Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, NSW, Australia.
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Behav Res Ther. 2018 Apr;103:24-32. doi: 10.1016/j.brat.2018.01.009. Epub 2018 Feb 2.
Negative rumination in social anxiety disorder (SAD) occurs in anticipation of a social event (pre-event rumination) and in its aftermath (post-event rumination). Both are proposed to be key maintaining factors of the vicious cycle of social anxiety. Despite this, there is a dearth of research investigating the processes that mediate the relationship between social anxiety and pre-event rumination and uncertainty regarding the cognitive and attentional processes that mediate the relationship between social anxiety and post-event rumination. To investigate this further, the current study utilised a clinical sample of participants with SAD to determine the hypothesised mediators of a social anxiety and pre-event model (N = 239) and a social anxiety and post-event rumination model (N = 216). Results from path analyses were broadly consistent with cognitive models of SAD that posit several interrelated processes mediate the relationship between social anxiety and pre- and post-event rumination. Results also indicated slightly different processes showed stronger prediction of pre-event rumination (i.e., biased performance appraisals) and post-event rumination (i.e., negative attentional focus). Treatment recommendations that aim to address the maladaptive role of negative rumination in social anxiety are made in keeping with the inter-connected and dynamic role played by cognitive and attentional processes in heightening social anxiety.
社交焦虑障碍（SAD）中的消极反刍发生在对社交事件的预期中（事前反刍）和事件发生后（事后反刍）。两者都被认为是社交焦虑恶性循环的关键维持因素。尽管如此，关于社交焦虑与事前反刍之间关系的中介过程以及关于社交焦虑与事后反刍之间关系的认知和注意力过程的中介过程的研究还很少。为了进一步研究这一点，本研究利用 SAD 的临床样本参与者来确定社交焦虑和事前模型（N=239）和社交焦虑和事后反刍模型（N=216）的假设中介。路径分析的结果与 SAD 的认知模型基本一致，认为几个相互关联的过程中介了社交焦虑与事前和事后反刍之间的关系。结果还表明，略有不同的过程对事前反刍（即有偏差的绩效评估）和事后反刍（即负面注意力焦点）有更强的预测作用。与认知和注意力过程在增强社交焦虑方面的相互关联和动态作用保持一致，提出了旨在解决社交焦虑中消极反刍的适应不良作用的治疗建议。
