  
Cognitive Behavioral ◽  
Mediation Effect ◽  
Self Help ◽  
Shame Proneness

Background Prior research has demonstrated the efficacy of internet-based cognitive behavioral therapy (ICBT) for social anxiety disorder (SAD). However, it is unclear how shame influences the efficacy of this treatment. Objective This study aimed to investigate the role shame played in the ICBT treatment process for participants with SAD. Methods A total of 104 Chinese participants (73 females; age: mean 24.92, SD 4.59 years) were randomly assigned to self-help ICBT, guided ICBT, or wait list control groups. For the guided ICBT group, half of the participants were assigned to the group at a time due to resource constraints. This led to a time difference among the three groups. Participants were assessed before and immediately after the intervention using the Social Interaction Anxiety Scale (SIAS), Social Phobia Scale (SPS), and Experience of Shame Scale (ESS). Results Participants’ social anxiety symptoms (self-help: differences between pre- and posttreatment SIAS=−12.71; Cohen d=1.01; 95% CI 9.08 to 16.32; P<.001 and differences between pre- and posttreatment SPS=11.13; Cohen d=0.89; 95% CI 6.98 to 15.28; P<.001; guided: SIAS=19.45; Cohen d=1.20; 95% CI 14.67 to 24.24; P<.001 and SPS=13.45; Cohen d=0.96; 95% CI 8.26 to 18.64; P<.001) and shame proneness (self-help: differences between pre- and posttreatment ESS=7.34; Cohen d=0.75; 95% CI 3.99 to 10.69; P<.001 and guided: differences between pre- and posttreatment ESS=9.97; Cohen d=0.88; 95% CI 5.36 to 14.57; P<.001) in both the self-help and guided ICBT groups reduced significantly after treatment, with no significant differences between the two intervention groups. Across all the ICBT sessions, the only significant predictors of reductions in shame proneness were the average number of words participants wrote in the exposure module (β=.222; SE 0.175; t96=2.317; P=.02) and gender (β=−.33; SE 0.002; t77=−3.13; P=.002). We also found a mediation effect, wherein reductions in shame fully mediated the relationship between the average number of words participants wrote in the exposure module and reductions in social anxiety symptoms (SIAS: β=−.0049; SE 0.0016; 95% CI −0.0085 to −0.0019 and SPS: β=−.0039; SE 0.0015; 95% CI −0.0075 to −0.0012). Conclusions The findings of this study suggest that participants’ engagement in the exposure module in ICBT alleviates social anxiety symptoms by reducing the levels of shame proneness. Our study provides a new perspective for understanding the role of shame in the treatment of social anxiety. The possible mechanisms of the mediation effect and clinical implications are discussed. Trial Registration Chinese Clinical Trial Registry ChiCTR1900021952; http://www.chictr.org.cn/showproj.aspx?proj=36977

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