Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, Germany.
Behav Res Ther. 2012 Oct;50(10):617-26. doi: 10.1016/j.brat.2012.06.001. Epub 2012 Jun 20.
This study investigated self-reported state (anxiety, physical symptoms, cognitions, internally focused attention, safety behaviors, social performance) and trait (social anxiety, depressive symptoms, dysfunctional self-consciousness) predictors of post-event processing (PEP) subsequent to two social situations (interaction, speech) in participants with a primary diagnosis of social anxiety disorder (SAD) and healthy controls (HC). The speech triggered significantly more intense PEP, especially in SAD. Regardless of the type of social situation, PEP was best predicted by situational anxiety and dysfunctional cognitions among the state variables. If only trait variables were considered, PEP following both situations was accounted for by trait social anxiety. In addition, dysfunctional self-consciousness contributed to PEP-speech. If state and trait variables were jointly considered, for both situations, situational anxiety and dysfunctional cognitions were confirmed as the most powerful PEP predictors above and beyond trait social anxiety (interaction) and dysfunctional self-consciousness (speech). Hence, PEP as assessed on the day after a social situation seems to be mainly determined by state variables. Trait social anxiety and dysfunctional self-consciousness also significantly contribute to PEP depending on the type of social situation. The present findings support dysfunctional cognitions as a core cognitive mechanism for the maintenance of SAD. Implications for treatment are discussed.
本研究调查了社交焦虑障碍(SAD)患者和健康对照组(HC)在经历两种社交情境(互动、演讲)后,自我报告的状态(焦虑、身体症状、认知、内部关注、安全行为、社交表现)和特质(社交焦虑、抑郁症状、自我意识障碍)预测因素(事后认知加工,PEP)。演讲会引发更强烈的 PEP,尤其是在 SAD 中。无论社交情境的类型如何,状态变量中,情境焦虑和认知障碍是 PEP 的最佳预测因素。如果仅考虑特质变量,那么两种情况下的 PEP 都可以用特质社交焦虑来解释。此外,自我意识障碍也会导致演讲后的 PEP。如果同时考虑状态和特质变量,那么对于两种情况,情境焦虑和认知障碍在特质社交焦虑(互动)和自我意识障碍(演讲)之上,仍然是 PEP 的最强预测因素。因此,社交情境后的 PEP 似乎主要由状态变量决定。特质社交焦虑和自我意识障碍也会根据社交情境的类型,对 PEP 产生显著影响。本研究结果支持认知障碍是 SAD 维持的核心认知机制。还讨论了治疗的影响。